Articles Posted in Insurance Company Delays

supreme_court_building_washington_3_9-scaledIf you are in a car accident and your insurance pays your claim, you likely expect the same thing will happen if you are subsequently in a similar accident. What happens if your insurer paid your prior claim, but tries to deny a subsequent claim? 

Brandon Forvendel was injured in a car accident. When the accident occurred, he was driving a car he owned and was insured by State Farm. Forvendel had uninsured motorist coverage. After the accident, Forvendel recovered under his uninsured motorist policy. 

When the accident occurred, he was living with his mother, who also had insurance through State Farm. Forvendel also tried to recover under his mother’s uninsured motorist policy, which had higher policy limits. State Farm denied his attempt to recover under both his and his mother’s policies under the anti-stacking provisions in La. R.S. 22:1295(1)(c). Forvendel then filed a lawsuit against State Farm. 

dsc05934_0-scaledDealing with the aftermath of a flood is never fun. This is especially true when the flood damages one of your vehicles. This is the situation Michael Jacobs found himself in after one of his cars was damaged in a flood. After a long fight with his insurance company, he eventually prevailed and was awarded damages. 

Jacobs owned multiple vehicles that GEICO insured. His parish in North Louisiana was affected by heavy flooding. When the flooding started, Jacobs and his brother tried to move the vehicles from his house to higher ground but were unable to remove them before the floodwaters rose, so they could not drive up to the house. Jacobs waded through the floodwater to retrieve one of the vehicles, a 2001 Honda Accord. In the days following the flood, the Honda kept overheating. Jacobs claimed this had only occurred after the flood. 

Jacobs submitted a claim to GEICO for the damage to the vehicle. The insurance inspector did not identify any flood-related problems and determined the upper radiator hose had blown out. Another mechanic gave Jacobs an opinion and concluded there were issues with his spark plugs. GEICO ultimately denied Jacobs’ claim because it had suffered a mechanical failure that was not flood-related. Jacobs filed a lawsuit against GEICO, alleging his Honda had been damaged from the flooding. At trial, the court ruled the Honda had suffered water damage and awarded vehicle property damages and attorney fees. GEICO filed an appeal.

ladder_art_red_garden-scaledIt can be challenging to interpret insurance policies, especially when they involve complex provisions such as coverage for an additional insured. Before signing an insurance policy, it is imperative to understand its language and what it does and does not cover. Here, the plain language of the insurance policy proved instrumental in the appellate court’s ruling.

Pamela Sloane was injured while working for Integrity Cleaning Services (“Integrity”) at Forestwood Apartments. She was cleaning a ceiling fan while standing on a ladder. She inadvertently touched an exposed wire, which electrocuted her, and she fell from the ladder. Sloane filed a lawsuit against CLK Multifamily Management (“CLK”) and others. Sloane claimed CLK had not adequately maintained the premises or warned of the dangerous condition of the exposed wire. CLK filed its answer to the lawsuit, denying the allegations, and added Travelers Indemnity (“Travelers”) to the lawsuit.  CLK claimed Integrity was contractually required to have a general liability insurance policy that covered CLK as additional insureds. 

Travelers filed a summary judgment motion, claiming CLK was not an additional insured under the policy. Travelers attached a copy of the relevant insurance policy to its summary judgment motion. CLK disagreed and claimed it was indeed an additional insured.  The trial court concluded CLK was not qualified as an additional insured and granted Travelers’ summary judgment motion. 

detail_forum_romanum_rome-scaledMost of us get into contracts, not fully understanding all the ins and outs of what we are signing. Similarly, the multiple provisions that can slither their way into contracts can include things like forum selection clauses which can be easily overlooked. But when a lawsuit erupts, can you argue a provision isn’t applicable? The United States Court of Appeals for the Fifth Circuit addresses this question in the following case.

Al Copeland Investments, L.L.C. owned a food manufacturing facility in Louisiana. In October and December of 2015, there was some property damage to the facility, and they submitted a reimbursement claim under an insurance policy. Their insurance was held with First Specialty Insurance Corporation (“First Specialty”). They denied this claim, and AI Copeland sued in the Eastern District of Louisiana, believing they were entitled to recover from the costs and damages of the property. First Specialty asked the court to dismiss the case because the policies forum selection clause requires litigation in New York State court, not Louisiana. 

A forum selection clause is a section in a contract that states how all disputes must be litigated in a specific court in a jurisdiction that the parties agreed to. 

flood_fields_pasture_trees-scaledThe story of an underdog seeking justice against a powerful corporation is a familiar legal narrative. And while we may be inclined to root for the little guy, that does not relieve him from proving he has a valid case.

In Louisiana, a plaintiff will not see his case go to trial if it lacks support to overcome a motion for summary judgment. The opposing side will look for holes in the plaintiff’s claim, posing the question: if you have not produced facts suggesting I committed this offense, how will you obtain the requisite evidence to prove it at trial? Accordingly, every “essential element” of a claim requires factual support to serve as a basis for deliberation at trial. La. C.C.P. art 996(c)(2).

The Mitchells, owners of a Shapes Gym in the Parish of Ascension, faced this “make it or break it” moment of summary judgment in their case against neighboring businesses, Wal-Mart, and Aaron’s. The Mitchells alleged that the neighbors’ improperly designed and maintained stormwater drainage systems were to blame for six inches of rainwater that flooded the gym in 2009 and again during litigation of the first flood claim in 2014. 

disc_brake_stainless_auto-scaledIf you have been involved in a motorcycle or car accident, you might not know how an expert witness could help support your claim in court. What happens if there is conflicting testimony from each party’s expert witness about the cause of the accident?

Robert Murphy was driving his motorcycle along Louisiana Highway 538 in Shreveport, Louisiana, while Shauntal Savannah was driving her car in the opposite direction. When Savannah turned left in front of Murphy, Murphy’s motorcycle hit Savannah’s passenger-side door in the lane Murphy had been in before the collision. 

Murphy and his wife, Pamela Murphy, filed a lawsuit against Savannah, her automobile insurer State Farm, and the State of Louisiana through the Department of Transportation and Development (“DOTD”). They claimed DOTD was at fault because it did not warn motorists about the dangerous condition or remedy the intersection’s deadly design. DOTD responded and denied knowing about any unsafe conditions. The Murphys settled with Savannah and State Farm. 

crash_test_collision_60_1-scaledOne of the joys of adulthood is figuring out insurance coverage for your vehicles. Selecting the right coverage can be incredibly challenging when you own a small business because there are unclear lines between personal and company vehicles. This can be especially challenging if an accident occurs when driving a different vehicle than you usually drive. Can your insurance policy cover you when driving a different vehicle because your regular vehicle is out of commission and needs repairs? The subsequent lawsuit helps answer this question.

Gerald Arceneaux owned Gerald’s Towing. Axis Plus Insurance sold him an insurance policy for the garage that included uninsured/underinsured motorist coverage. On the first day, the policy was in effect, Arceneaux got in a car accident in his Ford F250 while driving home from work. He claimed he was “on call” when the accident occurred, and his truck included tools and equipment sufficient to respond to service requests made to his towing company. He said he drove the Ford F250 when the accident occurred because the Ford F450 that Gerald’s Towing owned needed to be repaired. 

Axis filed a summary judgment motion, arguing the insurance policy did not provide uninsured/underinsured motorist coverage to Arceneaux for the claim under La. R.S.22:1295. Axis argued they didn’t cover the accident because it was Arcenaux’s personal vehicle, and he was not on call for Gerald’s Towing. The trial court granted Axis’s summary judgment motion. Arceneaux appealed. 

biker_motorcycle_stunt_man_0-scaledEven if you have a unique job like a stunt performer, you can still get brought down to Earth by the complexities of determining what your insurance policies do and do not cover if you are involved in an insurance coverage dispute. In that case, it is important to understand the plain language of your insurance contract, how different provisions in the policy interact, and how courts interpret insurance policies. 

Joshua Petrozziello worked as a professional stunt performer at Flypaper Productions. He was injured when a piece of equipment malfunctioned while performing a stunt as part of a movie product. As a result, he filed a lawsuit against Noway, Inc., who had manufactured and operated the equipment, and Employers Fire Insurance Company, who issued Flypaper’s primary and excess general liability policies. 

The parties settled all claims except Petrozziellos’ lawsuit against the excess liability policy from Employers Fire Insurance Company. That insurance policy had an exclusion for injuries sustained by an “employee of any insured” during and during employment. The Petrozziellos argued that this employee-injury exclusion had to be interpreted harmoniously with the “Separation of Insureds” policy provision. They claimed because Petrozziollo was not an employee of Noway, the exclusion did not apply. The trial court agreed with this argument and granted summary judgment in their favor. 

valves_sprinkler_water_pipe-scaledMardi Gras, a time of joyous celebration, took an unexpected turn for a store near a French Quarter hotel when a sprinkler head malfunctioned, resulting in significant water damage. Despite the storeowner’s insurance covering the damages, a lawsuit ensued to determine the hotel’s liability for the losses incurred. This case highlights the complexities of determining responsibility and legal remedies in property damage cases, emphasizing the importance of seeking legal counsel to navigate such situations effectively.

Hotel Management of New Orleans (“HMNO”) owned and operated the French Market Inn. A sprinkler head located in the hotel was triggered during Mardi Gras, which caused a water leak and flooding in the store two floors below. The storeowner claimed water leaked into its store for approximately two hours. During that time, HMNO did not try to turn off the sprinkler but instead waited for the fire department to turn off the sprinkler. This caused damage to the store.

State Farm insured the storeowner and paid the storeowner approximately $41k under its policy. State Farm then filed a lawsuit against HMNO and its insurer, Companion Property, and Casualty Insurance Company, seeking repayment of the $41k it paid to the storeowner under its policy. The trial court found in favor of State Farm and ordered HMNO and Companion to pay the stipulated damages of $41k. HMNO and Companion appealed, arguing that the trial court erred in finding that HMNO knew or should have known the sprinkler was defective, HMNO employees were negligent, and denying HMNO’s motion for involuntary dismissal. 

wheelchair_pattern_black_background_23-scaledMost adults fear the day that they will need to rely on the care of another to function. Unfortunately, the rampant negligence and mistreatment only exasperate this fear throughout the nursing home and hospice industry. Small mistakes by caregivers are normal and almost expected, yet, Shirley Marzell faced severe injuries after her caregivers improperly secured her to a wheelchair lift.

Marzell was a resident at Charlyn Rehabilitation Center in Tallulah, Louisiana, at the time of her accident. In 2010, Marzell was loaded onto a wheelchair lift for the lift van operated by Charlyn. During this process, Marzell and her wheelchair rolled off the platform. This mistake caused Marzell to strike her head on the pavement, causing severe injuries. This case reached the Second Circuit Court of Appeals after Marzell and her daughters appealed the summary judgment ruling of the trial court. 

During the trial, the Marzells argued that Charlyn’s insurance carrier should pay for Shirley’s injuries. The insurance policy held by Charlyn, however, included an automobile exclusion. This provision shielded the insurance company from liability whenever Charlyn owned or operated an automobile. Operation was defined to include “loading and unloading”. The summary judgment ruling made by the trial court hinged on whether or not “loading or unloading” encompassed the loading of human cargo. The trial court held that it did, dismissing the case in favor of Charlyn and their insurance company.

Contact Information