Louisiana Supreme Court Reverses Lower Courts’ Rulings, Renders Judgment For Defense
Feb 20, 2023
New Orleans attorneys Christina Culver, Marne Jones, Mark Hill, and Martin Schneider obtained a reversal of lower court’s summary judgment in favor of Plaintiffs, which included steep penalties and fees for their client. The case revolved around the issue of a Travel Protection Policy and the Louisiana Supreme Court determined that the policy is not considered a Health and Accident Policy under applicable Louisiana law.
The Plaintiffs purchased a Travel Protection Policy in advance of traveling on an overseas vacation, which provided numerous types of coverage (subject to the satisfaction of various pre-conditions) like trip interruption, travel delay, accident and sickness medical expenses, emergency medical evaluation, medical repatriation, non-medical evacuation, baggage and personal effects, among others.
While overseas, Plaintiff fell ill, was hospitalized, and received medical treatment. Plaintiffs demanded to be transported back to the States via private air flight. However, Plaintiffs failed to meet the pre-conditions set forth in the policy to warrant coverage for this service. As a result, Plaintiffs paid for this private air transport themselves and sued to recover same from the insurance carrier along with bad faith penalties under La. R.S. 22:1821.
Plaintiffs filed a Motion for Summary Judgment in the District Court arguing: (1) that the Travel Protection Policy should be considered a Health and Accident Policy within the meaning of La. R.S. 22:1821, which would subject the Insurer’s failure to pay to steep penalties and fees and (2) that they were entitled to Summary Judgment as a matter of law.
The Thompson Coe team opposed the motion arguing that: (1) whether or not the pre-conditions to trigger such coverage were met (they were not) presented material questions of fact precluding Summary Judgement and (2) that a Travel Protection Policy is not a Health and Accident Policy within the meaning of La. R.S. 22:1821 even though the policy included coverage for certain health situations and thus penalties thereunder were improper.
The District Court granted Plaintiffs motion and imposed steep penalties and fees on the Defendant. Louisiana’s Third Circuit affirmed the lower court’s ruling. However, the Louisiana Supreme Court overrode the decision of both Courts.
The courts reviewed whether the inclusion of coverage for accident and sickness provide for other coverages under the “Health and Accident” Policy under La. R.S. 22:1821. The courts also determined whether or not pre-conditions were met in a policy that would trigger coverage present material questions of fact precluding summary judgment.
The court has made similar determinations regarding life insurance policies, disability policies, and automobile policies finding that policies of insurance wherein other types of coverages exist outside of strictly health and accident coverage, the policy is not considered a Health and Accident Policy under applicable Louisiana law. So too should be the case for travel protection policies as they afford other coverages – not strictly health and/or accident.
In reversing prior court decisions, the Louisiana Supreme Court found that (1) a Travel Protection Policy is not a Health and Accident Policy, (2) the bad faith penalties imposed under La. R.S. 22:1821 are not applicable to Travel Protection Policies, and (3) when pre-conditions to coverage exist, a determination as to whether those pre-conditions we satisfied present a material question of fact precluding summary judgment.