New Orleans-Based Fifth Circuit Court of Appeals Finds for Insured in Dispute Over Application of Pre-Existing Condition Exclusion in Long-Term Disability Policy

In a brief per curiam decision dated June 11, 2019, and not designated for publication, a panel of the U.S. Court of Appeals for the Fifth Circuit affirmed a decision of the U.S. District Court for the Southern District of Mississippi rejecting United of Omaha Life Insurance Company’s application of a pre-existing condition exclusion to the claim for long-term disability …

Courts Find Car Driver Negligent but Not Legal Cause of Bicycle Accident in Metairie

On May 29, 2019, the Louisiana Fifth Circuit Court of Appeal  in Gretna upheld a jury’s verdict clearing a car driver of liability in a collision with a bicycle at the intersection of Airline Drive and Shrewsbury Road in Metairie. The defendant-driver was attempting to take a right turn towards the entrance ramp of the Causeway circle when the bicyclist …

New Orleans Court Finds Defendant Driver Not in Course and Scope of Employment

On February 28, 2018, the Louisiana Fourth Circuit Court of Appeal in New Orleans ruled on a case in which it had to consider the factors for determining when a defendant driver is in the course and scope of employment. The case is a personal injury suit arising from a pick-up truck colliding with a Regional Transit Authority bus. The …

Louisiana First Circuit Court of Appeal Upholds Summary Judgment in Favor of Best Western Plus Houma Inn in Slip and Fall Case

In a  February 28, 2019 judgment, the Louisiana First Circuit Court of Appeal affirmed a Terrebonne Parish judge’s decision to grant summary judgment in favor of a hotel in a slip and fall case. In this case, the plaintiff alleged he sustained injuries when he tripped over an elevated curb near the hotel’s entrance. The case is Primeaux v. Best …

New Orleans Court Affirms Verdict in Case of Bicyclist Injured in French Quarter

In the recently released decision of Antippas v. Nola Hotel Group, LLC, Docket No. 2017-CA-0798 the Louisiana Fourth Circuit Court of Appeal affirmed a New Orleans district court’s decision to award $105,000 in damages to a bicyclist injured when a hotel valet opened a car door in front of her in the French Quarter on Burgundy Street. The jury found …

U.S. District Court for Eastern District of Louisiana Ruling Shows Importance of Filing for Long-Term Disability at the Same Time You Are Appealing a Short-Term Disability Denial

In a recent case, Civil Action No. 19-1939, a ruling by Judge Feldman of the United States District Court for the Eastern District of Louisiana in New Orleans showed the importance of filing for long-term disability while appealing a short-term disability denial. In this case, the plaintiff filed for short-term disability with the defendant, was denied, and filed suit; however, …

Supreme Court Hears Oral Argument On Availability of Punitive Damages Under General Maritime Law – Big Potential Impact on Injured Louisiana Maritime Workers

On March 25, 2019, the U.S. Supreme Court heard arguments in the case of The Dutra Group v. Batterton. The main question of the case is whether a Jones Act seaman can recover punitive damages in a personal injury suit based on the unseaworthiness of the vessel that he worked on. The New Orleans-based U.S. Court of Appeals for the …

The Importance of Requesting Short-Term Disability (STD) and Long-Term Disability (LTD) Claim Files in Writing Before Appealing an Adverse Determination

Pursuant to Section 104(b) of ERISA and 29 C.F.R. §2560.503-1(h)(2)(iii), a long-term and/or short-term disability insurance company whose policy is governed by ERISA must provide the complete administrative claim file free of charge upon written request. This is important because it gives insight into the reasons the insurance company used to deny the claim and/or terminate disability payments. When a …

New ERISA Regulations Affecting Long-Term Disability (LTD) Claims

From time to time, the Department of Labor promulgates regulations under ERISA (The Employee Retirement Income Security Act of 1974) that affect the review of long-term and short-term disability claims. One such regulation recently went into effect. It allows claimants in disability insurance appeals to reply to evidence as the insurance company obtains it. This allows claimants and their attorneys …

Social Media and Your Disability, Personal Injury, or Worker’s Compensation Case

If you are involved in a claim for long-term disability benefits, personal injury, or worker’s compensation, or even thinking about filing for such a claim, you should be very careful about what you, your friends, and your family post about you on social media. This is especially important in any case involving an insurance company, such as a worker’s compensation …