80 So. 3d 1175
La. Ct. App.2011Background
- Three insurers—National Union, Republic, and U.S. Fire—issued PIL coverage to HANO, with overlapping time periods listed in the record.
- The trial court granted partial summary judgment holding that PIL coverages had no aggregate limits, based on perceived ambiguity in each policy.
- On de novo review, the court held National Union and Republic policies ambiguous, precluding summary judgment, while U.S. Fire was found to unambiguously provide PIL coverage without an aggregate limit but potentially reformable to reflect parties’ intent.
- The majority reverses and remands for further proceedings on the existence and/or amount of any aggregate limits for all three insurers.
- National Union’s policy shows a schedule with $500,000 printed under Coverage next to the word aggregate, creating an ambiguity as to the true aggregate limit ($500,000 vs. $500,000,000).
- Republic’s endorsement references Form L6394a; a conflict between an aggregate-limit directive and the form’s stated limits creates genuine issues of material fact about the correct aggregate limit.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Do PIL policies contain an aggregate limit? | National Union and Republic argue ambiguity eliminates any definite aggregate limit. | National Union and Republic contend the schedule and endorsements specify a clear aggregate amount or indicate an aggregate via attached forms. | Ambiguity found in National Union and Republic; summary judgment improper. |
| هلNational Union’s PIL limit is $500,000 or $500,000,000? | Ambiguity in placement of 500,000 on the schedule creates genuine issue of material fact. | Policy intent clear enough to imply a specific aggregate, with no need for extrinsic evidence. | Genuine issue of material fact; summary judgment improper. |
| Is Republic’s PIL aggregate limit determinate or ambiguous due to Form L6394a reference? | The Endorsement and Form L6394a conflict creates ambiguity about the aggregate limit. | Endorsement clearly sets the limit; no ambiguity. | Ambiguity found; summary judgment improper. |
| Does U.S. Fire’s PIL coverage actually provide an aggregate limit? | Endorsement 1 suggests an aggregate, implying a possible aggregate limit. | Endorsement 1 does not apply to PIL coverage; policy unambiguously contains no aggregate limit; reform may be possible but contested. | Policy unambiguously provides PIL without aggregate limit; reformation potential preserved; remand for merits. |
Key Cases Cited
- Edwards v. Daugherty, 883 So.2d 932 (La. 2004) (contract interpretation and ambiguity standards for insurance)
- Cadwallader v. Allstate Insurance Co., 848 So.2d 577 (La. 2003) (strict construction against insurer for ambiguous provisions)
- Sims v. Mulhearn Funeral Home, Inc., 956 So.2d 583 (La. 2007) (contractual interpretation; ambiguity resolved against insurer)
- Zeitoun v. Orleans Parish School Bd., 33 So.3d 361 (La. App. 4 Cir. 2010) (endorsement integration with policy terms)
- Bonin v. Westport Ins. Corp., 930 So.2d 906 (La. 2006) (summary judgment standard; de novo review; insurance contract interpretation)
- Edwards v. Daugherty, 883 So.2d 932 (La. 2004) (civil code interpretation of contracts and ambiguity)