Jones v. Fin. Indem. Co.
264 So. 3d 660
La. Ct. App.2019Background
- On Oct. 23, 2013, Texas resident Karen Jones was rear-ended in Shreveport, LA; she sought ER care in Louisiana and subsequent treatment in Texas. Her UM insurer, Farmers (policy issued in Texas), remained the sole defendant at trial.
- Karen had a preexisting L5–S1 fusion (2005) from a 2004 crash; post-2013 she saw Dr. Marks three times through Jan. 28, 2014 (primarily neck complaints) and did not return until Feb. 2016.
- Competing expert opinions: Dr. Marks attributed later neck and back treatment to the 2013 crash; Dr. Auer concluded the later lumbar condition/surgery need was degenerative and unrelated.
- The bench found vehicle damage minor, accepted that post-Jan. 2014 back complaints were more likely related to preexisting degeneration, but that at least some neck treatment was related to the accident.
- Trial awards: Karen — $22,500 general damages; $7,593.05 stipulated medical through Jan. 28, 2014; $6,006.79 for neck treatment after Jan. 28, 2014; total $36,099.84. Calvin — $1,500 loss of consortium. Court applied Texas “paid-not-incurred” rule to post-ER medical expenses.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Causation of post-Jan.2014 lumbar problems | Karen: 2013 crash aggravated preexisting fusion and caused current lumbar problems and need for two‑level fusion | Farmers: later lumbar complaints stem from degenerative disease; gaps in treatment undermine causation | Trial court crediting Dr. Auer: post‑Jan.2014 lumbar complaints more likely from preexisting degeneration; appellate court affirms (no manifest error) |
| Adequacy of general damages ($22,500) | Karen: award is abusively low given chronic pain and recommended surgery; asks for $400–500k | Farmers: evidence (minor collision, limited early complaints, long treatment gap, continued work) supports lower award | Court did not abuse discretion; award affirmed |
| Choice of law for medical expenses (Texas paid‑not‑incurred rule) | Karen: Louisiana law (full incurred medicals / collateral‑source protection) should apply | Farmers: Texas has stronger contacts (policy issued in TX, insured TX resident, most treatment and expenses in TX); Texas limits recovery to amounts actually paid/owed | Court applied choice‑of‑law analysis and held Texas law governs the calculation of medical expenses; affirmed |
| Future medical expenses & loss of consortium | Karen: future cervical injections and lumbar surgery probable; Calvin: higher consortium award (≥ $10,000) | Farmers: future treatment speculative; consortium effects limited (some household help, loss of activities) | Trial court reasonably denied future medical expense award (speculative) and awarded $1,500 for consortium; both affirmed |
Key Cases Cited
- Cole v. State Dept. of Public Safety & Corr., 825 So.2d 1134 (La. 2002) (standard for reviewing factfinder’s credibility and manifest error rule)
- Stobart v. State through Dept. of Transp. & Dev., 617 So.2d 880 (La. 1993) (appellate review: manifest error/clearly wrong standard)
- Rosell v. ESCO, 549 So.2d 840 (La. 1989) (deference to factfinder on credibility and factual inferences)
- Wainwright v. Fontenot, 774 So.2d 70 (La. 2000) (full indemnification principle for tort damages)
- Champagne v. Ward, 893 So.2d 773 (La. 2005) (choice‑of‑law framework for multistate cases and insurance issues)
- Haygood v. De Escabedo, 356 S.W.3d 390 (Tex. 2011) (Texas view on collateral source adjustments and recoverable medical expenses)
- Menard v. Lafayette Ins. Co., 31 So.3d 996 (La. 2010) (standard for proving future medical expenses: probability and medical testimony)