56 So. 3d 1016
La. Ct. App.2010Background
- Jones family's UM claim against Markel for Thomas Jones's injuries and Mary's death; policy limits are disputed (either $200,000 or $300,000 per policy).
- Medfax/St. Francis and Ingenix asserted ERISA-related medical liens that complicated proceeds distribution; lienholders' claims fluctuated over time.
- By July 2007, lienholders were brought into the suit, creating a potential concursus scenario and triggering consideration of penalties if Markel failed to tender.
- Markel prepared to tender $200,000 in late 2006 but disputed including Ingenix; Markel sought protective letters to address lien interests.
- Trial court found Markel had satisfactory proof of loss by July 5, 2007 and that Markel's failure to deposit $200,000 into registry was arbitrary and capricious, awarding penalties and fees.
- Judgment awarded $100,000 penalty and $10,000 in attorney fees; on appeal, court affirmed and awarded an additional $2,000 for appellate work.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Markel had satisfactory proof of loss triggering a tender before 2008. | Jones argued proof of loss existed by July 2007. | Markel contends proof of loss was not satisfactory until liens resolved. | Yes; Markel had satisfactory proof of loss by July 5, 2007. |
| Whether Markel's failure to deposit $200,000 into the registry was arbitrary and capricious. | Jones contends failure to tender into registry breached duties and warranted penalties. | Markel argues concursus was not required and tender outside registry sufficed. | Yes; failure was arbitrary and capricious; penalties imposed. |
| Appropriate calculation of penalties when policy limits are in dispute (200,000 vs 300,000). | Penalty should reflect the undisputed amount tendered ($200,000). | Penalties should reflect full policy limits as owed. | Penalty applied to $200,000 undisputed amount; 50% of $200,000. |
| Reasonableness of attorney fees awarded for entitlement to penalties and appellate work. | Attorney fees should reflect total recovery including penalties and final settlement. | Attorney fees should be tied to efforts to obtain recovery, not total settlement. | affirmed $10,000 for trial/entitlement and awarded $2,000 for appellate work. |
Key Cases Cited
- McDill v. Utica Mut. Ins. Co., 475 So.2d 1085 (La. 1985) (defines satisfactory proof of loss for UM claims)
- Reed v. State Farm Mut. Auto. Ins. Co., 857 So.2d 1012 (La. 2003) (penalties/duties when insurer lacks probable cause)
- Hart v. Allstate Ins. Co., 437 So.2d 823 (La. 1983) (statutory penalties; strict construction)
- Delores M. v. Southern Farm Bureau Cas. Ins. Co., 29 So.3d 654 (La. App. 2d Cir. 2010) (arbitrary/capricious standard; fact-specific review)
- Clark v. State Farm Mut. Auto. Ins. Co., 785 So.2d 779 (La. 2001) (unconditional tender and no-strings-attached requirement)
- French v. Detroit Fire & Marine Ins. Co., 38 So.2d 165 (La. App. 2d Cir. 1948) (concursus procedure as prudent response to competing claims)
- Berthelot v. Silver Oak Cas., Inc., 692 So.2d 578 (La. App. 3d Cir. 1997) (unconditional tender and registry deposit nuances)
- Marquez v. Progressive Ins. Co., 944 So.2d 876 (La. App. 3d Cir. 2006) (concurso involving lienholders and UM/auto claims)
- United Services Auto. Ass’n. v. Dugas, 593 So.2d 918 (La. App. 4th Cir. 1992) (concurso and tender principles in policy disputes)
