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56 So. 3d 1016
La. Ct. App.
2010
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Background

  • 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)
Read the full case

Case Details

Case Name: Jones v. Johnson
Court Name: Louisiana Court of Appeal
Date Published: Dec 15, 2010
Citations: 56 So. 3d 1016; 2010 La. App. LEXIS 1736; 2010 WL 5100192; No. 45,847-CA
Docket Number: No. 45,847-CA
Court Abbreviation: La. Ct. App.
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    Jones v. Johnson, 56 So. 3d 1016