248 So. 3d 392
La. Ct. App.2018Background
- O'Bannon, a Louisiana resident, was injured in Louisiana while working for Moriah Technologies, Inc. (a Texas corporation). TMIC was Moriah's workers' compensation insurer.
- O'Bannon filed a disputed claim in the Louisiana Office of Workers' Compensation (OWC); the WCJ found he was an employee injured in the course and scope of employment and awarded benefits, penalties, and fees against Moriah.
- The WCJ initially dismissed claims against TMIC and later, on remand, granted TMIC summary judgment, holding TMIC's policy did not provide coverage and giving full faith and credit to a Texas declaratory judgment finding no duty to defend or indemnify.
- TMIC sought to supplement the record with the Texas judgment and a Louisiana registration of that judgment; the appellate court denied supplementation of the latter as not part of the OWC record.
- The core dispute: whether TMIC's Texas-form WC/EL policy (which named Texas as the state of coverage and included a Limited Reimbursement endorsement for Texas employees injured out-of-state) covers O'Bannon or obligates TMIC to reimburse Moriah for Louisiana-ordered benefits.
- The court applied Texas law (per the policy's choice-of-law/stipulation) and concluded the policy unambiguously did not provide Louisiana coverage or reimbursement: O'Bannon was not a Texas employee under Texas Labor Code §§ 406.071–.072, his injury would not be shown compensable in Texas, and Moriah made no qualifying payments prior to seeking reimbursement.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether TMIC's policy provides WC coverage to O'Bannon under LWCA | O'Bannon argued the OWC has exclusive jurisdiction and TMIC's policy should provide coverage (or at least be adjudicated in Louisiana) | TMIC argued its policy only provides Texas coverage and a limited reimbursement endorsement that does not apply to O'Bannon | Held: Policy applies to Texas only; under its clear terms and Texas law O'Bannon and Moriah are not covered |
| Whether the Limited Reimbursement endorsement obligates TMIC to reimburse Moriah for Louisiana-ordered benefits | O'Bannon/Moriah contended endorsement might apply to out-of-state injury reimbursements | TMIC argued the endorsement applies only to qualifying Texas employees and sets Texas venue; O'Bannon lacks required Texas contacts and Moriah made no qualifying payments | Held: Endorsement does not apply—O'Bannon not a Texas employee and no qualifying payments were made; no reimbursement duty |
| Whether the OWC must give full faith and credit to the Texas declaratory judgment | O'Bannon argued OWC has exclusive jurisdiction over LWCA coverage disputes; Texas judgment should not be controlling in Louisiana proceedings | TMIC relied on the Texas judgment and later sought recognition in Louisiana | Held: Reversed the WCJ's giving full faith and credit to the Texas judgment because OWC has exclusive jurisdiction over LWCA coverage disputes in Louisiana |
| Whether appellate court may consider post-record Louisiana registration of the Texas judgment | O'Bannon implied the registration was not part of the record and should not be considered | TMIC moved to supplement the appellate record with the registration judgment | Held: Motion to supplement with the June 13, 2017 Louisiana registration judgment denied; court cannot consider documents not in the record on appeal |
Key Cases Cited
- O'Bannon v. Moriah Techs., Inc., 196 So.3d 127 (La. App. 1st Cir. 2016) (prior appellate decision addressing OWC jurisdiction and employee status)
- Sims v. Mulhearn Funeral Home, Inc., 956 So.2d 583 (La. 2007) (rules for interpreting insurance contracts)
- Magnon v. Collins, 739 So.2d 191 (La. 1999) (plain-meaning rule for contract interpretation)
- Marcus v. Hanover Ins. Co., 740 So.2d 603 (La. 1999) (insurers may limit liability by contract absent statutory or public-policy conflicts)
- Summers v. Pray, 850 So.2d 46 (La. App. 1st Cir. 2003) (circumstances for denying full faith and credit to sister-state judgments)