Workers’ Compensation – In Benoit v. Turner Industries Group, LLC, 2011-1130 (La. 1/24/12), the Louisiana Supreme Court reversed a judgment of the Office of Workers’ Compensation, which awarded the claimant $625,168.27. The claimant qualified for Medicaid, and Medicaid paid $203,124.68 for medical expenses. The remaining $422,043.59 was “written off” under the Medicaid program.
The Court held that “under La. R.S. 23:1212(A), the payment of medical expenses by Medicaid extinguishes any claim by the employee against the employer for those expenses [aside from] a narrow exception, whereby the state is granted a right to recover these expenses from the employer.” As such, the OWC erred in awarding the claimant medical expenses paid by Medicaid. Similarly, the claimant was not entitled to the “written off” amount. “[T]he mere fact that the employer may have benefited from a reduction of expenses through the Medicaid write-off process, does not impermissibly diminish the employer’s liability for medical expenses.”
The employer was liable for the reduced portion of the medical expenses paid by Medicaid, but that reimbursement was owed to the state, not the claimant.
Insurance – In Oubre v. Louisiana Citizens Fair Plan, 2011-0097 (La. 12/16/11), a divided Louisiana Supreme Court concluded that La. R.S. 22:658(A)(3), currently 22:1892, regarding the timely initiation of lost adjustment, does not require a showing of bad faith by the insurer. The statute simply requires proof of notice and no action for over thirty days. The Court also ruled that the provisions of La. R.S. 22:1220(C), currently 22:1973, “cap” the penalties for such inaction at $5,000 when damages are not proven.
Vicarious Liability – In Nizzo v. Wallace, 11-467 (La. App. 5 Cir. 12/28/11), an employee was involved in an altercation with a co-employee during the scope of her employment. The plaintiff/employee sued the employer and co-employee. The plaintiff/employee reached a settlement agreement with the employer, and the employer was released from the action.
Under these facts, the Court held that the settlement with the employer-tort feasor barred the recovery of damages against the co-employee for whom the employer was vicariously liable. The Court relied upon La. R.S. 9:3921 and Civil Code art. 2320. Because Louisiana law renders the employer primarily answerable for all damages occasioned by their employees while in scope of employment, the co-employee was effectively released when the employer was released. In reaching its ruling, the Court disregarded an express reservation of rights against the co-employee in the release documents with the employer.
Attorneys’ Fees – Courts examine a number of factors when attorneys’ fees are awarded. This examination should occur regardless of statutory authorization for an award of attorneys’ fees. These factors include: the ultimate result; the responsibility assumed; the importance of the litigation; the amount of money involved; the extent and character of the work performed; the legal knowledge, attainment and skill of the attorney; the number of appearances involved; the intricacies of the facts involved; the diligence and skill of counsel; and the Court’s own knowledge.
If there is no indication that the Trial Court took the above-listed factors into account when it made an award of attorneys’ fees, the matter should be remanded for a determination of the proper amount of attorneys’ fees to be awarded. Sicard v. Sicard, 11-423 (La. App. 5 Cir. 12/28/11).