Courts Address Circumstances that Support Summary Judgment Dismissing Claims of Bad Faith Against Insurers

The liability of a premises owner for third-party criminal acts has been the subject of many decisions issued by the Louisiana Supreme Court. But recently, the Court clarified how to analyze this issue in the context of summary judgment. In Campbell v. Orient-Express Hotels Louisiana, Inc. (Windsor Court), the Supreme Court reversed the court of appeal and held that Windsor Court was not liable for a robbery that occurred in its courtyard.

The factual background is simple: Campbell was a frequent guest at the Windsor Court. He decided to approach a vehicle near the entrance to the courtyard when he pulled a “substantial amount of cash” to show the female occupants in the vehicle. He placed the money back in his pocket and talked with them for one minute and forty-six seconds. When he pulled the cash from his pocket a second time, one of the occupants grabbed the cash and the vehicle sped away dragging him with it. Campbell then sued the Windsor Court alleging negligence, strict liability, failure to warn, failure to ensure the safety of its guests, etc.

The importance of this decision is found in how the Court analyzed the case to reach its conclusion that summary judgment was proper: The Court noted that it was not modifying prior duty/risk analysis but was clarifying how the analysis is to be conducted—The issues of “duty” and “scope of duty” are separate inquiries that require separate analysis.

In Campbell, the Court acknowledged that “duty” is a question of law for the court. It then concluded that “(w)hether a particular risk falls within the scope of that duty, by contrast, ‘is fact sensitive and ultimately turns on a question of policy as to whether the particular risk falls within the scope of that duty.’” However, the court continued, “‘(t)he determination of legal cause/scope of the duty involves a purely legal question.’” The Court conducted an historical analysis noting that prior decisions had “merged the concept of duty and scope of duty into a single consideration.”

On the threshold question of duty, the Court acknowledged that in the context of third-party criminal activity, Windsor Court, as an innkeeper, owed a duty to take reasonable precautions to protect its patrons from criminal acts of third parties. Having found this duty, the Court then concluded that “Campbell cannot meet the ‘scope of the duty’ element of his claim.” In other words, “the scope of the duty owed by the Windsor Court did not encompass the risk of the particular harm and Injury Mr. Campbell suffered.”

Here the court asked whether this particular risk and injury were “foreseeable.” The Court examined multiple factors to find that the robbery was not foreseeable, but the Court further noted “perhaps even more important to our decision is the manner in which the robbery occurred.” Campbell was not unexpectedly accosted, but his own actions placed him in peril. As such, the Court found no “ease of association” between Windsor Court’s duty to take reasonable precautions to protect its guests and the risk that the guest would voluntarily approach an unknown vehicle and flash a sizable pile of cash.

Justice Crain concurred in the opinion and noted that “scope of duty can be resolved on summary judgment if reasonable persons could not disagree that the manner of the injury is either within or beyond the scope of the duty.” Justice Crain also noted that the manner of injury must be analyzed in the context of “foreseeability” from the perspective of the premises owner and have an “ease of association” between the duty and the manner of injury—this analysis is necessary to “avoid making a defendant the insurer of all persons against all harms.” Thus, he agreed with the majority that Campbell was unable to establish the scope of duty element.

Reference:

Campbell v. Orient-Express Hotels Louisiana, Inc., 2024-00840 (La. 3/21/25), 403 So. 3d 573.

The Louisiana Legislature recently enacted Act 3, which reflects an effort to address the handling of insurance claims in Louisiana – particularly for catastrophic losses – and define ambiguities in the law. This blog addresses changes to Louisiana’s “bad faith” statutes. Broadly, Act 3 amends and enacts new sections of La. R.S. 22:1892, repeals La. R.S. 22:1973, and enacts La. R.S. 1892.2 to address situations involving catastrophic losses.

Prior Louisiana Bad Faith Statutes – La. R.S. 22:1892 and La. R.S. 22:1973

Previously, La. R.S. 22:1892(A) stated an insurer must:

• Issue payment to an insured within 30 days of receipt of satisfactory proof of loss;
• Pay the amount of a bona fide third-party’s property damage or reasonable medical expenses within 30 days of a written settlement agreement;
• Initiate loss adjustment within 14 days of notice of a non-catastrophic loss or within 30 days of receipt of notice of a catastrophic loss;
• Make a written offer to settle property damage within 30 days of receipt of satisfactory proof of loss.

If an insurer did not follow the requirements of La. R.S. 22:1892(A), the insurer could be required to pay the insured the amount owed under the policy plus a penalty if the insured established that the insurer’s conduct was “arbitrary, capricious and without probable cause.” Courts defined this standard as “vexatious” and without justification. The penalty is calculated as either 50% of the amount owed under the policy or 50% of the difference between the amount owed and a partial tender made by the insurer, if any. Additionally, if the insured established entitlement to the penalty, the insured could also recover attorneys’ fees and costs from the insurer.

Former La. R.S. 22:1973 codified an insurer’s duty of good faith and fair dealing. It set an affirmative duty to adjust claims fairly and promptly and make reasonable efforts to settle claims with the insured, a claimant or both. This general duty of good faith and fair dealing applies only to insureds.^ The statute also outlined six prohibits acts that, if knowingly performed, constituted a violation of the statute. Five of these six prohibited acts applied to both insureds and third-party claimants.^*

If an insured proved a knowing violation of La. R.S. 22:1973, the insurer could be required to pay the amount owed under the policy, damages caused by the insurer’s violation of the statute and a penalty of up to 200% of the damages that the insured or claimant incurred as a result of the breach. Such damages were separate and distinct from the amounts owed under the policy but could extend to anything for which the insured could establish a causal link.˚̃

Revisions to La. R.S. 22:1892

The new revisions enact several important changes. While the text of the new statute should be considered when evaluating any pending or potential claims, a summary is provided here.

1. Time Delays

Under amended and re-enacted La. R.S. 22:1892(A), insurers must generally adhere to the time delays and conduct outlined under the previous law. Under La. R.S. 22:1892.2, for catastrophic events at residential properties, an insurer’s payment is owed within 60 days of receipt of satisfactory proof of loss. For catastrophic losses at non-residential properties, the statute provides an insurer’s payment is owed within 90 days of receipt of satisfactory proof of loss.

Another exception exists when an insurer initiates loss adjustment before the 14-day or 30-day deadline. If this occurs, the insurer’s obligation to issue a written offer to settle is extended by the number of days the insurer initiates loss adjustment before the deadline.

2. Reciprocal Duty of Good Faith

Under the new law, La. R.S. 22:1973 is repealed and the general duty of “good faith and fair dealing” owed by an insurer to its insured and the prohibited insurer conduct previously outlined in La. R.S. 22:1973 is now encompassed within §1892.

The new statute also provides that the insured, the claimant or the representative of the insured/claimant owes the duty of good faith and fair dealing. If an insured fails to comply with affirmative duties under the policy, misrepresents pertinent facts and coverages, submits an estimate that lacks a basis in the evidence or the policy, then the insured’s conduct may be considered in determining whether the insurer’s conduct warrants an award of penalties.

3. Cure Period

For catastrophic losses, the new law states suits may only be brought if the insured first provides the insurer with “cure period notice.” This notice requires that the insured provide the insurer with written notice of the violation, a written formal demand and notice of the facts and circumstances of the dispute. After this notice, several options exist:

1. The insurer can pay the demand in full (along with the insured’s actual expenses and attorney fees no greater than 20%) within 60 days of the notice and extinguish any further cause of action.

• The insurer can issue partial payment on the claim within 60 days of the notice and reduce the penalty owed, if any, by half.

• The insurer can request additional information, but this does not extend the insurer’s other deadlines.

4. Revised Penalty Provisions

The amendments also modify the recoverable penalty. The statute specifies the calculation of the penalty based on the type of violation, the type of property and the type of loss event. Generally, the insured is no longer entitled to recover all damages sustained by a breach of the statute: now the claimant may only recover “proven economic damages.” Notably, the potential for a penalty of up to 200% of the damages sustained as a result of the breach no longer exists.

5. Timing

The law also formalizes and codifies the prescriptive period for claims brought under La. R.S. 22:1892 or La. R.S. 22:1892.2 to two years.

References:

^Theriot v. Midland Risk Ins. Co., 1995-2895 (La. 5/20/97) 694 So.2d 184.

* Team Contractors, L.L.C. v. Waypoint NOLA, L.L.C., 780 Fed.Appx. 132 (5th Cir. 2019).

˚Durio v. Horace Mann Ins. Co., 2011-0084 (La. 10/24/11) 74 So.3d 1159.

̃ Audubon Orthopedic and Sports Medicine, APMC v. Lafayette Ins. Co., 2009-0007 (La.App. 4 Cir. 4/21/10) 38 So.3d 963.

Imagine you are a defendant sued because you negligently injured someone in Louisiana. In the accident, the plaintiff received extensive medical treatment. The health insurer paid $50,000 for medical costs even though the doctors billed $150,000 for the plaintiff’s care. The plaintiff was only out-of-pocket $500 for his health insurance deductible. What amount should you have to pay: $150,000, $50,000, or only $500?

The answer to this question is not so simple. You will certainly have to pay more than the plaintiff’s deductible, that much is clear. But whether you are required to pay the medical providers’ full rate of $150,000, the insurer’s discounted rate of $50,000, or some other amount for the medical services provided is a more complicated issue.

This blog is broken down in a two-part series. This installment will address the background of the collateral source rule and the public policy behind the rule.

What is the Collateral Source Rule?

The collateral source rule provides that a tortfeasor is generally not entitled to a credit for payments made to a plaintiff through “collateral sources,” i.e., sources not provided by the defendant. Under this rule, a tortfeasor’s exposure for damages should be the same regardless of whether or not the plaintiff purchased health insurance.

The collateral source rule permits the plaintiff to recover medical expenses in excess of the amounts actually paid by the plaintiff or their insurer. Critics therefore assert that the rule provides a “windfall” to the plaintiff that violates the goal of Louisiana tort law, namely to make the victim “whole.” As applied, the rule can make the victim more than whole.

Origins of the Collateral Source Rule

To understand the collateral source rule, it helps to look at its origins. The rule in the United States at least dates back to the 1854 case The Propeller Monticello v. Mollison, 58 U.S. (17 How.) 152, 15 L.Ed. 68 (1854). In Propeller Monticello, two ships wrecked and one sank. The insurer of the ship that sank paid for the loss. The owner of the at fault ship asserted that the plaintiff had been fully compensated by the insurer’s payment and that it was therefore not obligated to pay for the damage. In rejecting this argument, the Propeller Monticello Court held the defendant was not a party to the insurance contract and could not reduce exposure by citing to the insurance available to the plaintiff.

Policies Behind the Collateral Source Rule

In Dep't of Transp. & Dev. v. Kansas City S. Ry. Co., 846 So. 2d 734 (La. 5/20/03), the Louisiana Supreme Court detailed the public policy concerns that support the collateral source rule. According to the court, the policies in favor of the rule include:

i. Fairness- a defendant should not gain an advantage from benefits provided to the plaintiff independent of any act of the defendant;

ii. Deterrence- the rule provides a deterrence to negligent conduct; and,

iii. Promotion of Insurance- victims could be dissuaded from purchasing insurance if that act could affect tort recovery.

So, how much do you owe: $50,000, $150,000, or some other amount? We’ll tell you in Part II of this blog.