The “Collateral Source Rule” & How it Can Cost (or Make) You Thousands – Part I

Courts around Louisiana continue to address factual scenarios for when summary judgment on an insured’s first party bad faith claim may be appropriate.

In Creamer Brothers Inc. et al. v. General Casualty Co. of Wisconsin, the federal court for the Western District of Louisiana addressed an insured’s claim for bad faith penalties and attorney’s fees arising out of an insurance claim for damages sustained in a February 2021 ice storm. The pertinent timeline is as follows:

• February 22, 2021: Date of Loss/Ice Storm
• February 26, 2021: Adjuster inspects property
• April 9, 2021: Adjuster completes estimate
• April 15, 2021: Insurer issues payment
• August 6, 2021: Insured submits damages estimate
• August 26, 2021: Insurer reinspects property with engineer
• September 24, 2021: Engineer submits report to Insurer
• October 7, 2021: Insurer prepares new estimate
• October 11, 2021: Insurer tenders supplemental payment
• October 12, 2022: Suit filed

The insurer argued summary judgment was appropriate because its damage assessment created a reasonable, well-founded dispute regarding the extent of damage caused by the ice storm. Plaintiff disagreed, arguing bad faith attached because the insurer relied solely on its own expert reports which they argued amounted to an investigation that was so inadequate it could be deemed unreasonable.

The Court sided with the insurer, granting its summary judgment. In so holding, the Court relied on the portion of La. R.S. 22:1892 which provides an insurer’s conduct must be “arbitrary, capricious, or without probable cause” for bad faith to attach. Specifically, the Court stated, “the fact that the parties’ experts reached different conclusions in their respective assessments gives rise to a dispute in the extent of Plaintiffs’ coverage, but does not illustrate a genuine issue of fact as to General Casualty’s ‘bad faith.’”

The Court noted the insurer sufficiently communicated with the insured, provided the insured with multiple expert reports containing their data and conclusions, and “ultimately made payments to Plaintiffs in accordance with those conclusions.” Plaintiff failed to point to evidence General Casualty’s conduct was arbitrary, capricious, or without probable cause, “despite yielding unsatisfactory results.”

In a case out of the Eastern District, Gentilly, LLC v. State Farm Fire & Cas. Co., the Court similarly relied on plaintiff’s failure to establish a general issue of material fact to show the insurer’s conduct was “arbitrary, capricious, or without probable cause.” The Gentilly case arose out of the plaintiff’s insurance claim for damages sustained to its commercial shopping center during Hurricane Ida. The parties engaged in a series of inspections, estimates, expert reports, payments, and supplemental payments over the course of about thirteen months, followed by several months of inactivity, then another period of investigation and adjustment over the course of about nineteen months.

Plaintiff argued the insurer’s 43-day delay in its first payout, failure to have an engineer inspect the property for a year, and gross under-evaluation of the damages as evidenced by its supplemental tender supported its bad faith claim. The Court disagreed.

In support of its conclusion, the Court noted the insurer advised plaintiff the inspection would take multiple days, and the delay in issuing payment arose out of the inspectors’ availability. The Court noted the insurer’s actions were “consistently in line with its expert appraisals.” In conclusion, the Court stated, “[t]hough the payout process was protracted by the scope and complexity of the insured loss, plaintiff fails to raise a genuine issue of material facts indicating that State Farm’s actions were arbitrary, capricious, or without probable cause.”

Louisiana courts have not established a bright-line rule for determining when summary judgment is appropriate on an insured’s bad faith claim. However, these cases seem to suggest that continued adjustment over a period of time may not give rise to bad faith claims where an insured cannot cite to evidence an insurer’s conduct was “arbitrary, capricious, or without probable cause.”

References:

Creamer Brothers Inc. et al. v. General Casualty Co. of Wisconsin, No. 22-cv-6110, 2025 WL 818579 (W.D. La. Mar. 13, 2025).

Gentilly, LLC v. State Farm Fire & Cas. Co., No. 23-cv-262, 2024 WL 5246606 (E.D. La. Dec. 30, 2024).

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.

On December 9, 1982, a victim was raped and stabbed multiple times in her Baton Rouge residence. In those harrowing moments, the victim was face-to-face with her assailant and vowed that she would remember the characteristics of her assailant in the unlikely event she survived. A friend arrived at the residence and entered the second-floor room containing the assailant and the wounded victim. Fortunately, at that moment, noise from a postal employee caused the assailant to flee the scene. The investigation began that same day.

Sometime later, Archie Williams became a suspect and was then criminally charged after the victim identified Mr. Williams as her attacker. The victim identified a prominent scar on the assailant which, in an unfortunate twist of fate, tended to match a scar on Mr. Williams. Several of the governmental officers involved in the investigation and the April 1983 criminal trial of Mr. Williams were sued many years later in the case styled Archie Williams v. City of Baton Rouge, ET AL. Keogh Cox attorneys Drew Blanchfield, Collin LeBlanc, Cathy Giering, and Chelsea Payne represented a forensic scientist, a lab technician, and a print examiner in the suit (the “Forensic Defendants.”) In his June 10, 2024 ruling, Judge Brian A. Jackson granted a Motion for Summary Judgment in favor of these defendants, dismissing the claims against them with prejudice.

At the 1983 criminal trial, Forensic Defendants testified that they could not identify Mr. Williams as the attacker. Similarly, both the prosecutor and defense counsel advised the jury that the physical evidence did not implicate Mr. Williams. Nevertheless, Mr. Williams was convicted based upon the passionate but mistaken testimony of the victim. Mr. Williams had not committed these crimes but remained incarcerated until his release decades later.

Mr. Williams consistently denied guilt. In 2008, he hoped DNA testing would help to prove his innocence. However, the DNA evidence was of no assistance. In 1999, The FBI launched its National Fingerprint Database (“IAFIS.”) Yet, a 2009 search generated no matches to fingerprints from the crime scene that had not already been identified. In 2014, Next Generation Identification (NGI) replaced IAFIS. By 2016, NGI held approximately 72,000,000 criminal fingerprints and 50,000,000 civil fingerprints. A 2019 search of this ever-expanding database matched fingerprint evidence taken from the 1983 crime scene to the prints of a convicted rapist who had died in prison years before. Mr. Williams was innocent and was soon released through a joint filing by the State of Louisiana and Mr. Williams. His lawsuit against multiple defendants followed.

In response, the Forensic Defendants filed a Motion that advanced the “qualified immunity” granted to governmental officials. In opposition to the Motion, the plaintiff possessed the burden: 1) to raise a fact dispute on whether his constitutional rights were violated by the defendants’ individual conduct; and 2) to show those rights were “clearly established” at the time of the alleged violation. The Court found that the plaintiff did not meet this burden. Although Plaintiff alleged that certain fingerprint evidence had been “suppressed” in violation of the “Brady Rule,” the Court cited the robust factual record showing that the jury was fully aware that no fingerprint evidence identified Mr. Williams and that unidentified prints were present at the crime scene. The Court also rejected the claim that there was any fabricated exculpatory blood or serology evidence.

The facts in Williams highlight the great technological improvements since the early 1980s which now aid the court system, prosecutors, and defense attorneys to protect against the conviction of an innocent suspect. These facts also tell a sad human story of an individual who spent more than 30 years in jail for a crime he did not commit. While it does not replace the lost years, Louisiana has created a fund which provides some financial resources to wrongfully convicted individuals to help them re-enter society. Williams was able to take advantage of this fund.

References:

Archie Williams v. City of Baton Rouge, ET AL, United States District Court, Middle District of Louisiana, No. 3:20-cv-00162.