Chelette v. American Guar. & Liability Ins., Inc.

480 So. 2d 363, 1985 La. App. LEXIS 10424
CourtLouisiana Court of Appeal
DecidedDecember 11, 1985
Docket84-936
StatusPublished
Cited by61 cases

This text of 480 So. 2d 363 (Chelette v. American Guar. & Liability Ins., Inc.) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Chelette v. American Guar. & Liability Ins., Inc., 480 So. 2d 363, 1985 La. App. LEXIS 10424 (La. Ct. App. 1985).

Opinion

480 So.2d 363 (1985)

Donald CHELETTE, Plaintiff-Appellee,
v.
AMERICAN GUARANTEE AND LIABILITY INSURANCE, INC., et al., Defendants-Appellants.

No. 84-936.

Court of Appeal of Louisiana, Third Circuit.

December 11, 1985.

Davidson, Meaux, Sonnier & McElligott, Steven M. Jankower, Lafayette, for defendants-appellants.

*364 Felix A. Dejean and Thomas J. Dejean, Opelousas, for plaintiff-appellee.

Before GUIDRY, DOUCET and LABORDE, JJ.

GUIDRY, Judge.

This case concerns a workers' compensation claim under the 1983 statutory revisions. Plaintiff, Donald Chelette, filed suit against American Guarantee and Liability Insurance, Inc. (hereafter referred to as Zurich), and the plaintiff's employer, Scaffold Builders, Inc. (hereafter referred to as SBI), praying for workers' compensation benefits, medical expenses, statutory penalties, and attorney's fees. Before trial, Zurich and the plaintiff settled the compensation benefits and medical expenses claims. After a trial on the merits, the trial court awarded plaintiff judgment against Zurich for penalties in the amount of $1816.68 and attorney's fees in the sum of $5,000.00. The defendant, Zurich, has perfected this suspensive appeal. Plaintiff filed an answer to the appeal requesting additional attorney's fees of $2,500.00 for services of his attorney on appeal.

FACTS

Early in the morning on August 15, 1983, Donald Chelette, after having a breakfast of coffee and toast, left his home in Opelousas and drove to the work site of his new job with SBI. This was his first day on the job. Chelette's job duties included building and tearing down scaffolds at various locations within the Exxon Refinery at Baton Rouge. Work began promptly at 7:30 a.m. Chelette's first assignment, on this hot August morning, was to assist in tearing down a scaffold. The planks of the scaffold were 8 to 10 feet long and weighed approximately 40 pounds each. Roy B. Morton, the job site foreman, and another co-employee handed the planks and scaffolding bars to Chelette, who stood on the ground. Chelette would then load the materials onto a truck. After loading the truck, the three men drove to a different location to unload and stack the scaffolding materials. Chelette testified that this operation took approximately one hour.

The next job assignment consisted of building a tent out of scaffolding material to shade welders from the heat of the sun. Chelette's assignment was to hand-up whatever materials his co-workers needed. At this time, approximately 9:00 or 9:30 a.m., Chelette, according to his testimony, started to experience some physical weakness. About one hour later slight pains started to occur in his chest area. This weakness and pain, however, did not stop Chelette from continuing to perform his job functions until the noon hour.

During lunch, Chelette sat in the shade and drank a soft drink. He did not eat his lunch because of his weakness and somewhat nauseated condition.

At 12:30 p.m. Chelette returned to the tent construction. Between 12:30 p.m. and 1:30 p.m. his condition became more acute. His foreman, Roy Morton, on a later date, reported to the SBI risk manager that Chelette almost passed out a couple of times. By 1:30 p.m. Chelette's condition was so aggravated that he could not continue working. At this time the foreman, Roy Morton, drove Chelette to a small shack where Chalette rested until quitting time. Chelette testified that by quitting time the pain in his chest had subsided enough for him to drive back to his home in Opelousas, however, while driving home, he had to stop three times because of his nauseated condition.

After arriving home, he immediately went to bed because the pain began to increase again. By 5:30 or 6:00 p.m., his pain was so intense that Chelette asked his father to take him to Opelousas General Hospital. Chelette was admitted to the emergency room of the hospital during the evening of August 15, 1983, and later transferred to the intensive care unit.

On August 18, 1983, Opelousas General Hospital, concerned about Chelette's insurance coverage, called SBI to request information concerning whether they provided workers' compensation insurance for Chelette's hospitalization. Ms. James, a representative *365 of Zurich, the insurer of SBI, testified that at that time SBI informed Opelousas General that they could not authorize any payment under their workers' compensation coverage because they were not sure that the claim was compensable.

Sometime between August 15, 1983 and August 25, 1983, Chelette contacted his attorney. His attorney attempted to report the injury to SBI by telephone, however, he was not able to reach the proper SBI representative. Plaintiff's attorney then sent a letter, via certified mail, to SBI, dated August 25, 1983, informing SBI of the severe myocardial infarction (heart attack) suffered by Chelette and requested immediate payment of benefits under SBI's workers' compensation coverage with Zurich. Plaintiff's attorney sent a second letter, via certified mail, to Zurich on September 1, 1983, informing them of the plaintiff's condition and claim.

On September 2, 1983, SBI, apparently concerned about the situation, filed an Employer's Report of Occupational Injury or Disease with the State Office of Workers' Compensation. This report contained a brief report of the August 15th occurrence. The plaintiff filed his claim for workers' compensation with the State Office on September 9, 1983, alleging that the heart attack was work-related. Also, on September 2nd, SBI wrote to Zurich that Chelette indeed was employed by them on August 15th; he had worked very hard that day; he felt ill while working and almost passed out a couple of times; and, he had informed his job foreman of his condition. However, SBI also indicated that they were unsure about whether or not the injury was work-related and felt that the matter required further investigation.

Zurich then commenced its further investigation. Ms. James, the Zurich representative, interviewed Roy Morton, the foreman, on September 14, 1983 and interviewed Chelette on September 20, 1983. Both of these interviews confirmed that Chelette had experienced weakness, nausea, pain, and dizziness while on the job. However, the interviews did not confirm the existence of a heart attack. Zurich also requested medical reports from Opelousas General and Lafayette General Hospitals. In connection with the hospital reports, Zurich requested medical reports and opinions from Chelette's treating physicians, Dr. Bienvenu, an internist, who first saw Chelette when he entered Opelousas General, and Dr. Ducote, a cardiac specialist, who saw Chelette at Opelousas General and at Lafayette General Hospital. These reports were not tendered to Zurich immediately.

In the meantime, on October 8, 1983, the Office of Workers' Compensation, based on the information submitted, advised the parties that the plaintiff's injury was not work-related, and therefore, not subject to payment of workers' compensation benefits. The Office of Workers' Compensation did not have any reports from the hospital or doctors but based their decision solely on information furnished by SBI and the plaintiff.

The plaintiff, after receiving the advisory opinion, rejected the board's recommendation; Zurich, of course, accepted. On October 31, 1983, the Office of Workers' Compensation sent all parties a Certificate of Rejection pursuant to R.S. 23:1310.1. Plaintiff then filed suit on November 2, 1983.

Soon after suit was filed, the hospitals and doctors filled Zurich's medical information request. The reports from Opelousas General and Dr.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Ardoin v. Firestone Polymers, LLC
30 So. 3d 177 (Louisiana Court of Appeal, 2009)
Hosli v. Rent-A-Center, Inc.
957 So. 2d 207 (Louisiana Court of Appeal, 2007)
Thomas v. Wal-Mart
849 So. 2d 592 (Louisiana Court of Appeal, 2003)
Goodman v. Manno Electric, Inc.
835 So. 2d 697 (Louisiana Court of Appeal, 2002)
Clay v. Delphi Interior & Lighting Systems
775 So. 2d 1207 (Louisiana Court of Appeal, 2000)
Moreno v. Simonton
779 So. 2d 887 (Louisiana Court of Appeal, 2000)
Liga/Mortem Risk Management v. Franks
768 So. 2d 622 (Louisiana Court of Appeal, 2000)
Ziegler v. Bagby Construction/LWCC
760 So. 2d 513 (Louisiana Court of Appeal, 2000)
Haws v. Professional Sewer Rehabilitation, Inc.
763 So. 2d 683 (Louisiana Court of Appeal, 2000)
Campbell v. Gootee Const. Co.
756 So. 2d 449 (Louisiana Court of Appeal, 2000)
Labarcena v. Schwegmann's Supermarkets
716 So. 2d 478 (Louisiana Court of Appeal, 1998)
Maggard v. Boh Bros. Const. Co.
712 So. 2d 247 (Louisiana Court of Appeal, 1998)
Antrainer v. Great Atlantic & Pacific Tea Co.
712 So. 2d 590 (Louisiana Court of Appeal, 1998)
Batiste v. Capitol Home Health
699 So. 2d 395 (Louisiana Court of Appeal, 1997)
Kortz v. Colt Energy Services, Inc.
698 So. 2d 460 (Louisiana Court of Appeal, 1997)
Landry v. City of New Iberia
689 So. 2d 564 (Louisiana Court of Appeal, 1997)
Foster v. Liberty Rice Mill
690 So. 2d 792 (Louisiana Court of Appeal, 1996)
Patterson v. Long
682 So. 2d 1327 (Louisiana Court of Appeal, 1996)
Augustus v. St. Mary Parish School Bd.
676 So. 2d 1144 (Louisiana Court of Appeal, 1996)
Starks v. Universal Life Ins. Co.
666 So. 2d 387 (Louisiana Court of Appeal, 1995)

Cite This Page — Counsel Stack

Bluebook (online)
480 So. 2d 363, 1985 La. App. LEXIS 10424, Counsel Stack Legal Research, https://law.counselstack.com/opinion/chelette-v-american-guar-liability-ins-inc-lactapp-1985.