Coliseum House, Inc. v. Brock

442 So. 2d 778
CourtLouisiana Court of Appeal
DecidedDecember 8, 1983
Docket83-CA-511
StatusPublished
Cited by4 cases

This text of 442 So. 2d 778 (Coliseum House, Inc. v. Brock) 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
Coliseum House, Inc. v. Brock, 442 So. 2d 778 (La. Ct. App. 1983).

Opinion

442 So.2d 778 (1983)

COLISEUM HOUSE, INC. d/b/a Coliseum House Hospital
v.
Henry J. BROCK.

No. 83-CA-511.

Court of Appeal of Louisiana, Fifth Circuit.

December 8, 1983.
Rehearing Denied January 17, 1984.

*779 Wilbur Woods Reynaud, Lutcher, for defendant/third-party plaintiff-appellee, Henry J. Brock.

Eugene R. Preaus, Virginia N. Roddy, Phelps, Dunbar, Marks, Claverie & Sims, New Orleans, for defendant/third-party defendant-appellant, Protective Life Ins. Co.

Before CHEHARDY, CURRAULT and DUFRESNE, JJ.

CURRAULT, Judge.

This appeal arises from a judgment against third-party defendant, Protective Life Insurance Company (Protective) for benefits under a hospitalization policy insuring third-party plaintiff Henry J. Brock.

A review of the facts leading to the action between the parties reveals that on January 1, 1971, Protective Life Insurance Company issued group policy No. GD-3164-023 to the St. James Parish School Board under which qualified employees and their covered family members could become insured subject to the terms and conditions of that policy. Henry J. Brock, an employee of the school board, became insured under the policy; and, under the terms of said policy, Blane Brock, his son was eligible for certain medical benefits.

The Insuring Clause in the supplement to Group Policy No. GD-3164-023 which provides for major medical expense benefits limits benefits for the treatment of mental or nervous disorders to a maximum of Two Thousand Five Hundred Dollars ($2,500) during any one calendar year.

During the calendar year 1978, claims on behalf of Henry J. Brock were submitted to Protective Life Insurance Company (Protective) for expenses incurred in the treatment of his son who had been hospitalized at Ochsner Foundation Hospital (Ochsner) and Coliseum House (Coliseum) for treatment of a mental and/or nervous condition. In 1978, Protective paid basic benefits in the amount of Three Thousand Eight Hundred Twenty-Two Dollars and Eighty Cents ($3,822.80) to Ochsner and Three Thousand Twenty-Seven Dollars and Twenty Cents ($3,027.20) to Coliseum for a total of Six Thousand Eight Hundred Fifty Dollars ($6,850). Additionally, it paid major medical benefits of One Thousand Four Hundred Forty-Two Dollars and Eighty-One Cents ($1,442.81) to Ochsner and One Thousand Fifty-Seven Dollars and Nineteen Cents ($1,057.19) to Coliseum, totaling Twenty-Five Hundred Dollars ($2,500) for the treatment of Blane Brock.

In May and June, 1978, in response to billing by Coliseum, Henry J. Brock was advised by Protective that it had paid the maximum benefits available for the calendar year 1978. Although Blane Brock was hospitalized during May and June, 1978, and later in that year, no further claims were made upon Protective pursuant to the maximum benefits of the contract.

On January 31, 1980, Coliseum filed a petition on open account claiming that Henry J. Brock was indebted to them for Twenty-One Thousand Ninety-Four Dollars and Sixteen Cents ($21,094.16). Henry J. Brock thereafter filed a third-party demand against Protective, claiming that pursuant to LSA-R.S. 22:213.2, Protective was obligated to offer benefits for treatment of mental disorders under the same condition as benefits for the treatment of other illnesses. The third-party demand filed December *780 2, 1981, also contained a demand for penalties and attorney's fees.

Protective answered the third-party demand denying its liability for the benefits claimed and denying the applicability of LSA-R.S. 22:213.2 to the policy of insurance at issue which was originally issued four years prior to the enactment of that statute.

A motion for summary judgment was filed on behalf of Protective on March 31, 1982, argued on April 20, 1982, and denied. Trial in this matter was held on June 10, 1982.

Following trial, appellant filed a peremptory exception of prescription under the terms of the contract.

On February 18, 1983, judgment was rendered in favor of plaintiff, Coliseum, and against defendant, Henry Brock, on the main demand and in favor of the defendant and against the third-party defendant, Protective, on the third-party demand. Protective filed a motion for new trial which was denied. It is from the judgment against the third-party defendant Protective which is now before this court on appeal.

Appellant Protective assigns the following as error by the trial court:

(1) The trial judge erred in denying appellant's motion for summary judgment;

(2) The trial judge erred in overruling appellant's exception of prescription;

(3) The trial judge erred in denying appellant's motion for new trial.

The following issues are presented for our consideration:

(1) Whether the demand of the insured against the insurer had prescribed prior to filing of the third-party demand against the insurer;

(2) Whether LSA-R.S. 22:213.2 is applicable to a contract of insurance negotiated prior to its enactment; and, if so, whether the policy of insurance issued to the policyholder at the commencement of each annual term constituted a "new policy" within the terms of LSA-R.S. 22:213.2.

In order to facilitate our analysis of the issues, the court will address the second issue first in consideration of the effect our determination has on the prescription question.

Appellant argues that LSA-R.S. 22:213.2 is inapplicable to a contract of insurance first negotiated prior to its enactment and that the annual renewal does not constitute a "new policy" within the terms of the statute. The statute, added in 1975 to Title 22 of the Louisiana Revised Statutes of 1950, provides that:

"Every insurer authorized to issue policies of health and accident insurance in this state shall offer to all prospective group, blanket, and franchise policyholders at their option a provision in the insurer's health and accident insurance policies which shall state that benefits shall be payable for services rendered for the treatment of mental and/or nervous disorders, under the same circumstances, conditions, limitations, and exclusions as benefits are paid under those policies for all other diagnoses, illnesses, or accidents; ...."

(Emphasis added)

The statute also provides that it "shall be applicable only to those policies issued on or after July 1, 1976."[1] Appellant asserts that the policy was issued in 1971, and that the trial court's application of the statute to the contract is an improper retroactive application of a law, citing LSA-C.C.P. art. 8. We agree that as a general rule, "laws are deemed to be prospective in effect unless their language clearly indicates otherwise." Green v. Liberty Mutual Ins. Co., 352 So.2d 366 (La.App. 4th Cir.1977), writ denied 354 So.2d 210 (La.1978); Guillory v. *781 McClinton, 359 So.2d 223 (La.App. 1st Cir. 1978).

LSA-R.S. 22:213.2 does not provide for retroactive-effect; however the trial court found that by the express provisions of the policy, each new annual term constituted a new contract and under the law reformed the contract so as to include the provisions of the statute during the period appellee's son was hospitalized.

The contract herein states that:

"The initial term of this Policy shall commence at 12:01 A.M. (standard time at the Policyholder's principal address as shown on the application) on the effective date of this Policy and end on the day immediately preceding the first renewal date.

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Bluebook (online)
442 So. 2d 778, Counsel Stack Legal Research, https://law.counselstack.com/opinion/coliseum-house-inc-v-brock-lactapp-1983.