Curtis v. BLUE CROSS BLUE SHIELD OF LOUIS.

971 So. 2d 1249, 7 La.App. 3 Cir. 782, 2007 La. App. LEXIS 2249, 2007 WL 4322222
CourtLouisiana Court of Appeal
DecidedDecember 12, 2007
Docket2007-782
StatusPublished
Cited by2 cases

This text of 971 So. 2d 1249 (Curtis v. BLUE CROSS BLUE SHIELD OF LOUIS.) 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
Curtis v. BLUE CROSS BLUE SHIELD OF LOUIS., 971 So. 2d 1249, 7 La.App. 3 Cir. 782, 2007 La. App. LEXIS 2249, 2007 WL 4322222 (La. Ct. App. 2007).

Opinion

971 So.2d 1249 (2007)

Thomas D. CURTIS
v.
BLUE CROSS BLUE SHIELD OF LOUISIANA, et al.

No. 2007-782.

Court of Appeal of Louisiana, Third Circuit.

December 12, 2007.

*1250 Christopher A. Edwards, Edwards Law Firm, Lafayette, LA, for Plaintiff/Appellant Thomas D. Curtis.

Thomas R. Hightower, Jr., Patrick Wade Kee, John Andrew Durrett, Lafayette, LA, for Defendant/Appellee Louisiana Health Services and Indemnity Company, d/b/a Blue Cross/Blue Shield of Louisiana.

Court composed of SYLVIA R. COOKS, MARC T. AMY, and ELIZABETH A. PICKETT, Judges.

AMY, Judge.

The plaintiff filed suit against the defendant insurance company arguing that it increased his premiums in violation of La. R.S. 22:228 and La.R.S. 22:229.1. Additionally, he alleged that the defendant committed fraud by not disclosing that it was utilizing a durational factor when determining the amount of his premiums. After a partial summary judgment was granted in the plaintiff's favor, the matter proceeded to trial. At the close of the plaintiff's case, the defendant moved for an involuntary dismissal, arguing that the plaintiff did not meet his burden of proof. The trial court granted the motion and dismissed the plaintiff's case. It is from this ruling that the plaintiff now appeals. For the following reasons, we affirm.

Factual and Procedural Background

In February 1999, the plaintiff, Thomas D. Curtis, and his wife obtained an individual health insurance policy with the defendant, Louisiana Health Service and Indemnity Company d/b/a Blue Cross Blue Shield of Louisiana (Blue Cross). The policy had an initial deductible of $500.00 and a monthly premium of $391.48. In January 2000, the monthly premium was increased to $432.21, and the deductible was increased to $750.00. Mr. Curtis was diagnosed with multiple sclerosis in September 2000. According to Mr. Curtis, his policy premiums continued to periodically increase, ultimately reaching $1,241.50 by March 2006. He filed suit against Blue Cross, alleging that by continuing to increase his premiums, in violation of La. R.S. 22:228 and La.R.S. 22:229.1, it unilaterally cancelled his policy. By amended petition, Mr. Curtis contended that Blue Cross committed fraud by failing to disclose that it was utilizing a "durational factor" to increase his premiums over the length of the policy.

On September 3, 2004, Mr. Curtis filed a motion for summary judgment, arguing that: (1) Blue Cross could not increase his premiums after September 18, 2000, the day that he was diagnosed with multiple sclerosis; (2) Blue Cross violated the law by charging him a "durational rating" that was never disclosed to him until January 2003; and (3) as a result of its fraud in using a durational rating, Blue Cross owed him attorney fees. Following a hearing, the trial court signed a judgment on March 17, 2005, in which it found that:

(1) By increasing premiums on the policy issued to Thomas D. Curtis, BlueCross has violated [La.R.S.] 22:228. Summary judgment on this issue is granted and the defendant is prohibited from changing their premiums on said policy above $432.21 per month with a *1251 deductible of $750.00 without prior court approval;
(2) By increasing premiums on the policy issued to Thomas D. Curtis, BlueCross has violated [La.R.S.] 22:229.1. Summary judgment on this issue is also granted in favor of plaintiff and defendant is prohibited from changing the premiums in said policy above $432.21 per month with a deductible of $750.00 without prior court approval;
(3) The Motion for Summary Judgment based upon fraud is denied;
(4) Defendant is cast for all cost[s] of this motion; and
(5) This is not a final Judgment as additional issues remain for determination by the Court.

Pursuant to a stipulation signed by the parties on March 24, 2005, they agreed that the March 17, 2005 judgment was not a final judgment and that it was "subject to revision at any time prior to submission as a final judgment[.]" On November 15, 2005, Mr. Curtis filed another motion for summary judgment concerning the following issues: (1) "date of receipt or notice of a covered claim as referred to in [La.R.S] 22:228 and 22:229.1"; (2) "specific amount of back-time overpaid premiums reimbursement owed by BlueCross to THOMAS CURTIS"; (3) "specific amount of prescription co-payment reimbursement owed by BlueCross to THOMAS CURTIS"; and (4) "attorney fees." In response, Blue Cross filed its own motion for summary judgment, alleging that Mr. Curtis could not prove that there is no genuine issue of material fact and that he is entitled to judgment as a matter of law. Following a hearing, the trial court denied both motions for summary judgment.

Trial of the matter was held on August 15, 2006. At the close of Mr. Curtis' case, Blue Cross moved for an involuntary dismissal, arguing that Mr. Curtis did not prove his fraud allegation or that the increase in premiums violated either La.R.S. 22:228.6 or La.R.S. 22:229.1. The trial court granted the motion. Mr. Curtis subsequently filed a motion for new trial, which the trial court denied. Mr. Curtis now appeals, raising the following issues:

(1) Was the trial judge manifestly erroneous in dismissing plaintiff's case at the end of plaintiff's presentation of evidence?
(2) Did plaintiff's case meet the requirements of La.R.S. 22:228?
(3) Did plaintiff's case meet the requirements of La.R.S. 22:229.1?
(4) Did BlueCross BlueShield commit fraud upon Thomas Curtis by applying a "durational factor" to increase his premiums and not telling him about it during the years 2000, 2001, and 2002?

Discussion

Involuntary Dismissal

Mr. Curtis contends that the trial court erred in dismissing his case at the end of his presentation of evidence.

Louisiana Code of Civil Procedure Article 1672(B) provides:

In an action tried by the court without a jury, after the plaintiff has completed the presentation of his evidence, any party, without waiving his right to offer evidence in the event the motion is not granted, may move for a dismissal of the action as to him on the ground that upon the facts and law, the plaintiff has shown no right to relief. The court may then determine the facts and render judgment against the plaintiff and in favor of the moving party or may decline to render any judgment until the close of all the evidence.

*1252 In Koonce v. Dousay, 06-1498, p. 3 (La. App. 3 Cir. 3/7/07), 952 So.2d 893, 895 (citations omitted), this court stated:

The trial court is granted much discretion in determining whether to grant an involuntary dismissal. If after considering and weighing the plaintiff's evidence, the trial court determines that the plaintiff has not met his burden of proof, it must dismiss the plaintiff's case. The trial court's grant of an involuntary dismissal is subject to the well-settled manifest error standard of review.

When moving for an involuntary dismissal, Blue Cross addressed Mr. Curtis's fraud allegation:

The Court had previously entered a preliminary ruling saying that no fraud had occurred and there were no attorneys fees, et cetera, available. We would reurge that at this time.

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Bluebook (online)
971 So. 2d 1249, 7 La.App. 3 Cir. 782, 2007 La. App. LEXIS 2249, 2007 WL 4322222, Counsel Stack Legal Research, https://law.counselstack.com/opinion/curtis-v-blue-cross-blue-shield-of-louis-lactapp-2007.