Dyna Mitte v. Progressive Security Ins. Co.

CourtLouisiana Court of Appeal
DecidedOctober 5, 2011
DocketCA-0010-1301
StatusUnknown

This text of Dyna Mitte v. Progressive Security Ins. Co. (Dyna Mitte v. Progressive Security Ins. Co.) 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
Dyna Mitte v. Progressive Security Ins. Co., (La. Ct. App. 2011).

Opinion

NOT DESIGNATED FOR PUBLICATION

STATE OF LOUISIANA COURT OF APPEAL, THIRD CIRCUIT

CA 10-1301

DYNA MITTE

VERSUS

PROGRESSIVE SECURITY INS. CO.

**********

APPEAL FROM THE FIFTEENTH JUDICIAL DISTRICT COURT PARISH OF LAFAYETTE, NO. C-20060803 HONORABLE KRISTIAN DENNIS EARLES, DISTRICT JUDGE

BILLY HOWARD EZELL JUDGE

Court composed of Elizabeth A. Pickett, Billy Howard Ezell, and Shannon J. Gremillion, Judges.

AFFIRMED.

Bennett Boyd Anderson, Jr. Anderson & Dozier P. O. Box 82008 Lafayette, LA 70598-2008 (337) 233-3366 Counsel for Plaintiff/Appellant: Dyna Mitte Ian Alexander Macdonald Jones Walker P. O. Drawer 3408 Lafayette, LA 70502-3408 (337) 262-9000 Counsel for Defendant/Appellee: Progressive Security Ins. Co. EZELL, Judge.

Dyna Mitte appeals the decision of a jury finding that her uninsured motorist

insurer, Progressive Security Insurance Company, was not arbitrary and capricious

in failing to tender claims to her arising from an auto accident. For the following

reasons, we hereby affirm the decisions of the jury and trial court.

This suit arises from an April 20, 2004 auto accident in which Ms. Mitte was

struck by an underinsured driver and severely injured. Ms. Mitte had UM

insurance through Progressive. Progressive made pre-trial tenders to Ms. Mitte in

the amount of $393,624. She had already received $32,000 from the other driver‟s

insurance company. Ms. Mitte filed suit seeking penalties and attorney fees for

what she alleges were inadequate and untimely tenders. Liability and coverage

were not contested at trial. At the conclusion of trial, a jury found that the tenders

made by Progressive were not adequate and awarded Ms. Mitte over $1.6 million

dollars. However, the jury found that Progressive was not arbitrary or capricious

in its handling of Ms. Mitte‟s claim and refused to award her penalties and attorney

fees. Progressive did not appeal the jury‟s determination and paid the remainder of

its policy limits. Ms. Mitte, however, appeals.

On appeal, Ms. Mitte asserts three assignments of error. She claims the jury

erred in finding that Progressive was not arbitrary or capricious in its tenders to

her; that the trial court erred in failing to grant her motions for judgment

notwithstanding the verdict and/or for new trial; and that the trial court was in error

in allowing certain testimony from the Progressive claims adjuster handling her

claim.

Ms. Mitte first claims the jury erred in failing to find Progressive arbitrary or

capricious in its payment of tenders for her claim. In Guillory v. Lee, 09-75, pp.

30-32 (La. 6/26/09), 16 So.3d 1104, 1126-27, the supreme court discussed claims

for penalties and attorney fees arising from disputed tenders from insurance companies, stating (case citations omitted) (footnote omitted) (alteration in

original):

In order to establish a cause of action for penalties and/or attorney fees and costs under La. R.S. 22:658, a claimant must show that (1) an insurer has received satisfactory proof of loss, (2) the insurer failed to tender payment within thirty days of receipt thereof, and (3) the insurer‟s failure to pay is arbitrary, capricious or without probable cause. La. R.S. 22:658. Similarly, La. R.S. 22:1220 provides that an insurer owes to his insured a duty of good faith and fair dealing, which includes an affirmative duty to adjust claims fairly and promptly and to make a reasonable effort to settle claims with the insured or the claimant, or both. An insurer who breaches those duties is liable for damages sustained as a result of that breach. The statute further provides that a breach includes “[f]ailing to pay the amount of any claim due any person insured by the contract within sixty (60) days after receipt of satisfactory proof of loss from the claimant when such failure is arbitrary, capricious, or without probable cause.” La. R.S. 22:1220.

With regard to what constitutes “arbitrary, capricious, or without probable cause,” this court has held that the phrase is synonymous with “vexatious.” Furthermore, a “vexatious refusal to pay” means “unjustified, without reasonable or probable cause or excuse.” Both phrases describe an insurer whose willful refusal of a claim is not based on a good-faith defense.

This court has also stated that penalties should be imposed only when the facts “negate probable cause for nonpayment.” Moreover, whether or not a refusal to pay is arbitrary, capricious, or without probable cause depends on the facts known to the insurer at the time of its action, and this court has declined to assess penalties “when the insurer has a reasonable basis to defend the claim and acts in good- faith reliance on that defense.” More specifically, not only are the statutory penalties inappropriate when the insurer has a reasonable basis to defend the claim and acts in good-faith reliance on that defense, especially when there is a reasonable and legitimate question as to the extent and causation of a claim, bad faith should not be inferred from an insurer‟s failure to pay within the statutory time limits when such reasonable doubt exists. An insurer who does not tender unconditionally a reasonable payment, a figure over which reasonable minds could not differ, will be subject to penalties and attorney‟s fees. Finally, the question of arbitrary and capricious behavior is essentially a factual issue, and the trial court‟s finding should not be disturbed on appeal absent manifest error.

2 Ms. Mitte claims that because the jury awarded a large amount compared to

the tenders made by Progressive, its actions were necessarily arbitrary or

capricious. However, Progressive did not need to meet some percentage of the

total claim awarded her to avoid penalties and attorney fees. Rather, Progressive

needed to tender only a figure over which reasonable minds could not differ.

Progressive‟s adjuster, William George, testified thoroughly about his

handling of the claim. He noted Ms. Mitte initially claimed that she was not

seeking lost earning capacity and her extensive travel with her actor son as reasons

for not tendering payment for any loss of earning capacity. The record reflected

the fact that Ms. Mitte spent four to six months a year in New Mexico and another

four to six months a year in Los Angeles with her son. Moreover, Ms. Mitte‟s

vocational rehabilitation specialists limited her to sedentary desk-type work, much

like she had done prior to the accident, meaning her earning capacity could have

been found by a jury to have not dropped. Likewise, Mr. George expressed

Progressive‟s doubt as to whether a gastric bypass surgery performed upon Ms.

Mitte was required as a result of the accident. The jury clearly chose to give

significant weight to the testimony of Mr. George and found these doubts to be

reasonable. The jury concluded that Progressive undervalued Ms. Mitte‟s general

damages by a fairly large extent. However, after hearing all the evidence presented

at trial, the jury was unanimous in its finding that Progressive was not arbitrary or

capricious in its handling of Ms. Mitte‟s claim. There is a reasonable factual basis

for this finding evident in the record. Therefore, that determination cannot be

found to be manifestly erroneous.

As her second assignment of error, Ms. Mitte claims that the trial court erred

in denying her motions for judgment notwithstanding the verdict and new trial.

Under Louisiana Code of Civil Procedure Article 1811,

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