Guidry v. Shelter Ins. Co.

535 So. 2d 393, 1988 WL 85413
CourtLouisiana Court of Appeal
DecidedAugust 18, 1988
DocketW88-164
StatusPublished
Cited by6 cases

This text of 535 So. 2d 393 (Guidry v. Shelter 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
Guidry v. Shelter Ins. Co., 535 So. 2d 393, 1988 WL 85413 (La. Ct. App. 1988).

Opinion

535 So.2d 393 (1988)

Nolan A. GUIDRY, Plaintiff-Respondent,
v.
SHELTER INSURANCE COMPANY, Defendant-Relator.

No. W88-164.

Court of Appeal of Louisiana, Third Circuit.

August 18, 1988.

Juneau, Hill, Judice & Adley, P.L.C., Kathleen F. Drew, Lafayette, for defendant/relator.

Koury & Koury, Joseph Koury, Lafayette, for plaintiff/respondent.

Before STOKER, DOUCET and KING, JJ.

KING, Judge.

This court granted supervisory writs in this case following the trial judge's denial of defendant's Motion for Summary Judgment.

*394 The issue presented for review is whether a non-group health insurance policy issued by defendant provides coverage for all of plaintiff's medical expenses related to an accident occurring during the policy period but incurred after the lapse of the policy for non-payment of premiums.

STATEMENT OF THE CASE

On December 13, 1982, in consideration of a monthly premium of $108.86, Shelter Insurance Company (hereinafter defendant) issued to Nolan A. Guidry (hereinafter plaintiff) a non-group accident and medical benefits policy (hereinafter the policy) which provided coverage for plaintiff and his family. The policy went into effect November 24, 1982 and, under its terms, was renewable "by the timely payment of each premium" as it became due.

On June 10, 1983, plaintiff was involved in an automobile accident in St. Martin Parish, Louisiana. As a result of this accident, plaintiff suffered numerous injuries and incurred medical expenses in excess of $12,000.00, which were submitted to defendant for payment under the policy. Due to his injuries, plaintiff was unable to return to his former employment and became unable to pay the monthly premiums. Consequently, the policy issued by defendant to plaintiff lapsed on December 24, 1983 for non-payment of premium.

Prior to the end of the benefit period of plaintiff's policy, which was January 1, 1984, defendant paid, under the continuous loss provision of the policy, approximately $621.80 in accident-related medical expenses; however, it refused to pay the remainder of the accident related medical expenses incurred after January 1, 1984.

On February 6, 1987, plaintiff filed suit alleging defendant was responsible for all medical expenses arising from his accident under the continuous loss coverage provisions of the policy. Defendant filed an answer and a motion for summary judgment, contending there was no material issue of fact regarding its contractual liability for medical expenses arising after January 1, 1984, as the continuous loss provision of the policy was only effective during the policy benefit period, which was from 12:01 A.M. January 1, 1983 to 12:01 A.M. January 1, 1984.

A hearing was held on defendant's Motion for Summary Judgment on January 7, 1988, and the trial court rendered judgment in favor of plaintiff and against defendant denying defendant's Motion for Summary Judgment. A written judgment was signed on January 13, 1988.

In his reasons for judgment, the trial judge ruled that all of plaintiff's claims for medical expenses arising from the automobile accident were covered by defendant's policy, notwithstanding the fact that they were incurred after the lapse of the policy. In arriving at his decision, the trial judge relied on the cancellation provisions of LSA-R.S. 22:213(B)(7), as written at the time of the issuance of the policy and in effect when the medical expenses were incurred,[1] and the cases of Cataldie v. La. *395 Health Service & Indem. Co., 433 So.2d 367 (La.App. 3 Cir.1983), affirmed, 456 So. 2d 1373 (La.1984), and Cabibi v. Louisiana Health Service & Indemnity Company, 465 So.2d 56 (La.App. 4 Cir.1985) interpreting this statute.

Since defendant could not appeal from the court's refusal to render summary judgment, its only available remedy was to apply for a writ of certiorari. LSA-C.C. P. art. 968; Kiefer v. Whittaker, 468 So.2d 587 (La.App. 4 Cir.1985), writ den., 469 So.2d 979 (La.1985); Batson v. Time, Inc., 298 So.2d 100 (La.App. 1 Cir.1974), writ den., 299 So.2d 803 (La.1974). The exercise of supervisory jurisdiction by appellate courts is within their plenary power. La. Const. 1974 Art. 5, Sec. 10. Appellate courts generally will not exercise such jurisdiction unless an error in the trial court's ruling will cause the relator irreparable injury or an ordinary appeal does not afford an adequate remedy. Stevens v. Patterson Menhaden Corporation, 191 So.2d 692 (La.App. 1 Cir.1966), writ den., 250 La. 5, 193 So.2d 524 (1967). When the overruling of an exception or motion is arguably incorrect, when a reversal will terminate the litigation, and when there is no dispute of fact to be resolved, judicial efficiency and fundamental fairness to the litigants dictates that the merits of an application for supervisory writs should be decided in an attempt to avoid the waste of time and expense of a possibly useless future trial on the merits. Herlitz Construction Company, Inc. v. Hotel Investors of New Iberia, Inc., 396 So.2d 878 (La.1981).

LAW

The pertinent provision of the insurance policy with reference to termination of coverage is as follows:

"TERMINATION OF COVERAGE.
* * * * * *
15. Termination of Your Policy will be without prejudice to any Continuous Loss which began while it was in force. We will pay benefits for such loss only until the end of the Benefit Period during which your Policy terminates."

The terms "Benefit Period" and "Continuous Loss" are defined in the policy as follows:

"DEFINITIONS
* * * * * *
8. `BENEFITS PERIOD' means the Calendar Year starting 12:01 A.M. and ending at 12:01 A.M. the next following January 1.
* * * * * *
24. `CONTINUOUS LOSS' means Covered Charges incurred during that part of a Benefit Period following the termination of your Policy, provided:
a. Covered Charges are incurred for the same or related causes during that part of the Benefit Period prior to termination; and
b. In an amount to satisfy the Deductible."

In the portion of the policy entitled "Benefit Provisions," the last sentence of that section provides that "A charge is incurred on the date of treatment, service rendered or a supply is furnished."

In its application for supervisory writs defendant contends the trial court erred in relying on LSA-R.S. 22:213(B)(7) and Cataldie, supra, and that it is entitled to judgment as a matter of law as there is no issue of material fact regarding its obligation under the policy. LSA-C.C.P. Art. 966. Defendant argues that the lapse of the policy due to non-payment of the premiums is not a cancellation of the policy, which would clearly be subject to the rules *396 of the Louisiana Insurance Code. Additionally, defendant argues that, in the instant case, Cataldie, supra, is not controlling because we are not dealing with unconscionable changes in the terms of the policy by the insurer or in the premium charged by the insurer, resulting in the insured having to cancel his policy.

Although the terms "cancellation" and "termination" are frequently used synonymously, they are two separate and distinct acts, each carrying significantly different legal requirements and consequences. Soniat v. Travelers Ins. Co.,

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Cite This Page — Counsel Stack

Bluebook (online)
535 So. 2d 393, 1988 WL 85413, Counsel Stack Legal Research, https://law.counselstack.com/opinion/guidry-v-shelter-ins-co-lactapp-1988.