Hebert v. Cigna

637 So. 2d 1221, 1994 WL 228306
CourtLouisiana Court of Appeal
DecidedMay 25, 1994
Docket93-1400
StatusPublished
Cited by14 cases

This text of 637 So. 2d 1221 (Hebert v. Cigna) 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
Hebert v. Cigna, 637 So. 2d 1221, 1994 WL 228306 (La. Ct. App. 1994).

Opinion

637 So.2d 1221 (1994)

Lenis J. HEBERT, Plaintiff-Appellee,
v.
CIGNA, Defendant-Appellant.

No. 93-1400.

Court of Appeal of Louisiana, Third Circuit.

May 25, 1994.

*1222 Roger C. Sellers, Abbeville, for Lenis J. Hebert.

Denis Paul Juge, Metairie, for CIGNA.

Denis Paul Juge, Frank Reynolds Whiteley, III, Metairie, for Insurance Co. of North America.

Michael Gerard Lemoine, Lafayette, for Murphy's Lease and Welding.

Before SAUNDERS, DECUIR and BERTRAND[1], JJ.

SAUNDERS, Judge.

Defendant-appellant, Insurance Company of North America[2] (hereinafter INA), appeals the judgment of the Office of Workers' Compensation, District 4, granting plaintiff-appellee, Lenis J. Hebert (hereinafter HEBERT), workers' compensation benefits, penalties, and attorney's fees. In INA'S response to HEBERT'S initial claim, INA made a third party demand against Gerald and May Libersat who owned the horse that caused HEBERT'S injuries. After rendering the judgment in favor of HEBERT, the hearing officer refused to transfer INA'S cross-claim against the LIBERSATS to a state district court.

INA contends that the hearing officer erred when: it ruled that the insurance policy issued to HEBERT'S employer, Murphy's Lease and Welding Service, Inc. (hereinafter MURPHY'S), by INA covered plaintiff's employer's cattle ranching operations; it found that plaintiff was in the course and scope of his employment with MURPHY'S at the time of the accident; it ruled that INA was arbitrary and capricious in handling HEBERT'S claims; and it denied INA'S request that its cross-claim be transferred to the 15th Judicial District Court.

For the reasons which follow, we affirm in part and reverse in part the hearing officer's ruling and remand with instructions.

FACTS

Plaintiff-appellee, HEBERT, was employed by MURPHY'S as a roustabout for approximately ten (10) years. He was guaranteed fifty (50) hours of work per week at $6.67 per hour. He worked Monday through Friday from 7:00 a.m. to 5:00 p.m. Generally, HEBERT reported to work at 7:00 a.m. and received work assignments from MURPHY'S *1223 foreman, James Baudoin, on a day-to-day basis. HEBERT had no specific duties and was assigned various tasks including truck driving, sweeping, grass cutting, and other similar assignments.

In addition, HEBERT was occasionally assigned to do personal work for Gerald Libersat (hereinafter LIBERSAT) and May Libersat. LIBERSAT and his mother, May Libersat, co-owned the controlling stock in MURPHY'S. LIBERSAT was the manager of MURPHY'S and was responsible for oversight with respect to hiring and firing employees, entertaining and servicing clients, financing, making project bids, and generally running the business on a day-to-day basis. HEBERT'S duties for the LIBERSATS also included mowing grass at LIBERSAT'S personal home and at his mother's home. HEBERT was also assigned work at LIBERSAT'S cattle operation located on property near MURPHY'S.

On March 12, 1990, LIBERSAT talked with James Boudoin to determine if HEBERT would be available to rope an orphaned calf from the pasture. That same morning, Boudoin and HEBERT discussed LIBERSAT'S order. After lunch, HEBERT left in a MURPHY'S shop truck and went to the pasture where the LIBERSAT cows were located. He retrieved a quarter horse located on the farm and proceeded to rope the calf. While performing the task, the horse stumbled and threw HEBERT. The horse fell on HEBERT rendering him a paraplegic. A few days after the accident, MURPHY'S issued a letter and an Employer's First Report of Injury Form to its workers' compensation carrier, INA, explaining the facts and circumstances surrounding the accident.

Generally, from the date of the accident to approximately September of 1990, INA paid workers' compensation and medical benefits to HEBERT. Problems arose in September of 1990 with respect to requests made by HEBERT to repair, remodel, or rebuild his home to make it wheelchair accessible and to modify his car to provide manual hand controls. On January 15, 1991, when medical payments were becoming delinquent and modifications to HEBERT'S home and car were not undertaken, HEBERT filed a workers' compensation claim against INA and MURPHY'S.

On February 5, 1991, INA filed an answer denying the claims made by HEBERT for benefits and medical care and denying that it was required to make the requested modifications to HEBERT'S home and car. Subsequent to this filing, INA issued a letter to the Social Security Administration stating that HEBERT was outside the course and scope of his employment at the time of his disabling accident, and therefore, INA was terminating benefits as of December 1, 1991. HEBERT subsequently amended his claim on January 27, 1992, seeking penalties and attorney's fees alleging that INA'S termination of benefits was arbitrary and capricious.

On September 10, 1992, a trial on the merits was conducted to determine whether HEBERT was in the course and scope of his employment at MURPHY'S at the time of his accident and whether INA was arbitrary and capricious in handling his claims. A stipulation was entered into on the record by all parties that if the hearing officer found HEBERT to be in the course and scope of his employment at MURPHY'S at the time of the accident, INA was obligated to provide workers' compensation benefits to HEBERT.

The hearing officer found that HEBERT was in the course and scope of his employment with MURPHY'S at the time of the accident. The hearing officer also ruled that INA was arbitrary and capricious in failing to reasonably controvert HEBERT'S claims and unilaterally terminating workers' compensation benefits on December 1, 1991. HEBERT was awarded attorney's fees in the amount of $10,000.

I. Issues Presented

1) Whether the insurance policy issued by INA to MURPHY'S covered LIBERSAT'S cattle ranching operations. 2) Whether HEBERT was in the course and scope of his employment with MURPHY'S at the time of the accident. 3) Whether INA was arbitrary and capricious in handling HEBERT'S claims. 4) Whether INA'S request that its *1224 cross-claim be transferred to the District Court should be granted.

This court pretermits the first issue raised by appellant because we find that the record supports the hearing officer's finding that at the time of the accident HEBERT was in the course and scope of his employment with MURPHY'S. Consequently, the first issue is moot.

II. Law and Argument—Issue I

Whether HEBERT suffered his injury during the course and scope of his employment at MURPHY'S.

To establish that a claimant is entitled to workers' compensation benefits, claimant must prove by a preponderance of the evidence that an accident occurred during the course and scope of his employment; the accident caused his injuries; and the injury caused his disability. Kennedy v. Security Indus. Ins. Co., 623 So.2d 174 (La. App. 1st Cir.), writ denied, 629 So.2d 389 (La.1993); reconsideration denied, 630 So.2d 251 (La.1993). It is undisputed in this case that HEBERT suffered a disabling injury that was caused by an accident in which he fell from a horse as he attempted to rope a calf.

At trial the parties entered into a stipulation that INA was liable for HEBERT'S claims as workers' compensation insurer of MURPHY'S, if the hearing officer found that the accident arose out of and in the course and scope of HEBERT'S employment with MURPHY'S.

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Cite This Page — Counsel Stack

Bluebook (online)
637 So. 2d 1221, 1994 WL 228306, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hebert-v-cigna-lactapp-1994.