Lifecare Hosp. v. B & W Quality Growers

887 So. 2d 624, 34 Employee Benefits Cas. (BNA) 1463, 2004 La. App. LEXIS 2505, 2004 WL 2389550
CourtLouisiana Court of Appeal
DecidedOctober 27, 2004
Docket39,065-CA
StatusPublished
Cited by9 cases

This text of 887 So. 2d 624 (Lifecare Hosp. v. B & W Quality Growers) 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
Lifecare Hosp. v. B & W Quality Growers, 887 So. 2d 624, 34 Employee Benefits Cas. (BNA) 1463, 2004 La. App. LEXIS 2505, 2004 WL 2389550 (La. Ct. App. 2004).

Opinion

887 So.2d 624 (2004)

LIFECARE HOSPITALS, INC., Plaintiff-Appellee
v.
B & W QUALITY GROWERS, INC., Defendant-Appellant.

No. 39,065-CA.

Court of Appeal of Louisiana, Second Circuit.

October 27, 2004.

*626 Cook, Yancey, King & Galloway, by Bryce J. Denny Shreveport, for appellant.

Wiener, Weiss & Madison, by James R. Madison, Shreveport, for appellee.

Before WILLIAMS, PEATROSS and MOORE, JJ.

MOORE, J.

A local acute care hospital admitted an out-of-state minor patient for treatment after verifying her dependent insurance coverage through the employer's self-funded insurance plan administrator. Subsequently, the employer reduced the patient's maximum benefits retroactively, *627 thereby eliminating coverage for a large part of the treatment costs provided by the hospital. The hospital sued for tortious misrepresentation. From a summary judgment granted in favor of the hospital, the defendant appeals. For the reasons that follow, we affirm.

FACTS

This is an action for damages allegedly arising out of tortious misrepresentation. Lifecare Hospitals, Inc. ("Lifecare") is an acute care hospital located in Shreveport, Louisiana. The defendant, B & W Quality Growers, Inc., is a multi-state farming operation based in Fellsmore, Florida. The dispute in this case arose out of insurance coverage for 58 days of hospital care provided by Lifecare to an acutely ill, 17 year-old patient, Jennifer Franco ("Franco"). Franco was covered as an employee dependent under B & W's self-funded health insurance plan ("Plan").

Lifecare alleges that Franco's hospital bill for the medical services it rendered amounted to $142,908.47. Prior to admitting Franco on December 20, 2000, Lifecare verified that Franco had health insurance that would cover Lifecare's services. Lifecare alleged that it was advised by B & W's Plan administrator, Professional Administrators, Inc. ("PAI"), that Franco's health insurance provided a two million dollar lifetime maximum benefit, of which $380,000 had been used, leaving $1,620,000 benefits remaining. Lifecare alleged that it admitted Franco for treatment based on representations of coverage by B & W's agent, PAI, and it would not have admitted Franco had it known that insurance coverage would not be available because of B & W's decision to retroactively reduce benefits.

On January 17, 2001, Franco's mother informed Lifecare that B & W told her husband that its health care Plan had been modified to decrease the lifetime maximum benefit from $2,000,000 to $400,000, and the reduction applied retroactively to the date coverage began. At that time, Franco was seriously ill and could not be safely released until February 17, 2001. Because of the reduction in the maximum lifetime benefit, Franco's lifetime maximum benefit was already exhausted before Lifecare could be paid for all its services, leaving an unpaid balance of $81,762.92.

Lifecare filed the instant suit on June 29, 2001 against B & W for breach of its duty to provide complete and accurate information through its agent, PAI, regarding Franco's insurance coverage, including its plans to reduce the lifetime maximum benefit. It sought damages equal to the amount owed for the patient's treatment, plus legal interest on that amount from the date of judicial demand, and that defendant be cast for costs of the proceedings.

B & W did not file an answer to Lifecare's petition, but instead filed a petition for removal of the case to Federal District Court for the Western District of Louisiana, Shreveport Division, alleging that the case was governed by 29 USC § 1001 et seq., commonly known as ERISA, an acronym for the Employee Retirement Income Security Act. B & W contended that any remedy to which Lifecare is entitled is exclusively provided under ERISA.

Lifecare filed a motion to remand the case back to state district court. On December 10, 2001, U.S. Magistrate Roy Payne granted the motion to remand and ordered the case remanded back to the First Judicial District Court. B & W appealed to the district court for review of the magistrate's order. U.S. District Judge Tom Stagg reviewed the magistrate's order de novo and affirmed the order to remand the case back to state district court on March 15, 2002.

*628 Following remand to the First Judicial District Court, B & W filed the declinatory exception of lack of jurisdiction in personam. B & W alleged that it owns no property in Louisiana and does not engage in any of the activities under La. R.S. 13:3201 that would confer personal jurisdiction. Additionally, it alleged that the exercise of personal jurisdiction over B & W would offend traditional notions of fair play and substantial justice.

The court overruled the exception, expressly relying on the analysis in the case of Guidry v. United States Tobacco Co. Inc., 188 F.3d 619 (5th Cir.1999), a case which held that a tort committed outside the state that causes damage within the state can confer personal jurisdiction over the tortfeasor. Subsequently, the trial granted Lifecare's motion to compel compliance with its discovery requests in the form of interrogatories and production of documents, including any and all agreements between B & W and PAI.

On June 30, 2003, Lifecare filed a motion for summary judgment on its negligent misrepresentation claim. B & W opposed the motion, again asserting that the trial court lacked in personam jurisdiction and that the claim was preempted by ERISA. B & W insisted that the claim was really a claim for coverage under the Plan, and the claim was without evidentiary support, claiming that there was no proof that the claim would have been paid but for the change in coverage limits. It further argued that neither the Plan administrator, PAI, or the case management company, Beachtree, both of whom Lifecare had communicated with regarding the admission and care of Franco under the Plan, were authorized by B & W to misrepresent coverage under the Plan.

The trial court granted Lifecare's motion for summary judgment. B & W filed this appeal, alleging that the trial court erred in finding that the district court had personal jurisdiction over B & W, that it erred finding that this claim was not pre-empted by federal law, and that it erred in granting summary judgment on insufficient evidence.

Discussion

Personal Jurisdiction

B & W is a large-scale agricultural corporation domiciled in Florida with farms located in Florida, Tennessee, Alabama, West Virginia, Maryland and Pennsylvania. The company grows and markets herbs such as cilantro, mint and watercress. B & W does not conduct business in Louisiana and has never conducted agricultural business in this state and has no customers or employees in this state. The only contact with this state has been through its agent, PAI, the Plan administrator for its self-funded medical insurance plan, and that contact amounted to telephone calls verifying coverage. B & W argues that a telephone call to verify insurance coverage does not constitute minimum contacts sufficient to support the exercise of personal jurisdiction. Memorial Hospital System v. Blue Cross, 830 F.Supp. 968 (S.D.Tex.1993).

Jennifer Franco was a dependent of one of B & W's employees, Tony Franco. Mr. Franco lives in Tennessee and manages one of B & W's farms in New Market, Alabama.

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Cite This Page — Counsel Stack

Bluebook (online)
887 So. 2d 624, 34 Employee Benefits Cas. (BNA) 1463, 2004 La. App. LEXIS 2505, 2004 WL 2389550, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lifecare-hosp-v-b-w-quality-growers-lactapp-2004.