Seal v. Lionel F. Favret Company

113 So. 2d 468, 238 La. 60, 1959 La. LEXIS 1068
CourtSupreme Court of Louisiana
DecidedJune 25, 1959
Docket44472
StatusPublished
Cited by20 cases

This text of 113 So. 2d 468 (Seal v. Lionel F. Favret Company) is published on Counsel Stack Legal Research, covering Supreme Court of Louisiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Seal v. Lionel F. Favret Company, 113 So. 2d 468, 238 La. 60, 1959 La. LEXIS 1068 (La. 1959).

Opinion

SIMON, Justice.

Plaintiff brought suit for compensation under Paragraph 2 of LSA-R.S. 23:1221 (formerly Paragraph B of Subsection 1 of Section 8 of the Employer’s Liability Act, Act No. 20 of 1914, as variously amended) for an injury alleged to have produced permanent total disability to do work of any reasonable character, and to recover penalties and reasonable attorney’s fees as provided for by LSA-R.S. 22:658 (formerly Section 14:48 of the Insurance Code, Act 195 of 1948).

The trial court awarded plaintiff compensation benefits as of total permanent disability not to exceed 400 weeks, subject to credits for the amounts previously paid as compensation benefits, and denied his claim for penalties and attorney’s fees. This judgment was affirmed by the Orleans Court of Appeal. Plaintiff applied for and was granted a writ of certiorari to have us review the judgment denying penalties and attorney’s fees. Hence the sole question here presented is whether he is entitled to this assessment.

The pertinent parts of LSA-R.S. 22 :- 658 require all insurers insuring any type of contract, other than those specified in LSA-R.S. 22:656 and 22:657, to pay the amount of any claim due any insured including any employee under our Workmen’s Compensation Statute (Chapter 10 of Title 23, LSA-R.S.) within sixty days after receipt of satisfactory proof of loss from the employee, and failing to do so, when such failure is found to be arbitrary, capricious, or without probable cause, shall subject the *63 insurer to a penalty, in addition to the amount of the loss, of 12% damages for the total amount of the loss, payable to the employee, together with all reasonable attorney’s fees for the prosecution and collection of such loss.

We find the facts of the case to be as follows:

On July 1, 1957, plaintiff was an employee of Lionel F. Favret Company, Inc., discharging his duties as a carpenter in connection with the construction of the Monteleone Hotel Garage. On that date he received back injuries in an accidental fall from a lumber scaffold which arose out of and in the course of his employment. He immediately reported the accident to his foreman, and on the following day was referred by his employer to Drs. Houston, Roy & Faust. Dr. Faust, after an examination, diagnosed plaintiff’s injury as a lumbar and lumbosacral joint strain, and prescribed the application of heat, complete rest on a firm and rigid bed, and the use of codeine to alleviate pain.

As plaintiff failed to make satisfactory progress as an office patient, Dr. Houston, on July 24, 1957, placed him as a patient in Touro Infirmary for treatment consisting of bed rest, bilaterial leg .traction and physiotherapy treatment. He was discharged from the hospital on August 3, 1957.

On September 16, 1957, Dr. Houston referred plaintiff to Dr. H. R. Soboloff, orthopedic specialist retained by the defendant insurer. After examining plaintiff Dr. Soboloff recommended that he “should be given a trial on returning to work.” On September 20, 1957 Dr. Houston thereupon discharged plaintiff with instructions to return to work and resume his former occupation. On the same day plaintiff returned to the Monteleone Hotel Garage and requested that he be allowed to work, but was advised by the employer’s superintendent that no additional employees were needed, the work force being gradually decreased due to the near completion of the project.

On September 23, 1957, plaintiff secured work as a carpenter for a Mr. Johnson. Due to severe back pains he was, however, unable to perform his duties and so notified his employer. On September 26, 1957, because of recurring incapacitating pain, he returned to the offices of Drs. Houston, Roy and Faust. After an examination, Dr. Houston, theorizing that the pain plaintiff claimed to be experiencing was not usually associated with a herniated disc, thereupon referred plaintiff to Dr. Gilbert Tomskey, an urologist. Dr. Tomskey concluded that plaintiff was suffering from chronic prostatitis, but reported to the defendant insurer that he did not believe this condition was the sole cause of plaintiff’s back pain. Neither Dr. Houston nor Dr. Soboloff saw-plaintiff again until the date of trial below.

On the same day plaintiff visited his own physician, Dr. Vernon Kroll, a general *65 surgeon, who found objective evidence of back injury, and concluded that plaintiff was unable to resume his former duties. On the basis of plaintiff’s injury and persistent backaches, Dr. Kroll strongly suspected a ruptured intervertebral disc and recommended that plaintiff consult a neurosurgeon.

On September 28, 1957, the defendant insurer cancelled payment of all workmen’s compensation benefits to plaintiff.

On October 17, 1957 and December 9, 1957, plaintiff consulted Dr. Homer D. Kirgis, a neuro-surgeon at Ochsner Clinic. He concluded that plaintiff “had sustained a rather sever compression of the fifth lumbar nerve on the left with herniation of the fourth lumbar intervertebral disc.” He advised plaintiff that a myelogram test was unnecessary to confirm his conclusion because plaintiff’s history and clinical findings were typical of the ruptured intervertebral disc syndrome. A copy of Dr. Kirgis’ report was received by the defendant insurer on January 3, 1958.

Defendant insurer, on February 7, 1958, referred plaintiff to Dr. George Battalora, an orthopedist. Dr. Battalora reported in writing to the insurer that plaintiff “presented findings which were indicative of lower lumbar disc herniation.” He suggested plaintiff be given benefit of a myelogram and if it showed definite herniation, he would then recommend surgery.

The defendant insurer refused to renew or reinstate plaintiff’s workmen’s compensation benefits. Thereafter, on March 24, 1958, plaintiff instituted suit against the defendants, employer and insurer.

On May 15, 1958, the defendant insurer referred plaintiff to Dr. Richard Corales, a neuro-surgeon. Dr. Corales reported to the insurer that plaintiff’s condition “was suggestive of nerve root involvement, most likely 1^5 nerve root on the left side * * * diagnosis that must be considered as ruptured intervertebral disc at this interspace.

Plaintiff was re-examined on May 17, 1958, by Dr. Kirgis and again on May 19, 1958, and as a result of which he reaffirmed his previous opinion that plaintiff had suffered a ruptured intervertebral disc. This suit was heard on its merits beginning May 27, 1958.

The defense of the insurance company is that it was fully justified in terminating plaintiff’s compensation payments when the reports of Dr. Houston and Dr. Soboloff of date September 20, 1957, and September 16, 1957, respectively, indicated that plaintiff “should be given a trial on returning to work,” both being of the belief that he could resume his work as a carpenter. To defendant insurer’s defense that relying on this recommendation it was justified in stopping plaintiff’s compensation payments, we make no comment as the pivotal ques *67

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Bluebook (online)
113 So. 2d 468, 238 La. 60, 1959 La. LEXIS 1068, Counsel Stack Legal Research, https://law.counselstack.com/opinion/seal-v-lionel-f-favret-company-la-1959.