Thomas v. STATE EMPLOYEES GROUP BENEFITS

934 So. 2d 753, 2006 WL 741546
CourtLouisiana Court of Appeal
DecidedMarch 24, 2006
Docket2005 CA 0392
StatusPublished
Cited by17 cases

This text of 934 So. 2d 753 (Thomas v. STATE EMPLOYEES GROUP BENEFITS) 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
Thomas v. STATE EMPLOYEES GROUP BENEFITS, 934 So. 2d 753, 2006 WL 741546 (La. Ct. App. 2006).

Opinion

934 So.2d 753 (2006)

Kae Francis THOMAS
v.
STATE EMPLOYEES GROUP BENEFITS PROGRAM.

No. 2005 CA 0392.

Court of Appeal of Louisiana, First Circuit.

March 24, 2006.

*755 Richard L. Fewell, Jr., Robert T. Knight, West Monroe, Counsel for Plaintiff/Appellant Kae Francis Thomas.

Pamela Bartfay Rice, Baton Rouge, Counsel for Defendant/Appellee State Employees Group Benefits Program.

Before: CARTER, C.J., DOWNING and GAIDRY, JJ.

GAIDRY, J.

The plaintiff-appellant, Kae Francis Thomas, appeals a judgment of the 19th Judicial District Court sustaining the peremptory exception of prescription of the defendant-appellee, the Louisiana Division of Administration, Office of Group Benefits (OGB),[1] and dismissing her petition with prejudice. For the following reasons, we affirm.

FACTS AND PROCEDURAL BACKGROUND

Plaintiff, an employee of the Ouachita Parish School Board, filed a petition for damages against OGB, her group health and hospitalization plan, on May 17, 2004. She alleged that she was diagnosed as having mammary hypertrophy, for which bilateral breast reduction surgery was recommended by her physician. She further alleged that on November 30, 1999, her physician mailed medical records and photographs to OGB to document the medical necessity of the recommended procedure. The photographs depicted plaintiff nude from the waist up. According to plaintiff, the records and photographs were "signed for" by a representative of OGB on December 8, 1999.[2] Plaintiff further claimed that upon contacting OGB by telephone in mid-December, she learned that OGB had lost the photographs, and that the photographs remained lost through the time her petition was filed.

Plaintiff alleged that OGB was negligent in losing and failing to recover the photographs, and that it intentionally or negligently caused her emotional distress. She further contended that OGB is liable to *756 her for damages under both a "continuing tort theory" and a "contract theory." The only factual basis stated for the latter theory of recovery was "the premise that the relationship between [plaintiff] and [OGB] was that of an insurance contract or agreement."

On July 6, 2004, OGB filed a peremptory exception of prescription, objecting to plaintiff's petition on the grounds that her alleged cause of action was prescribed. The exception was originally fixed for hearing on September 20, 2004, but the hearing was continued to November 8, 2004. No evidence was introduced on behalf of either party at the hearing. At the conclusion of the hearing, the trial court ruled in favor of OGB. Its judgment sustaining the exception and dismissing plaintiff's petition and cause of action with prejudice was signed on December 9, 2004.

Plaintiff now appeals, contending that the trial court erred in failing to find her allegations sufficiently stated both a continuing tort and a cause of action based in contract and in dismissing her petition.

ANALYSIS

All personal actions, including actions to enforce contractual obligations, are generally subject to a liberative prescription of ten years, unless otherwise provided. La. C.C. art. 3499. Delictual actions are subject to a liberative prescription of one year, running from the day injury or damage is sustained. La. C.C. art. 3492. As plaintiff's petition was filed some four-and-a-half years after the time she learned of the photographs' loss, the proper characterization of the nature of her cause of action is crucial to the determination of the issues before us.

In the case of Leger v. Spurlock, 589 So.2d 40 (La.App. 1st Cir.1991), the plaintiff, a police officer, sued a physician for breach of confidentiality, alleging that the physician violated the physician-patient privilege by discussing his chemical dependency treatment with a district attorney, with the result that the plaintiff was fired and had criminal charges brought against him. The defendant physician responded to the suit with a dilatory exception of prematurity, arguing that the claim was required to be presented to a medical review panel under the Louisiana Medical Malpractice Act, La. R.S. 40:1299.41, et seq. The plaintiff contended that because his cause of action was based on implied contract and intentional tort, it fell outside the definition of malpractice. Although we agreed with the plaintiff's dual characterization of his cause of action, we nevertheless held that the Medical Malpractice Act applied, since the cause of action for breach of contract was encompassed within the statutory definition of malpractice. Id. at 43. In so doing, we observed that a physician's unauthorized divulgence of confidence constituted "the breach of an implied condition of the contract that arises when a physician is employed in his professional capacity by a patient," an implied condition having its basis in the venerable Hippocratic Oath.[3]Id.

In the case of a health care insurer, however, no corresponding implied condition *757 of confidentiality can be read into its contract with its insured by virtue of its intrinsic nature or longstanding custom or tradition. A contractual duty on the part of an insurer to maintain the confidentiality of its insured's medical records might arise independently of any duty under the general tort law, if the insurer expressly assumes such an obligation under the terms of the insurance contract. See, e.g., Robley v. Blue Cross/Blue Shield of Mississippi, 2003-CA-02209-COA, pp. 3-4 (Miss.App.6/21/05), 935 So.2d 1021, 1023, 2005 WL 1500300. But plaintiff has neither shown nor argued how the terms of the contract in question established such a contractual duty on OGB's part. In this appeal, she simply asserts that because her relationship with OGB is contractual, and because the photographs were sent in order to substantiate her claim for benefits under the insurance contract, the duty allegedly breached is contractual. We disagree.

The nature of the duty breached determines whether the action is in tort or in contract. Roger v. Dufrene, 613 So.2d 947, 948 (La.1993). The classic distinction between damages ex contractu and damages ex delicto is that the former flow from the breach of a special obligation contractually assumed by the obligor, whereas the latter flow from the violation of a general duty owed to all persons. Trinity Universal Insurance Company v. Horton, 33,157, p. 2 (La.App. 2nd Cir.4/5/00), 756 So.2d 637, 638, citing Harrison v. Gore, 27,254, p. 8 (La.App. 2nd Cir.8/23/95), 660 So.2d 563, 568, writ denied, 95-2347 (La.12/8/95), 664 So.2d 426. Even when tortfeasor and victim are bound by a contract, courts usually apply the delictual prescription to actions that are actually grounded in tort. Id. The mere fact that the circumstances arose in the context of a contractual relationship does not make the cause of action contractual. The courts are not bound to accept a plaintiff's characterization of the nature of his cause of action if unsupported by factual allegations. See United Gas Pipe Line Company v. Cargill, Inc., 612 So.2d 783, 786 (La.App. 1st Cir.1992).

We of course accept the proposition that a cause of action may exist against an insurer who intentionally or negligently discloses an insured's confidential medical records. Such a cause of action, however, does not derive from any implied condition of the insurance contract or policy, as would be the case in a physician-patient relationship.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Dow Construction v. B P X Operating
140 F.4th 246 (Fifth Circuit, 2025)
Elizabeth Franklin v. Regions Bank
976 F.3d 443 (Fifth Circuit, 2020)
Christopher A. Bailey (D) v. Dr. Michael Loewe
Louisiana Court of Appeal, 2020
Carriere v. JACKSON HEWITT TAX SERVICE INC.
750 F. Supp. 2d 694 (E.D. Louisiana, 2010)
Trust for Schwegmann v. Schwegmann Family Trust
51 So. 3d 737 (Louisiana Court of Appeal, 2010)
Roba, Inc. v. Courtney
47 So. 3d 500 (Louisiana Court of Appeal, 2010)
Reese v. ICF Emergency Management Services, Inc.
684 F. Supp. 2d 793 (M.D. Louisiana, 2010)
Kroger Co. v. L.G. Barcus & Sons, Inc.
13 So. 3d 1232 (Louisiana Court of Appeal, 2009)
Gallant Investments, Ltd. v. Illinois Central Railroad
7 So. 3d 12 (Louisiana Court of Appeal, 2009)
Hargett v. ESTATE OF HARGETT
977 So. 2d 311 (Louisiana Court of Appeal, 2008)
Onstott v. Certified Capital Corp.
950 So. 2d 744 (Louisiana Court of Appeal, 2006)

Cite This Page — Counsel Stack

Bluebook (online)
934 So. 2d 753, 2006 WL 741546, Counsel Stack Legal Research, https://law.counselstack.com/opinion/thomas-v-state-employees-group-benefits-lactapp-2006.