The Louisiana Third Circuit Court of Appeal recently addressed an insurance coverage dispute in a personal injury lawsuit following a work-related injury suffered by a deputy sheriff while supervising trustee inmates. At issue in the case were the extent of liability coverage and ambiguities in the insurance policy exclusions and definitions.
Plaintiff Jackie Doucet worked as a deputy sheriff for the Evangeline Parish Sheriff’s Department and the Evangeline Parish Sheriff. He was injured while watching inmates at an automobile repair shop. Mr. Doucet attempted to sit in a chair and it collapsed, causing him to fall to the floor and suffer injuries to his right arm and shoulder. Mr. Doucet received continuing medical treatment and surgical procedures for his injuries. The Sheriff’s Department paid him his full salary and employment benefits, despite his inability to work. The Department also paid for his medical expenses and medical insurance premiums.
After being advised that his compensation and benefits would terminate, Mr. Doucet brought a lawsuit, together with his wife’s loss of consortium claim. The Sheriff and the Sheriff’s Department were named defendants, as was the insurance company for the Sheriff’s Department. The trial court held that the insurance policy at issue in this case was the “Police Professional Lability Policy.” The trial court found that there were ambiguities in the Policy and denied the insurer’s exceptions and motion for summary judgment. The insurance company appealed.
The appellate court stated that an insurance policy is a contract, construed according to the rules of interpretation of contracts. The insurer argued that the policy did not offer general liability coverage but only coverage for professional liability. The plaintiffs then argued that since the policy had ambiguous terms and definitions, the court could interpret it in favor of general coverage for the plaintiffs’ claims. A major aspect of the plaintiffs’ argument was that the exclusion for deputy sheriffs from workers’ compensation coverage factored into the parties’ intent and purpose for purchasing a liability insurance policy with the insurer.
The court here turned to whether there were conflicting terms of coverage in the policy. The policy makes clear that it covers negligence, the “neglect” of the named insured. The professional liability language used by the insurer for “professional skills and inherent risk” was not used to limit coverage in the policy.
As written, the court stated the policy could be interpreted in favor of coverage of the deputy sheriff. While the defendants wanted to limit coverage to “professional skills or inherent risks” of a Sheriff’s Department, the policy stated there is coverage for a Law Enforcement Wrongful Act. The court found that if the insurer intended to limit coverage, they would have been more specific in their definitions.
Next, the court assessed the insurer’s allegation that deputy sheriffs were employees and therefore “insured” under the Professional Liability Policy. It followed, the insurer argued, that sheriffs were prevented from recovering for claims by an insured against an insured. The appellate court upheld the lower court’s finding that deputy sheriffs were not employees for the purposes of recovering under insurance policies and against the Sheriff Department. Again, they cited the lack of recovery for injured sheriffs under workers’ compensation.
Regarding claims of ambiguity, the appellate court stated the policy had unclear definitions and exclusions, and they could be read differently. This created an inherent ambiguity in the policy. The insurer contended that the plaintiffs’ claims did not qualify for coverage. The plaintiffs alleged that the policy definitions were overly broad. The appellate court found the trial court did not err when it held ambiguities existed in the language of the policy.
The appellate court affirmed the trial court’s ruling, denying the motion for summary judgment and finding that the plaintiffs’ coverage for injuries and claims were properly covered under the Police Professional Liability Policy.
The Louisiana insurance bad-faith lawyers at Lavis Law have years of experience resolving claims for compensation following an accident, as well as insurance coverage disputes and claims of insurance bad faith. We offer a complimentary consultation, and our office can be reached by calling 866.558.9151.
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