Richard And Judith Williams v. United States Fire Insurance, Et Al.

Supreme Court of Louisiana
February 14, 2023
Chief Deputy Clerk of Court
For the Court
The Supreme Court of the State of Louisiana
RICHARD AND JUDITH WILLIAMS
VS.
UNITED STATES
FIRE INSURANCE, ET AL.
No. 2022-C-01637
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_ _ _ _
I
N RE: United States Fire Insurance Company - Applicant Defendant; Trip Mate,
Inc. - Applicant Defendant; Applying For Writ Of Certiorari, Parish of Rapides, 9th
Judicial District Court Number(s) 268,548, Court of Appeal, Third Circuit,
Number(s) CA2200071;
_ _ _ _ _ _
February 14, 2023
Writ application granted. See per curiam.
JBM
JLW
JDH
SJC
JTG
WJC
PDG
02/14/2023 "See News Release 007 for any Concurrences and/or Dissents."

S
UPREME COURT OF LOUISIANA
No
. 2022-C-01637
RI
CHARD AND JUDITH WILLIAMS
VS.
UNITED STATES FIRE INSURANCE, ET AL.
O
n Writ of Certiorari to the Court of Appeal, Third Circuit, Parish of Rapides
PE
R CURIAM.
This case is before the Court on a grant of summary judgment in plaintiffs’
favor on several issues. First, the lower courts determined that the insurance policy
at issue, a “Travel Protection Policy” issued by United States Fire Insurance
Company (“USFIC”) is a health and accident policy. Second, the lower courts
determined that the plaintiffs are entitled to coverage under USFIC’s policy; such a
finding necessarily required a determination that all conditions triggering coverage
under the policy were met. Third, the lower courts determined that USFIC (or Trip
Mate, identified by the court of appeal as USFIC’s adjuster) failed to timely pay the
plaintiffs’ claim under the policy. Lastly, the lower c ourts awarded both general
damages and penalties under La. R.S. 22:1821 A.
This Court recently reiterated the well- settled law regarding motions for
summary judgment:
A motion for summary judgment is a procedural device
used when there is no genuine issue of material fact for all
or part of the relief prayed for by a litigant. LSA -C.C.P.
art. 966(B)(2). As such, a motion for summary judgment
should only be granted if the motion, memorandum, and
supporting documents show that there is no genuine issue
as to any material fact and the mover is entitled to
judgment as a matter of law. LSA -C.C.P. art. 966(A)(3).
A genuine issue is one about which reason able persons
could disagree. Hines v. Garrett, 04-0806 (La. 6/25/04),
876 So.2d 764, rehearing denied, 04 -0806 (La. 9/24/04),
02/14/23

2

882 So.2d 1134. Only if reasonable persons could reach
only one conclusion is summary judgment on that issue
appropriate. A fact is “material” if it is one that would
matter at a trial on the merits. Suire v. Lafayette City -
Parish Consol. G ov’t, 04 -1459, 04 -1460, 04- 1466 (La.
4/12/05), 907 So.2d 37.

King v. Town of Clarks, 2021-01897, pp. 1-2 (La. 2/22/22), 345 So. 3d 422. Based
on the foregoing principles and the record before us, we find that the lower courts
erred in granting summary judgment in this case.
At the outset, we note that the lower courts erred as a matter of law in their
determination that the USFIC policy is a health and accident policy. Health and
accident insurance is defined by La. R.S. 22:47 (2)(a) as “insurance of human beings
against bodily injury, disablement, or death by accident or accidental means, or the
expense thereof, or against disablement, or expense resu lting from sickness or old
age. . . .”
Travel insurance, on other hand, is defined by La. R.S. 22:135 2 (12) to have
“the same meaning as in R.S. 22:1782.1.”
1 Under La. R.S. 22:1782.1 (3) (a):
“Travel insurance” . . . means insurance coverage for
personal risks incident to planned travel, including but not
limited to the following:

(i) Interruption or cancellation of a trip or event.

(ii) Loss of baggage or personal effects.

(iii) Damages to accommodations or rental vehicles.

(iv) Sickness, accident, disability, or death occurring
during travel.

A review of the USFIC policy reflects that it provides numerous coverages:
trip interruption; travel delay; accident and sickness medical expense ; emergency
medical evacuation; medical rep atriation and return of remains; non-medical
emergency evacuation; air flight only accidental death and dismemberment; baggage

1 “Travel insurance” also includes a “Travel protection plan.” La. R.S. 22:1352 (13) (a).

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and personal effects; and baggage delay . W here, as here, coverage for medical
treatment is incidental to other coverages provided by an insurance policy, it will not
be transformed into a health and accident policy.2 Thus, although the USFIC policy
includes coverage for certain medical expenses under its “accident and sic kness
medical expense” coverage, and “medical repatriation,” it is clearly a travel
insurance policy and not a health and accident policy.
Based on our finding that USFIC’s policy is a tr avel insurance policy , we
further find that, as a matter of law, the lower courts erred in awarding statutory
penalties. While we express no opinion as to whether the plaintiffs proved that
USFIC and/or Trip Mate failed to timely pay a claim under the fac ts of this matter
which would subject them to statutory penalties, it is patently obvious that t he
penalty provision of La. R.S. 22:1821 A is inapplicable in this matter. As that statute
plainly states, it only applies to “claims arising under the terms of health and accident
contracts. . . .” Id.
As concerns the remaining issues in this case, including whether plaintiffs
complied with the terms of the policy such that coverage was triggered for medical
repatriation, whether the plaintiffs timely and properly submitted a claim under the
policy, and whether USFIC and/or Trip Mate may be liable for any other penalties,
these are issues of f act for which summary judgment was inappropriate. We
therefore reverse the judgments of the lower courts and remand this matter to the
trial court for further proceedings consistent with this per curiam.

2 See, e.g., Carmouche v. Riverside Life Ins. Co ., 459 So. 2d 1353, 1354 (La. App. 3 Cir. 1984)
(life insurance policy providing coverage for disability is not a health and accident policy); Tarpley
v. Consol. Am. Life Ins. Co., 386 So. 2d 1067 (La. App. 3 Cir. 1980) ( although a life insurance
policy provided coverage for total, permanent disability, it is not a health and accident policy);
Woodard v. Prudential I ns. Co. of Am ., 350 So. 2d 948 (La. App. 2 Cir. 1977) (policy which
provided payment of loans in one lump sum to a credit union to discharge the borrower’s
indebtedness in the event the borrower became totally and permanently disabled is not a health
and accident policy policy); Johnson v. State Farm Mut. Auto. Ins. Co., 342 So. 2d 664, 668- 69
(La. 1977) (although an automobile insurance policy provided for total disability benefits, “the
policy…is not health and accident insurance…but, rather, vehicle insurance”); Miles v. Cent. Nat.
Ins. Co. of Omaha, 163 So. 2d 838 (La. App. 4 Cir. 1964) (although automobile insurance policy
contained a medical payments provision, it is not a health and accident policy).