Aaron Allen Stall v. Mercury Ins. Co. of Florida

STATE OF LOUISIANA
COURT OF APPEAL, THIRD CIRCUIT

17-439

AARON ALLEN STALL

VERSUS

MERCURY INS. CO. OF FLORIDA, ET AL.

**********

APPEAL FROM THE
FIFTEENTH JUDICIAL DISTRICT COURT
PARISH OF LAFAYETTE, NO. C-20144241
HONORABLE JULES DAVIS EDWARDS, DISTRICT JUDGE

**********

JOHN E. CONERY
JUDGE

**********

Court composed of Marc J. Amy, Elizabeth A. Pickett, Shannon J. Gremillion,
John E. Conery, and Candyce G. Perret, Judges.

Pickett, J., dissents and assigns written reasons.
Amy, J., dissents and assigns reasons.

REVERSED AND REMANDED.

Robert I. Siegel
Michael E. Hill
Tara E. Clement
Gieger, Laborde & Laperouse, LLC
701 Poydras Street, Suite 4800
New Orleans, Louisiana 70139-4800
(504) 561-0400
COUNSEL FOR DEFENDANT/APPELLANT:
National Union Fire Insurance Co. of Pittsburgh, PA

J. Lomax Jordan, Jr.
Victor R. A. Ashy
1817 West University Avenue
Lafayette, Louisiana 70506
(337) 233-9984
COUNSEL FOR PLAINTIFF/APPELLEE:
Aaron Allen Stall

CONERY, Judge.

FACTS AND PROCEDURAL HISTORY

Aaron Stall, an employee of CVS Caremark Corporation, and Gustavo

Garcia-Jimenez were involved in a two-vehicle accident on January 1, 2014. Mr.

Stall was operating a vehicle provided by CVS. National Union Fire Insurance

Company of Pittsburgh, Pennsylvania issued a business auto policy to CVS that

covered the vehicle and its employee/driver, Mr. Stall. Mr. Stall filed suit against

Mr. Garcia-Jimenez and his alleged insurer, Mercury Insurance Company of

Florida.1 He also sued National Union, among others, alleging that Mr. Garcia-

Jimenez was at fault, was uninsured or underinsured, and National Union’s

uninsured/underinsured policy provided coverage for the accident. National Union

denied coverage, claiming the policy issued to CVS insuring the CVS vehicle Mr.

Stall was driving contained a proper waiver of uninsured or underinsured (UM)

coverage.

Mr. Stall filed a motion for partial summary judgment, alleging that the UM

waiver produced by National Union in discovery was defective. However, there

was no dispute that the waiver was executed on a form provided by the Louisiana

Department of Insurance and signed by “David Huntley” in the space provided for

the named insured or representative. Mr. Huntley’s printed, handwritten name

also appears on the form in the proper space. It is dated December 19, 2012. Mr.

Huntley’s initials appear in the blank waiving UM coverage, all in compliance with

the form prepared by the Louisiana Department of Insurance for such purposes.

1
Mr. Garcia-Jimenez owned a Chrysler Pacifica Touring Utility 4x24D, which was
insured by Mercury Insurance Company of Florida, until his policy was cancelled on October 7,
2013, due to non-payment of his insurance premium.

The evidence presented in connection with the hearing on the motion for

partial summary judgment on the issue of the validity of the UM waiver showed

that the policy for which the UM waiver was purportedly executed on December

19, 2012, was in effect from January 1, 2013, through January 1, 2014, at 12:01

a.m. The accident at issue occurred at 1:29 a.m. on January 1, 2014, after that

policy had expired. The policy was timely renewed before the accident, and the

new policy was effective January 1, 2014 through January 1, 2015, at 12:01 a.m.,

and issued by AIG/National Union. However, a UM waiver for the renewal policy

was not executed until February 21, 2014, several weeks after the accident at issue

herein, and hence, on its face, the UM waiver attached to that policy was signed

too late to be effective. National Union claims that since the 2014/2015 policy was

a renewal, the UM waiver executed on December 19, 2012 for the 2013/2014

policy year was still binding pursuant to specific statutory law so providing.2

Following the hearing on Mr. Stall’s motion for partial summary judgment,

the trial court found that the UM waiver was not valid. In written reasons, the trial

court stated:

The Court granted the Motion for Partial Summary Judgment
filed on behalf of Aaron Stall and held that the waiver of
uninsured/underinsured motorist coverage executed by David Huntly
[sic] as legal representative to CVS on December 19, 2012, did not
clearly and unmistakably waive uninsured/underinsured motorist
coverage under the policy issued. Accordingly, the Court held that
the waiver was invalid and inapplicable to preclude
uninsured/underinsured motorist coverage for the accident that
occurred on January 1, 2014.

2
Louisiana Revised Statutes 22:1295(1)(a)(ii) provides in pertinent part:

The form signed by the insured or his legal representative which initially rejects
coverage, selects lower limits, or selects economic-only coverage shall remain
valid for the life of the policy and shall not require the completion of a new
selection form when a renewal, reinstatement, substitute, or amended policy is
issued to the same named insured by the same insurer or any of its affiliates.

2

The waiver at issue cast [sic] doubt as to which policy it was
applicable to. The policy existing at the time the waiver was executed
was insured by Chartis. The policy existing at the time of the accident
and at the time a second waiver was signed after the accident on
February 21, 2014, was insured by AIG/National Union. The 2012
waiver did not have the policy listed on it; however failure to list the
policy number on the waiver is not a sole basis for finding the waivers
ambiguous. The waivers also did not contain the name of the current
policy issuer; the 2012 waivers named Chartis, not AIG/National
Union.

The Court found that the totality of the facts at issue and the
form of the purported waiver of uninsured/underinsured motorist
coverage made the waiver unclear and mistakable. Accordingly, the
Court found that the uninsured/underinsured coverage waiver was
invalid.

The trial court certified the ruling as final and appealable. National Union

now timely appeals the judgment of the trial court. For the following reasons, we

reverse, finding that there is a genuine issue of material fact as to whether a valid

UM waiver was properly executed.

ASSIGNMENT OF ERROR

National Union asserts one assignment of error on appeal: “The trial court

erred in granting Plaintiff’s Motion for Summary Judgment on the validity of the

UM/UIM waiver form.”

DISCUSSION

Summary judgment motions must be filed using the procedures set forth in

La.Code Civ.P. art. 966, and “shall be granted if the motion, memorandum, and

supporting documents show that there is no genuine issue as to material fact and

that the mover is entitled to a judgment as a matter of law.” La.Code Civ.P. art.

966(A)(3).

Louisiana Revised Statutes 22:1295 (emphasis added), which governs

uninsured motorist coverage, states in pertinent part:

3

The following provisions shall govern the issuance of uninsured
motorist coverage in this state:

(1)(a)(i) No automobile liability insurance covering liability
arising out of the ownership, maintenance, or use of any motor vehicle
shall be delivered . . . unless coverage is provided therein or
supplemental thereto[ ] . . . for the protection of persons insured
thereunder who are legally entitled to recover nonpunitive damages
from owners or operators of uninsured or underinsured motor vehicles
because of bodily injury, sickness, or disease, including death
resulting therefrom[.]
(ii) Such rejection . . . shall be made only on a form prescribed
by the commissioner of insurance. The prescribed form shall be
provided by the insurer and signed by the named insured or his legal
representative. The form signed by the named insured or his legal
representative which initially rejects such coverage[ ] . . . shall be
conclusively presumed to become a part of the policy or contract
when issued and delivered, irrespective of whether physically attached
thereto. A properly completed and signed form creates a
rebuttable presumption that the insured knowingly rejected
coverage[.] . . . The form signed by the insured or his legal
representative which initially rejects coverage[ ] . . . shall remain
valid for the life of the policy and shall not require the completion
of a new selection form when a renewal, reinstatement, substitute,
or amended policy is issued to the same named insured by the
same insurer or any of its affiliates. . . . For the purpose of this
Section, a new policy shall mean an original contract of insurance
which an insured enters into through the completion of an application
on the form required by the insurer.

This court discussed appellate review of a motion for summary judgment in

the context of a UM waiver case in Hayes v. De Barton, 16-541, pp. 2-3 (La.App.

3 Cir. 2/15/17), 211 So.3d 1275, 1278, writ denied, 17-458 (La. 5/1/17), 220 So.3d

743:

An appeals court reviews summary judgments de novo, using
the same criteria as the trial court. Gray v. Am. Nat'l Prop. & Cas.
Co., 07-1670 (La. 2/26/08), 977 So.2d 839. In order to prevail on a
motion for summary judgment, the moving party must show that
“there is no genuine issue of material fact and that he is entitled to
judgment as a matter of law.” La.Code Civ.P. art. 966(A)(3).

Generally, interpretation of an insurance contract concerns a
legal question that can be resolved in the framework of a motion for
summary judgment. Cutsinger v. Redfern, 08-2607 (La. 5/22/09), 12
So.3d 945. Insurance policies are interpreted according to the general

4

rules of contract interpretation, and liability insurance policies are
interpreted to provide coverage not deny coverage. Supreme Servs. &
Specialty Co., Inc. v. Sonny Greer, Inc., 06-1827 (La. 5/22/07), 958
So.2d 634.

Louisiana law provides that “[n]o automobile liability
insurance” policy shall be issued in the state unless it provides UM
coverage for persons injured in accidents involving “owners and
operators of uninsured or underinsured motor vehicles.” La.R.S.
22:1295(1)(a)(i). This law embodies a strong public policy to allow
innocent automobile accident victims to fully recover their damages.
Cutsinger, 12 So.3d 945. “Thus, under the UM statute, the
requirement of UM coverage is an implied amendment to any
automobile liability policy, even when not expressly addressed, as
UM coverage will be read into the policy unless validly rejected.”
Duncan v. USAA Ins. Co., 06-363, p. 4 (La. 11/29/06), 950 So.2d 544,
547.

“The liberal construction given the UM statute requires the statutory

exceptions to the coverage requirement be interpreted strictly. Any exclusion from

coverage in an insurance policy must be clear and unmistakable.” Roger v. Estate

of Moulton, 513 So.2d 1126, 1130 (La.1987).

In Duncan v. U.S.A.A. Ins. Co., 06-363, p. 4 (La. 11/29/06), 950 So.2d 544,

551, the supreme court held that the UM waiver form promulgated by the

Louisiana Department of Insurance then in effect required the presence of six

elements to be valid:

(1) initialing the selection or rejection of coverage chosen; (2) if limits
lower than the policy limits are chosen (available in options 2 and 4),
then filling in the amount of coverage selected for each person and
each accident; (3) printing the name of the named insured or legal
representative; (4) signing the name of the named insured or legal
representative; (5) filling in the policy number; and (6) filling in the
date.

Since Duncan, the Department of Insurance has amended the UM waiver

form. When the amended form was issued, the Commissioner of the Department

of Insurance simultaneously issued LDOI Bulletin No. 08-02 (emphasis added),

which stated:

5

Policy number and other policy identification information - The
revised UM form includes two boxes on the lower right hand corner
of the form.

- The upper box contains an area that the insurer may use for policy
information purposes (e.g. policy number, binder number,
application number, etc.) This box does not need to be filled in
for the form to be properly completed.

Accordingly, National Union argues that the requirement in Duncan that the policy

number appear on the form was abrogated by the Department of Insurance.

The sole issue in this case is whether there remains an issue of fact as to the

validity and sufficiency of the UM waiver completed by Mr. Huntley on December

19, 2012, and whether that UM waiver applied to the renewal policy and excluded

UM coverage for the accident that occurred on January 1, 2014.

National Union argues that the form is sufficient because the option to waive

coverage is initialed and signed by Mr. Huntley, whom it claims is a legal

representative of CVS. Mr. Huntley’s name is properly printed below the

signature in the box the commissioner’s form provided for the named insured or

legal representative to sign, the form is properly initialed rejecting UM coverage,

and is dated. Having presented a properly completed and signed form, National

Union argues that it is entitled to a rebuttable presumption that UM coverage was

validly waived for the renewal policy issued by AIG/National Union, effective

January 1, 2014 through January 1, 2015.

Mr. Stall argues that the UM coverage waiver is unclear and mistakable

because it does not adequately reference the underlying policy. He further argues

that while the form purports to meet the requirements enunciated by the

Department of Insurance, the form completed by Mr. Huntley lacks sufficient

information to connect it to the underlying policy because it does not include the

6

name of the named insured or a policy number. Further, the name of the insurance

group printed on the 2012 form, Chartis, is different from the name of the group

that issued the 2014-2015 renewal policy, AIG. Finally, Mr. Stall pointed out at

the hearing on the motion for partial summary judgment that there is no evidence

in the record before the court that showed who Mr. Huntley is or in what capacity

he signed the waiver of UM coverage.

In Harper v. Direct Gen. Ins. Co., 08-2874 (La. 2/13/09), 2 So.3d 418, the

supreme court held that when a legal representative signs a UM coverage waiver

form and the name of the corporate insured is printed on the form, it is unnecessary

for the name of the insured to be included on the form. The court specifically

pointed out that the disjunctive “or” is used in La.R.S. 22:1295(1)(a)(ii) (emphasis

added): “named insured or legal representative.” Harper, 2 So.3d at 420. It was

unnecessary for the form to include the named insured and the name of the legal

representative who signs on behalf of the named insured.

Similarly, in Banquer v. Guidroz, 09-466 (La. 5/15/09), 8 So.3d 559, the

supreme court found a UM coverage waiver was valid where the name of the

person who signed the form did not appear on the form, but the name of the

corporation on whose behalf he was acting did appear on the form. We note that in

both Harper and Guidroz, the UM insurer introduced unrefuted affidavits stating

the name of the legal representative and the fact that they had the authority to act

on behalf of the named insured. Similar affidavits were not produced in this case;

however, we are not ruling on National Union’s motion. “A summary judgment

may be rendered or affirmed only as to those issues set forth in the motion under

consideration by the court at that time.” La.Code Civ.P. art. 966(F). National

Union notes that in this case the UM waiver was actually attached to the 2013

7

policy at issue and introduced into evidence at the summary judgment hearing, thus

creating a rebuttable presumption that the otherwise properly executed UM waiver

was valid. We agree.

The “CVS Caremark’s Privilege Log for Documents Produced by Marsh,”

the insurer’s agent, in response to the Subpoena Duces Tecum issued by Mr. Stall,

references Policy Number 519-62-34, valid from January 1, 2013 to January 1,

2014 at 12:01 a.m., and its renewal Policy Number 706-27-98, valid from January

1, 2014 to January 1, 2015 at 12:01a.m. Although the entirety of Policy Number

519-62-34 is not part of Mr. Stall’s submissions in support of his partial motion for

summary judgment, the December 19, 2012 UM waiver immediately follows the

“CERTIFICATE OF LIABILITY INSURANCE” form dated 12/28/2012 for

“CVS CAREMARK CORPORATION” as a portion of the attachments filed on

October 24, 2016, and properly introduced into evidence by Mr. Stall’s counsel in

connection with the summary judgment hearing.

Further, in support of National Union’s opposition to Mr. Stall’s motion for

partial summary judgment filed on November 28, 2016, National Union filed into

the record the entirety of the policies at issue, covering the period from January 1,

2013 through January 1, 2015 at 12:01 a.m., with the UM waiver properly

attached. The renewal Policy Number 706-27-98, valid from January 1, 2014 to

January 1, 2015 at 12:01 a.m., is applicable to the accident at issue occurring on

January 1, 2014, and “shall remain valid . . . and shall not require the completion of

a new selection form when a renewal . . . policy is issued to the same named

insured by the same insurer or any of its affiliates.” La.R.S. 22:1295(1)(a)(ii).

In Nat’l Interstate Ins. Co. v. Collins, 08-693 (La.App. 1 Cir. 2/13/09), 9

So.3d 881, the first circuit held that the owner of a bus company did not validly

8

waive UM coverage where the form he signed included neither the name of the

insured company nor a statement that the signatory was signing in a representative

capacity. The supreme court granted a writ of certiorari and summarily reversed,

stating:

We find the Uninsured/Underinsured Motorist Bodily Injury
Coverage Form in this matter satisfies the six-part test enunciated in
Duncan v. U.S.A.A. Ins. Co., 06-363 (La. 11/29/06), 950 So.2d 544;
see Harper v. Direct General Insurance Company, et al., 08-2874
(La.2/13/09), 2 So.3d 418. While the facts in Harper are
distinguishable from this matter in that the named insured was printed
on the form, Harper reiterates that in Duncan this Court used the
disjunctive “or” with regard to the completion of task “3” stating that
“printing the name of the named insured or legal representative”
satisfies task “3.” Harper, 2 So.3d at 419. As such, because there
was no question as to which policy was involved and the legal
representative’s name was printed on the waiver form, it is valid. The
Court of Appeal’s ruling is reversed and the judgment of the trial
court is reinstated.

Nat’l Interstate Ins. Co. v. Collins, 09-1214 (La. 11/6/09), 21 So.3d 316 (emphasis

added).

In that case, the policy number was on the UM waiver form and the supreme

court found that there was no question that the owner of the bus company intended

to waive UM coverage for the bus company. Similarly, in this case, the UM

waiver was incorporated into the renewals of all policies at issue and filed in

evidence with the entire applicable policies by National Union.

Likewise, a panel of this court found that UM coverage was validly waived

in Weems v. Houston Specialty Ins. Co., 17-14 (La.App. 3 Cir. 5/17/17), 222 So.3d

728, writ denied, 17-1038, (La. 10/9/17), 227 So.3d 836. In Weems, “Tim Moran”

signed a UM coverage waiver for a policy provided to Cane River Construction

LLC and printed his own name on the form. The form did not include the policy

9

number. In finding that the form met the requirements of LDOI Bulletin No. 08-

02, this court stated:

Certain facts pertaining to the execution of the UM waiver are
undisputed. Mr. Tim Moran was the owner and principal of Cane
River in 2011, and was authorized to either accept or reject UM
coverage on behalf of Cane River when he obtained the automobile
bodily injury liability insurance policy at issue. Mr. Moran negotiated
with Moreman Moore’s agent, Mr. Dickerson, in order for Cane River
to secure insurance coverage.

Weems, 222 So.3d at 729.

As part of the summary judgment evidence in this case, plaintiff alleged, and

defendant admitted that the policies produced by the insured’s agent and

introduced in evidence at the summary judgment hearing were in force and effect

and did provide liability coverage at the time of the collision. There was no

dispute that the 2014 policy was a renewal of the 2013 policy, and that the UM

waiver on the form provided by the Commissioner was executed and attached to

that policy. In its brief on appeal, counsel for National Union agreed that the UM

waiver attached to the 2014 policy was dated after the accident in question, but

noted that the UM waiver attached to the 2013 policy applied to the 2014 policy

renewal pursuant to La.R.S. 22:1295(1)(a)(ii) (emphasis added), which does not

require “the completion of a new selection form when a renewal, reinstatement,

substitute, or amended policy is issued to the same insured by the same insurer or

any of its affiliates.” Here, there is no dispute that National Union provided the

coverage in 2012, 2013, 2014, and 2015, as shown by the policies in evidence, and

that La.R.S. 22:1295(1)(a)(ii) applies to the policies at issue. The underlying

liability and UM policy limits admittedly did not change when the policy was

renewed.

Counsel for plaintiff and the trial court noted that the printed name of the

10

insurer on the 2012 policy was “Chartis,” while the printed name on the renewal

policy in 2014 was “AIG/National Union.” All policies are in evidence and show

that the affiliated company actually issuing the policy is National Union, the entity

plaintiff named in his suit as the proper UM carrier for CVS, the named insured.

We find no merit to plaintiff’s argument that the difference in printed names on the

bottom of the UM waiver is significant and creates uncertainty, but if it does,

again, that presents an issue of fact making summary judgment improper as to

plaintiff’s motion.

In Fontenot v. American Home Assurance Co., 12-243 (La.App. 1 Cir.

11/15/12) (unpublished opinion), writ denied, 12-2704 (La. 2/8/13), 108 So.3d 90,

a panel of the first circuit held that the UM statute does not require the execution of

an affidavit attesting to the validity of the UM waiver form or the authority of the

representative who signed the form.

Finally, the recent decision in the United States District Court, W.D. District

Louisiana, Osborne v. Benson, No. 6:15-CV-02845, 2017 WL 4365821, (W.D. La.

9/29/17) was brought to our attention by counsel for National Union in a post-

argument letter brief. In that case, the trial judge held that the LDOI Bulletin 08-

02, which provides mandatory instructions for a complete and valid UM form,

“does not contain a requirement for an affidavit, nor any further evidence

confirming the name of the authorized representative.” Osborne, 6:15-CV-02845,

2017 WL 4365821, at * 5 (W.D. La. 9/29/17).

In this case, it is undisputed that the named insured is CVS. David Huntley

did print his name in the exact space on the Commissioner’s form provided for the

named insured, and then signed his name properly in the space labeled “signature.”

The rejection of UM coverage was likewise clearly initialed by Mr. Huntley on the

11

form. This form is attached to and forms part of the policy plaintiff alleges

provides UM coverage, and all policies in question are in evidence.

As in Collins, 21 So.3d 316, we find that the UM rejection form is

presumptively valid in this case even though the representative capacity of the

signatory was not placed on the form. The supreme court noted that “printing the

name of the named insured or legal representative” on the form was sufficient.

Collins, 21 So.3d 316 (emphasis added) (quoting La.Code Civ.P. art. 966(D)).

See also Fontenot, 21 So.3d 316, and Osborne, 2017 WL 4365821.

National Union filed a cross motion for partial summary judgment on this

issue, but it has not yet been heard. Thus, we are addressing only plaintiff’s

motion at this time. As to that motion, we find that the UM waiver is

presumptively valid. At the very least, on the record before us there is a genuine

issue of material fact as to the authority of Mr. Huntley to sign the waiver on

behalf of CVS.

CONCLUSION

For the foregoing reasons, we hereby reverse the trial court’s ruling granting

partial summary judgment on the issue of the validity of the UM waiver and

remand the case to the trial court for further proceedings. All costs are assessed to

plaintiff, Aaron Allen Stall.

REVERSED AND REMANDED.

12

NUMBER 17-439

COURT OF APPEAL, THIRD CIRCUIT

STATE OF LOUISIANA

AARON ALLEN STALL

VERSUS

MERCURY INS. CO. OF FLORIDA, ET AL.

AMY, J., dissenting.

I respectfully dissent from the majority opinion, as I find that an affirmation

is appropriate. Reference to the burden of proof is critical in this case. The

plaintiff filed the underlying motion for summary judgment. In this regard,

La.Code Civ.P. art. 966(D)(1) provides that the burden of proving entitlement to

summary judgment rests with the mover. However, pertinent to this case, Article

966(D)(1) further provides that:

[I]f the mover will not bear the burden of proof at trial on the issue
that is before the court on the motion for summary judgment, the
mover’s burden on the motion does not require him to negate all
essential elements of the adverse party’s claim, action, or defense, but
rather to point out to the court the absence of factual support for one
or more elements essential to the adverse party’s claim, action, or
defense. The burden is on the adverse party to produce factual
support sufficient to establish the existence of a genuine issue of
material fact or that the mover is not entitled to judgment as a matter
of law.

Of course, National Union, as the insurer, would bear the burden of proving at trial

that the named insured rejected UM coverage equal to the bodily injury coverage

or that it selected lower limited coverage. Gray v. Am. Nat’l Prop. & Cas. Co., 07-

1670 (La. 2/26/08), 977 So.2d 839 (quoting Duncan v. U.S.A.A. Ins. Co., 06-0363

(La. 11/29/06), 950 So.2d 544).

In my opinion, and for reasons more specifically addressed by Judge Pickett

in her dissent, the plaintiff adequately pointed out an absence of factual support for

National Union’s claim of a valid UM waiver. Namely, the waiver form lacked a

policy number, the name of the insured, or any indication of the signatory’s

authority. Thus, it was incumbent on National Union, as the party that would be

required to bear the burden of proof at trial, “to produce factual support sufficient

to establish the existence of a genuine issue of material fact or that the mover is not

entitled to judgment as a matter of law.” La.Code Civ.P. art. 966(D)(1). However,

and given the deficiencies of the UM waiver form, National Union failed to

produce further factual support establishing the existence of a genuine issue of

material fact as to the validity—or rather invalidity—of that waiver. Rather,

National Union’s opposition to the motion for summary judgment was silent as to

those deficiencies. Thus, in my opinion, National Union failed to satisfy the

requirements of La.Code Civ.P. art. 966(D)(1) in its opposition to the plaintiff’s

motion for summary judgment, and the trial court’s ruling must be affirmed.

2

STATE OF LOUISIANA
COURT OF APPEAL, THIRD CIRCUIT

17-439

AARON ALLEN STALL

VERSUS

MERCURY INSURANCE COMPANY OF FLORIDA, ET AL.

Pickett, J., dissents and assigns reasons.

I respectfully dissent from the majority’s opinion.

I join Judge Amy’s dissent, which concludes that the burden of proof rests

with National Union to prove a valid waiver of UM coverage. Based on the

totality of circumstances in this case, I find the UM coverage waiver produced by

National Union is insufficient to prove that CVS clearly and unmistakably waived

UM coverage. The form signed by Mr. Huntley on December 19, 2012, lacks any

indicia of connexity with the policy in force on January 1, 2014, when the accident

at issue in this case occurred. There is no policy number to reference the UM

waiver form to the original 2013-2014 policy or the 2014-2015 renewal policy, as

in National Interstate Insurance Co. v. Collins, 08-693 (La.App. 1 Cir. 2/13/09), 9

So.3d 881, reversed, 09-1214 (La. 11/6/09), 21 So.3d 316. The name of the

insured, CVS, which would link the UM coverage waiver to the underlying policy

is not on the form. There is nothing on the form to indicate that Mr. Huntley is

signing the form as an agent for CVS. Finally, unlike the signatory in Weems v.

Houston Specialty Insurance Co., 17-14 (LaApp. 3 Cir. 5/17/17), 222 So.3d 72,

there is no showing that Mr. Huntley had the capacity to act on behalf of CVS.

Because National Union failed to prove that a valid UM coverage waiver

was executed for the National Union policy in force on January 1, 2014, I would

affirm the judgment of the trial court.