Flanagan Partners prevails in major insurance case in the Louisiana Supreme Court.
Enrolling on appeal, the firm achieves a precedent-setting victory.
After the Supreme Court granted writs to review a favorable appellate ruling, Flanagan Partners enrolled on behalf of the plaintiffs in this putative class action. At issue was whether a major health insurer bore potential liability for losses sustained by an insured who was "balance billed" by an in-network healthcare provider. This was an issue of first impression in Louisiana. In briefing, Flanagan Partners emphasized the policy language, which promised deep discounts on covered healthcare if insureds sought treatment from favored providers. The insurer argued that any potential liability fell upon the providers alone. After full briefing and oral argument, the Supreme Court ruled for the insured. In a scholarly opinion, the Court engaged in a detailed analysis of the insurance policy, and it recognized the fundamental economic bargain between insurer and insured. If the insurer failed to deliver healthcare at discounted prices, which was a core object of the policy, it was potentially liable for breach of contract. Citing Civil Code article 1977 and the doctrine of promesse de porte fort, the Court explained that the insurer's reliance upon third parties to fulfill its contractual promises did not immunize it from liability. The case now proceeds to arguments on class certification in the district court. Emigh v. West Calcasieu Cameron Hosp., 2013-2985 (La. 7/1/14), 2014 WL 2937095.