Source: https://www.jeremywrichter.com/page/32/
Timestamp: 2019-04-19 03:27:04+00:00

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When Does an Insurer Become Obligated to Make Medical Payments?
In Alabama, an insurance company becomes obligated to make medical payments when its insured suffers a bodily injury and incurs medical bills resulting from treatment of the injury.
As with any general conversation about insurance coverage, there is a giant caveat that must be stated – the outcome of any coverage question depends on the specific language of a particular policy.
With that being said, typically in Alabama, medical payments (“med-pay”) coverage is written into auto policies. Unlike other types of coverage, med-pay is “no-fault” coverage. The med-pay provision of a personal auto insurance policy does not require that an insured be legally entitled to recover in order for medical payments to be made. Med-pay coverage typically simply requires that in order for medical payments to be made, the insured must have incurred necessary medical expenses subsequent to a bodily injury caused by an accident.
An insurer may decline to make medical payments if it determines either that the insured did not sustain a bodily injury caused by an accident, or that the insured, subsequent to an accident, did not incur medical bills within the timeframe identified in the policy. However, in order to maintain this position, the insurer must through the course of a claim (or subsequent litigation) continue to assert its denial and cannot admit that the insured has suffered a bodily injury as defined in the policy.
In short, an insurer becomes obligated to make medical payments when its insured suffers a bodily injury, as defined in the medical payments provision of the auto policy, in an accident (regardless of fault) and thereafter incurs medical expenses in the treatment of that injury.
Board of Zoning Adjustment of the City of Huntsville v. Janet M. Watson: Where a landowner has self-created a hardship pertaining to zoning ordinances, this hardship cannot serve as the basis for seeking a zoning variance.
On August 12, 2016, the Alabama Court of Civil Appeals decided the matter of Board of Zoning Adjustment of the City of Huntsville v. Janet M. Watson [Ms. 2150314], — So.3d — (Ala.Civ.App. 2016). The issu e before the court was whether a self-inflicted hardship that runs with the land creates an undue hardship that should be remedied with a zoning variance.
The lot in question had previously been a part of a much larger parcel of land. The larger parcel was divided into a subdivision in 2002, with the subject parcel being carved out and retained by Watson. At the time this decision was made, Watson knew that the subject parcel did not conform with the R1-A zoning designation and would disallow residential construction from occurring on the property due to the lot size. Nevertheless, Watson was hoping to sell the parcel in the future when adjacent land was developed. Unfortunately for Watson, the adjacent land has never been developed.
In 2013, a prospective buyer, Cantrell, offered to purchase the subject parcel, contingent on Watson obtaining a variance from the zoning board that would allow residential construction on the property. Watson petitioned the zoning administrator for the City of Huntsville, who denied her request for a variance; she then appealed that decision to the Board of Zoning Adjustment of the City of Huntsville, who likewise deemed her land to be non-conforming and denied a variance.
Watson appealed to the Madison County Circuit Court, who overruled the Board and ordered that a variance be granted. The Board then appealed to the Alabama Court of Civil Appeals, arguing that the variance being sought by Watson was based on a claim of “unnecessary hardship” that does not meet the definition of the term as applied by the courts. Specifically, the Supreme Court of Alabama has “repeatedly recognized that variances should be granted sparingly, and only under unusual and exceptional circumstances where the literal enforcement of the ordinance would result in unnecessary hardship.” Bd. of Zoning Adjustment for Fultondale v. Summers, 814 So.2d 851, 855 (Ala. 2001). The Board further argued that because Watson’s hardship was self-created, it could not serve as the basis for granting a variance.
The appellate court found the evidence to be undisputed that Watson had elected to create the subject parcel such that it would be too small to contain a house in accordance with the applicable zoning ordinance and that she had excluded the subject parcel from inclusion in the platted subdivision. It then held that there is no authority for the proposition that a property owner can self-create a hardship that would run with the land and then seek a variance under a claim of undue or unnecessary hardship. Moreover, Alabama law establishes affirmatively that a self-inflicted hardship cannot serve as a basis for a variance. As such, the trial court had erred in ordering a variance and the matter was remanded back to the trial court.
Ex parte North American Adjusters, Inc.: In Alabama under Alabama Rule of Civil Procedure 38, a jury demand is required to be endorsed, but not signed.
It’s time for a bit of transparency – in my years of practice, it hasn’t occurred to me to question the sufficiency of a jury demand. Maybe it should have. And maybe I didn’t question it because, in all but a handful of instances, I wanted my case to be tried by a jury. But recently in Alabama the question arose of whether a jury demand was sufficient if it was only endorsed and not signed.
In April 2016, the Supreme Court of Alabama decided the matter of Ex parte North American Adjusters, Inc. [Ms. 1150278], — So.3d — (Ala. 2016), wherein the Court decided whether an unsigned jury demand endorsement on the plaintiff’s complaint was sufficient to entitle the plaintiff to a trial by jury.
In the underlying case Jeffery Saulsberry v. Green Tree Financial, LLC, In the Circuit Court of Wilcox County, CV-2013-000007, filed a complaint, and included at the end a demand for “A Trial By a Struck Jury” and in each of his claims, he asserted that damages were to be determined by jury. Saulsberry, in an amended complaint, attempted to withdraw his jury demand on the that it was “without proper attestation.” North American Adjusters was opposed to the withdrawal of the jury demand and argued that the demand had been properly attested under Alabama Rule of Civil Procedure 38(d), which reads in pertinent part: “A demand for trial by jury made as herein provided may not be withdrawn without the consent of that parties….” North American Adjusters did not consent to withdrawal of the jury demand. The trial court ruled against North American Adjusters, finding that the jury demand was not endorsed (signed).
The Court further found that Saulsberry had timely filed his endorsed jury demand, and thus he could not withdraw the jury demand without consent of the parties. Therefore, the trial court exceeded its discretion in denying a jury trial.
If you practice takes you to federal court, Federal Rule of Civil Procedure 38 requires that a jury demand be served on the other parties in writing, but likewise does not require that it be signed.
Leesburg Yarn Mills, Inc. v. Thomas Hood: Under the Alabama Workers’ Compensation Act, cumulative trauma may result in a compensable injury.
In 2016, the Alabama Court of Civil Appeals decided the matter of Leesburg Yarn Mills, Inc. v. Thomas Hood [Ms. 2140888], — So.3d — (Ala.Civ.App. 2016), wherein the trial court found that Thomas Hood had suffered a compensable injury under the Alabama Workers’ Compensation Act (Ala. Code § 25-5-1) and accordingly, awarded compensation and medical benefits to Hood. Hood had been employed by Leesburg for approximately twenty-three (23) years, and continued to be employed by Leesburg during the trial of this matter. While Hood did not suffer an acute injury during his employment, he ultimately developed trigger finger and contended that his duties at Leesburg Yarn Mills exposed him to a greater risk of incurring trigger finger than was experienced by other persons not working in that job.
In matters of gradual deterioration or cumulative stress, an employee must establish through legal and medical causation by clear and convincing evidence. that his injury falls under the Workers’ Compensation Act. See Safeco Ins. Cos. v. Blackmon, 851 So.2d 532, 537 (Ala.Civ.App. 2002); see also Ex parte McInish, 47 So.3d 767, 778 (Ala. 2008). The trial court agreed that the cumulative trauma Hood experienced in his manual labor, involving repetitive motion (including pinching and grasping – he operated twenty-four carding machines and was responsible for transporting cans of cotton between various stations in the plant) as a routine part of his job over an extended period of time, caused his injury. To establish legal causation, “one seeking redress under the Workers’ Compensation Act for ‘nonaccidental’ injuries need only establish that the performance of his or her duties as an employee exposed him or her to a danger or risk materially in excess of that to which people are normally exposed in their everyday lives.” Ex parte Trinity Indus., Inc., 680 So. 2d 262, 269 (Ala. 1996).
Upon review by the Alabama Court of Civil Appeals, the appellate court held that where the trial court could reasonably be clearly convinced that an employee’s cumulative trauma that developed over the course of his employment legally and medically caused an injury, a finding of a compensable injury and awarding of compensation and medical benefits under the Alabama Workers’ Compensation Act is appropriate.
Ex parte Lowe’s Home Centers, LLC: Under Alabama worker’s compensation law, a court finding of a compensable injury without assigning disability or benefits is inadequate.
In 2016 the Alabama Court of Civil Appeals decided the matter of Ex parte Lowe’s Home Centers, LLC [Ms. 2140885], — So.3d — (Ala.Civ.App. 2016), holding that in a worker’s compensation matter, a court order finding that the employee had suffered a compensable injury and ordering the employer to pay for necessary medical treatment, but failing to determine the extent of disability (if any) the employee has suffered as a result of the injury or the benefits (if any) to which the employee is entitled, is inadequate and immediately appealable via writ of mandamus.
George E. Cutler v. University of Alabama Health Services Foundation, P.C., and Paul G. Matz, M.D.: A legal injury occurs, not when the harm manifests itself, but rather when the malpractice itself occurs.
On July 8, 2016, the Supreme Court of Alabama entered its decision in George E. Cutler v. University of Alabama Health Services Foundation, P.C., and Paul G. Matz, M.D., [Ms. 1150546], — So.3d — (Ala. 2016), in a medical malpractice action. The alleged medical malpractice occurred on June 28, 2005, when the defendants, Cutler and UAHSF, failed to inform Cutler about a tumor in his brain. Cutler filed his Complaint more than ten years later, on October 14, 2015, alleging that his cause of action did not accrue until February 11, 2015, when he first suffered a legal injury, in the form of a seizure that required surgical resection of the tumor.
Cutler alleges, that because the malpractice and resulting injury did not occur simultaneously, the applicable limitations period (as set forth in Alabama Code § 6-5-482, establishing a four-year statute of repose) did not begin to run until the legal injury occurred. Under Alabama law, in medical malpractice actions, the legal injury occurs at the time of the negligent act or omission, regardless of whether the injury is or could be discovered within the statutory period. See Ex parte Hodge, 153 So.3d 734 (Ala 2014); Ex parte Sonnier, 707 So.2d 635 (Ala. 1997).
It was therefore the Court’s determination that Cutler first suffered a legal injury caused by the defendants’ failure to inform him of the tumor on June 28, 2005, and that based on Cutler’s allegations, he suffered a legal injury (the harmful growth of the tumor) within four years following June 2005, rather than the injury occurring in February 2015, as alleged by Cutler. Consistent with its prior opinions, the Court held that the legal injury occurred at the time of the malpractice, not at the time of the manifestation of the suffered harm. Applying its finding, the Court held that Cutler would be unable to prove any set of facts to support his contention that his legal injury occurred after the expiration of the four-year statute of repose.
I was recently confronted with a situation in which I had to determine whether the driver of an all-terrain vehicle could be liable for an injury sustained by his passenger when he wrecked the ATV upon entering a highway. If the situation had involved a car, truck, or other vehicle made to operate on highways, the answer would have been easy – unless the driver was acting recklessly, no.
Alabama has a law commonly known as the guest-passenger statute (Alabama Code (1975) § 32-1-2) whereby the operator of a motor vehicle is not liable for loss or damaging arising from injuries to or death of a guest while being transported. There are certain caveats. If the death or injury was a result of driver’s willful or wanton misconduct, he can still be liable. If the guest has paid for the transportation, the driver can be liable.
The fly in the ointment in my scenario was whether Alabama law recognizes ATVs as motor vehicles. The State of Alabama defines a motor vehicle (in pertinent part) as: “Every self-propelled vehicle which is designed for use upon a highway.” Alabama Code (1975) § 32-7-2. That definition does not specifically answer the question. An four-wheeler is certainly self-propelled, but not necessarily designed for use upon the highway. However, Alabama courts have interpreted the law to include ATVs: “The plain, ordinary, and commonly understood meaning of the term ‘motor vehicle’ includes a four-wheeler,” because it is a self-propelled machine. Johnson v. State, 82 So.3d 776, 780 (Ala.Crim.App. 2011).
In the situation that confronted me, the driver of the four-wheeler likely would not be liable for injuries of his passenger.
Ex parte Jimmy Harris: Subjective intent for an arrest and subsequent prosecution is immaterial so long as there is probable cause, even when there is evidence of personal animosity and a competing financial interest.
On July 29, 2016, the Supreme Court of Alabama decided jointly the related matters of Ex parte Jimmy Harris [Ms. 1141345] and Ex parte Town of Mosses [Ms. 1141385], — So.3d — (Ala. 2016), subsequent to separate writs of mandamus on the heels of the parties’ motions for summary judgment.
Geraldine Bryson brought suit against the Town of Mosses and its police chief Tommy Harris arising out of Harris’ arrest of Bryson, as the owner of “The Spot.” On May 2, 2010, a beer bash was held at The Spot despite Bryson not having a liquor license for the premises. A citizen made the mayor aware of the occasion, and the mayor advised police chief Harris. Bryson was arrested and charged with selling alcohol without a license; ultimately, the charges were dismissed because the prosecution was unable to produce any witness to testify in its behalf. There was also evidence of personal animosity between Harris and Bryson.
Bryson brought claims against Harris and the Town of Mosses for false arrest/false imprisonment and malicious prosecution, as well as other claims not decided herein, alleging (among other things) that her arrest and prosecution were driven by Chief Harris’ contentious relationship with Bryson and a competing financial interest. The Alabama Supreme Court held that even where an arresting officer has personal animosity and a competing financial interest against an arrestee, an arresting officer’s subjective intent is immaterial, and the only criteria for determining whether the arrest was valid is that at the time of the arrest, the officer had probable cause. Likewise, as pertains to a claim of malicious prosecution, subjective intent is immaterial when there is probable cause to initiate a judicial proceeding. In the instant case, there was probable cause for both the arrest and prosecution. The Court further found that both Harris and the Town had statutory state-agent immunity from these claims.
Additionally, the Town argued that Bryson’s claim of intentional infliction of emotional distress against Harris could not be imputed to the Town, pursuant to Alabama Code (1975) § 11-47-190. The Court agreed that the Town is immune from any intentional tortious conduct alleged against its agent.
City of Birmingham v. Alex Thomas: A pension board is a separate entity from the municipality under certain conditions.
On July 22, 2016, the Alabama Court of Civil Appeals handed down its decision in the matter of City of Birmingham v. Alex Thomas, [Ms. 2150329] — So.3d — (Ala.Civ.App. 2016), arising from post-judgment proceedings that originated with Thomas’ mediated worker’s compensation settlement with the City of Birmingham. Pursuant to the settlement, Birmingham made a lump sum payment and subsequent scheduled payments; it was further agreed that Thomas was eligible to apply for both Ordinary (“OD”) and Extraordinary Disability Benefits (“EOD”). Thomas did apply to the Retirement and Relief Pension Board, and was granted disability benefits. The Board granted Thomas EOD benefits but applied a setoff that was subject to the worker’s compensation benefits and resulted in net benefits of $0.00. Thomas filed a motion to enforce the settlement agreement, alleging that Birmingham had unilaterally reduced his pension benefits in contravention of the settlement agreement. Birmingham responded that it had made all agreed-upon payments and that the Board, which was a separate entity, which had made all decisions regarding the EOD benefits. The trial court granted Thomas’ motion, finding that because the settlement agreement was silent as to the setoff, Birmingham had waived its right to setoff and was estopped from asserting a setoff.
Birmingham appealed, arguing that the Board was the entity responsible for paying benefits and for effecting the setoff. Thomas alleged that the Retirement and Relief Pension Board was an instrumentality of Birmingham, and the enforcement judgment against Birmingham was therefore proper. The question to be decided by the appellate court was whether the Board is a separate entity or an instrumentality of the City of Birmingham.
The appellate court has previously (albeit loosely) set forth the principles from which distinguishing between municipalities and their “instrumentalities” can be inferred: (1) do the pertinent statutes require the board be dependent upon the express approval and consent of the municipality; (2) did the legislature delegate choices to the municipality regarding how the board should disburse benefits; and (3) did the legislature mandate that the board’s funds be kept separate from the municipality’s funds? See Harris v. Ethics Comm’n of Alabama, 585 So.2d 93 (Ala.Civ.App. 1991). Applying that test to the case at bar, the appellate court found that the Board was a separate entity, rather than an instrumentality of the City. The legislature has not required that retirement and relief systems seek approval or consent of their respective municipalities. There are a limited number city officials who are permitted to serve on the Board. Finally, the pension fund administered by Board was maintained in a separate account from the City.
The Alabama Court of Civil Appeals found that the City had complied with the settlement agreement, and the Board’s decision not to pay additional benefits to Thomas was not within the trial court’s enforcement power. Moreover, because the City is a separate entity from the Board, the City cannot have waived any right the Retirement and Relief Pension Board has to apply a setoff to Thomas’ EOD benefits.

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