Seymour v. Cigna Insurance Co.

Docket: No. 93-CA-229

Court: Louisiana Court of Appeal; July 27, 1993; Louisiana; State Appellate Court

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Weber Marine, Inc., Weber Management Services, Inc., and West of England Shipowners Mutual Insurance Association (London) Ltd. appealed a jury verdict favoring plaintiff Stanley Seymour. The appeal centers on whether there was sufficient evidence for the jury to classify Seymour as a seaman under the Jones Act and whether the damages awarded were appropriate. The court affirmed the jury’s decision. Seymour, employed by Weber Marine, suffered an ankle injury while unloading a supply truck. Weber's compensation insurer, CIGNA Insurance Company, paid benefits under the Longshore and Harbor Workers’ Compensation Act, after which Seymour initiated a lawsuit against CIGNA, Weber, and West of England for damages under the Jones Act and maritime law. CIGNA intervened to recover paid benefits. Summary judgment was granted to Weber and West of England on the unseaworthiness claim, but the issue of seaman status was reserved for jury determination. After four days of testimony, the jury awarded Seymour $240,000, dismissed CIGNA on a directed verdict, and awarded it $23,898.73 for past medical expenses. Weber and West of England contested the jury's finding of Seymour's seaman status, arguing he was primarily a day laborer, not permanently assigned to any vessel, and engaged solely in land-based activities. They did not contest the damage amount. Seymour countered the appeal seeking punitive damages, attorney’s fees, increased compensatory damages, and sanctions for a frivolous appeal. The court found Seymour's response timely. The definition of 'seaman' under the Jones Act is derived from case law, emphasizing an employment-related connection to a vessel, with key elements including performing work contributing to the vessel's function. The Fifth Circuit has established that an injured worker must be either permanently assigned to a vessel or perform a substantial part of their work aboard it, with duties contributing to the vessel's mission.

The excerpt addresses a legal case involving the interpretation of "permanent attachment" to a vessel under the Jones Act. In **Bach v. Trident Steamship Co.**, a river pilot who had no permanent attachment to the vessel he was about to pilot suffered a heart attack and sued, but his claims were dismissed by the trial court and affirmed by the Fifth Circuit. The Fifth Circuit ruled that his temporary work did not meet the criteria of permanent attachment or substantial work aboard the vessel, emphasizing the need for a clear standard in the seaman test. The Supreme Court later vacated this decision for reconsideration in light of **Wilander**, but upon remand, the Bach court maintained its original opinion, asserting that **Wilander** did not alter its stance.

Additionally, related cases in Louisiana, such as **Sider v. Robin Temporary Service** and **Folse v. Western Atlas Intern. Inc.**, reinforced the need to satisfy both prongs of the Robinson test for coverage under the Jones Act. The Louisiana Supreme Court noted that **Wilander** focused on employment connection to a vessel as the primary criterion, dismissing the significance of permanent attachment.

The document then shifts to Seymour, a worker with limited education who obtained his inland marine pilot's license and was hired by Weber to pilot a tugboat. On December 17, 1988, after being told the tugboat was out of commission, he worked as a deckhand on another tug, the **Mar G**. During a run to pick up cargo, he was injured when a forklift, left running by the pilot, moved unexpectedly, jamming his ankle.

Weber contested Seymour's status as a seaman by presenting testimonies that highlighted key points regarding Seymour's role and activities on the Mar G. Dennis Leroy Adair, the pilot, stated he had no interest in the trial outcome and emphasized that during his two weeks of piloting, Seymour was merely a passenger, not a deckhand, and did not contribute to the vessel's operations on December 17th. Although Adair acknowledged that Seymour assisted in unloading supplies, he clarified that such actions did not constitute formal employment as a deckhand. 

Donald Hawthorne, assistant manager at Weber, explained that crew boat operators and day laborers, who operate forklifts, have separate roles. Earl Spurlock, labor foreman, noted that while Seymour was working with him to unload paint, he was not officially assigned to the Mar G and was effectively a passenger. Spurlock suggested it was unlikely Seymour would have assisted in unloading a single pallet, indicating that one deckhand sufficed for such a task. Robert Wooten, vice president of Weber, confirmed that Seymour was hired as a pilot in July 1989 but had no direct involvement in his assignments. Wooten further clarified that day laborers are hired on an as-needed basis, contrasting their hourly pay with the daily rates for boat operators and deckhands.

Wooten testified regarding the payroll sheets, indicating that the individuals listed on the left side are permanently assigned to a vessel, typically working daily with the same crew. He noted that the Mar G generally employs one pilot and one deckhand, with additional deckhands hired only when necessary. On December 17th, Seymour was recorded as a day laborer and did not appear on time sheets as a pilot or deckhand during the period from December 9th to 17th. Wooten asserted that Seymour did not operate as a deckhand or perform significant work aboard a vessel that day. During cross-examination, Wooten acknowledged Seymour was hired as a pilot but stated he was not involved in daily hiring decisions. He mentioned an incident involving a payroll error concerning Mike Martinez, which was attributed to an inexperienced dispatcher. 

The legal standard for reviewing Jones Act claims in state court aligns with federal law, and appellate courts do not disturb jury findings unless there is no reasonable evidentiary basis for their conclusions. The jury's determination that Seymour was performing ship's work was upheld, supported by Wooten's credible testimony and the absence of counter-evidence regarding Seymour's work assignments. The receipt of Longshore and Harbor Workers' Compensation Act (LHWCA) benefits does not preclude a Jones Act claim, as established in precedent. Consequently, it was affirmed that Seymour was a seaman under the Jones Act at the time of his injury.

Seymour contended that the jury's general damages award was insufficient and sought punitive damages due to Weber's alleged gross negligence and actions regarding medical benefits. Evidence showed Seymour underwent two surgeries for his ankle injury, with ongoing treatment from Dr. Watermeier, who prescribed various medications and suggested further surgical procedures. The conclusion was reached that Seymour has experienced, and will likely continue to experience, significant pain related to his injury.

Gordon Nutik, M.D., an orthopedic surgeon, examined Seymour and found equal callus formation on both feet, indicating he was walking normally. Seymour testified he continues to walk, drive, and care for his children, but has had to give up swimming, roller skating, football, and cycling. The jury awarded $35,000 for pain and suffering, which, while perceived as low, was deemed within their discretion. Seymour alleged that CIGNA acted arbitrarily by delaying necessary treatments, specifically sympathetic nerve blocks and surgery for reflex sympathetic dystrophy. Although CIGNA covered all medical bills except for the surgery, Dr. Watermeier highlighted unreasonable delays in performing recommended diagnostic tests. However, the court found that the delays did not constitute arbitrary or capricious behavior, as all recommendations except the sympathectomy were approved and paid for, based on Dr. Nutik's assessment that Seymour did not have reflex sympathetic dystrophy.

Seymour also contended that Weber Marine was grossly negligent due to untrained forklift operator Spurlock's actions. However, evidence showed Spurlock had significant experience operating forklifts, and his negligence in leaving equipment running did not meet the threshold for gross and wanton negligence. The court dismissed the claim of frivolity regarding the appeal, affirming that the issues surrounding seaman status were complex and that the appeal was not solely for delay. The judgment awarded Seymour $240,000 against Weber Marine and West of England, with the latter responsible for appeal costs.