To prevail under § 22:1892, a plaintiff must establish that "(1) an insurer has received satisfactory proof of loss, (2) the insurer fails to tender payment within thirty days of receipt thereof, and (3) the insurer's failure to pay is arbitrary, capricious or without probable cause." Levy Gardens Partners 2007, L.P. v. Commonwealth Land Title Ins. Co., 706 F.3d 622, 635 (5th Cir. 2013) (quoting La. Bag Co., Inc. v. Audubon Indem. Co., 2008-0453, pp. 11-12 (La. 12/2/08), 999 So. 2d 1104, 1112-13).
"The phrase 'arbitrary, capricious, or without probable cause' . . . describe[s] an insurer whose willful refusal of a claim is not based on a good-faith defense." Levy Gardens Partners 2007, L.P. v. Commonwealth Land Title Ins. Co., 706 F.3d 622, 635 (5th Cir. 2013) (quoting La. Bag Co. v. Audubon Indem. Co., 999 So.2d 1104, 1114 (La. 2008)). "Under Louisiana law, 'penalties should be imposed only when the facts negate probable cause for nonpayment,' not 'when the insurer has a reasonable basis to defend the claim and acts in good-faith reliance on that defense.'"
A “satisfactory proof of loss” is that which is sufficient to fully apprise the insurer of the insured's claim. Louisiana Bag Company, Inc. v. Audubon Indemnity Company, 08–0453 (La.12/2/08), 999 So.2d 1104, 1119; McDill v. Utica Mutual Insurance Company, 475 So.2d 1085, 1089 (La.1985). To establish a “satisfactory proof of loss,” the insured must show that the insurer received sufficient facts which fully apprise the insurer that (1) the owner or operator of the other vehicle involved in the accident was uninsured or underinsured, (2) that he was at fault, (3) that such fault gave rise to damages, and (4) establish the extent of those damages.
(Id. (citing Sher v. Lafayette Ins. Co. , 2007-2441 (La. 4/8/08), 988 So. 2d 186, 206–07 ).) Lamar argues that in La. Bag Co., Inc. v. Audubon Indem. Co. , 2008-0453 (La. 12/2/08), 999 So.2d 1104, the Louisiana Supreme Court explained that under Louisiana Revised Statutes 22:1892, an insurer need not pay a disputed amount in a claim for which there are substantial, reasonable and legitimate questions as to the extent of the insurer's liability or of the insured's loss.
A "satisfactory proof of loss" is that which is sufficient to fully apprise the insurer of the insured's claim. Louisiana Bag Co., Inc. v. Audubon Indem. Co., 2008-0453 (La. 12/2/08), 999 So.2d 1104, 1119 ; McDill v. Utica Mut. Ins. Co., 475 So.2d 1085, 1089 (La. 1985). To establish a "satisfactory proof of loss," the insured must show that the insurer received sufficient facts which fully apprise the insurer that (1) the owner or operator of the other vehicle involved in the accident was uninsured or underinsured, (2) that he was at fault, (3) that such fault gave rise to damages, and (4) establish the extent of those damages.
It is well-settled that a satisfactory proof of loss is that which is sufficient to fully apprise the insurer of the insured's claims. Louisiana Bag Co., Inc. v. Audubon Indem. Co., 08-0453 (La.12/2/08), 999 So.2d 1104, 1119. See also McDill v. Utica Mut Ins. Co., 475 So.2d 1085, 1089 (La. 1985).
The Louisiana Supreme Court has held that an insurer who fails to pay an undisputed amount within the statutory time limit is, "by definition, arbitrary, capricious or without probable cause." La. Bag Co. v. Audubon Indem. Co., 999 So.2d 1104, 1116 (La. 2008). Though it disputed liability below, on appeal Allstate does not disagree that it is liable for § 22:658 penalties because it failed, in 2005, to timely pay the undisputed portion of the Plaintiffs' wind-damage claim.
A "satisfactory proof of loss" is that which is sufficient to fully apprise the insurer of the insured's claim. Lemoine, 148 So.3d at 215, citingLouisiana Bag Company, Inc. v. Audubon Indemnity Company, 2008-0453 (La. 12/2/08), 999 So.2d 1104, 1119 and McDill v. Utica Mutual Insurance Company, 475 So.2d 1085, 1089 (La. 1985). To establish a "satisfactory proof of loss," the insured must show that the insurer received sufficient facts which fully apprise the insurer that (1) the owner or operator of the other vehicle involved in the accident was uninsured or underinsured, (2) that he was at fault, (3) that such fault gave rise to damages, and (4) establish the extent of those damages.
(penalties accrue upon "failure to make such payment within thirty days after receipt of such satisfactory written proofs and demand therefor"). Satisfactory "proof of loss is a flexible requirement to advise an insurer of the facts of the claim, and . . . need not be in any formal style." La. Bag Co. v. Audubon Indem. Co., 999 So.2d 1104, 1119 (La. 2008) (internal quotation marks and citation omitted). Penalties "are inappropriate when the insurer has a reasonable basis to defend the claim and acts in good-faith reliance on that defense."
REV. STAT. § 22:658. La. Bag Co. v. Audubon Indem. Co., 2008-0453, p. 14 (La. 12/2/08); 999 So. 2d 1104, 1114 (citation omitted). Id. (quoting Reed v. State Farm Mut. Auto. Ins. Co., 2003-0107, p. 13 (La. 10/21/03); 857 So. 2d 1012, 1021) (internal quotation marks omitted).