Thus, although the USFIC policy includes coverage for certain medical expenses under its "accident and sickness medical expense" coverage, and "medical repatriation," it is clearly a travel insurance policy and not a health and accident policy.See, e.g., Carmouche v. Riverside Life Ins. Co., 459 So.2d 1353, 1354 (La. App. 3 Cir. 1984) (life insurance policy providing coverage for disability is not a health and accident policy); Tarpley v. Consol. Am. Life Ins. Co., 386 So.2d 1067 (La. App. 3 Cir. 1980) (although a life insurance policy provided coverage for total, permanent disability, it is not a health and accident policy); Woodard v. Prudential Ins. Co. of Am., 350 So.2d 948 (La. App. 2 Cir. 1977) (policy which provided payment of loans in one lump sum to a credit union to discharge the borrower's indebtedness in the event the borrower became totally and permanently disabled is not a health and accident policy policy); Johnson v. State Farm Mut. Auto. Ins. Co., 342 So.2d 664, 668-69 (La. 1977) (although an automobile insurance policy provided for total disability benefits, "the policy...is not health and accident insurance...but, rather, vehicle insurance"); Miles v. Cent. Nat. Ins. Co. of Omaha, 163 So.2d 838 (La. App. 4 Cir. 1964) (although automobile insurance policy contained a medical payments provision, it is not a health and accident policy). Based on our finding that USFIC's policy is a travel insurance policy, we further find that, as a matter of law, the lower courts erred in awarding statutory penalties.
Inferring the existence of an agency, a number of courts have held insurers responsible for administrative errors committed by employers (or other group policyholders) who act on their behalf. See, e.g., John Hancock Mut. Life Ins. Co. v. Dorman, 108 F.2d 220, 222-223 (9th Cir. 1939); Clauson v. Prudential Ins. Co., 195 F. Supp. 72, 80 (D. Mass.), aff'd on other grounds, 296 F.2d 76, 79 (1st Cir. 1961) (applying Delaware law); Blue Cross-Blue Shield v. Thornton, 56 Ala. App. 678, 684 (1975); Metropolitan Life Ins. Co. v. State Bd. of Equalization, 32 Cal.3d 649, 659 (1982); Elfstrom, supra at 512-513; Woodard v. Prudential Ins. Co., 350 So.2d 948, 952 (La. App. 1977); Norby, supra at 470; Hirsch v. TravelersIns. Co., 153 N.J. Super. 545, 553 (1977); Baum v. Massachusetts Mut. Life Ins. Co., 357 P.2d 960, 964 (Okla. 1960); Paulson v. Western Life Ins. Co., 292 Or. 38, 48 (1981).
A review of the accident report sent by The Bolton Company to Fireman's Fund shows that it does not constitute a proper demand. Compare Woodard v. Prudential Ins. Co. of America, 350 So.2d 948 (La.App. 2nd Cir. 1977), writ refused, 352 So.2d 1046 (La. 1977); Steadman v. Pearl Assurance Company, 167 So.2d 527 (La.App. 4th Cir. 1964), application denied, 246 La. 911, 168 So.2d 822 (1964). In Jacks v. Banister Pipelines America, 418 So.2d at 529 (La. 1982), the Louisiana Supreme Court set forth when the sixty-day period of LSA-R.S. 22:658 commenced to run as follows:
STANDARD OF CARE The trial judge in his "Reasons for Judgment" and appellee in his brief cite Neider v. Continental Assur. Co., 213 La. 621, 35 So.2d 237 (1948), and Woodard v. Prudential Insurance Company of America, 350 So.2d 948 (La.App. 2nd Cir. 1977). Although these cases (and the others referred to by appellee) are concerned mostly with employers acting negligently as agents for insurance companies, this wording in Neider is significant:
However, we are required to follow the Supreme Court cases of Neider v. Continental Assur. Co., 213 La. 621, 35 So.2d 237, and Tabb v. La. Health Services Indem. Co., La., 361 So.2d 862, which hold that the employer is considered the agent of the insurer and an employer's omission of such insurance-related duty owed to the employee is attributable to the insurer.Richard v. Am. Federation of Unions, etc., La.App., 378 So.2d 564; Woodard v. Prudential Ins. Co. of America, La.App., 350 So.2d 948; Mistric v. Republic Nat'l Life Insurance Company, La.App. 314 So.2d 472; Loubat v. Audubon life Insurance Company, La.App., 170 So.2d 745; Finch v. Baton Rouge Production Credit Association, La.App., 154 So.2d 60. Finally, we consider the question of the penalties and attorney's fees claimed by plaintiff.
Appellants have cited no law, and we believe there is none, which would require a different result on these facts. Local 102 was at all times herein acting as the agent of the insurer, Blue Cross. Woodard v. Prudential Insurance Company of America, 350 So.2d 948 (La.App. 2nd Cir. 1977); Mistric v. Republic National Life Insurance Company, 314 So.2d 472 (La.App. 1st Cir. 1975). An agent authorized to issue policies and other such actions on behalf of a company binds that company by all the waivers, representations or other acts within the scope of his business.
Allen v. Houston Fire and Casualty Company, 243 So.2d 905 (La.App. 3rd Cir. 1971). Our attention has been directed to Woodard v. Prudential Insurance Company of America, 350 So.2d 948 (La.App. 2d Cir. 1977), which involved payment of proceeds of a health and accident policy to a credit union in discharge of the insured's loan. In the cited case, the court awarded 12% penalties on the amount paid the lender, without discussion of whether such payment was "loss, payable to the insured . . ."