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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. 03-15-00314-CV
Regular Panel Decision
Aug 07, 2015

California Insurance Guarantee Association, Oklahoma Property and Casualty Insurance Guaranty Association, and Texas Property and Casualty Insurance Guaranty Association v. Hill Brothers Transportation, Inc.

The appellants, California Insurance Guarantee Association (CIGA), Oklahoma Property and Casualty Insurance Guaranty Association (OPCIGA), and Texas Property and Casualty Insurance Guaranty Association (TPCIGA), collectively "Guaranty Associations," are appealing a summary judgment granted in favor of the appellee, Hill Brothers Transportation, Inc. ("Hill Bros."). The suit was filed on March 31, 2009, alleging Hill Bros. failed to reimburse the Guaranty Associations for payments of workers' compensation benefits and claim handling expenses within the deductible limits of a policy issued by the insolvent Legion Insurance Company ("Legion"). The District Court granted summary judgment to Hill Bros. based on the statute of limitations, ruling that the cause of action accrued on April 1, 2002. The Guaranty Associations argue that the accrual date is incorrect, as their statutory obligations had not been triggered, payments had not been made, and demand for reimbursement had not occurred by that date. They also contend that their compliance with Pennsylvania law (the "Pennsylvania Act") in seeking reimbursement through Legion in Liquidation constitutes a mitigating circumstance for any delay, making reasonableness a fact question. Furthermore, they assert the policy was a continuing contract, and the statute of limitations should not have accrued until full performance on April 28, 2009. Alternatively, they argue that claims for deductible payments made within four years of filing suit (March 31, 2005) are not barred.

Workers' CompensationInsurance Guaranty AssociationStatute of LimitationsBreach of ContractDeductible ReimbursementInsolvencyInsurance PolicyContinuing ContractPennsylvania ActTravis County
References
21
Case No. 03-10-00385-CV
Regular Panel Decision
Aug 26, 2011

John H. Carney & Associates v. Texas Property and Casualty Insurance Guaranty Association

John H. Carney & Associates (Carney) sued the Texas Property and Casualty Insurance Guaranty Association (the Association) to recover damages from a judgment against an insolvent insurer, Texas Select Lloyds Insurance Company. Carney asserted the judgment was a 'covered claim' under the Texas Property and Casualty Insurance Guaranty Act, arising from an assigned interest in a first-party homeowners policy claim of their former client, Joy Lincoln. The Association moved for summary judgment, arguing Carney was not an 'insured' or 'third-party claimant' as defined by the Act, among other grounds. The trial court granted summary judgment without stating the specific grounds. The appellate court affirmed the trial court's decision, concluding that the Guaranty Act's remedy is limited to 'insureds' and 'third-party claimants' and does not extend to assignees, based on statutory construction and comparison with similar laws.

Insurance LawGuaranty ActAssignee RightsSummary JudgmentStatutory ConstructionAppellate ReviewInsurer InsolvencyCovered ClaimAttorney's FeesProperty Damage
References
91
Case No. ADJ14895207; ADJ162421; ADJ14895259; ADJ14894712
Regular
Feb 13, 2023

DENISE ARMTROUT vs. PLEASANTON UNIFIED SCHOOL DISTRICT, KEENAN ASSOCIATES

This case involves an applicant seeking reconsideration of a Workers' Compensation Appeals Board decision denying her petition. The applicant, Denise Armtrout, sought authorization for lymphatic massage therapy for lymphedema. Independent medical review initially denied the treatment, citing a lack of evidence for its necessity and the applicant's ability to perform self-treatment. The Board adopted the WCJ's report and denied reconsideration, upholding the prior decision to deny the petition.

Workers' Compensation Appeals BoardPetition for ReconsiderationDenying PetitionIndependent Medical Review (IMR)Lymphatic MassageLymphedemaChild Nutrition SpecialistAgreed Medical Evaluator (AME)Utilization Review (UR)Plainly Erroneous Finding of Fact
References
1
Case No. 06-05-00087-CV
Regular Panel Decision
May 11, 2006

Michael Pullara v. American Arbitration Association, Inc., Paxson & Associates, P.C. and Stephen B. Paxson

Michael Pullara appealed a summary judgment granted against him in favor of the American Arbitration Association (AAA), Paxson & Associates, P.C., and Stephen B. Paxson. Pullara sued Paxson and the AAA for damages, alleging Paxson failed to disclose his long-standing role as general counsel for the Greater Houston Builders Association (GHBA) before being selected as an arbitrator in a dispute between Pullara and Becker Fine Builders, Inc. Pullara contended this nondisclosure revealed a bias. The appellate court affirmed the trial court's judgment, holding that Pullara's claims are barred by the doctrine of arbitral immunity, which extends to arbitrators and their sponsoring organizations for acts performed in their quasi-judicial capacity, including failure to disclose potential biases. The court rejected Pullara's arguments that arbitral immunity conflicts with Texas statutory law or prior Texas Supreme Court holdings on evident partiality, emphasizing that the remedy for non-disclosure is vacating the award, not a cause of action for damages.

ArbitrationArbitral ImmunityDisclosureBiasSummary JudgmentAppellate ReviewTexas LawCivil Practice and Remedies CodeJudicial ImmunityLegal Malpractice
References
65
Case No. 03-13-00077-CV
Regular Panel Decision
Feb 25, 2015

Texas State Board of Examiners of Marriage and Family Therapists Charles Horton in His Official Capacity Sandra DeSobe in Her Official Capacity, and Texas Association of Marriage // Cross-Appellant,Texas Medical Association v. Texas Medical Association// Texas State Board of Examiners of Marriage and Family Therapists Charles Horton in His Official Capacity Sandra DeSobe in Her Official Capacity, and Texas Association of Marriage

The amicus brief, submitted by The Association of Marital and Family Therapy Regulatory Boards (AMFTRB), urges the Third Court of Appeals to grant en banc reconsideration and reverse a panel's decision that found 22 TEX. ADMIN CODE §801.42(13) invalid. The brief argues that Licensed Marriage and Family Therapists (LMFTs) are fully qualified, trained, and tested to perform diagnostic assessments within their therapeutic role. It asserts that diagnosis alone, in the context of marriage and family therapy, does not constitute the practice of medicine under the Texas Medical Practice Act, and preventing LMFTs from performing these assessments would effectively prohibit their professional practice and create a shortage of mental health professionals in Texas. The AMFTRB also highlights that the legislature did not intend for LMFTs to be supervised by physicians and that the structure of the Occupations Code supports marriage and family therapy as a stand-alone profession. Additionally, the brief questions the qualification of the Texas Medical Association's expert witness due to prior ethical lapses.

Marriage and Family TherapyDiagnostic AssessmentMedical Practice ActOccupations CodeRegulatory BoardsLicensureScope of PracticeMental Health ServicesTexasAccreditation
References
9
Case No. 03-97-00567-CV
Regular Panel Decision
Jul 30, 1998

Memorial Medical Center of East Texas v. James A. Howard, Special Deputy Receiver of Texas Employers' Insurance Association and Texas Property and Casualty Insurance Guaranty Association

Memorial Medical Center of East Texas appealed a summary judgment granted in favor of James A. Howard, Special Deputy Receiver of Texas Employers' Insurance Association, and Texas Property and Casualty Insurance Guaranty Association. Memorial sought a declaration that the appellees were obligated to reimburse defense costs incurred in a separate suit brought by its employees. The trial court granted the appellees' motions for summary judgment without specifying the grounds. The appellate court affirmed the trial court's judgment, holding that both the Receiver and the Association were statutorily precluded from defending Memorial or reimbursing its defense costs under relevant provisions of the Texas Insurance Code.

Summary judgmentInsurance CodeDuty to defendReimbursementImpaired insurerReceivershipGuaranty AssociationAppellate reviewStatutory interpretationWorkers' compensation insurance
References
11
Case No. 01-18-00242-CV
Regular Panel Decision
Apr 02, 2019

Nephrology Leaders and Associates and M. Atiq Dada, MD v. American Renal Associates LLC

Nephrology Leaders and Associates and M. Atiq Dada, M.D. (collectively, "Nephrology") appealed a trial court's order that temporarily sealed certain documents from a subpoena issued to American Renal Associates, LLC. Nephrology argued the trial court abused its discretion by setting the motion for a hearing sua sponte and that evidence was insufficient to support the order. American Renal countered that Nephrology lacked standing to appeal. The Court of Appeals for the First District of Texas agreed, concluding that Nephrology had not demonstrated a redressable injury, which is a constitutional prerequisite for standing in Texas. Consequently, the appeal was dismissed for want of subject-matter jurisdiction, affirming that statutory provisions cannot enlarge constitutional jurisdiction.

Appellate ProcedureSubject Matter JurisdictionStandingSealing OrderTemporary SealingDiscovery SubpoenaAbuse of DiscretionTrial Court OrderConstitutional StandingJudicial Review
References
27
Case No. No. 21-0797
Regular Panel Decision
Jun 16, 2023

Levinson Alcoser Associates, L.P. and Levinson Associates, Inc. v. El Pistolon II, Ltd.

The Supreme Court of Texas reversed a court of appeals' judgment concerning equitable tolling in a defective design and development lawsuit. Plaintiff El Pistolón II, Ltd. initially sued Levinson Alcoser Associates, L.P. and Levinson Associates, Inc. for negligence and breach of contract, but the suit was dismissed for a deficient certificate of merit. El Pistolón refiled, arguing that the limitations period should have been tolled during the appeal of the earlier suit. The Court clarified that equitable tolling, including "Hughes tolling" or a broader "legal impediment rule," is limited in scope and does not apply when an earlier suit is dismissed and refiled. As a result, El Pistolón's claims were deemed time-barred, and the trial court's summary judgment was reinstated.

Equitable TollingStatute of LimitationsCertificate of MeritCivil Practice and Remedies CodeDefective PleadingLegal PrecedentAppellate ReviewSummary JudgmentTexas LawConstruction Defects
References
46
Case No. 06-09-00009-CV
Regular Panel Decision
Feb 26, 2010

Walker & Associates Surveying, Inc., and Dennis Walker, D/B/A Walker and Associates Construction v. Royce Roberts

Royce Roberts hired Walker & Associates Surveying, Inc. (WAS) and Dennis Walker d/b/a Walker and Associates Construction (WAC) to extend a horse training racetrack, leading to a dispute over construction requirements. WAS filed a mechanic's lien and suit, while Roberts counterclaimed for fraudulent lien and usurious interest. The appellate court partially affirmed the usury finding under Texas Finance Code Section 305.003 but remanded damages for recalculation. The fraudulent lien summary judgment was reversed and remanded due to a fact question on intent to cause financial harm, and the claim for usury under Section 305.004 was reversed. The court otherwise affirmed the judgment, including the jury's findings on WAC's breach of contract and quantum meruit.

Horse Racetrack ConstructionMechanic's LienFraudulent LienUsury LawTexas Finance CodeQuantum MeruitBreach of ContractSummary JudgmentAppellate ReviewSufficiency of Evidence
References
65
Case No. MISSING
Regular Panel Decision

Associated Indemnity Corp. v. Dixon

Associated Indemnity Corporation appealed a judgment finding Mark Dixon totally and permanently incapacitated due to an occupational disease incurred while working for Kroger. The appeal centered on the improper admission of two prejudicial letters from Dixon's attorney to Dr. Faust, containing legal definitions and Dr. Faust's purported answers regarding Dixon's injury. The court determined these letters were inadmissible hearsay, not qualifying as medical or business records, and precluded cross-examination. Additionally, the court ruled that the letters, containing ultimate legal conclusions, could not serve as a reliable basis for Dr. Daughety's medical opinion. The testimony of Associated's claims adjuster regarding her opinion of Dixon's incapacity was also deemed inadmissible hearsay. Consequently, the judgment was reversed and the case remanded for further proceedings.

Hearsay EvidenceBusiness Records ExceptionExpert Medical TestimonyWorkers' Compensation LawTotal Permanent IncapacityAdmissibility of EvidencePrejudicial ErrorAppeal and RemandCross-Examination RightsMedical Opinion Basis
References
10
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