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

Case No. MISSING
Regular Panel Decision

What Happened in Felix vs. Weber Metals Reconsideration?

Justice Hecht's concurring opinion addresses the complex issues surrounding insurance bad-faith liability in Texas. He critiques the existing 'no reasonable basis' standard for its difficulty in appellate review, particularly due to the limitations of no-evidence review which prevents weighing conflicting evidence. He advocates for defining bad faith as 'unscrupulous, arbitrary conduct' and for treating the 'reasonably clear' liability standard as a legal question rather than a factual one. This approach, he argues, would provide clearer guidelines for insurers and enable meaningful judicial review, preventing juries from arbitrarily defining bad faith. Furthermore, he emphasizes that the requisite mental state for bad-faith liability should involve intentional or reckless conduct, not mere negligence. He concurs with the judgment that Universe Life wrongfully delayed Giles' claim (thus implying the claim for benefits was granted) but finds no evidence for punitive damages.

Insurance bad faithTexas lawtort liabilitycontractual disputesappellate reviewevidentiary standardsjudicial roleinsurer conductdamagespunitive damages
References
152
Case No. 2021 NY Slip Op 01050 [191 AD3d 884]
Regular Panel Decision
Feb 17, 2021

How Did the WCAB Rule in Hardgrove vs. Intercon Security?

The mother, Faith M., appealed an order from the Family Court, Kings County, which found her to have derivatively neglected her child, Faith A.M. This finding stemmed from a prior neglect determination in May 2014 concerning her other children due to excessive corporal punishment, which the court deemed proximate in time to the current proceeding. The evidence presented, including statements from siblings, testimony from a school counselor, and observations of injuries, corroborated the ongoing use of excessive corporal punishment. The Family Court's assessment of the mother's credibility, finding her denials incredible, was supported by the record, reinforced by her guilty plea to disorderly conduct related to similar allegations. The Appellate Division affirmed the Family Court's order, as the mother failed to provide evidence that the circumstances leading to the neglect finding no longer existed.

Child NeglectDerivative NeglectCorporal PunishmentFamily Court ActAppellate ReviewParental JudgmentPreponderance of EvidenceCredibilityPrior FindingsRisk of Harm
References
11
Case No. MISSING
Regular Panel Decision

What Did the WCAB Decide in Cuadra vs. Community Home Care?

This is an appeal in a bad faith insurance case involving Head Industrial Coatings and Services, Inc. (Head) and Maryland Insurance Company (Maryland). Head sued Maryland for denying a contractual liability claim, which was missing from its policy due to an agent's clerical error. The appellate court upheld the cause of action for bad faith, ruling that the agent's knowledge was imputable to Maryland, making the conduct knowingly wrongful. However, the court reduced Head's damage award to policy limits and reversed a statutory penalty. The case also involves a third-party action by Maryland against Gans & Smith Insurance Agency, which was remanded for a new trial due to issues with the jury's finding on breach of fiduciary duty.

Bad Faith InsuranceInsurance Code ViolationsContractual LiabilityAgent ErrorClerical ErrorIndemnity AgreementUnfair Claims Settlement PracticesDuty of Good Faith and Fair DealingImputed KnowledgeDamages Calculation
References
59
Case No. MISSING
Regular Panel Decision

How Were Death Benefits Handled in Bocanegra vs. Sun-Gro Commodities?

Lorenzo Rangel appealed a summary judgment granted in favor of Hartford Accident & Indemnity Company regarding his bad faith claim. Rangel alleged Hartford delayed workers' compensation payments following a job-related accident in May 1988, with payments ceasing in October 1988 and resuming in February 1989 after an Industrial Accident Board (IAB) conference. The underlying compensation claim was settled for $29,000, and the Compromise Settlement Agreement (CSA), approved by the IAB, noted that the carrier's liability or extent of injury was uncertain. Hartford successfully moved for summary judgment based on collateral estoppel, arguing Rangel was precluded from relitigating the issue of uncertainty. The appellate court affirmed the summary judgment, concluding that the IAB's finding of uncertainty of liability provided a reasonable basis for Hartford's delay in payments, thus defeating Rangel's bad faith claim.

Workers' CompensationBad Faith ClaimDelay in PaymentSummary JudgmentCollateral EstoppelIssue PreclusionCompromise Settlement AgreementTexas Industrial Accident BoardReasonable Basis for DelayUncertainty of Liability
References
12
Case No. 05-20-00859-CV
Regular Panel Decision
Aug 11, 2022

Can a WCJ Be Disqualified for Appearance of Bias?

Kenneth May and Desire Ophelia Fuentes-May (Appellees) sued Full of Faith Christian Center, Inc. and related entities/individuals (Appellants) for nuisance, trespass, negligence, and unlawful diversion of water. A no-answer default judgment was entered against Appellants. Appellants challenged the default judgment, raising issues with citation, substituted service, and an unserved supplemental petition, among others. The appellate court found service and citation were not defective and upheld the denial of the motion for new trial on most grounds. However, the court reversed the award of punitive damages against appellants jointly and severally, remanding for a new trial solely on exemplary damages, and affirmed the trial court's judgment in all other respects.

Default JudgmentService of ProcessSubstituted ServicePunitive DamagesJoint and Several LiabilityMotion for New TrialAppellate ReviewTexas Civil ProcedureNuisanceTrespass
References
33
Case No. MISSING
Regular Panel Decision

What Were the Key Rulings in Torrez vs. SuperShuttle?

Plaintiff Dorothy G. Chandler sued Prudential Insurance Company of America after the termination of her long-term disability benefits. She alleged bad faith, outrageous conduct, and violations of the Tennessee Consumer Protection Act. The trial court granted partial summary judgment to Prudential on the outrageous conduct, tort of bad faith, and Consumer Protection Act claims. Plaintiff later nonsuited her claim for the statutory bad-faith penalty. The appellate court affirmed the trial court's decision, ruling that the statutory bad-faith penalty (T.C.A. § 56-7-105) provides the exclusive remedy for bad faith actions against insurers in Tennessee. The court also found that the plaintiff failed to state a cause of action for outrageous conduct and that the Tennessee Consumer Protection Act was not applicable based on the facts presented.

Disability BenefitsInsurance PolicyBad Faith ClaimOutrageous ConductConsumer Protection ActSummary JudgmentExclusive RemedyAppellate ReviewInsurance LawTort Law
References
17
Case No. MISSING
Regular Panel Decision

Why Was Removal Denied in Rush vs. California Correctional Institution?

Appellant Bonnie F. Price appealed a summary judgment granted in favor of Texas Employers’ Insurance Association (TEIA) concerning her claim of bad faith in handling two workers' compensation claims. Price's initial workers' compensation claims were settled in March 1988, after which she initiated a separate bad faith claim against TEIA. TEIA successfully moved for summary judgment in the trial court, asserting that Price's bad faith claim was barred by res judicata/collateral estoppel due to the prior settlement judgment, that her previous agreements constituted judicial admissions, and that evidence negated essential elements of her bad faith claim. The appellate court reviewed the summary judgment, focusing on the applicability of collateral estoppel and judicial admissions stemming from the prior workers' compensation settlement. Ultimately, the appellate court affirmed the trial court's summary judgment, concluding that TEIA had successfully proven its affirmative defenses and negated elements of Price's bad faith claim.

Summary JudgmentWorkers' CompensationBad Faith ClaimDuty of Good Faith and Fair DealingRes JudicataCollateral EstoppelJudicial AdmissionSettlement AgreementAppellate ReviewInsurance Carrier Liability
References
11
Case No. MISSING
Regular Panel Decision

What Did the WCAB Clarify in Ontiveros vs. Savers Stores?

Paul and Teri Luker sued St. Paul Guardian Insurance Company after their claim for lost household goods in a fire was denied under a homeowner's policy issued to Kim's father, Emmett Luker. St. Paul denied the claim, alleging arson by the Lukers and misrepresentation, despite a prior stipulation agreeing to coverage for the Lukers' personal effects. A jury awarded the Lukers contractual damages for property loss and tort damages for bad faith and mental anguish. On appeal, the court affirmed the contractual damages, finding St. Paul owed a duty of good faith and fair dealing to the Lukers as third-party beneficiaries due to the stipulation. However, the court reversed the awards for exemplary damages and bad faith tort damages, remanding the bad faith claim for a new trial, citing insufficient evidence that St. Paul acted in bad faith or with conscious indifference in denying the claim.

Insurance disputeArson defenseBad faith claimContractual damagesTort damagesThird-party beneficiaryStipulation in litigationExemplary damages reversedMental anguish claimProperty loss
References
31
Case No. MISSING
Regular Panel Decision

Why Was Reconsideration Denied in Gomez vs. Dorothy Stevens?

Columbia Universal Life Insurance Company appealed a jury finding that it canceled Carl David Miles' health insurance policy in bad faith. Miles, the appellee, suffered from chronic immune deficiency conditions (IGA and agammaglobulinemia) that he claimed were disclosed during the application process but not recorded by the agent. Columbia rescinded the policy after discovering these undisclosed pre-existing conditions, which made Miles uninsurable per their underwriting guidelines, prompting Miles to file a bad faith claim. The court, applying established legal sufficiency standards for bad faith, found that Columbia had a reasonable basis for its actions due to the undisputed omission of critical medical history and Miles' previous denial of coverage by another insurer. Consequently, the appellate court reversed the trial court's judgment, ruling that Miles should take nothing on his bad faith claim.

Insurance LawBad Faith ClaimPolicy CancellationMisrepresentation in ApplicationPre-existing ConditionImmune DeficiencyDeclaratory JudgmentLegal Sufficiency ReviewDuty to InvestigateContractual Dispute
References
16
Case No. MISSING
Regular Panel Decision

Why Was Reconsideration Dismissed in Sabino vs. Johnson Pump Company?

The petitioner, Victor Soto, a tenured Correction Officer, was terminated during a probationary period on January 19, 1989, following disciplinary charges related to an auto accident and subsequent alleged excessive lateness. Soto filed a CPLR article 78 petition to challenge his termination, claiming bad faith, arguing that many of his eight latenesses were excusable due to external factors like snowstorms and transportation issues, and emphasizing his otherwise good work record. The Supreme Court dismissed his petition, finding no evidence of bad faith. This appellate decision affirmed the dismissal, ruling that the petitioner failed to prove bad faith, and that termination for lateness is a rational basis, particularly for a probationary employee, under the limited scope of judicial review for such cases. The dissenting opinion argued that the circumstances, including excusable latenesses and strong support from supervisors, demonstrated bad faith.

Correction OfficerProbationary EmploymentEmployee TerminationExcessive LatenessBad Faith AllegationCivil Service LawArticle 78 ReviewUnemployment BenefitsJudicial Review ScopeAppellate Affirmation
References
12
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