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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
Apr 14, 2010

Employers Insurance Co. of Wausau v. Penn-America Insurance Co.

This federal insurance dispute involves Employers Insurance Co. of Wausau seeking reimbursement from Penn-America Insurance Company and Prestige Oysters, Inc. Wausau settled claims for a restaurant customer injured by contaminated oysters, whose initial suit involved Bon Secour Fisheries and Shamrock Foods Company. Wausau argues for reimbursement based on Prestige Oysters' contractual and statutory indemnity obligations, while defendants assert Texas law precludes subrogation and allege Bon Secour's independent negligence. The court denied both parties' motions for summary judgment, finding that Texas law does not inherently bar Wausau's subrogation claim, but the record is insufficient to establish Bon Secour's independent liability. A status conference is scheduled to address unresolved issues.

Insurance DisputeSubrogationIndemnificationProducts LiabilityOystersNegligenceContractual IndemnityStatutory IndemnitySummary JudgmentTexas Law
References
30
Case No. 07-05-00188-CV
Regular Panel Decision
Jun 20, 2007

Yorkshire Insurance Co., LTD. and Ocean Marine Insurance Co., LTD. v. Roy S. Seger, Individually and Shirley Faye Hoskins, Individually and as Administrator of the Estate of Randall Jay Seger

The case involves an appeal by Yorkshire Insurance Co., Ltd., and Ocean Marine Insurance Co., Ltd., against Roy Seger and Shirley Faye Hoskins. The insurers appealed a judgment of over $26 million in actual damages related to a "Stowers" action, stemming from the death of Randall Jay Seger in a drilling accident. The core issues involved whether the insurers were unauthorized, the applicability of a "leased-in worker" exclusion in their CGL policy, and whether the Segers' settlement demands were within policy limits. The court ruled that the 1993 amendments to the Insurance Code applied retroactively and affirmed that the Segers made a sufficient settlement demand within policy limits. However, it reversed the summary judgment on coverage, finding the "leased-in worker" exclusion unambiguous and potentially applicable, and also reversed the directed verdict on damages, as a fact issue remained regarding whether the underlying judgment was the result of a "fully adversarial trial." The case was thus largely remanded for a new trial.

Insurance disputeStowers actionNegligent failure to settleSurplus lines insuranceUnauthorized insurersContract defensesSummary judgmentDirected verdictDamagesFully adversarial trial
References
33
Case No. 07-05-0386-CV
Regular Panel Decision
Aug 17, 2007

Yorkshire Insurance Co. v. Diatom Drilling Co.

Insurers (Yorkshire Insurance Co., Ltd. and Ocean Marine Insurance Co., Ltd.) appealed a summary judgment granted in favor of Diatom Drilling Co. and Employer’s Contractor Services, Inc. Insurers sought declaratory relief regarding a CGL policy's exclusion of liability for injury or death to "leased-in employees/workers." The case stems from a 1992 accident where Randall Jay Seger, an employee leased by ECS to Diatom, was killed. The appellate court found that the "Excluding Leased-In Employees/Workers" condition unambiguously excludes claims against Diatom/ECS related to such workers. The court reversed the trial court's summary judgment in favor of Diatom and ECS and rendered summary judgment for the Insurers, declaring the exclusion valid. The award of attorney's fees to Diatom and ECS was also reversed and remanded for reconsideration.

Insurance policyDeclaratory judgmentSummary judgmentCGL policyLeased employeesWorker injuryCoverage disputePolicy exclusionAttorney's feesAppellate review
References
14
Case No. NO. 01-02-00441-CV
Regular Panel Decision
Apr 10, 2003

Wayne Duddlesten, Inc. v. Highlands Insurance Co.

The case involves an appeal by Wayne Duddlesten Inc. (appellant) against Highlands Insurance Co. and Aberdeen Insurance Co. (appellees) concerning various claims, including breach of contract, violations of the Texas Insurance Code and Deceptive Trade Practices Act, and negligence related to worker's compensation insurance policies. Duddlesten alleged that appellees improperly investigated and settled claims, and challenged the validity of retrospective premium payment plans. The trial court had granted summary judgment against Duddlesten on several of its claims and ruled in favor of Highlands on its counterclaims, awarding damages and attorney's fees. On appeal, Duddlesten contested these rulings, as well as the dismissal of its breach of fiduciary duty and negligence claims. The Court of Appeals for the First District of Texas affirmed the trial court's judgment across all issues, concluding that Duddlesten failed to provide sufficient evidence for its claims and that the premium agreements were valid.

Insurance LawContract DisputeSummary Judgment ReviewDTPA ClaimBreach of Fiduciary DutyNegligence ClaimWorker's CompensationRetrospective Rating PlanAppellate DecisionTexas Insurance Code
References
31
Case No. E2009-01330-COA-R3-CV
Regular Panel Decision
Jun 17, 2010

Hartford Underwriters Insurance Co. v. Dale Penney, d/b/a DLP Construction Co.

Hartford Underwriters Insurance Co. sued Dale Penney, d/b/a DLP Construction Co., to recover additional workers' compensation insurance premiums. The dispute centered on whether workers utilized by Penney were employees or independent contractors for premium assessment purposes, particularly in light of I-18 "Election of Non-Coverage by Subcontractor" Forms. The trial court ruled in favor of Hartford, finding the workers to be employees and awarding $12,316 plus costs and pre-judgment interest. On appeal, the Court of Appeals of Tennessee affirmed the trial court's finding that the workers were employees, thus upholding the premium assessment, but vacated the award of pre-judgment interest and remanded that issue for further clarification from the trial court.

Insurance PremiumsEmployee ClassificationIndependent Contractor StatusI-18 FormsPremium AuditPre-judgment InterestAppellate Court DecisionWorkers' Compensation LawContractual ObligationsTennessee Law
References
18
Case No. MISSING
Regular Panel Decision

Roy Seger v. Yorkshire Insurance Co., Ltd., and Ocean Marine Insurance Co., Ltd.

The parents of a deceased derrick hand, Randy Seger, brought a wrongful death action against Diatom Drilling Co., the owner of the rig where their son died. Diatom's commercial general liability (CGL) insurers, Yorkshire Insurance Co. and Ocean Marine Insurance Co., refused to defend, citing lack of coverage. After obtaining a judgment against Diatom, Randy's parents, Roy Seger and Shirley Faye Hoskins (the Segers), filed a Stowers action against the insurers. The central issue was whether Randy was a 'leased-in worker,' which would exclude coverage under Diatom's CGL policy. A jury initially found he was not, but on appeal, this Court, after reviewing the burden of proof for coverage and policy exclusions, determined that the evidence conclusively established Randy was a 'leased-in worker' as a matter of law. Consequently, coverage was precluded, and the Stowers action failed, affirming the court of appeals' judgment that the Segers take nothing.

Insurance CoverageStowers ActionLeased-in Worker ExclusionCommercial General Liability (CGL) PolicyWrongful DeathBurden of ProofLegal Sufficiency of EvidenceObiter DictumVoidable ContractsSurplus Lines Insurance
References
48
Case No. MISSING
Regular Panel Decision

Getty Oil Co. v. Insurance Co. of North America

Getty Oil Company sued NL Industries, Inc. and its insurers (INA and Youell) for breach of contract to provide insurance coverage, following a wrongful death judgment against Getty. The dispute arose from an explosion of chemicals purchased from NL, resulting in a jury finding Getty 100% negligent. Getty sought reimbursement, arguing NL's insurance should cover its liability under a purchase order provision. The trial court granted summary judgment for defendants, citing the Texas Oilfield Anti-Indemnity Statute, express negligence rule, res judicata, and collateral estoppel. The court of appeals affirmed based on res judicata. The Supreme Court partially affirmed, holding Getty's claims against NL were barred by res judicata as they arose from the same transaction as previous litigation. However, the Court reversed the judgment regarding Getty's claims against NL's insurers (INA and Youell), finding those claims were not barred by res judicata due to 'no action' policy provisions and procedural rules preventing their joinder in the prior suit. The Court also held the Anti-Indemnity Statute and express negligence doctrine did not invalidate the additional insured provision for NL's insurers.

Oilfield Anti-Indemnity StatuteInsurance CoverageContractual IndemnityRes JudicataCollateral EstoppelExpress Negligence RuleTexas Civil LawContract InterpretationAdditional Insured ProvisionsLiability Insurance
References
40
Case No. 03-96-00265-CV
Regular Panel Decision
Jul 24, 1997

Metro Temps, Inc. and Metromarketing Services, Inc. v. Texas Workers' Compensation Insurance Facility Wm. Rigg Co. And Employers Insurance of Wausau

Metro Temps, Inc. and Metromarketing Services, Inc. appealed the trial court's dismissal of their claims against Texas Workers' Compensation Insurance Facility, Wm. Rigg Co., and Employers Insurance of Wausau. The appellants had failed to exhaust their administrative remedies concerning disputes over workers' compensation policy premiums and surcharges. The Third District Court of Appeals, Austin, affirmed the trial court's decision, holding that a district court lacks jurisdiction over claims, even those outside an administrative body's direct authority, when resolution depends on issues within the administrative body's jurisdiction and those remedies have not been exhausted. The court also dismissed the appellants' venue transfer claim due to insufficient record presentation.

Workers' CompensationAdministrative RemediesJurisdictionExhaustion of RemediesDeclaratory JudgmentBreach of ContractFraudConspiracyVenue TransferTexas Insurance Code
References
4
Case No. MISSING
Regular Panel Decision

Houston General Insurance Co. v. Association Casualty Insurance Co.

This case involves an appeal stemming from a dispute between two workers' compensation insurance carriers, Houston General Insurance Company (Appellant) and Association Casualty Insurance Company (Appellee), regarding which carrier is obligated to pay compensation benefits to an injured employee, Johnnie Featherston, of Mallory Propane, Inc. Houston General initially paid the benefits and then sought judicial review after adverse administrative rulings. The core issue is whether Houston General waived its right to contest coverage by not disputing the claim within 60 days, as per Tex. Lab. Code Ann. § 409.021(c). Houston General argued that the issue was "coverage" rather than "compensability" and that waiver and estoppel do not create an insurance contract where none existed. The trial court granted summary judgment in favor of Association Casualty. The appellate court reversed the trial court's summary judgment, concluding that the issue was one of coverage, not compensability, and that waiver or estoppel could not extend coverage. However, the appellate court also denied Houston General's motion for summary judgment regarding equitable subrogation due to a need for a balancing of equities. The case was reversed and remanded for further proceedings.

Workers' CompensationInsurance CarriersCoverage DisputeWaiverEstoppelEquitable SubrogationSummary JudgmentTexas LawAppellate ReviewRemand
References
10
Case No. MISSING
Regular Panel Decision

Continental Casualty Co. v. Employers Insurance

Plaintiff insurance companies, Continental Insurance Co. and American Casualty Co. (CNA), initiated a declaratory judgment action seeking a declaration that they have no duty to indemnify Robert A. Keasbey Co. (Keasbey) for asbestos-related claims, arguing that all claims fall under exhausted products hazard/completed operations coverage. The defendant class of asbestos claimants sought coverage under a new 'operations' theory not subject to aggregate limits. The trial court ruled in favor of the claimants, but the appellate court reversed. The appellate court found that equitable affirmative defenses like laches applied against the claimants, who stood in Keasbey’s shoes. It further determined that coverage is triggered by 'injury-in-fact' rather than mere exposure to asbestos, and that the aggregate limits of the primary and excess policies were exhausted, thus absolving CNA of further indemnity obligations.

AsbestosInsurance Coverage DisputeDeclaratory JudgmentProducts HazardCompleted OperationsOperations CoverageAggregate LimitsExcess InsuranceBodily InjuryInjury-in-Fact
References
29
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