CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. 14-04-00651-CV
Regular Panel Decision
Mar 08, 2007

Coastal Refining & Marketing, Inc., Coastal Offshore Insurance Limited, and Lexington Insurance Company v. United States Fidelity and Guaranty Company

This insurance coverage dispute centers on whether United States Fidelity and Guaranty Company (USF&G) had a duty to reimburse its insured, Coastal Refining & Marketing, Inc., and two other carriers, Coastal Offshore Insurance Limited and Lexington Insurance Company, for costs incurred in settling a personal injury lawsuit. USF&G moved for summary judgment, arguing late notice, settlement without consent, and failure to cooperate by its insured. The appellate court reversed the trial court's summary judgment, finding that USF&G failed to produce evidence of actual prejudice resulting from the insured's actions. The court clarified that for bodily injury and property damage claims, actual, not merely speculative, prejudice must be demonstrated to void coverage. The case was remanded for further proceedings consistent with this opinion.

Insurance CoverageSummary JudgmentPrejudice (Insurance Law)Late Notice (Insurance)Voluntary Payment ClauseDuty to Cooperate (Insurance)IndemnificationContract LawAppellate ReviewTexas Law
References
41
Case No. 13-0096
Regular Panel Decision
Aug 22, 2014

Tenet Hospitals Limited, a Texas Limited Partnership D/B/A Providence Memorial Hospital, and Michael D. Compton, M.D. v. Elizabeth Rivera, as Next Friend for M.R.

This case concerns a challenge to the constitutionality of the Medical Liability Act's ten-year statute of repose. Petitioners, Tenet Hospitals Limited and Michael D. Compton, M.D., sought summary judgment arguing the statute barred a medical negligence claim filed by Elizabeth Rivera on behalf of M.R. The alleged negligence occurred in 1996, and the suit was filed in 2011, five years after the 2003 repose statute's 2006 deadline. The trial court granted summary judgment, but the court of appeals reversed, finding the statute unconstitutional as applied to M.R. The Supreme Court of Texas reversed the court of appeals' judgment, holding that Rivera, acting as M.R.'s next friend, failed to demonstrate due diligence in filing the claim within the three-year grace period afforded by the statute. The Court also found the retroactivity challenge failed due to the compelling public interest in the Medical Liability Act and the sufficient grace period provided. Consequently, the Supreme Court rendered judgment that the plaintiff take nothing.

Medical MalpracticeStatute of ReposeOpen Courts ProvisionRetroactivityDue DiligenceMinor's ClaimConstitutional LawSummary JudgmentTexas Supreme CourtHealthcare Liability
References
26
Case No. 14-02-00860-CV
Regular Panel Decision
Feb 23, 2006

Lennar Corporation, Lennar Homes of Texas Land and Construction, Limited, and Lennar Homes of Texas Sales and Marketing, Limited, D/B/A Village Builders v. Great American Insurance Company, American Dynasty Surplus Lines Insurance Company, Markel American Insurance Company Gerling America Insurance Company, RLI Insurance Company, Insurance Company of the State of Pennsylvania and Westchester Fire Ins Company

This case concerns an insurance coverage dispute between homebuilder Lennar Corporation and its CGL insurance carriers over damages caused by defective stucco (EIFS) applied to homes. The court analyzed whether negligently defective construction constitutes an "occurrence" and distinguished between covered costs (repairing actual water damage) and non-covered costs (preventative EIFS replacement, overhead). While affirming summary judgment for several insurers due to unmet self-insured retentions based on individual homes as separate occurrences, the court reversed for American Dynasty and Markel, citing unresolved factual issues regarding "known loss" and policy conditions. Lennar's extra-contractual claims against American Dynasty were ultimately denied for lack of proven damages or statutory violations.

Insurance Policy InterpretationConstruction DefectsCommercial Liability InsuranceProperty Damage ClaimsStucco DefectsDuty to IndemnifySelf-Insured RetentionsKnown Loss PrincipleSubcontractor LiabilityTexas Law
References
96
Case No. MISSING
Regular Panel Decision

In re the Liquidation of Midland Insurance

Policyholders New York Dock Railway (NYDR) and Brooklyn Eastern District Terminal (BEDT), joined by claimants Buividas and Romacho, moved to confirm a referee's report that found coverage for their claims by the Stock Workers' Compensation Security Fund. The Superintendent of Insurance, as liquidator of Midland Insurance Company, cross-moved to disaffirm the report, arguing against Security Fund coverage based on his interpretation of relevant statutes. The court reviewed the referee's decision, finding it erroneous due to a misinterpretation of legislative history and intent regarding security fund coverage limitations, particularly concerning Chapter 801 amendments. Upholding the Superintendent's rational interpretation, the court denied the motion to confirm and granted the cross-motion to disaffirm, affirming the denial of security fund coverage.

Workers' Compensation Security FundInsurance Coverage DisputeMidland Insurance Company LiquidationFederal Employers' Liability ActJones ActLongshoremen's and Harbor Workers' Compensation ActStatutory InterpretationLegislative HistoryThird-Party IndemnificationEmployer's Liability
References
6
Case No. MISSING
Regular Panel Decision

Oneida Ltd. v. Utica Mutual Insurance

Oneida Ltd., a self-insured employer, initiated a declaratory judgment action against its insurers, Utica Mutual and Republic Western, to determine liability for a substantial claim arising from a workplace accident involving the Ketchum brothers. The core dispute centered on whether Republic Western's excess workers' compensation policy, designed for self-insureds, was legally mandated to provide unlimited employer's liability coverage, or if its stated $1,000,000 limit was valid. Oneida Ltd. argued for the validity of the limit, which would then obligate Utica Mutual's $10,000,000 umbrella policy for the excess. Utica Mutual contended that employer's liability coverage must be unlimited in New York and that its policy disclaimed such coverage. The court ultimately sided with Oneida Ltd. and Republic Western, ruling that excess reinsurance policies for self-insured employers are not required to provide unlimited employer's liability coverage, thus upholding Republic Western's $1,000,000 limit. The court also found that Utica Mutual's policy did not effectively disclaim coverage, making it liable for amounts exceeding Republic Western's limit.

Insurance Policy DisputeDeclaratory ReliefEmployer Liability InsuranceExcess CoverageUmbrella LiabilitySelf-Insurance RegulationsInsurance Contract InterpretationThird-Party IndemnificationRegulatory Agency InterpretationSummary Judgment Motion
References
12
Case No. MISSING
Regular Panel Decision

Mele v. General Accident Insurance

This appeal concerns an arbitration award where the arbitrators granted the petitioner an amount exceeding the underinsurance coverage limits of an automobile policy issued by the respondent. The petitioner had settled with a tortfeasor for $50,000 and sought additional recovery under a policy with $10,000 per person underinsurance coverage. Despite the policy's stated limit, arbitrators awarded $45,000. The Supreme Court confirmed this award, but the appellate court reversed, holding that arbitrators cannot exceed contractual policy limits. Citing Insurance Law § 3420 (f) (2), the court affirmed that optional supplementary coverage can be contractually limited, thereby reducing the award to the $10,000 policy limit.

Underinsurance CoverageArbitration Award ConfirmationInsurance Policy LimitsJudicial Review of ArbitrationAutomobile Liability PolicySupplementary Uninsured Motorist CoverageStatutory InterpretationContractual LimitationsDamages in ArbitrationAppellate Reversal
References
7
Case No. MISSING
Regular Panel Decision

Weiss v. Tri-State Consumer Insurance

This case involves an appeal concerning the amount of supplementary uninsured/underinsured motorist (SUM) coverage available under an insurance policy issued by Tri-State Consumer Insurance Company. The plaintiffs, daughters and administrators of the estates of Rifka and Anton Goldenberg who died in a car accident, sought $400,000 in SUM coverage. Tri-State contended the coverage was limited to $145,000, arguing that payments from the tortfeasor's insurer ($100,000) and a Dram Shop recovery ($255,000) reduced the $500,000 policy limit. The Supreme Court initially granted the plaintiffs' motion for $400,000 in coverage and denied Tri-State's cross-motion. However, the appellate court reversed this decision, ruling that the Dram Shop recovery, as damages from sources other than motor vehicle liability insurance, correctly reduced the SUM endorsement, thus limiting the available coverage to $145,000.

Supplementary Uninsured/Underinsured MotoristSUM CoverageInsurance Policy InterpretationDram Shop ActWrongful DeathSummary JudgmentAppellate ReviewInsurance LawContract LawAutomobile Insurance
References
8
Case No. 03 Civ. 0332(AKH)
Regular Panel Decision
Oct 29, 2004

In Re September 11th Liability Insurance Coverage Cases

This opinion and order addresses two Rule 12(c) motions regarding insurance coverage for the World Trade Center properties following the September 11, 2001, attacks. The Port Authority of New York and New Jersey sought a declaration that it is an "Additional Insured" under Zurich American Insurance Company's policies, while World Trade Center Properties LLC (WTCP) sought a declaration that Zurich is obligated to cover defense costs. The court, presided over by District Judge Hellerstein, denied both motions. It found ambiguity in the binder regarding the Port Authority's "Additional Insured" status, stating that the issue was premature without further discovery. Furthermore, the court held that New York Insurance Regulation 107 does not require rewriting Zurich's binder and policies to include defense costs, considering the unique circumstances, the sophistication of the insured, and the fact that Zurich explicitly excluded defense costs, which Silverstein (WTCP's affiliate) accepted after failing to secure conventional coverage. The court also affirmed supplemental jurisdiction over the insurance claims due to their close relation to the underlying September 11th liability cases.

Insurance CoverageSeptember 11 AttacksWorld Trade CenterRule 12(c) MotionDeclaratory ReliefAdditional Insured StatusDefense CostsInsurance BinderNew York Insurance LawRegulation 107
References
48
Case No. MISSING
Regular Panel Decision

Dewan v. Blue Man Group Limited Partnership

Plaintiff Brian Dewan, a musician, sued the Blue Man Group entities and individuals, seeking a declaration of co-authorship for musical compositions used in their "Blue Man Group: Tubes" performance and damages for state law claims. Dewan claimed he collaborated with the defendants in composing music for the show and was repeatedly assured of his co-authorship rights and that an agreement would be formalized, but it never materialized. Defendants moved to dismiss, arguing the co-authorship claim under the Copyright Act was time-barred. The court found that Dewan's equitable estoppel argument was unreasonable after late 1993 or 1994, as he had sufficient notice that a lawsuit was necessary. Consequently, the court dismissed the federal co-authorship claim due to the expiration of the statute of limitations and declined to exercise supplemental jurisdiction over the remaining state law claims.

Copyright ActCo-authorshipStatute of LimitationsEquitable EstoppelMotion to DismissFederal JurisdictionState Law ClaimsMusical CompositionsCollaborationDeclaratory Judgment
References
11
Case No. MISSING
Regular Panel Decision

in Re Deepwater Horizon

Justice Johnson dissents from the Court’s decision on construing an insurance contract between BP and Transocean. Johnson argues that BP’s coverage under the policy should not be limited to liabilities Transocean assumed in the drilling contract. The dissent emphasizes that the policy's language for additional insureds and its definitions of "Insured" and "Insured Contract" should grant BP full coverage for liabilities imposed by general law, not solely those contractually assumed by Transocean. Johnson further notes that the insurer had previously used restrictive language in other contexts but chose not to in this policy concerning BP's status, and that the policy's "Conflicting Conditions Clause" mandates the broadest interpretation in favor of the Insured.

Insurance contract interpretationadditional insuredcontractual liabilitypolicy languagescope of coveragedissenting opiniontort liabilitywaivers of subrogationgeneral conditionsdefinitions
References
4
Showing 1-10 of 5,420 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational