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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Employers Insurance v. General Accident, Fire & Life Assurance Corp.

Employers Insurance of Wausau (Wausau) sought summary judgment for 50% reimbursement of a $500,000 settlement and defense costs. The settlement stemmed from an underlying personal injury action where Frank Rayno, an employee of Sage Garage, was injured on a construction site in 1976. Wausau provided workers' compensation and employer's liability insurance to Sage Garage, while General Accident provided general liability coverage. Wausau paid the full settlement and then pursued General Accident for contribution. General Accident argued for a pro rata contribution based on policy limits. The court granted Wausau's motion for summary judgment, ruling that both insurers should contribute equally up to the limit of the smaller policy, which was General Accident's $500,000 policy, meaning General Accident owed $250,000. The defendants' cross-motion was denied.

Insurance disputeSummary judgmentDeclaratory judgmentContribution among insurersReimbursementPolicy limitsEmployer's liability insuranceGeneral liability insuranceWorkers' compensationPro rata contribution
References
0
Case No. MISSING
Regular Panel Decision
Jun 30, 1992

National General Insurance v. Hartford Accident & Indemnity Co.

This case concerns a declaratory judgment action regarding insurance coverage following a fatal airplane crash. Warren Geddes, president of American Investor Services, Inc. (AIS), was piloting a plane carrying Gary Conway, an AIS employee, when it crashed, killing both. National General Insurance Company, insurer of the plane owner, sought for Hartford Accident and Indemnity Company, AIS's workers' compensation insurer, to defend and indemnify AIS and Geddes' Estate in a wrongful death action. Hartford denied coverage for Geddes' Estate, arguing he was not a named or additional insured under their policy. The court modified the initial judgment, declaring that Hartford has no duty to defend or indemnify the Estate of Geddes, while otherwise affirming the judgment.

Insurance CoverageDeclaratory JudgmentWrongful DeathDuty to DefendDuty to IndemnifyNamed InsuredAdditional InsuredWorkers' Compensation PolicyAirplane CrashEstate Liability
References
5
Case No. MISSING
Regular Panel Decision

Home Life & Accident Co. v. Wade

This case involves an appeal by the Home Life & Accident Company from an award of the Industrial Accident Board in favor of C. Wade. Wade, an an employee of A. C. MacParlane, sustained injuries while loading steel cranes onto a barge in the navigable Sabine River. The central legal question was whether Wade's maritime injury fell under the Texas Workmen’s Compensation Law or the exclusive admiralty jurisdiction of federal courts. The trial court initially awarded compensation to Wade under state law. However, the appellate court, citing various U.S. Supreme Court precedents and an Attorney General's opinion, concluded that maritime injuries are subject to federal admiralty law, thus precluding state workers' compensation jurisdiction. Consequently, the trial court's judgment was reversed, and the appellate court ruled in favor of the Home Life & Accident Company.

Admiralty lawMaritime jurisdictionWorkers' compensationFederal preemptionState lawInjury at workNavigable watersLongshoremanSabine RiverEmployer liability
References
5
Case No. MISSING
Regular Panel Decision

Aubry v. General Accident Insurance

Aubry Transportation, Inc. hired Wayne Felts to perform welding work, during which Donald Aubry's son lost consciousness due to poisonous fumes, and Aubry subsequently suffered a fatal heart attack. The administratrix of Aubry's estate sued Aubry Transportation, Inc. for negligence. General Accident Insurance, the corporation's insurer, disclaimed coverage and refused to defend, citing policy exclusions for employee injury in the course of employment and obligations under the Workers’ Compensation Law, along with a failure to give prompt notice. The plaintiff then initiated an action seeking a declaration that General Accident had a duty to defend. General Accident appealed from an order denying its motion for summary judgment, with a dissenting opinion arguing that summary judgment should have been granted due to the clear applicability of policy exclusions and the lack of coverage.

Insurance Coverage DisputeDuty to DefendPolicy ExclusionsSummary Judgment AppealEmployer NegligenceWorkers' Compensation ExclusionLate Notice ClaimDeclaratory Relief ActionWrongful DeathWelding Accident
References
2
Case No. MISSING
Regular Panel Decision

O'Keefe v. General Accident Insurance

Plaintiff Violet O'Keefe initiated an action against General Accident Insurance Company, alleging disparate treatment and retaliation based on age and sex, violating Title VII, ADEA, and New York Human Rights Law. O'Keefe claimed a discriminatory work environment and unlawful termination following her refusal of a proposed job transfer. The defendant argued O'Keefe's performance was poor and the transfer was a lateral move. The District Court denied the defendant's motion for summary judgment regarding the federal discrimination and retaliation claims, finding a genuine issue of material fact existed as to whether General Accident's reasons for termination were pretextual. However, the Court granted summary judgment for the defendant on the state law claims, declining to exercise pendent jurisdiction.

DiscriminationAge DiscriminationSex DiscriminationTitle VIIADEARetaliationSummary JudgmentEmployment LawPretextPrima Facie Case
References
19
Case No. 13-21-00361-CV
Regular Panel Decision
Oct 12, 2023

Accident Fund General Insurance Company v. Rodrigo Mendiola

Rodrigo Mendiola, a truck driver, suffered severe burns in an accident, leading to an above-the-knee amputation and significant injury to his left hand. His employer's workers' compensation insurer, Accident Fund General Insurance Company, disputed his claim for lifetime income benefits based on the total loss of use of his left hand. The trial court, applying the Travelers Insurance Co. v. Seabolt standard, found sufficient evidence that Mendiola's hand lacked substantial utility, entitling him to benefits. The Court of Appeals affirmed the trial court's judgment, upholding the application of the Seabolt standard and concluding the evidence factually supported the finding of total loss of use.

Workers' CompensationLifetime Income BenefitsTotal Loss of UseBurn InjuriesHand InjuryAmputationMedical EvidenceFactual SufficiencyAppellate ReviewStare Decisis
References
29
Case No. MISSING
Regular Panel Decision

Government Employees Insurance v. Kolodny

Government Employees Insurance Company (GEICO) initiated a declaratory judgment action to determine if it was obligated to indemnify Chaim S. Kolodny or provide coverage for claims stemming from a fatal 1990 automobile accident. GEICO argued a policy exclusion applied because the vehicle was for Kolodny's regular use. The Supreme Court initially granted GEICO's motion for summary judgment. However, the appellate court reversed this decision, ruling that GEICO's disclaimer, issued over a year after receiving notice of the accident, was untimely and lacked an adequate explanation for the delay. Consequently, GEICO was found to be obligated to provide coverage. The appeal from the intermediate order was dismissed.

Insurance CoverageAutomobile AccidentDeclaratory JudgmentTimely DisclaimerPolicy ExclusionSummary JudgmentAppellate ReviewEstate AdministrationIndemnificationRegular Use Clause
References
6
Case No. W2008-01771-COA-R3-CV
Regular Panel Decision
Jan 26, 2011

Shelby County Health Care Corporation, d/b/a Regional Medical Center v. John Baumgartner, Elizabeth Baumgartner, a/k/a Daray Baumgartner, Nationwide Mutual Insurance Company, and Hartford Accident and Indemnity

This appeal concerns the impairment of a hospital lien by Shelby County Health Care Corporation (The MED) against John Baumgartner and his insurance providers, Nationwide Mutual Insurance Company and Hartford Accident and Indemnity. Mr. Baumgartner received extensive medical treatment at The MED following an automobile accident, incurring over $500,000 in expenses, for which The MED filed a hospital lien. Subsequently, Nationwide and Hartford settled with the Baumgartners, paying out policy limits of $25,000 and $100,000 respectively, without remitting any funds to The MED. The trial court initially granted partial summary judgment, finding impairment of the lien and awarding damages. On appeal, the Court of Appeals affirmed the finding of lien impairment but reversed the damage awards, concluding that The MED's recovery is limited to one-third of the amounts the insurers paid to the Baumgartners, and remanded the case for further proceedings consistent with this interpretation.

Hospital Lien ActInsurance LawAutomobile AccidentSubrogationMade-Whole DoctrineStatutory InterpretationDamages for ImpairmentConstructive NoticeMedical ExpensesSettlement Agreements
References
33
Case No. MISSING
Regular Panel Decision

Texas Employers Insurance Ass'n v. Goad

Leslie Jean Goad and her children initiated a worker's compensation lawsuit to claim fatal benefits after the death of John Goad, her husband. John Goad, an installation foreman for S. K. Church Furniture Company, died in a truck accident while allegedly returning from a job in Spring Hill, Texas. The jury found that Goad was in the course and scope of his employment at the time of the fatal accident, leading to a judgment in favor of the plaintiffs. The insurance company appealed, contesting the sufficiency of evidence regarding Goad's employment status and arguing that the jury's verdict was based on speculation. The appellate court affirmed the trial court's judgment, concluding that there was ample circumstantial evidence for the jury to infer that Goad was engaged in his employer's business at the time of the accident.

Worker's CompensationFatal BenefitsCourse and Scope of EmploymentTruck AccidentTravel TimeJury VerdictAppellate ReviewSufficiency of EvidenceInferencesSpeculation
References
20
Case No. MISSING
Regular Panel Decision
Feb 15, 1950

Hartford Accident & Indemnity Co. v. Christensen

O. L. Christensen filed two consolidated suits after losing his right eye: one for common-law damages against Q. J. Aaberg and Passmore, and another for workmen's compensation against Hartford Accident and Indemnity Co., Aaberg's insurer. The core dispute was whether Aaberg's workmen's compensation policy with Hartford covered Christensen, especially as Aaberg claimed he did not intend to cover employees in the specific welding shop where Christensen was injured. The trial court and Court of Civil Appeals initially found coverage, but the Supreme Court of Texas reversed this, ruling that Aaberg did not contract with Hartford to provide compensation coverage for Christensen's employment. Consequently, the judgment in the compensation suit was rendered in favor of Hartford, and Christensen's common-law action for damages was remanded to the trial court.

Workers' CompensationInsurance CoverageEmployee StatusIndependent ContractorCommon-Law DamagesConsolidated CasesEmployer LiabilityEye InjuryTexas LawPolicy Interpretation
References
3
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