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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. MISSING
Regular Panel Decision

K. R. Playa VI, S. De R.L. De C v. v. Stewart Title Guaranty Company and Stewart Title Guaranty De Mexico, S.A. De C v.

This case involves a consolidated appeal over title insurance claims for properties in Mexico. Appellants Citigroup Global Markets Realty Group and K.R. Playa VI challenged a trial court's judgment favoring appellees Stewart Title Guaranty Company and Stewart Title Guaranty de Mexico. The dispute centered on whether an exclusion in the title insurance policies, related to K.R. Playa's knowledge of a Mexican expropriation decree affecting the properties, precluded coverage and influenced the damages award. The jury found K.R. Playa knew of the decree for ten properties and awarded zero damages for the remaining six. The appellate court affirmed the trial court's judgment, upholding the jury's findings on K.R. Playa's knowledge and the zero damages, and addressing issues concerning expert testimony and state-law claims.

Title InsuranceReal Estate DisputeProperty ValuationBreach of ContractGood Faith and Fair DealingTexas Insurance CodeExpropriation DecreeMexican LawInternational PropertyAppellate Review
References
18
Case No. 03-01-00084-CV
Regular Panel Decision
Nov 07, 2002

John W. Berkel and John W. Berkel, P.C./Texas Property and Casualty Insurance Guaranty Association v. Texas Property and Casualty Insurance Guaranty Association/John W. Berkel and John W. Berkel, P.C.

This case involves cross-appeals from a judgment by the District Court of Travis County. John W. Berkel and John W. Berkel, P.C. (Berkel) sued the Texas Property and Casualty Insurance Guaranty Association (TPCIGA) and a receiver, seeking to enforce a contract for $6,306, which represented a previously approved "covered claim" for legal services. The trial court awarded Berkel the $6,306 but denied claims for statutory attorney's fees, prejudgment, and postjudgment interest. TPCIGA appealed the $6,306 award, arguing the claim was not a covered claim, but the appellate court affirmed this part, holding the Receiver's prior determination was binding. Berkel appealed the denial of attorney's fees and interest, and the appellate court reversed and remanded this part for further proceedings.

Insurance LawReceivershipImpaired InsurerCovered ClaimsStatutory InterpretationAttorney's FeesPrejudgment InterestPostjudgment InterestSummary JudgmentContract Enforcement
References
9
Case No. MISSING
Regular Panel Decision
Feb 26, 1998

Texas Property & Casualty Insurance Guaranty Ass'n v. Southwest Aggregates, Inc.

This appeal addresses an insurer's (Alliance) duty to defend its insured (Southwest Aggregates) in silicosis lawsuits and the Texas Property and Casualty Insurance Guaranty Association's (Guaranty Association) obligations after another insurer (ECC) became insolvent. Key issues included whether an insurer's defense duty is pro rata for occurrences spanning multiple policy periods, if the right to a defense must be exhausted against solvent insurers before the Guaranty Association's duty triggers, and the availability of attorney's fees. The court affirmed that an insurer owes a complete, not pro rata, defense and that the right to defense must be exhausted against solvent insurers. However, the court reversed the denial of attorney's fees to the Guaranty Association, holding they are recoverable for a subrogated breach of contract claim.

Insurance LawDuty to DefendPro Rata AllocationExhaustion DoctrineImpaired InsurerGuaranty AssociationSubrogation RightsAttorney's FeesSummary Judgment AppealContract Breach
References
42
Case No. 03-11-00688-CV
Regular Panel Decision
Jul 03, 2012

Approach Operating, LLC v. Resolution Oversight Corporation, as Special Deputy Receiver of Financial Insurance Company of America And the Texas Property and Casualty Insurance Guaranty Association

This case concerns an appeal from a summary judgment regarding a workers' compensation carrier's subrogation rights. Appellant Approach Operating, LLC, a general contractor, argued that the carrier had waived its subrogation rights through a Master Service Agreement (MSA) with subcontractor Lilly Construction, Inc. An employee of Lilly, Rodolfo Martinez, was injured and received workers' compensation benefits from Financial Insurance Company of America (FICA) and later The Texas Property and Casualty Insurance Guaranty Association (TPCIGA). The district court found no waiver of subrogation and granted summary judgment for FICA and TPCIGA. The Texas Court of Appeals, Third District, affirmed the lower court's judgment, emphasizing that explicit contractual language is required for a waiver of subrogation, which was absent in the MSA.

Workers' CompensationSubrogation WaiverMaster Service AgreementContract InterpretationSummary JudgmentTexas Court of AppealsInsurance LawOil and Gas IndustryExplicitness RuleThird-Party Claim
References
24
Case No. MISSING
Regular Panel Decision

Muller v. Stewart Title Guaranty Co.

This case involves a business venture for a golf resort in La Paz, Mexico, where Thomas Muller contributed funds to an escrow agreement managed by Stewart Title Guaranty Company (STGC) and its employee Joseph Alvarado. Muller sued STGC and Alvarado for releasing remaining escrow funds to a La Paz account instead of to him after the agreement was cancelled. The trial court granted summary judgment in favor of STGC and Alvarado, and also struck Muller's amended petition and La Paz's petition in intervention. On appeal, Muller argued errors in summary judgment on contract and fiduciary claims, and abuses of discretion regarding discovery and striking petitions. The appellate court affirmed the trial court's judgment, concluding Muller was neither a party nor a third-party beneficiary to the escrow agreement, thus STGC owed him no contractual or fiduciary duties, and the trial court did not abuse its discretion in striking La Paz's interventions.

Business VentureEscrow AgreementSummary JudgmentContract ClaimsFiduciary ClaimsThird-Party BeneficiaryAppellate ReviewAbuse of DiscretionInterventionTexas Law
References
52
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. MISSING
Regular Panel Decision

Steven L. Scherer, Michael Joseph Neal and Total Solutions, Inc. v. the Texas Property and Casualty Insurance Guaranty Association

The case concerns an appeal by Steven L. Scherer, Michael Joseph Neal, and Total Solutions, Inc. against the denial of attorney's fees from the Texas Property and Casualty Insurance Guaranty Association. Appellants sought reimbursement for fees incurred defending a copyright infringement suit, arguing their original insurer, International Underwriters Insurance Company (IUIC), failed its duty to defend. After IUIC was declared impaired, the Guaranty Association was added as a defendant. The appellate court affirmed the summary judgment, holding that the attorney's fees incurred before the insurer's impairment determination were explicitly excluded from "covered claims" under the Property and Casualty Guaranty Act, irrespective of the insurer's duty to defend. The court also noted the Act's $100,000 cap on claims, with an exception for workers' compensation which did not apply here.

Insurance DisputeAppellate LawAttorney Fee RecoveryStatutory ExclusionInsurer InsolvencyProperty and Casualty Guaranty ActDuty to DefendCopyright LitigationTexas LawSummary Judgment Appeal
References
2
Case No. MISSING
Regular Panel Decision

United States Fidelity & Guaranty Co. v. Bituminous Casualty Corp.

Bituminous Casualty Corporation initiated a declaratory judgment suit against United States Fidelity and Guaranty Company, the City of Kingsport, and James Christian to ascertain which insurer was liable for a workers' compensation judgment awarded to Christian. The core of the dispute revolved around the specific date of Christian's injury, with two potential dates falling under different insurance coverage periods. The trial court initially assigned liability to United States Fidelity and Guaranty Company, finding Christian's disability resulted from an injury on February 8, 1960. However, on appeal, this Court reversed that decision. The appellate court determined that the issue of Christian's injury date had already been conclusively litigated in a prior workers' compensation suit, making the plea of res judicata applicable, and also concluded that the evidence pointed to the earlier injury date of September 28, 1959. Consequently, the trial court's judgment was reversed, and the case was dismissed, with all appeal costs charged to Bituminous Casualty Corporation.

Res JudicataWorkers' CompensationInsurance LiabilityDeclaratory ReliefInjury Date DeterminationAppellate CourtBurden of ProofEstoppel by JudgmentTennessee LawPrior Adjudication
References
4
Case No. NO. 03-06-00631-CV
Regular Panel Decision
Mar 26, 2009

Samuel Campos v. Texas Property & Casualty Insurance Guaranty Association for Reliance National Indemnity Company, an Impaired Carrier

Samuel Campos, an employee, was injured on the job, leading to disputes over his impairment rating and reimbursement for travel expenses. The Texas Workers’ Compensation Commission affirmed a designated doctor's 6% impairment rating and denied travel expenses, which Campos challenged in court. The case involved the Texas Property & Casualty Insurance Guaranty Association (TPCIGA) because Campos's employer's insurer became impaired. Initially filed in Winkler County, the case was transferred to Travis County, where TPCIGA was granted summary judgment. The Third District Court of Appeals reversed the summary judgment, ruling that the Workers' Compensation Act's specific mandatory venue provision, which places venue in the county of the employee's residence at the time of injury (Winkler County), overrides the Guaranty Act's general venue provision, which would place it in Travis County. The court remanded the case with instructions to transfer it to Winkler County.

Workers' CompensationVenue DisputeMandatory VenueStatutory ConstructionTexas Labor CodeTexas Insurance CodeImpairment RatingTravel Expenses ReimbursementJudicial ReviewAppellate Procedure
References
12
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