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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
Nov 07, 1975

Buchanan v. New York City Health & Hospitals Corp.

The case concerns an appeal challenging a hospital lien and the application of a contractual period of limitations in an insurance policy. The plaintiff, as executrix of Percy Buchanan, sought to challenge a lien filed by the New York City Health and Hospitals Corporation and compel Associated Hospital Services (AHS) to cover remaining hospital costs. The lower court initially granted AHS summary judgment, finding the action time-barred. However, the appellate court modified this decision, denying AHS's cross-motion for summary judgment. It ruled that a question of fact existed regarding whether AHS could be estopped from asserting the limitations period, given its silence on claim rejections until after the period had expired.

Hospital LienContractual Limitations PeriodSummary Judgment MotionEquitable EstoppelHealth Insurance PolicyStatute of LimitationsAppellate Court DecisionInsurance Coverage DisputeExecutorshipGroup Health Insurance
References
3
Case No. MISSING
Regular Panel Decision

Bashara v. Baptist Memorial Hospital System

This case involves a quantum meruit claim by attorney Sam C. Bashara for fees from a hospital lien held by Baptist Memorial Hospital System. Kelley F. Axtell, Bashara's client, was injured in an automobile accident, leading to a settlement with Texas Farmers Insurance Company. Bashara sought a portion of the settlement proceeds allocated to Baptist Hospital's lien. The trial court initially awarded Bashara quantum meruit recovery, but the court of appeals reversed this decision. The Supreme Court of Texas affirmed the court of appeals, holding that a plaintiff’s attorney cannot enforce a quantum meruit claim against a health care provider to reduce the amount recoverable by a hospital lien. The Court rejected arguments based on quantum meruit, the common fund doctrine, and an analogy to workers' compensation statutes, emphasizing the statutory intent to ensure full payment of hospital liens.

Hospital LienQuantum MeruitAttorney FeesCommon Fund DoctrineStatutory InterpretationTexas Property CodeCivil ProcedureDebtor-CreditorSettlement ProceedsMedical Services
References
18
Case No. MISSING
Regular Panel Decision

Huntington Hospital v. Huntington Hospital Nurses' Ass'n

Huntington Hospital initiated an action under the Federal Arbitration Act to partially vacate an arbitration award, while the Huntington Hospital Nurses’ Association cross-petitioned to confirm it. The dispute originated from the Hospital unilaterally granting two nurses, Betty Evans and Lynn Meyer, longevity pay credits exceeding the ten-year cap stipulated in their collective bargaining agreement (CBA). The arbitrator found the Hospital violated the CBA's sections on pay and exclusive bargaining rights. The arbitrator mandated the Hospital roll back excess credits and recover overpayments. The District Court denied the Hospital's petition, dismissing arguments regarding public policy, manifest disregard for law, and lack of award finality, ultimately confirming the arbitration award.

Arbitration AwardCollective Bargaining AgreementLabor LawFederal Arbitration ActWage DisputesLongevity PayUnion RightsPublic Policy ExceptionManifest Disregard of LawContract Interpretation
References
22
Case No. 03-02-00429-CV
Regular Panel Decision
May 30, 2003

Hospitals and Hospital Systems v. Continental Casualty Company

Hospitals and Hospital Systems appealed a declaratory judgment favoring Continental Casualty Company and other insurers, concerning the application of a one-year statute of limitations (rule 133.305(a)) for workers' compensation medical claims. The claims arose after the 1992 Acute Care Hospital Fee Guideline was invalidated. Hospitals argued the limitations period should be tolled due to prior litigation challenging the guideline and that the Commission waived the rule through a settlement agreement. The Texas Court of Appeals, Third District, Austin, found no basis for tolling, noting hospitals were not prevented from filing claims earlier. It also ruled that the Commission's executive director lacked authority to waive the rule, and that any waiver could not revive time-barred claims. The court affirmed the trial court's judgment, upholding the applicability of rule 133.305(a) and barring the Hospitals' claims.

Workers' CompensationAdministrative LawDeclaratory JudgmentStatute of LimitationsTollingWaiverTexas Court of AppealsFee GuidelinesMedical Dispute ResolutionAgency Rules
References
10
Case No. NO. 09-04-368 CV
Regular Panel Decision
Apr 28, 2005

Silsbee Hospital, Inc. D/B/A Columbia Silsbee Doctors Hospital v. Lonny George

Lonny George, an employee of Silsbee Hospital, Inc., a nonsubscriber to workers' compensation, sustained injuries and sued the hospital. He had signed a waiver agreement related to an employee benefit plan, which the hospital contended released them from liability for personal injuries. The Court of Appeals examined the waiver agreement's language, applying contract construction rules and the express negligence doctrine, and found it only applied to the parent company, Columbia/HCA Healthcare Corporation, not the subsidiary Hospital, as George's injuries arose from employment with the Hospital. The court also rejected the Hospital's affirmative defenses of ratification, release, waiver, and estoppel. However, the appellate court determined there was harmful error in jury selection due to the trial court's failure to strike two unequivocally biased veniremembers. Consequently, the judgment was reversed and the case remanded for a new trial.

NonsubscriberWorkers' Compensation WaiverEmployee InjuryExpress Negligence RuleJury BiasAppellate ReversalRemand for New TrialContract InterpretationAffirmative DefensesTexas Law
References
38
Case No. 09-05-231 CV
Regular Panel Decision
May 25, 2006

Joseph Richards v. American National Property and Casualty Company, Joanie Cummins, Dewey L. Vines, Tina M. Vines, Brenda Vines and Christus Health Southeast Texas D/B/A Christus St. Elizabeth Hospital

Joseph Richards (Appellant) filed a petition for declaratory relief against American National Property and Casualty Company (ANPAC), Joanie Cummins, Dewey L. Vines, Tina M. Vines, Brenda Vines, and Christus Health Southeast Texas d/b/a Christus St. Elizabeth Hospital (Appellees). Richards sought a determination regarding the defendants' alleged violation of a settlement release agreement by issuing a separate draft payable to him and St. Elizabeth Hospital. The dispute arose from an automobile accident where Richards incurred medical expenses at St. Elizabeth, and ANPAC issued two checks, one to Richards and his attorney, and another to Richards and St. Elizabeth, after being informed of a hospital lien. The trial court granted summary judgment motions in favor of the defendants, which Richards appealed. The Court of Appeals affirmed the trial court's judgment, finding ANPAC acted reasonably and the hospital lien was valid.

Settlement AgreementHospital Lien LawTexas Property CodeSummary JudgmentDeclaratory ReliefBreach of ContractMotion for ContinuanceMotion for New TrialAutomobile AccidentMedical Expenses
References
14
Case No. 2-05-303-CV
Regular Panel Decision
Mar 30, 2006

Sally Downs v. Triad-Denton Hospital, L.P. D/B/A Denton Community Hospital

Sally Downs, a licensed vocational nurse employed by Advantage Nursing Services, Inc., sustained injuries after slipping and falling on a wet floor at Triad-Denton Hospital, where she was temporarily assigned. Downs received workers' compensation benefits through her employer's policy. She subsequently sued the Hospital for her injuries. The Hospital moved for summary judgment, asserting the affirmative defense of the Texas Workers’ Compensation Act’s exclusive remedy provision, arguing Downs was a borrowed servant. The trial court granted summary judgment in favor of the Hospital. The Court of Appeals reversed and remanded the case, holding that the trial court erred because the Hospital failed to specially plead the affirmative defense as required by Texas Rule of Civil Procedure 94, and Downs had properly objected to this omission.

Workers' CompensationBorrowed Servant DoctrineSummary JudgmentAffirmative DefenseExclusive RemedyTexas Labor CodeAppellate ProcedureProcedural ErrorPersonal InjuryPremises Liability
References
2
Case No. 03-21-00242-CV
Regular Panel Decision
Dec 28, 2022

Vista Medical Center Hospital, Surgery Specialty Hospital of America, Southeast Houston and Vista Hospital of Dallas v. Texas Mutual Insurance Company

This appeal stems from a dispute over workers' compensation medical benefits reimbursement between multiple hospitals (Vista Parties) and numerous insurance carriers (Carriers) in Texas. The core issue revolves around the application of a "stop-loss exception" under Former Rule 134.401, designed for unusually costly or lengthy hospital stays, which the Vista Parties sought for 542 injured workers. After the State Office of Administrative Hearings (SOAH) largely denied additional reimbursement, the district court affirmed SOAH's order. The Court of Appeals, Third District, affirmed the district court's judgment, rejecting the Vista Parties' arguments that the SOAH order was arbitrary and capricious or lacked substantial evidence. The court found that SOAH properly conducted a case-by-case inquiry into whether services were "unusually costly and unusually extensive" and did not err in its application of the rule or in its findings.

Workers' CompensationMedical ReimbursementStop-Loss ExceptionAdministrative LawAppellate CourtTexas Court of AppealsSubstantial Evidence ReviewArbitrary and CapriciousFee GuidelinesHospital Reimbursement
References
51
Case No. MISSING
Regular Panel Decision

League of Voluntary Hospitals & Homes v. Local 1199, Drug, Hospital & Health Care Workers Union

The court addresses an application for a preliminary injunction against Local 1199, a union planning a three-day strike. The League of Voluntary Hospitals and Homes of N. Y. sought the injunction following a previous temporary restraining order concerning a one-day strike. The union argued that each planned strike required a new legal proceeding, but the court deemed the strikes "episodic and organically connected." Citing concerns about blocked ingress/egress to hospitals and the union president's threats to "shut down" facilities, the judge found a preliminary injunction necessary under Labor Law § 807 to protect public health and safety. The injunction restrains the union from unlawfully interfering with hospital operations, blocking access, and picketing within certain distances of hospital entrances and emergency rooms.

Labor DisputePreliminary InjunctionStrike ActionUnion ActivityHospital AccessPicketing RegulationsCollective BargainingCivil Disobedience ThreatPublic Health and SafetyIngress Egress Interference
References
1
Case No. MISSING
Regular Panel Decision

Hermann Hospital v. Vardeman

Hermann Hospital intervened in a wrongful death lawsuit, asserting a hospital lien for medical services. After the original parties settled, the hospital pursued its claims for prejudgment interest and attorney's fees from the settlement proceeds. The trial court denied these additional claims, upholding only the hospital's original lien amount. On appeal, the Chief Justice affirmed the trial court's decision, ruling that the hospital lien statute does not provide for prejudgment interest or attorney's fees. The court further determined that the rationales of Cavnar v. Quality Control Parking, Inc. and Tex.Civ.Prac. & Rem.Code Ann. sec. 38.001 do not apply to an intervenor's action based strictly on the hospital lien statute.

Hospital lienPrejudgment interestAttorney's feesIntervenorWrongful deathSettlementStatutory interpretationTexas Property CodeTexas Civil Practice and Remedies CodeAppellate review
References
2
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