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

Case No. 10-11-00142-CV
Regular Panel Decision
Jul 18, 2013

Dan Daniels v. Indemnity Insurance Co. of North America

Dan Daniels, an elevator installer for ThyssenKrupp Elevator Corporation, sued Indemnity Insurance Company of North America, his former employer's workers' compensation carrier, after an adverse administrative decision by the Texas Department of Insurance, Division of Workers’ Compensation (DWC). Daniels sought judicial review regarding the calculation of his Average Weekly Wage (AWW) and his post-injury earnings, specifically contesting the exclusion of certain payments made by ThyssenKrupp to his union for "health and other benefits" from his pre-injury AWW, and the valuation of a vehicle provided by the State of Missouri as part of his post-injury earnings. The trial court granted summary judgment for Indemnity and denied Daniels's motion for partial summary judgment. The appellate court affirmed the trial court's decision, concluding that the payments to the union were not includable in AWW and that Daniels's post-injury pecuniary and nonpecuniary wages were not less than 80% of his pre-injury AWW, thus disentitling him to Supplemental Income Benefits (SIBs).

Workers' CompensationSupplemental Income BenefitsAverage Weekly WageNonpecuniary WagesSummary JudgmentAppellate ReviewTexas Labor CodeAdministrative DecisionEmployer PaymentsPost-Injury Earnings
References
14
Case No. MISSING
Regular Panel Decision

Pacific Indemnity Insurance Company v. Liberty Mutual Insurance Company and Vidal Lopez

Pacific Indemnity Insurance, a workers' compensation carrier, sued Liberty Mutual Insurance for reimbursement in district court without first exhausting administrative remedies with the Industrial Accident Board (IAB). This lawsuit stemmed from a worker's injury in 1984 and subsequent re-injury in 1988. Pacific Indemnity, the carrier for the initial injury, continued to pay benefits after the re-injury and sought reimbursement from Liberty Mutual, the subsequent carrier, which was denied. The IAB issued orders regarding payments but did not address the reimbursement claim. The district court granted summary judgment for Liberty Mutual, a decision upheld on appeal because Pacific Indemnity failed to obtain an IAB ruling on the reimbursement issue before filing suit, thereby lacking jurisdiction in district court. The failure to exhaust administrative remedies bars the suit as a matter of law.

Administrative RemediesExhaustion DoctrineSummary JudgmentInsurance ReimbursementIndustrial Accident BoardJurisdictionAppellate ReviewCarrier DisputeRepetitious TraumaTexas Workers' Compensation Law
References
3
Case No. MISSING
Regular Panel Decision

Travelers Indemnity Co. of Rhode Island v. Starkey

The Travelers Indemnity Company of Rhode Island appealed a trial court's judgment that awarded death benefits to Lynn Edward Starkey and Hazel Dean Starkey under the Texas Workers’ Compensation Act. The case stemmed from Jonathan Starkey's work-related injuries in 1984, for which Travelers paid indemnity benefits until his death in 2001. His parents subsequently sought death benefits, which Travelers disputed, asserting a right to deduct previously paid benefits. The trial court found that Travelers had waived this credit in a third-party settlement agreement. The appellate court affirmed, concluding that the contractual language constituted a waiver of Travelers' rights to an offset and upheld the award of benefits, attorneys' fees, interest, and costs to the Starkeys.

Workers' CompensationDeath BenefitsIndemnity BenefitsThird-Party SettlementContractual WaiverCredit OffsetWage Rate DisputeAppellate CourtTexas LawEvidentiary Sufficiency
References
22
Case No. 03-95-00464-CV
Regular Panel Decision
Jun 12, 1996

Robert Schorovsky v. SIR Lloyds Insurance Company and Standard Financial Indemnity Corporation

Robert Schorovsky sued SIR Lloyds Insurance Company and Standard Financial Indemnity Corporation (SFIC) for alleged failure to timely pay workers' compensation benefits after an on-the-job injury. SFIC, Schorovsky's workers' compensation carrier, was placed into temporary and then permanent receivership, leading to suspensions of benefit payments. Schorovsky appealed the trial court's grant of summary judgment in favor of the appellees. The Court of Appeals affirmed the trial court's judgment, concluding that Schorovsky failed to preserve his constitutional challenge to Article 21.28, § 4(f) of the Texas Insurance Code and did not successfully challenge all independent grounds for summary judgment against SFIC. Furthermore, the court found SIR Lloyds was not liable as it was not the carrier at the time of the injury.

Workers' CompensationSummary JudgmentReceivershipInsurance LawAppellate ProcedureConstitutional LawTexas Insurance CodeBenefit ReviewExhaustion of Administrative RemediesOpen Courts Doctrine
References
12
Case No. 03-94-00339-CV
Regular Panel Decision
Aug 16, 1995

Charlie Franks and Industrial Indemnity Insurance Company v. Sematech, Inc., F/D/B/A Semi Conductor Manufacturing Technology Initiative And Burle Industries, Inc.

This case from the Texas Court of Appeals addresses an injured employee's third-party liability claim and an insurance carrier's derivative subrogation rights under the Texas Workers' Compensation Act. Charlie Franks was injured, and the workers' compensation carrier, Industrial Indemnity Insurance Company, paid benefits and subsequently filed a subrogation lawsuit. Franks intervened with his own negligence claim, but his intervention was dismissed due to the two-year statute of limitations. Consequently, the trial court granted summary judgment against Industrial Indemnity, ruling its derivative subrogation claim moot as Franks's underlying rights could not be established. The appellate court affirmed both decisions, emphasizing that Industrial Indemnity's initial suit did not assert Franks's full third-party liability cause of action for his joint benefit.

Workers' CompensationSubrogationStatute of LimitationsThird-Party LiabilitySummary JudgmentPlea in InterventionAppellate ReviewTexas LawInsurance Carrier RightsDerivative Claim
References
17
Case No. MISSING
Regular Panel Decision

Home Indemnity Co. v. Pate

Home Indemnity, a worker's compensation carrier, made payments to employee Charles Riddle, who subsequently sued Allied Chemical Corporation in federal court. Home Indemnity's attempt to intervene in the federal suit to assert its subrogation lien was denied as untimely. Riddle and Allied Chemical settled without addressing Home Indemnity's claim. Consequently, Home Indemnity filed a state court suit against Riddle, Allied Chemical, attorney Gordon Pate, and his law firm, alleging conversion for disbursing funds without acknowledging the lien. Pate's motion for summary judgment, citing res judicata/collateral estoppel and good faith reliance on the federal judgment, was granted by the trial court. The appellate court reversed and remanded, ruling that Home Indemnity was not barred by res judicata or collateral estoppel since it was not a party to the federal judgment on the merits of its claim, and that good faith is not a defense to conversion.

Subrogation LienSummary Judgment AppealRes JudicataCollateral EstoppelConversionInsurance Carrier RightsThird-Party LiabilityTexas Civil PracticeFederal Judgment ImpactAttorney Liability
References
16
Case No. MISSING
Regular Panel Decision
May 26, 1993

Hartford Accident & Indemnity Co. v. Buckland

This case involves Hartford Accident and Indemnity Company appealing a trial court's judgment in favor of the Buckland family. Hartford, a workers' compensation insurer, had issued a policy to Fish Engineering and Construction, Inc. and waived its subrogation rights against Phillips Petroleum and Phillips 66 by contract. Buckland, an injured employee of Fish, received a $3.2 million settlement from Phillips Petroleum and Phillips 66 and a $75,000 settlement from Figgie. Hartford sought a credit for future benefit payments from the Phillips settlement and disputed the award of attorney's fees to Buckland's attorney from the Figgie settlement. The appellate court affirmed the trial court's decision, ruling that Hartford's waiver of subrogation rights also waived its right to future credits and upheld the attorney's fee award to Buckland's attorney, finding no abuse of discretion.

Workers' CompensationSubrogation WaiverAttorney's Fees ApportionmentContractual InterpretationFuture Benefit CreditSummary Judgment ReviewAbuse of Discretion StandardTexas Workers' Compensation ActThird-Party LiabilityInsurance Law
References
17
Case No. MISSING
Regular Panel Decision

Texas General Indemnity Co. v. Hearn

This workers' compensation case involves Margaret Ann Hearn (appellee) and Texas General Indemnity Company (appellant). Hearn alleged a work-related injury at Louisiana-Pacific and filed a claim for benefits under the Texas Workers’ Compensation Act. Texas General Indemnity Company, the workers' compensation insurer, contended that Hearn made an election of remedies by previously filing for and receiving medical and disability benefits from Louisiana-Pacific's group health carrier, Metropolitan Life Insurance Company, based on representations that her condition was not work-related. The trial court prevented the introduction of evidence regarding the election of remedies, and a jury returned a verdict in favor of Hearn. The appellant appealed, and the higher court reversed the judgment, remanding the case for a full trial on the merits, ruling that the exclusion of evidence regarding the election of remedies was an error.

election of remediesworkers' compensationevidentiary errorreversalremandgroup health benefitsjob-related injurynon-work related injuryappellate proceduretrial court error
References
9
Case No. MISSING
Regular Panel Decision

Associated Indemnity Co. v. Hartford Accident & Indemnity Co.

Hartford Accident & Indemnity Company, a workmen's compensation insurer for a temporary labor contractor (Greene's Temporaries, Inc.), sued Associated Indemnity Company, the insurer for a customer (Frito-Lay Company), seeking subrogation for a compensation claim paid to an injured temporary employee. Hartford contended the loss was covered by Associated's policy as the employee was under Frito-Lay's control. The court reversed the trial court's decision in favor of Hartford, denying equitable subrogation. The appellate court found that Hartford had collected premiums for the temporary employees and was charged with knowledge of the contractual arrangement, thus preventing unjust enrichment if subrogation were granted.

Workmen's CompensationTemporary EmploymentSubrogationInsurance LawBorrowed Servant DoctrineRight of ControlEquitable RemediesUnjust EnrichmentInsurance PremiumsContractual Agreements
References
17
Case No. MISSING
Regular Panel Decision

Claim of Joslin v. City of Albany Fire Department

The claimant appealed a Workers’ Compensation Board decision regarding the method of payment for his hearing loss benefits, specifically challenging the biweekly installment plan. The claimant argued that Workers’ Compensation Law § 49-bb, which governs occupational loss of hearing claims, mandated a different payment method. The court rejected this contention, asserting that Workers’ Compensation Law § 15 (3) (m), which covers schedule awards for hearing losses generally, and § 49-cc, which directs occupational loss of hearing compensation to align with § 15 (3), govern the payment. Consequently, the court affirmed that the claimant was entitled to biweekly scheduled payments, consistent with other schedule loss awards.

Hearing lossWorkers' CompensationOccupational diseaseSchedule awardBiweekly paymentsStatutory interpretationAppealCompensation benefitsWorkers' Compensation Board
References
2
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