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

Case No. 03-04-00050-CV
Regular Panel Decision
Jul 29, 2004

Al Boenker Insurance Agency, Inc. v. the Texas FAIR Plan Association The Texas Department of Insurance And Jose Montemayor, Commissioner of Insurance

Appellant Al Boenker Insurance Agency, Inc. appealed a summary judgment ruling in favor of the Texas FAIR Plan Association (FAIR Plan). Al Boenker had challenged a bulletin issued by FAIR Plan, which restricted fees insurance agencies could charge for homeowners insurance applications and allowed for termination of agencies violating the contract. Al Boenker argued that FAIR Plan violated the separation-of-powers doctrine and exceeded its statutory authority. The Court of Appeals affirmed the district court's judgment, concluding that FAIR Plan is not a state agency subject to the Texas Administrative Procedure Act's rulemaking provisions and acted within its authority derived from the FAIR Plan Act and its Plan of Operation by contractually limiting agent compensation and establishing conditions for agent termination.

Administrative LawInsurance LawContract LawSummary JudgmentDeclaratory JudgmentInjunctionAgency AuthoritySeparation of PowersStatutory ConstructionTexas Court of Appeals
References
16
Case No. MISSING
Regular Panel Decision
Jun 18, 1992

Shelton Insurance Agency v. St. Paul Mercury Insurance Co.

This case involves an appeal by Shelton Insurance Agency and John M. Roberts against St. Paul Mercury Insurance Company regarding the alleged mishandling of an insurance claim. Shelton Agency initially sued St. Paul for violations of the DTPA, Texas Insurance Code, breach of contract, and breach of the duty of good faith and fair dealing after St. Paul denied coverage to its customer, Frio Drilling Company. A jury found in favor of Shelton Agency, awarding actual and exemplary damages, but the trial court granted St. Paul's motion for judgment n.o.v. The appellate court affirmed the trial court's judgment on the DTPA, insurance code, breach of good faith, and punitive damages claims. However, it reversed and rendered the judgment on the breach of contract claim, ruling that Shelton Agency was entitled to recover $34,000 for premiums it wrote off.

Insurance LawAgency LiabilityBreach of ContractGood Faith and Fair DealingDTPATexas Insurance CodeDenial of CoverageInsurance Bad FaithPunitive DamagesJudgment N.O.V.
References
30
Case No. 14-07-00103-CV
Regular Panel Decision
Aug 27, 2008

Sonic Systems International, Inc. v. Randy Croix, Eddie Croix Insurance Agency, Inc., and Texas Mutual Insurance Company F/K/A Texas Worker's Compensation Insurance Fund

Appellant, Sonic Systems International, Inc. (Sonic), sued appellee, Texas Mutual Insurance Company f/k/a Texas Worker=s Compensation Insurance Fund (TMI), based on TMI=s denial of insurance coverage relative to a work-related injury sustained by a Sonic employee. Sonic also sued appellees, Randy Croix and Eddie Croix Insurance Agency, Inc. (collectively the Croix Parties), based on their alleged failure to properly procure insurance to cover the employee=s claims. The trial court granted separate motions for summary judgment filed by TMI and the Croix Parties. The trial court rendered a final judgment that Sonic take nothing from all appellees. Sonic presents four appellate issues, challenging both summary judgments. The appellate court reverses the portions of the judgment ordering that Sonic take nothing on all its contractual and extra-contractual causes of action against TMI to the extent they are based on TMI=s denial of the claim for Texas workers= compensation benefits at issue in this suit. It affirms the portions of the judgment ordering that Sonic take nothing on all its contractual and extra-contractual causes of action to the extent they are not based on TMI=s denial of the Texas workers= compensation claim. It also affirms the summary judgment on Sonic=s request for declaratory relief and the judgment in favor of the Croix Parties.

Workers' Compensation InsuranceInsurance Coverage DisputeEmployer ClaimsInsurance Agent NegligenceSummary Judgment AppealTexas Labor LawDeceptive Trade Practices ActBad Faith ClaimsOut-of-State Workers' InjuryElection of Remedies
References
21
Case No. 13-11-00005-CV AND 13-11-00013-CV
Regular Panel Decision
Jul 25, 2013

Brannan Paving Gp, LLC D/B/A Brannan Paving Company v. Pavement Markings, Inc., San Juan Insurance Agency, Inc. D/B/A Valley Insurance Providers and Leicht General Agency

This case involves an appeal from a breach of contract dispute between a contractor, Brannan Paving, and its subcontractor, Pavement Markings. Brannan Paving alleged Pavement Markings breached a subcontract by failing to obtain additional insured coverage. Pavement Markings joined its insurance agents, VIP and LGA, for negligence in procuring insurance. The appellate court found the trial court erred by including a waiver instruction in the jury question, as there was insufficient evidence of Brannan Paving's intent to waive. Consequently, the breach of contract claims were reversed and remanded. However, the take-nothing judgments on Brannan Paving's negligence claims against VIP and LGA were affirmed due to lack of privity, and Pavement Markings' cross-appeal for attorney's fees under the DTPA was denied due to the absence of actual damages.

Breach of ContractSubcontractor AgreementAdditional Insured CoverageWaiver InstructionJury Charge ErrorNegligence ClaimsInsurance Agent LiabilityPrivity of ContractDeceptive Trade Practices ActAttorney's Fees
References
60
Case No. MISSING
Regular Panel Decision
Aug 21, 2012

Fred Loya Insurance Agency, Inc., and Loya Insurance Company v. Martin W. Cohen, Martin W. Cohen & Co., and Nehoc Advisors, Inc.

This case involves a double appeal concerning competing motions for summary judgment between Fred Loya Insurance Agency, Inc. and Loya Insurance Company (collectively 'Loya') and Martin W. Cohen, Martin W. Cohen & Company, and Nehoc Advisors, Inc. (collectively 'Cohen'). Loya challenged the summary judgment granted to Cohen on Loya's breach of fiduciary duty claim and the award of attorney's fees. Cohen cross-appealed orders striking an affidavit, granting Loya's summary judgment motions, and denying Cohen's motion to reconsider. The core dispute revolved around a verbal 1% Agreement for accounting and lobbying services, its terminability at will, and related claims of breach of fiduciary duty and fraudulent inducement. The appellate court affirmed the trial court's decision, upholding the termination of the 1% Agreement at will and rejecting Loya's breach of fiduciary duty claim and Cohen's fraudulent inducement claim, while also affirming the award of attorney's fees based on intertwined claims.

Contract LawSummary JudgmentBreach of Fiduciary DutyFraudulent InducementAttorney's FeesAt-Will ContractAgency RelationshipIndependent ContractorContract TerminationAppellate Review
References
60
Case No. 2017 NY Slip Op 08926 [156 AD3d 1192]
Regular Panel Decision
Dec 21, 2017

Cromer v. Rosenzweig Insurance Agency Inc.

Plaintiff, Bradley E. Cromer, as assignee, sued Rosenzweig Insurance Agency Inc. and other defendants for negligence, breach of contract, and fraud, alleging failure to procure appropriate insurance coverage for his assignors, Allen Skriloff and SOS 1031 Properties 112, LLC. The lawsuit stemmed from a workplace injury where the assignors' insurance carrier disclaimed coverage due to an employee exclusion. The Supreme Court granted summary judgment to the insurance agency, finding the assignors were presumed to know their policy's contents. The Appellate Division affirmed this decision, concluding that plaintiff failed to demonstrate a specific request for the excluded coverage or establish a 'special relationship' with the broker that would impose a higher duty of advisement beyond the written notice provided.

Insurance Broker LiabilityNegligenceBreach of ContractFraudMaterial MisrepresentationSummary JudgmentAppellate ReviewSpecial RelationshipDuty to AdviseCommercial General Liability
References
11
Case No. M2007-02787-COA-R3-CV
Regular Panel Decision
Mar 19, 2009

Liberty Mutual Insurance Company v. Friendship Home Health Agency, LLC

This case involves an appeal from the Chancery Court for Davidson County concerning a dispute over workers' compensation insurance premiums. Liberty Mutual Insurance Company sued Friendship Home Health Agency, LLC for unpaid balances after audits revealed underreported payroll. Friendship Home Health Agency, LLC appealed the trial court's judgment, citing the denial of a continuance, the rejection of an accord and satisfaction defense, and a waived statute of frauds argument. The Court of Appeals of Tennessee affirmed the trial court's decision, finding no abuse of discretion in denying the continuance and no evidence to preponderate against the finding of no accord and satisfaction. The court also deemed the statute of frauds defense waived due to improper raising.

Workers' Compensation InsuranceInsurance PremiumsAudit DisputeContinuance MotionAccord and SatisfactionStatute of FraudsAbuse of DiscretionAppellate ReviewContract LawPayroll Underestimation
References
37
Case No. 01-15-01096-CV
Regular Panel Decision
Jul 12, 2016

Texas City Patrol, LLC v. El Dorado Insurance Agency, Inc.

Texas City Patrol, LLC appealed the trial court's dismissal of its claims against El Dorado Insurance Agency, Inc. The case originated when Texas City Patrol, a security company, obtained a commercial automobile insurance policy through El Dorado, and a company employee was later injured in an accident. The insurer, Progressive, initially denied an uninsured motorist claim, leading Texas City Patrol to allege misrepresentation by El Dorado regarding coverage. Texas City Patrol subsequently sued El Dorado, alleging violations of the Texas Insurance Code, DTPA, breach of contract, and breach of the duty of good faith and fair dealing. The trial court granted El Dorado's motion to dismiss and awarded attorney's fees. The appellate court affirmed the trial court's decision, concluding that El Dorado, as an insurance agent and not the insurer, was not liable under the various statutes and common law duties invoked by Texas City Patrol.

Insurance LawDeceptive Trade Practices ActBreach of ContractDuty of Good Faith and Fair DealingPrompt Payment of Claims ActMotion to DismissTexas Rule of Civil Procedure 91aInsurance Agent LiabilityUninsured Motorist CoverageAttorney's Fees
References
7
Case No. MISSING
Regular Panel Decision

Blazer Insurance Agency, Inc. v. Jim Cogdill Dodge Co.

This case involves an appeal by Jim Cogdill Dodge Company (Defendant) from a judgment for alleged unpaid insurance premiums owed to Blazer Insurance Agency, Inc. (Plaintiff). The dispute arose after Cogdill canceled insurance policies, citing non-delivery of policy documents and unresolved issues with premium calculations. The trial court initially ruled in favor of Blazer, holding Cogdill liable at a 'short rate' for cancellation. On appeal, the court found Cogdill was justified in canceling the policies due to Blazer's failure to deliver them and Cogdill's lack of notice regarding the termination of Blazer's agent. The judgment was modified, establishing Cogdill's liability for premiums from March 6, 1987, through July 15, 1987, calculated at a regular pro rata rate instead of the 'short rate' basis.

Insurance LawContract LawAgency LawCancellation of InsuranceInsurance PremiumsDelivery of PolicyVenue DisputeAppellate ReviewConstructive DeliveryAgent Authority
References
8
Case No. MISSING
Regular Panel Decision

Hartford Casualty Insurance Co. v. Walker County Agency, Inc.

Hartford Casualty Insurance Company appealed a summary judgment granted in favor of Walker County Agency, Inc. Hartford had filed a cross-action for contribution, indemnity, fraud, and breach of fiduciary duty against Walker County after settling claims with Roy Dean Jackson. Jackson, an employee of a subcontractor to an insured of Hartford, was injured and initiated several lawsuits, including workers' compensation and breach of good faith and fair dealing claims against Hartford. Hartford alleged that Walker County, its agent, improperly provided an insurance binder. The appellate court affirmed the denial of Hartford's claims for contribution and indemnity related to the bad faith settlement. However, it reversed and remanded the summary judgment on Hartford's claims for breach of contract, breach of fiduciary duty, negligence, misrepresentation, and common law indemnity regarding the workers' compensation settlement, finding that Walker County failed to negate these causes of action.

Insurance Agent LiabilityBreach of Agency AgreementWorkers' Compensation InsuranceFiduciary Duty BreachSummary Judgment AppealContribution and IndemnityDeceptive Trade Practices Act (DTPA)Contractual ObligationPrincipal-Agent RelationshipNegligence of Agent
References
22
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