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Case Law Database

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

Case No. 03-96-00156-CV
Regular Panel Decision
Nov 20, 1996

All Star Sheet Metal and Roofing, Inc. v. Texas Department of Insurance Texas Commissioner of Insurance And Texas Workers' Compensation Insurance Facility

All Star Sheet Metal and Roofing, Inc. appealed a district court judgment that affirmed an order by the Texas Commissioner of Insurance. The Commissioner's order concluded that All Star's actions of discharging and rehiring employees to allow them to waive workers' compensation coverage were not genuine new beginnings of employment, thus requiring All Star to pay premiums for these employees. The Texas Court of Appeals, Third District, reviewed the Commissioner's findings under the 'substantial evidence rule' of the Administrative Procedure Act. The court found that the Commissioner's findings of fact reasonably supported the conclusions of law regarding the legitimacy of the discharges and rehirings. The appellate court affirmed the Commissioner's order and the district-court judgment, also overruling a cross-point by the Facility alleging an appeal without sufficient cause.

Workers' CompensationInsurance PremiumsEmployee WaiversJudicial ReviewAdministrative LawSubstantial Evidence RuleEmployer-Employee RelationshipTexas LawAppellate ReviewContested Case
References
15
Case No. 03-01-00448-CV
Regular Panel Decision
Dec 13, 2001

Western Clipper Inc., D/B/A Southwest Roofing Company v. Texas Department of Insurance Commissioner of Insurance of the State of Texas And Texas Workers' Compensation Insurance Facility

The appellant, Western Clipper Inc., doing business as Southwest Roofing Company, and the appellees, Texas Department of Insurance, Commissioner of Insurance of the State of Texas, and Texas Workers’ Compensation Insurance Facility, settled their disputes during oral argument. A joint motion to dismiss the appeal was filed by the parties. The court granted the motion, resulting in the dismissal of the appeal.

Texas LitigationAppellate CourtVoluntary DismissalSettlement AgreementInsurance LawState AgenciesCivil AppealsTravis CountyJudicial Decision
References
0
Case No. 03-95-00298-CV
Regular Panel Decision
Dec 13, 1995

Turner Brothers Trucking Company, Inc. v. Commissioner of Insurance of the State of Texas and Texas Workers' Compensation Insurance Facility

Turner Brothers Trucking Company, Inc. appealed a district court judgment affirming an order by the Commissioner of Insurance. The appeal concerned a retroactive premium increase in its workers' compensation insurance policy by the Texas Workers' Compensation Insurance Facility and the Facility's authority to offset this balance against a refund owed to Turner Brothers. Turner Brothers argued that the retroactive increase was impermissible under the applicable Manual rules and policy terms, and that the Facility lacked the authority to offset the outstanding balance. The court affirmed the judgment of the district court, finding the Commissioner's interpretation of the Manual to be reasonable and consistent with the policy terms regarding the retroactive change in the experience modifier. Furthermore, the court concluded that the Facility had the authority to offset the debt and credit as they arose from sufficiently related transactions concerning workers' compensation insurance coverage.

Workers' Compensation InsuranceRetroactive PremiumExperience ModifierInsurance Policy OffsetAgency InterpretationJudicial ReviewTexas Insurance CodeWorkers' Compensation FacilityPremium AdjustmentInterstate Operations
References
8
Case No. 03-96-00336-CV
Regular Panel Decision
Apr 17, 1997

Southwest-Tex Leasing Company, Inc. D/B/A Advantage Rent-A-Car and D/B/A Premier Parking And Walker Resources, Inc. v. Elton Bomer, Commissioner of Insurance And Texas Workers' Compensation Insurance Facility

This case involves an appeal by Southwest-Tex Leasing Company, Inc. and Walker Resources (collectively 'Advantage') against the Commissioner of Insurance and the Texas Workers' Compensation Insurance Facility. The dispute arose when Advantage's workers' compensation insurance premiums increased due to the retroactive application of an experience modifier and surcharge by Liberty Mutual, a servicing company for the Facility, after Advantage initially received a policy based on an Assigned Risk Rating Program (ARRP) factor. Advantage challenged the Facility's and Commissioner's decisions upholding Liberty Mutual's actions. The appellate court affirmed the district court's judgment, finding that the Commissioner's decision was supported by substantial evidence and was not an error of law, as the TDI rules allowing retroactive application of the experience modifier were incorporated into the policy and consistent with its terms.

Workers' CompensationInsurance PolicyPremium AdjustmentExperience ModifierAssigned Risk Rating ProgramRegulatory InterpretationAdministrative LawAppellate ReviewTexas Insurance CodeContract Ambiguity
References
15
Case No. 03-11-00179-CV
Regular Panel Decision
Aug 29, 2013

the Attorney General of Texas and the Commissioner of Insurance v. Farmers Insurance Exchange, Fire Insurance Exchange, Mid-Century Insurance Company of Texas, Texas Farmers Insurance Company, and Farmers Texas County Mutual Insurance Company

This case involves an appeal concerning public-information requests made to the Texas Department of Insurance (TDI) for rate-filing information submitted by a group of appellee insurers. The central issue was whether this information, declared "open to public inspection" by the Insurance Code, was subject to exceptions under the Public Information Act (PIA). The district court initially ruled that the PIA's exceptions applied. However, the Court of Appeals reversed this decision, holding that the clear and unambiguous language of former section 2251.107 of the Insurance Code mandated public inspection without regard to the PIA's exceptions. The court emphasized plain-meaning statutory construction and dismissed arguments based on legislative history and constitutional challenges.

Statutory InterpretationPublic Information ActInsurance CodeOpen RecordsTrade SecretsRate FilingsTexas Department of InsuranceAppellate ReviewGovernment TransparencyTakings Clause
References
50
Case No. 14-22-00298-CV
Regular Panel Decision
Mar 28, 2023

Carlyle T. Poindexter Poindexter & Associates, Inc. And Surety One, Inc. v. Insurance Commissioner Cassie Brown and the Texas Department of Insurance

This case involves an appeal of an administrative order revoking the insurance licenses of Carlyle T. Poindexter, Poindexter & Associates, Inc., and Surety One, Inc. The Texas Department of Insurance (the Department) alleged that the appellants overcharged the Maverick County Solid Waste Authority (MCSWA) for bond premiums by several hundred thousand dollars over six years. Following a contested case hearing before an administrative law judge (ALJ), the ALJ recommended revocation, which the Commissioner adopted. A Travis County district court affirmed this order. The Fourteenth Court of Appeals affirmed the trial court's judgment, concluding that substantial evidence supported the Commissioner's findings that the appellants willfully violated the Insurance Code by collecting unauthorized payments, and that the order was not arbitrary or capricious.

Insurance License RevocationSurety Bond OverchargingAdministrative Law AppealInsurance FraudAgent FeesUnfair Business PracticesWillful ViolationTexas Department of InsuranceMaverick CountyLexon Insurance Company
References
34
Case No. 03-05-00067-CV
Regular Panel Decision
May 22, 2008

Mike Geeslin, Commissioner of Insurance, and Texas Department of Insurance v. State Farm Lloyds

This appeal concerns the validity of a rate order issued by the commissioner of insurance, requiring State Farm Lloyds to reduce its homeowners insurance rates. The district court vacated the order, finding the underlying statute unconstitutional and State Farm Lloyds's due process rights violated. The Court of Appeals affirmed that the "proof provision" of article 5.26-1, section 4, is unconstitutional on its face and as applied, and that State Farm Lloyds's due process rights were violated due to the unconstitutional proof requirement and denial of discovery. The court, however, found the unconstitutional provision severable, reversed the trial court's judgment as to the constitutionality of the remainder of the statute, and remanded the case to the Texas Department of Insurance for further proceedings consistent with the opinion, ensuring a fair and reasonable return standard.

Insurance RatesHomeowners InsuranceTexas Department of InsuranceRate RegulationConstitutional LawDue ProcessSeverabilityAdministrative LawConfiscatory RatesReasonable Profit
References
45
Case No. 03-05-00176-CV
Regular Panel Decision
Nov 07, 2007

LHR Enterprises, Inc. Task Services, Inc. Business Staffing, Inc. Harry Sewill Rick Chapman And Transglobal Mortgage, Inc. v. Mike Geeslin, in His Official Capacity as Commissioner of Insurance for the State of Texas Texas Department of Insurance And State Office of Administrative Hearings for the State of Texas

The appellants challenged the Commissioner of Insurance's authority to refer them to the State Office of Administrative Hearings (SOAH) for alleged unauthorized insurance practices, seeking a declaratory judgment. The district court granted a plea to the jurisdiction, which led to this appeal. While the appeal was pending, the Commissioner issued a final order absolving the appellants of wrongdoing. The Texas Court of Appeals subsequently dismissed the appeal for lack of subject-matter jurisdiction, deeming the controversy moot and affirming the prohibition against advisory opinions.

JurisdictionDeclaratory Judgment ActSovereign ImmunityMootness DoctrineAdministrative HearingsInsurance RegulationTexas Civil PracticeAppellate ProcedureJusticiable ControversyRipeness
References
18
Case No. 03-04-00105-CV
Regular Panel Decision
Mar 03, 2006

Liberty Mutual Insurance Company, Liberty Mutual Fire Insurance Company, and Liberty Insurance Corporation v. Texas Department of Insurance and Jose Montemayor, as Commissioner of Insurance Amber, Inc., Champagne-Webber, Inc. Churchill Truck Lines, Inc. And Royal Seating Corp.

Liberty Mutual Insurance Company and its affiliates appealed a district court judgment requiring them to issue rebates to workers' compensation policyholders for 1991 and 1992 surpluses. The appellants argued that a rule from the Texas Department of Insurance, which mandated these pass-throughs, unconstitutionally impaired their contractual rights, deprived them of property without due process, and constituted an impermissible retroactive law. The appeals court affirmed the district court's decision, finding that the Department's rule was a valid exercise of legislative power, served a legitimate public purpose by preventing insurers from retaining unforeseen windfalls, and did not violate constitutional prohibitions regarding retroactive legislation, contract impairment, or due process rights.

Insurance LawWorkers' Compensation InsuranceRetrospective Rating PlanInsurance RegulationConstitutional ChallengesContractual ObligationsDue ProcessRetroactive LegislationAppellate Court DecisionTexas Department of Insurance
References
35
Case No. NO. 03-13-00332-CV
Regular Panel Decision
Mar 18, 2015

Gordon G. McWatt, D.O. v. David Mattax, Texas Commissioner of Insurance Ryan Brannan, Commissioner of Workers' Compensation And Texas Department of Insurance, Division of Workers' Compensation

Gordon G. McWatt, D.O., appealed an administrative penalty of $15,000 and an order to attend an educational course for violating reporting and record-keeping requirements as a 'designated doctor' with the Division of Workers’ Compensation. The audit focused on the timely submission and electronic transmission of DWC Form-69s. McWatt argued that the ALJ and Commissioner lacked authority, retroactively applied rules, misinterpreted Rule 130.1 by holding him responsible for his employer Concentra's failures, and arbitrarily assessed penalties. The court found that the Division had proper authority for the audit and that Rule 130.1 held McWatt ultimately responsible for compliance, irrespective of his employer's role in filing. Consequently, the trial court's judgment affirming the ALJ's monetary penalty and the Commissioner's non-monetary sanction was affirmed.

Workers' CompensationAdministrative LawJudicial ReviewReporting RequirementsRecord KeepingAdministrative PenaltiesMedical EvaluationMaximum Medical ImprovementImpairment RatingDesignated Doctor
References
17
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