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

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. 04-25-00040-CV
Regular Panel Decision
Nov 26, 2025

Enrique Cantu and Bridgefield Casualty Insurance Company v. Javier A. Libson, Nosbil, Inc., Jose Luis Ramirez, Utica National Insurance Group, Utica National Insurance Company of Texas, Utica Mutual Insurance Company, and Republic Franklin Insurance Company

Appellants Enrique Cantu and Bridgefield Casualty Insurance Company appealed a no-evidence summary judgment. Cantu's claims of negligence per se, negligent hiring, training, retention, and negligent entrustment were affirmed. However, the summary judgment for Cantu's ordinary negligence claims was reversed and remanded. Additionally, the judgment favoring the insurance defendants (Utica National Insurance Group, Utica National Insurance Company of Texas, Utica Mutual Insurance Company, and Republic Franklin Insurance Company) was also reversed, as their motion for summary judgment was not properly heard. The case involved a collision between Cantu and Jose Luis Ramirez, an employee of Nosbil, Inc., in foggy conditions, leading to Cantu suing for negligence and insurance claims.

NegligenceAutomobile AccidentSummary JudgmentAppellate ReviewProximate CauseDuty of CareBreach of DutyCausationInsurance ClaimsVicarious Liability
References
36
Case No. 18-0216
Regular Panel Decision
Jun 26, 2020

Texas Mutual Insurance Company, Hartford Underwriters Insurance Company, Tasb Risk Management Fund, Transportation Insurance Company, Truck Insurance Exchange, Twin City Fire Insurance Company, Valley Forge Insurance Company v. Phi Air Medical, LLC

This concurring opinion addresses whether the Texas Workers' Compensation Act is shielded from federal preemption by the McCarran–Ferguson Act. The core issue is whether the Texas Act, which dictates how insurance carriers pay claimants like air-ambulance services, constitutes the 'business of insurance.' Justice Bland argues that the Act was indeed enacted for regulating the business of insurance, particularly given Texas's reliance on private insurers for workers' compensation. Therefore, its provisions should be protected from federal encroachment, leading to the reversal of the court of appeals' judgment.

McCarran-Ferguson ActFederal PreemptionState Insurance RegulationTexas Workers' Compensation ActBusiness of InsuranceAir-ambulance ServicesInsurance CarriersPolicyholder RiskThird-Party BeneficiaryAntitrust Exemption
References
19
Case No. 05-16-00875-CV
Regular Panel Decision
Jul 20, 2018

Peerless Indemnity Insurance Company, America First Insurance Company, the Netherlands Insurance Company, and America First Lloyds Insurance Company A.K.A. America First Insurance Company v. GLS Masonry, Inc.

The case involves an appeal by several insurance companies (Appellants) against GLS Masonry, Inc. (Appellee) after a take-nothing judgment in their suit to collect unpaid insurance premiums. The dispute centered on whether GLS's masonry workers were independent contractors or employees for premium calculation purposes, particularly for workers' compensation and general liability policies. The Appellants argued that GLS owed additional premiums due to audits reclassifying workers as employees and based on a lack of liability insurance for subcontractors. The trial court sided with GLS, finding that the insurance companies failed to establish the applicability of certain labor code provisions and did not sufficiently prove that GLS owed additional premiums, especially considering evidence that the workers were independent contractors and payments were made on policies. The Court of Appeals affirmed the trial court's judgment.

Insurance DisputeUnpaid PremiumsCommercial General LiabilityPremium AuditIndependent Contractor StatusEmployee ClassificationBreach of ContractTexas Appellate LawFactual Sufficiency ReviewSworn Account Claim
References
12
Case No. 14-02-00860-CV
Regular Panel Decision
Feb 23, 2006

Lennar Corporation, Lennar Homes of Texas Land and Construction, Limited, and Lennar Homes of Texas Sales and Marketing, Limited, D/B/A Village Builders v. Great American Insurance Company, American Dynasty Surplus Lines Insurance Company, Markel American Insurance Company Gerling America Insurance Company, RLI Insurance Company, Insurance Company of the State of Pennsylvania and Westchester Fire Ins Company

This case concerns an insurance coverage dispute between homebuilder Lennar Corporation and its CGL insurance carriers over damages caused by defective stucco (EIFS) applied to homes. The court analyzed whether negligently defective construction constitutes an "occurrence" and distinguished between covered costs (repairing actual water damage) and non-covered costs (preventative EIFS replacement, overhead). While affirming summary judgment for several insurers due to unmet self-insured retentions based on individual homes as separate occurrences, the court reversed for American Dynasty and Markel, citing unresolved factual issues regarding "known loss" and policy conditions. Lennar's extra-contractual claims against American Dynasty were ultimately denied for lack of proven damages or statutory violations.

Insurance Policy InterpretationConstruction DefectsCommercial Liability InsuranceProperty Damage ClaimsStucco DefectsDuty to IndemnifySelf-Insured RetentionsKnown Loss PrincipleSubcontractor LiabilityTexas Law
References
96
Case No. MISSING
Regular Panel Decision

Nationwide Insurance v. Empire Insurance Group

This case concerns a dispute over insurance coverage. Marcos Ramirez was injured while working for Fortuna Construction, Inc. at premises owned by 11194 Owners Corp. Fortuna had subcontracted work from Total Structural Concepts, Inc. and agreed to add Total Structural as an additional insured on its general liability policy with Empire Insurance Group and Allcity Insurance Company. Ramirez sued 11194 Owners Corp. and Total Structural. Total Structural then commenced a third-party action against Fortuna. Nationwide Insurance Company, as Total Structural's insurer and subrogee, initiated a declaratory judgment action against Empire and Allcity after discovering Total Structural was an additional insured on their policy, demanding coverage for the Ramirez action. The Supreme Court granted Nationwide's motion for summary judgment, but the appellate court reversed, finding that Total Structural failed to provide timely notice of the Ramirez action to Empire and Allcity as required by the policy. The court emphasized that timely notice is a condition precedent to recovery and that lack of diligent effort to ascertain coverage vitiates the policy. Consequently, the appellate court granted Empire and Allcity's cross-motion, declaring they are not obligated to defend or indemnify Nationwide/Total Structural.

Insurance CoverageTimely NoticeCondition PrecedentDeclaratory JudgmentAdditional InsuredSubrogationSummary JudgmentBreach of ContractPersonal InjuryGeneral Liability Policy
References
8
Case No. 03-00-00427-CV
Regular Panel Decision
Aug 30, 2001

All American Life Insurance Company American General Life Insurance Company American National Insurance Company American National Life Insurance Company of Texas IDS Life Insurance Company And USLIFE Life Insurance Company v. Carole Keeton Rylander, Comptroller of Public Accounts of Texas And John Cornyn, Attorney General of Texas

Several insurance companies appealed a district court judgment affirming the Comptroller's assessment of premium and maintenance taxes on 'internal rollover' transactions, where policyholders transfer accumulation values within the same company for new policies. The Texas Court of Appeals, Third District, At Austin, reviewed the construction of Texas Insurance Code articles 4.11 and 4.17 de novo. The court determined that 'internal rollovers' do not involve funds being 'received' or 'collected' by the insurance companies, as the funds remain within the company. Therefore, these transactions are not subject to the premium and maintenance taxes. The judgment of the district court was reversed in part, and the case was remanded for a determination of the refund amounts owed to the companies.

Insurance LawTax LawPremium TaxInternal RolloversStatutory ConstructionTexas Court of AppealsInsurance CompaniesComptrollerGross PremiumsTax Refund
References
9
Case No. 3-94-122-CV
Regular Panel Decision
Jan 18, 1995

Texas Workers' Compensation Insurance Facility v. State Board of Insurance, Aetna Casualty & Surety Company, Hartford Accident & Indemnity Company, Houston General Insurance Company, Liberty Mutual Fire Insurance Company, United States Fire Insurance Company

The Texas Workers' Compensation Insurance Facility (Facility) appealed a district court judgment that affirmed an order by the State Board of Insurance. The Board had ordered the Facility to indemnify several servicing companies for legal expenses incurred in litigation brought by Standard Financial Indemnity Company (SFIC). The Facility argued that Article 5.76-2, section 2.05(i) of the Texas Insurance Code, which states the Facility 'may not indemnify the servicing companies,' terminated the servicing companies' right to indemnification. The appellate court affirmed the trial court's judgment, holding that the servicing companies had a vested contractual right to indemnification which arose when they entered into servicing company agreements, and that section 2.05(i) could not be applied retroactively to impair these vested rights. The court found that the law existing at the time the contracts were made, which included the Facility's bylaws allowing for indemnification, was incorporated into the agreements.

Workers' CompensationInsurance LawContractual RightsVested RightsRetroactive Application of LawIndemnificationStatutory InterpretationAdministrative LawAppellate ReviewTexas Insurance Code
References
32
Case No. 03-05-00189-CV
Regular Panel Decision
Mar 21, 2008

Texas Department of Insurance, Division of Workers' Compensation v. Insurance Council of Texas, Texas Mutual Insurance Company, Texas Property and Casualty Insurance Guaranty Association, and Envoy Medical Systems, Inc.

The Texas Department of Insurance, Division of Workers' Compensation (the "Division") promulgated a rule (28 Tex. Admin. Code § 133.309) to create a less expensive alternative review procedure for workers' compensation claims concerning the necessity of medical treatment. The Insurance Council of Texas, Texas Mutual Insurance Company, Texas Property and Casualty Insurance Guaranty Association, and Envoy Medical Systems, L.P. (the "Joint Appellees") challenged the rule's validity in a declaratory judgment action. The district court granted the Joint Appellees' motion for summary judgment, declaring the rule invalid. The appellate court affirmed the district court's judgment, concluding that the rule was not in harmony with relevant governing statutes that allowed for judicial review of medical necessity disputes.

Workers' Compensation LawAdministrative LawJudicial ReviewStatutory InterpretationDeclaratory JudgmentSummary JudgmentMedical Necessity DisputesAlternative Dispute ResolutionAgency Rule ValidityTexas Court of Appeals
References
15
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
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