CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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. 03-05-00524-CV
Regular Panel Decision
Aug 22, 2008

State Farm Lloyds v. Mike Geeslin (Successor to Jose' Montemayor) in His Official Capacity as Commissioner of Insurance and Texas Department of Insurance

In this appeal, State Farm Lloyds challenged an enforcement action by the Texas Department of Insurance (TDI) seeking restitution and sanctions for allegedly excessive residential property insurance rates. The trial court had sided with TDI, but the Court of Appeals previously found the statutory proof requirement for insurers unconstitutional in a related rate appeal. This present appeal addressed whether TDI could use its general enforcement powers to penalize State Farm Lloyds for charging rates authorized during the pendency of that earlier appeal. The court held that TDI lacked such authority, emphasizing that the legislature provided specific refund mechanisms for overcharged premiums during appeals, thus precluding general enforcement for conduct permitted by statute. Therefore, the trial court's judgment was reversed, and judgment rendered for State Farm Lloyds.

Insurance LawRate RegulationStatutory InterpretationAdministrative LawJudicial ReviewSummary JudgmentTexas Insurance CodeDue ProcessEnforcement AuthorityRestitution
References
22
Case No. 11-06-00214-CV
Regular Panel Decision
Oct 25, 2007

Centre Insurance Company, Successor to Business Insurance Company v. Carl Pollitt

This workers' compensation dispute involves Carl Pollitt, who received benefits from Centre Insurance Company after an on-the-job injury. Despite reaching statutory maximum medical improvement (MMI) in 1997, Pollitt underwent multiple spinal surgeries and sought an increased impairment rating, claiming a substantial change in his condition. The trial court granted his motion, raising his impairment rating to twenty-six percent. On appeal, Centre Insurance Company argued that impairment ratings cannot be reevaluated after the statutory MMI date. The Eleventh Court of Appeals reversed the trial court's judgment, holding that a substantial change in condition must occur before the statutory MMI date, thus rendering judgment that Pollitt take nothing.

Workers' CompensationImpairment RatingMaximum Medical ImprovementStatutory MMISpinal SurgeryJudicial ReviewAdministrative RemediesTexas LawAppellate CourtSummary Judgment
References
4
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. 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. 03-09-00178-CV
Regular Panel Decision
Aug 26, 2010

Vista Healthcare, Inc. v. Texas Mutual Insurance Company Texas Department of Insurance, Division of Workers' Compensation Texas Association of School Boards Risk Management Fund And the Travelers Insurance Companies

This case involves Vista Healthcare, Inc.'s challenge to a district court judgment regarding a workers' compensation medical benefits reimbursement dispute. Vista, an ambulatory surgical center, argued for reimbursement of its "usual and customary" charges, while Texas Mutual Insurance Company applied a methodology based on Medicare rates. The dispute centered on the interpretation of Division rules governing reimbursement rates, specifically rule 134.1, in the absence of specific medical fee guidelines. The court affirmed the district court's judgment, deferring to the Division's interpretation that "fair and reasonable" reimbursement incorporates all standards from labor code section 413.011, including ensuring quality of medical care and achieving effective cost control, and found the rule not unconstitutionally vague.

Workers' CompensationMedical BenefitsReimbursement DisputeAmbulatory Surgical CenterFee GuidelinesRule InterpretationConstitutional VaguenessTexas Labor CodeAdministrative Procedure ActJudicial Review
References
21
Case No. MISSING
Regular Panel Decision

Attorney General of Texas v. Farmers Insurance Exchange

This appeal addresses public-information requests made to the Texas Department of Insurance (TDI) concerning rate-filing information submitted by a group of insurers. The central legal question is whether exceptions to disclosure under the Public Information Act (PIA) apply to information explicitly declared 'open to public inspection' by the Texas Insurance Code. The district court had previously ruled that PIA exceptions were applicable, which could allow the insurers to withhold proprietary trade secrets. The appellate court, upon de novo review, overturned this decision, asserting that the clear and unambiguous language of the Insurance Code mandates public inspection without the limitations of PIA exceptions. The court dismissed arguments based on legislative history, constitutional separation of powers, and the takings clause, emphasizing its duty to interpret statutes based on their plain meaning.

Public Information ActTexas Insurance CodeRate FilingsTrade SecretsStatutory ConstructionOpen Records RequestsAppellate ReviewGovernmental DisclosurePublic InspectionSeparation of Powers
References
30
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
Showing 1-10 of 16,749 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational