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

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. 14-09-00860-CV
Regular Panel Decision
May 26, 2011

Weingarten Realty Management Company and Scottsdale Insurance Company v. Liberty Mutual Fire Insurance Company

This case involves an appeal from a trial court's summary judgment in an insurance-coverage dispute. Appellants Weingarten Realty Management Company and Scottsdale Insurance Company sought to compel appellee Liberty Mutual Fire Insurance Company to defend Weingarten Management in an underlying lawsuit where it was mistakenly identified as a lessor. The appellate court affirmed the trial court's decision, allowing the consideration of extrinsic evidence as a narrow exception to the eight-corners rule. This exception applies when an insurer proves, using extrinsic evidence, that the party seeking defense is a stranger to the policy and could not be entitled to coverage under any circumstances, without touching on the merits of the underlying claim. The court concluded that Weingarten Management was not an actual lessor and therefore not an insured under Liberty Mutual's policy.

Insurance CoverageDuty to DefendEight-Corners Rule ExceptionExtrinsic EvidenceSummary Judgment ReviewAppellate Court DecisionInsurance Policy InterpretationLessor StatusContractual DisputesTexas Civil Procedure
References
30
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. 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. 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. 14-17-00528-CV
Regular Panel Decision
Aug 21, 2018

Liberty Mutual Insurance Company v. Buddy J. Trahan

Liberty Mutual Insurance Company appealed a summary judgment from the 240th District Court, Fort Bend County, Texas, which affirmed a decision by the Texas Department of Insurance, Division of Workers’ Compensation (TDI). The TDI had ruled that Liberty Mutual contractually waived its right to reimbursement and/or subrogation under sections 417.001 and 417.002 of the Texas Labor Code. This waiver pertained to workers’ compensation benefits paid to Buddy J. Trahan, preventing Liberty Mutual from recovering these funds from Trahan's settlement with a third party. The court referenced the Supreme Court of Texas's decision in Wausau Underwriters Insurance Company v. Wedel, which involved a substantively identical waiver endorsement. Applying the precedent set by Wedel, which held that such a waiver precludes a carrier from seeking reimbursement indirectly from an injured employee out of third-party settlement funds, the appellate court affirmed the trial court's judgment.

Reimbursement WaiverSubrogation RightsSummary JudgmentAppellate ReviewThird-Party SettlementContractual WaiverInsurance LawJudicial PrecedentInterpretation of EndorsementInjury Claim
References
5
Case No. 03-03-00704-CV
Regular Panel Decision
Jan 21, 2005

Texas Mutual Insurance Company// Eckerd Corporation H.E. Butt Grocery Company Third-Party Solutions, Inc. Wal-Mart Stores, Inc. Apollo Enterprises, Inc. And Walgreen Company v. Eckerd Corporation H.E. Butt Grocery Company Third-Party Solutions, Inc. Wal-Mart Stores, Inc. Apollo Enterprises, Inc. And Walgreen Company//Cross-Appellee,Texas Mutual Insurance Company

This case involves cross-appeals concerning whether an insurance company must first exhaust administrative remedies under the Texas Workers' Compensation Act before filing a lawsuit for alleged overcharges by health care providers. Appellant Texas Mutual Insurance Company sued several pharmacies and billing companies for negligent misrepresentation and money had and received, claiming they over-billed for prescription drugs. The district court denied the defendants' motion to dismiss for lack of subject matter jurisdiction but granted partial summary judgment against Texas Mutual. The Court of Appeals, relying on prior precedent, determined that the Texas Workers' Compensation Commission holds exclusive jurisdiction over medical fee disputes within the Act's pervasive regulatory scheme. Consequently, the appellate court reversed the district court's judgment, concluding that the trial court lacked jurisdiction as Texas Mutual had not exhausted its administrative remedies.

Workers' Compensation ActAdministrative RemediesExclusive JurisdictionMedical Fee DisputesPharmaceutical Fee GuidelineOverbillingNegligent MisrepresentationMoney Had and ReceivedStatutory InterpretationAppellate Review
References
10
Case No. 05-95-01259-CV
Regular Panel Decision
Feb 26, 1997

Lemke Concrete Construction v. Employers Mutual Casualty Company, Union Mutual Insurance Company of Providence, Emcasco Insurance Company, Patterson, Lamberty, Stanford, Walls & Dwyer, P.C. and John R. Robinson

Lemke Concrete Construction appealed the trial court's summary judgment in favor of Employers Mutual Casualty Company, Union Mutual Insurance Company of Providence, and Emcasco Insurance Company (carriers). Lemke alleged breach of contract, negligence, breach of good faith, and violations of the Texas Deceptive Trade Practices-Consumer Protection Act and Texas Insurance Code, stemming from the carriers' handling of a workers' compensation claim and a subsequent retaliatory discharge suit filed by Lemke's employee, Jesus Gonzalez. The carriers had settled the workers' compensation claim but denied coverage for the wrongful discharge claim, leading Lemke to incur legal fees and a settlement. The trial court granted summary judgment for the carriers, concluding that the policies did not cover wrongful discharge claims and, thus, the carriers owed no duty to defend or settle such claims. The appellate court affirmed the trial court's judgment, upholding that without coverage, Lemke's claims of bad faith and negligence were meritless, and estoppel could not create coverage.

Workers' CompensationSummary JudgmentBreach of ContractGood Faith and Fair DealingInsurance CoverageNegligenceTexas Deceptive Trade Practices-Consumer Protection ActTexas Insurance CodeVicarious LiabilityRetaliatory Discharge
References
31
Case No. 02-11-00059-CV
Regular Panel Decision
Oct 20, 2011

Liberty Mutual Insurance Company AND Texas Department of Insurance, Division of Workers' Compensation v. Ricky Adcock

This case involves an appeal by Liberty Mutual Insurance Company and the Texas Department of Insurance, Division of Workers’ Compensation, challenging a trial court's summary judgment in favor of Ricky Adcock. Appellants argued that the Division had jurisdiction to review a 1997 award of Lifetime Income Benefits (LIBs) to Adcock. Adcock had received LIBs in 1997 due to a total and permanent functional loss of use of his right foot and hand from a 1991 injury. Liberty Mutual sought to reopen the case, asserting Adcock was no longer entitled to LIBs. The district court, however, agreed with Adcock, ruling that the Division lacked jurisdiction to revisit the LIBs issue. The Court of Appeals affirmed the trial court's judgment, concluding that the Division has no express or implied authority under Labor Code section 408.161 to review LIBs after initial administrative and appellate remedies are exhausted, given the legislature's intent as evidenced by the statutory language and the absence of a review provision unlike other benefit types.

JurisdictionLifetime Income BenefitsWorkers' Compensation ActStatutory ConstructionAdministrative Agency PowersRes JudicataCollateral EstoppelTexas Labor CodeSummary JudgmentAppellate Review
References
23
Case No. 3-91-003-CV
Regular Panel Decision
May 19, 1993

Texas Commissioner of Insurance Georgia D. Flint, Permanent Receiver of Standard Financial Indemnity Corporation v. Aetna Casualty & Surety Company, Employers Insurance of Wausau, a Mutual Company, the Hartford Accident and Indemnity Company, Houston General Insurance Company, CIGNA Insurance Company of Texas, Liberty Mutual Fire Insurance Company

Standard Financial Indemnity Corporation (SFIC) appealed the Travis County district court's judgment dismissing its suit for lack of subject matter jurisdiction. SFIC alleged antitrust and tortious interference claims, arguing that the Workers' Compensation Assigned Risk Pool and its members conspired to monopolize the market and unfairly treated its servicing company application. The Hidalgo County district court transferred venue to Travis County, a decision SFIC contested. The Court of Appeals found that SFIC had pleaded valid common law causes of action not solely governed by statutory procedures and that the venue transfer based on forum non conveniens was unauthorized under Texas law. Consequently, the court reversed the judgment and remanded the case with instructions to return it to Hidalgo County for further proceedings.

AntitrustTortious InterferenceSubject Matter JurisdictionVenue TransferForum Non ConveniensWorkers' Compensation Assigned Risk PoolTexas Free Enterprise and Antitrust ActStatutory InterpretationAppellate ReviewDistrict Court
References
19
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