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

Case No. MISSING
Regular Panel Decision

Receiver for Citizen's National Assurance Co. v. Hatley

Johnny Ray Hatley was injured in a work-related truck accident and settled a third-party claim for $85,000, from which the Receiver for Citizen’s National Assurance Company received $16,000. Hatley then pursued workers' compensation benefits, and a jury found him totally and permanently incapacitated. The trial court awarded Hatley approximately $78,000 in benefits, rejecting the Receiver's argument that the third-party settlement should offset the workers' compensation recovery under former article 8307, section 6a. The Receiver appealed, contending the statutory offset was mandatory and the release had no legal effect or lacked consideration. The appellate court affirmed the trial court's judgment, finding that the release explicitly waived the Receiver's statutory rights and was supported by valid consideration, thereby precluding the application of the offset.

Workers' CompensationThird-Party SettlementStatutory OffsetRelease of ClaimsContract InterpretationConsiderationTexas LawSubrogation RightsReimbursement RightsAppellate Review
References
7
Case No. 3-92-298-CV
Regular Panel Decision
Apr 07, 1993

Receiver for Citizen's National Assurance Company, an Impaired Company v. Johnny Ray Hatley

This case involves an appeal by the Receiver for Citizen's National Assurance Company (appellant) against Johnny Ray Hatley (appellee) regarding workers' compensation benefits. Hatley was injured in a truck accident and received a third-party settlement, part of which went to the Receiver. The Receiver had signed a release of all claims and rights but argued that the settlement should be treated as an advance against future workers' compensation benefits under former article 8307, section 6a of the workers' compensation law, contending the release was not legally effective or lacked consideration. The Court of Appeals affirmed the trial court's judgment in favor of Hatley, ruling that the release constituted a specific waiver by the Receiver of its statutory rights and was supported by valid consideration.

Workers' Compensation LawThird-Party LiabilitySettlement AgreementStatutory OffsetContractual ReleaseConsideration in ContractsSubrogation WaiverReimbursement RightsAppellate ReviewTravis County District Court
References
7
Case No. 03-99-00293-CV
Regular Panel Decision
Feb 10, 2000

Texas Property and Casualty Insurance Guaranty Association v. Jack M. Webb, as Special Deputy Receiver of Employers Casualty Co. Jack M. Webb, as Special Deputy Receiver of Employers National Insurance Co.

This case involves an appeal from a summary judgment concerning the claims priority scheme within the Texas Insurance Code's liquidation statute. The appellant, Texas Property and Casualty Insurance Guaranty Association (TPCIGA), challenged the classification of its claims for defense costs incurred in defending liability and workers' compensation claims under policies of insolvent insurers. TPCIGA argued these costs should receive Class 1 priority as claims-handling expenses, while appellees contended they were Class 2 payments of policyholder claims. The court concluded that, prior to a 1995 amendment to the statute, such defense costs were properly classified as Class 2 claims. Therefore, the district court's judgment classifying them as Class 2 was affirmed.

Insurance LawClaims PriorityLiquidation StatuteTexas Insurance CodeGuaranty ActPolicyholder ClaimsDefense CostsStatutory InterpretationSummary JudgmentReceivership
References
22
Case No. 03-07-00552-CV
Regular Panel Decision
Feb 26, 2009

Rehabworks, LLC v. Michael F. Flanagan, as Receiver for Century Care of America, Inc.

Rehabworks, LLC, a therapy service provider, sued Century Care of America, Inc. for unpaid services and obtained a judgment. When Michael F. Flanagan was appointed as receiver for Century Care during a foreclosure action, Rehabworks intervened, asserting several claims to recover payment. The trial court granted summary judgment to Flanagan, finding him protected by derived judicial immunity for actions taken as receiver. On appeal, Rehabworks challenged this ruling, arguing against the applicability of immunity for implied-contract claims and citing legislative authorization for suits against receivers. The appellate court affirmed the trial court's judgment, concluding that Flanagan's actions were within his authority as an arm of the court, thus entitling him to derived judicial immunity.

Derived Judicial ImmunityReceiver ImmunitySummary Judgment AppealForeclosure ProceedingsImplied Contract ClaimsQuantum MeruitMoney Had and ReceivedAppellate Court DecisionTexas Civil PracticeCourt-Appointed Officer Authority
References
15
Case No. 03-97-00055-CV
Regular Panel Decision
Oct 02, 1997

Brookshire Grocery Company v. Elton Bomer, as Permanent Receiver of Texas Employers Insurance Association

Brookshire Grocery Company challenged a judgment favoring Elton Bomer, Permanent Receiver of Texas Employers Insurance Association (TEIA). The trial court deemed a 'side agreement' between Brookshire and TEIA void, as it aimed to secure an illegal dividend for a workers' compensation policy, ordering Brookshire to pay $270,057. The Court of Appeals affirmed, finding the side agreement invalid, illegal, and void due to violations of statutory and regulatory requirements, including a failure to file with the State Board of Insurance and an attempt to retroactively alter premium factors to indirectly provide a prohibited dividend. The court further ruled the Receiver was not bound by the side agreement's terms and dismissed Brookshire's statute of limitations defense, asserting the cause of action accrued when the Receiver demanded payment in 1993. This decision underscores the necessity of regulatory adherence in insurance contracts and forbids agreements that bypass stipulated premium rates.

Insurance PolicySide AgreementRetroactive PremiumStatutory ViolationRegulatory ComplianceContract LawPublic PolicyStatute of LimitationsAppeals CourtTexas Law
References
9
Case No. 03-08-00481-CV
Regular Panel Decision
Jul 10, 2009

Resolution Oversight Corporation as Special Receiver of Financial Insurance Company of America v. Arturo Garza

Resolution Oversight Corporation, acting as the special receiver for Financial Insurance Company of America (FIC), sought to enforce FIC's subrogation rights against funds paid by Home State County Mutual Insurance Company to Arturo Garza. Garza, an injured employee, had received workers' compensation benefits from FIC following an automobile accident and subsequently settled a claim with Home State, the uninsured/underinsured motorist (UIM) carrier for his employer, Texas Towing. The trial court initially granted summary judgment in favor of Garza, denying FIC's subrogation interest in the UIM proceeds. On appeal, the court reversed this decision, affirming FIC's valid subrogation lien and rejecting the 'made whole' doctrine for statutory subrogation. The appellate court further determined that Garza was entitled to reasonable attorney's fees from FIC's recovery, remanding the case for their determination.

Workers' CompensationSubrogation rightsUninsured/Underinsured Motorist (UIM) benefitsSummary JudgmentStatutory ConstructionAttorney's FeesInsurer Receivership ActTexas Labor CodeContractual LiabilityThird-party action
References
27
Case No. 03-97-00567-CV
Regular Panel Decision
Jul 30, 1998

Memorial Medical Center of East Texas v. James A. Howard, Special Deputy Receiver of Texas Employers' Insurance Association and Texas Property and Casualty Insurance Guaranty Association

Memorial Medical Center of East Texas appealed a summary judgment granted in favor of James A. Howard, Special Deputy Receiver of Texas Employers' Insurance Association, and Texas Property and Casualty Insurance Guaranty Association. Memorial sought a declaration that the appellees were obligated to reimburse defense costs incurred in a separate suit brought by its employees. The trial court granted the appellees' motions for summary judgment without specifying the grounds. The appellate court affirmed the trial court's judgment, holding that both the Receiver and the Association were statutorily precluded from defending Memorial or reimbursing its defense costs under relevant provisions of the Texas Insurance Code.

Summary judgmentInsurance CodeDuty to defendReimbursementImpaired insurerReceivershipGuaranty AssociationAppellate reviewStatutory interpretationWorkers' compensation insurance
References
11
Case No. MISSING
Regular Panel Decision

Massachusetts Mutual Life Insurance v. Avon Associates, Inc.

This case addresses a motion by defendants mortgagors to vacate an ex parte order appointing a receiver during a mortgage foreclosure action. Defendants asserted that the lack of notice for the receiver's appointment violated CPLR 6401 and their Federal constitutional due process rights, citing Fuentes v Shevin. The court found that New York's Real Property Actions and Proceedings Law § 1325 (subd 1) permits ex parte receiver appointments when the mortgage contract explicitly waives notice. Furthermore, the court distinguished the present case from Fuentes, concluding that the sophisticated business operators involved had knowingly and voluntarily waived their right to notice, akin to the circumstances in Overmyer Co. v Frick Co. Based on these findings, the court affirmed the validity of the ex parte order and denied the defendants' motion to vacate the appointment of the receiver.

Mortgage ForeclosureReceiver AppointmentEx Parte OrderDue ProcessWaiver of NoticeContractual WaiverCPLRReal Property Actions and Proceedings LawConstitutional LawBusiness Disputes
References
9
Case No. 03-00-00467-CV
Regular Panel Decision
Feb 28, 2001

Texas Property and Casualty Insurance Guaranty Association, as Receiver for Employers' Casualty v. Texas Workers' Compensation Commission, Subsequent Injury Fund

The Texas Property and Casualty Insurance Guaranty Association (Association) appealed a summary judgment ruling against it in favor of the Texas Workers' Compensation Commission, Subsequent Injury Fund (Fund). The Fund sought to recover death benefits under the Texas Workers' Compensation Act after the Association, acting as receiver for an impaired insurer, terminated payments to the Fund. The Association argued that the Fund's claim was not a 'covered claim', that it was not an 'insurance company' liable for such payments, and that there was no evidence to support a conversion claim. The appellate court rejected all of the Association's contentions, affirming that the Fund had a covered claim and the Association had the obligations of the impaired insurer. The trial court's judgment was affirmed.

Workers' CompensationDeath BenefitsInsurance Guaranty AssociationSubsequent Injury FundStatutory InterpretationSummary Judgment AppealAppellate Court DecisionImpaired Insurer ObligationsCovered ClaimTexas Law
References
15
Case No. 03-11-00688-CV
Regular Panel Decision
Jul 03, 2012

Approach Operating, LLC v. Resolution Oversight Corporation, as Special Deputy Receiver of Financial Insurance Company of America And the Texas Property and Casualty Insurance Guaranty Association

This case concerns an appeal from a summary judgment regarding a workers' compensation carrier's subrogation rights. Appellant Approach Operating, LLC, a general contractor, argued that the carrier had waived its subrogation rights through a Master Service Agreement (MSA) with subcontractor Lilly Construction, Inc. An employee of Lilly, Rodolfo Martinez, was injured and received workers' compensation benefits from Financial Insurance Company of America (FICA) and later The Texas Property and Casualty Insurance Guaranty Association (TPCIGA). The district court found no waiver of subrogation and granted summary judgment for FICA and TPCIGA. The Texas Court of Appeals, Third District, affirmed the lower court's judgment, emphasizing that explicit contractual language is required for a waiver of subrogation, which was absent in the MSA.

Workers' CompensationSubrogation WaiverMaster Service AgreementContract InterpretationSummary JudgmentTexas Court of AppealsInsurance LawOil and Gas IndustryExplicitness RuleThird-Party Claim
References
24
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