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. 01-01-00812-CV
Regular Panel Decision
Jan 09, 2003

the Texas Property and Casualty Insurance Guaranty Association for Reliance National Indemnity Company, an Impaired Insurer v. Martell Guillot

The Texas Property and Casualty Insurance Guaranty Association, acting for Reliance National Indemnity Company, appealed a summary judgment in favor of Martell Guillot. Reliance sought to claim statutory subrogation rights over proceeds from a 1995 lawsuit where Guillot was awarded $30,000 for a non-work-related automobile accident. Reliance argued that a portion of this award covered medical and income benefits it paid for Guillot's subsequent 1996 work-related injury. The appellate court affirmed the trial court's decision, holding that the defendant in the 1995 lawsuit was not liable for Guillot's compensable injury. The court concluded that the jury's award in the 1995 lawsuit was exclusively for the 1994 accident, thereby preventing a double recovery, and denied Reliance's claim.

Workers' CompensationSubrogation RightsSummary Judgment AppealThird-Party LiabilityAutomobile AccidentCompensable InjuryDouble Recovery PreventionInsurance Guaranty AssociationAppellate ReviewTexas Labor Code
References
5
Case No. MISSING
Regular Panel Decision

Peters v. Reliance Standard Life Insurance Co.

Reginald Peters initiated a lawsuit against Reliance Standard Life Insurance Company after they ceased his long-term disability payments. This cessation occurred because Peters had previously entered into a settlement agreement with his employer, Averitt Express, Inc., which included a general release of Averitt and its insurers from future liability. Peters argued that Reliance, not being specifically named in the settlement, was still obligated to pay benefits. The court, presiding over an ERISA-governed claim, applied federal common law to assess the validity of the release. It concluded that the agreement's broad language, which encompassed Averitt's insurers and long-term disability benefits, did include Reliance. Citing adequate consideration and Peters's legal representation, the court granted Reliance's motion to dismiss, barring Peters's claim.

Disability BenefitsERISAMotion to DismissSettlement AgreementRelease of ClaimsFederal Common LawWaiver ValidityLong-Term DisabilityInsurer LiabilityFifth Circuit Law
References
29
Case No. MISSING
Regular Panel Decision

Robbins v. Reliance Insurance Co.

Appellant Maurice Robbins, executor of the estate of Charles M. Robbins, appealed a summary judgment in favor of Reliance Insurance Company. The case concerns a dispute over accidental death benefits under an insurance policy, specifically the conflicting benefit amounts between a 'renewal certificate' ($250,000) and a 'renewal rider' ($50,000). The appellate court first denied the appellee's request to stay the appeal based on a Pennsylvania court order, determining that the Pennsylvania court lacked jurisdiction to issue an anti-suit injunction against Texas litigation. On the merits, the court found the conflicting benefit provisions to create an ambiguity in the policy. Construing this ambiguity strictly against the insurer and liberally in favor of the insured, the court reversed the trial court's summary judgment for Reliance and granted summary judgment for the appellant for the higher benefit amount. The case was remanded for a determination of attorney's fees.

Accidental Death BenefitsInsurance Policy DisputeSummary JudgmentFull Faith and Credit ClauseAnti-Suit InjunctionPennsylvania LawTexas LawInsurance RehabilitationStatutory InterpretationContract Ambiguity
References
24
Case No. CIV.A.H-98-1484
Regular Panel Decision
Aug 28, 2000

Sandwich Chef of Texas v. Reliance Nat. Indemnity Ins. Co.

Sandwich Chef of Texas, Inc. (d/b/a Wall Street Deli), as plaintiff, filed a class action against numerous insurance carriers, including Reliance National Indemnity Insurance Company, alleging that they defrauded employers by charging excessive workers' compensation premiums between May 1988 and January 1990. The plaintiff claims that the defendants utilized the National Council on Compensation Insurance, Inc. (NCCI) as a racketeering enterprise to commit mail and wire fraud. This was allegedly done by improperly factoring 'residual market charges' (RMLs) into premiums, which were purportedly unfiled and unapproved. The defendants moved for a Supplemental Motion for Summary Judgment, arguing that the plaintiff's claims failed to allege indictable acts of racketeering, lacked a basis for proving injury 'by reason of' alleged misrepresentations due to a 'presumption of knowledge' of filed rates, and were precluded by the McCarran-Ferguson Act. The United States District Court, S.D. Texas, Houston Division, denied the defendants' motion for summary judgment, finding that overbilling can constitute RICO mail fraud, that claims to enforce filed rates are not barred by the 'presumption of knowledge,' and that the McCarran-Ferguson Act did not preclude RICO's application as it complemented state regulations. The court also allowed the plaintiff's 'fraud-on-the-regulator' theory and conspiracy claims to proceed.

RICO ActWorkers' Compensation InsuranceMail FraudWire FraudClass ActionSummary JudgmentFiled Rate DoctrineInsurance FraudRetrospectively Rated InsuranceResidual Market Charges
References
15
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. MISSING
Regular Panel Decision

Reliance Insurance Co. v. Kronzer, Abraham & Watkins

The Reliance Insurance Company appealed a trial court's decision that awarded 25% of its subrogation recovery to the claimant's attorneys, Kronzer, Abraham & Watkins, as fees. Reliance had intervened in a personal injury lawsuit to recoup worker's compensation benefits paid to Chester Gilson. The core of the dispute was the applicability of a 1973 amendment to Article 8307, Section 6a, Texas Revised Civil Statutes Annotated, which permitted such attorney's fees. Reliance contended that its pre-existing right to full subrogation, which accrued with payments made to Gilson before the amendment's effective date of September 1, 1973, was protected by Article 8309, Section 3b, preventing retroactive application of the amendment. The appellate court agreed, concluding that Reliance's inchoate or contingent right to full recovery, including its own enforcement costs, had accrued prior to the amendment. Consequently, the trial court was unauthorized to deduct attorney's fees from Reliance's subrogation amount. The judgment was reformed to remove the attorney's fee provision and affirmed as modified.

Workers CompensationSubrogationAttorney's FeesRetroactivityStatutory InterpretationVested RightsTexas LawIndustrial Accident BoardInsurance CarrierSettlement
References
7
Case No. MISSING
Regular Panel Decision
Jan 03, 2000

Fireman's Fund Insurance v. Newark Insurance

This case concerns an appeal regarding an insurance coverage dispute. The Supreme Court, New York County, declared in favor of plaintiff insurer Fireman's, requiring defendant-appellant insurer Reliance to defend and indemnify Fireman's insured, Fisher, in an underlying personal injury action. The injury occurred at a construction site where Fisher was the general contractor and Reliance's insured, Consultants, was a subcontractor. The court affirmed the decision, finding that Fisher, as an additional insured on Reliance's policy, was entitled to the same coverage as Consultants, without a specific limitation for Consultants' negligence. The ruling also noted that General Obligations Law § 5-322.1 (1) does not affect the validity of insurance contracts, even while voiding agreements to indemnify negligent parties against their own negligence.

insurance coverageadditional insuredindemnificationduty to defendpersonal injuryconstruction liabilitysubcontractorgeneral contractorinsurance policy interpretationappellate review
References
3
Case No. MISSING
Regular Panel Decision

Sandwich Chef of Texas, Inc. v. Reliance National Indemnity Insurance

Wall Street Deli, as the plaintiff, filed a class action lawsuit against Reliance Insurance Company and numerous other insurance carriers, alleging violations of the Racketeer Influenced and Corrupt Organizations Act (RICO). The lawsuit claims that defendants conspired to illegally inflate workers' compensation insurance premiums through fraudulent filings with state regulators and deceptive invoices. The court granted Wall Street's motion for class certification, determining that common legal and factual issues, particularly concerning the nationwide fraudulent scheme and the 'filed rate doctrine,' predominated over individual concerns. The ruling also addressed and rejected various defenses, including state law variations, proximate cause, counterclaims, materiality, statute of limitations, in pari delicto, and arbitration agreements, confirming that a class action is the superior method for resolving this complex commercial dispute.

Workers' CompensationInsurance FraudRICOClass ActionClass CertificationRetrospective RatingFiled Rate DoctrineMail FraudInterstate CommerceConspiracy
References
81
Case No. 13-00-645-CV
Regular Panel Decision
Nov 01, 2001

Maurice Robbins, as of the Estate of Charles M. Robbins v. Reliance Insurance Company and Schneider National Carriers, Inc.

This case involves an appeal from a summary judgment concerning accidental death benefits. Maurice Robbins, as executor of Charles M. Robbins' estate, sued Reliance Insurance Company and Schneider National Carriers, Inc., seeking $250,000 in benefits. The dispute arose from conflicting terms in a 'renewal certificate' and a 'renewal rider' regarding the benefit amount. The court also addressed a motion to stay based on a Pennsylvania court order, which was denied due to lack of jurisdiction and non-compliance with Texas law. The appellate court found an ambiguity in the insurance documents, construing it against the insurer, and reversed the trial court's summary judgment, rendering judgment in favor of the appellant for the higher benefit amount. The case is remanded for a determination of attorney's fees.

Accidental Death BenefitsInsurance PolicySummary JudgmentRenewal RiderRenewal CertificateContract InterpretationAmbiguityFull Faith and CreditPennsylvania LawTexas Insurance Code
References
25
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
Showing 1-10 of 15,924 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