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

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

American Home Shield Corp. v. Lahorgue

This case addresses the enforceability of a contractual indemnity clause under Texas fair notice requirements. American Home Shield (American Home) sought indemnity from Turn-Key Pool & Spa (Turn-Key) following a personal injury suit stemming from a spa heater explosion serviced by Turn-Key. The trial court denied American Home's motion for summary judgment and granted Turn-Key's, ruling the indemnity provision failed both the conspicuousness requirement and the express negligence doctrine. On appeal, American Home contended the provision satisfied fair notice or, alternatively, Turn-Key had actual notice. The appellate court affirmed the trial court's judgment, concluding the indemnity provision was not conspicuous and American Home failed to establish actual knowledge, thus rendering the clause unenforceable.

Contractual IndemnityFair Notice RequirementsConspicuousnessExpress Negligence DoctrineActual Knowledge ExceptionSummary JudgmentTexas LawIndemnity ClauseService Agreement DisputeAppellate Review
References
14
Case No. MISSING
Regular Panel Decision

American Home Assurance Co. v. McDonald

American Home Assurance Company sought judicial review of a workers' compensation decision involving Sherrill McDonald. McDonald counterclaimed for attorney's fees under the Texas Labor Code § 408.221(c). American Home subsequently non-suited its claim, leading McDonald to file a Motion for Summary Judgment on the counterclaim, which the trial court granted. American Home appealed, arguing McDonald was not a 'prevailing party' under the statute. The appellate court affirmed the trial court's judgment, aligning with precedents from other Texas Courts of Appeals that a claimant in McDonald's position is indeed a 'prevailing party' entitled to attorney's fees.

Workers' CompensationAttorney's FeesPrevailing PartySummary JudgmentJudicial ReviewTexas Labor CodeAppellate ReviewInsurance Carrier AppealNon-suitStatutory Interpretation
References
4
Case No. 2025 NY Slip Op 04576 [241 AD3d 563]
Regular Panel Decision
Aug 06, 2025

New York Bus Operators Compensation Trust v. American Home Assur. Co.

The New York Bus Operators Compensation Trust (NYBOCT), a self-insured entity, brought an action against its excess-of-loss insurer, American Home Assurance Co., alleging breach of contract and seeking declaratory relief. This dispute arose after American Home denied coverage for a workers' compensation claim due to untimely notice. The Supreme Court granted American Home's motion to dismiss the complaint as time-barred, which NYBOCT appealed. The Appellate Division affirmed the Supreme Court's decision, ruling that the six-year statute of limitations for breach of contract began when American Home disclaimed coverage on May 18, 2012, making NYBOCT's 2020 lawsuit untimely. The court rejected arguments related to the continuing-wrong doctrine and estoppel.

Limitation of ActionsBreach of ContractInsurance ContractDisclaimer of CoverageStatute of LimitationsWorkers' CompensationExcess-of-Loss PolicySelf-Insured TrustUntimely NoticeAppellate Review
References
29
Case No. 2-04-234-CV
Regular Panel Decision
Jan 06, 2005

American Home Assurance Company v. Steven H. Green

Appellee Steven H. Green, a baggage handler for American Airlines, filed a workers' compensation claim for bilateral carpal tunnel syndrome (CTS). Appellant American Home Assurance Company, the insurer, disputed the date of injury and timely notice. The Texas Workers’ Compensation Commission (TWCC) appeals panel determined the injury date was October 29, 2002, and Green provided timely notice. The trial court granted Green’s motion for summary judgment and denied American Home’s. The Court of Appeals, Second District of Texas, Fort Worth, affirmed the trial court's judgment, holding that Green's date of injury was indeed October 29, 2002, which was when he was diagnosed with CTS, not April 4, 2002, when he was diagnosed with non-compensable arthritis. Consequently, his notice to the employer on October 29, 2002, was timely.

Workers' Compensation LawOccupational Disease ClaimCarpal Tunnel SyndromeDate of Injury DeterminationTimely Notice RequirementSummary Judgment AppealAppellate Court DecisionTexas Labor CodeMedical Diagnosis EvidenceEmployer's Insurance Liability
References
11
Case No. MISSING
Regular Panel Decision

American Home Assurance Co. v. Poehler

The appeals court addressed an appeal by American Home Assurance Company against Susan Poehler concerning a workers' compensation dispute. Key issues included Poehler's impairment rating and her entitlement to supplemental income benefits. The court ruled that Poehler's impairment rating is 5%, reversing the trial court's 20% finding. It affirmed her entitlement to supplemental income benefits for quarter 1 due to procedural default by American Home, but reversed her entitlement for other quarters. The award of attorney's fees to Poehler was also reversed and remanded for a jury trial.

References
0
Case No. MISSING
Regular Panel Decision

Mayberry v. American Home Assurance Co.

John Mayberry was injured at work and filed a workers' compensation claim against American Home Assurance Company. He initially filed for judicial review in Jefferson County, Texas, but the case was transferred to Angelina County because Mayberry resided there at the time of injury, as required by Tex. Lab. Code Ann. § 410.252(b)(1). In Angelina County, American Home Assurance Company successfully moved for summary judgment, arguing the court lacked jurisdiction due to untimely filing in the 'appropriate court.' The core issue on appeal was whether section 410.252(b), concerning venue, is jurisdictional. The appellate court, guided by Dubai Petroleum Co. v. Kazi, held that section 410.252(b) is not jurisdictional but rather designates appropriate venue. Therefore, the trial court in Angelina County erred in granting summary judgment, and the Jefferson County court had jurisdiction to transfer the case. The case was reversed and remanded for further proceedings.

Workers' CompensationSummary JudgmentJurisdictionVenueStatutory InterpretationAppellate ReviewTexas Labor CodeJudicial ReviewResiding CountyTransfer of Venue
References
9
Case No. 4-85-00485-CV
Regular Panel Decision
Mar 30, 1988

American Home Assurance Co. v. Rodriguez

Ana B. Rodriguez, an employee of Del Monte Corporation, suffered a back injury and filed a worker's compensation claim. She entered into a compromise settlement agreement with American Home Assurance Company for $3,600 and two years of future medical expenses. Rodriguez later sued to set aside the agreement, claiming misrepresentation regarding her injuries, as her condition was later diagnosed as a herniated disc requiring surgery, not just a sprain as initially reported by doctors. The trial court set aside the agreement. The Court of Appeals initially reversed, finding no evidence of misrepresentation or reliance. However, the Texas Supreme Court reversed the appellate court, finding some evidence to support the trial court's judgment and remanded for consideration of factual insufficiency. On remand, the Court of Appeals (majority opinion) affirmed the trial court's judgment, finding sufficient evidence that American Home used Rodriguez's doctor's reports (making the doctor its agent) and that Rodriguez relied on Dr. Williams' representations. A dissenting opinion argued that the evidence was factually insufficient to support the jury's findings of agency and reliance.

MisrepresentationWorkers' CompensationCompromise Settlement AgreementHerniated DiscAgency RelationshipFactual InsufficiencyRelianceBack InjuryAppellate ReviewSupreme Court Remand
References
10
Case No. 12-09-00293-CV
Regular Panel Decision
Oct 20, 2010

American Home Assurance Company v. Susan Poehler

American Home Assurance Company appealed a trial court's judgment in favor of Susan Poehler regarding workers' compensation benefits. Poehler, a machine operator, sustained a lower back injury and Dr. Phillip Williams assigned a 20% impairment rating based on a Division Advisory. American Home challenged this rating, arguing it was invalid, and also disputed Poehler's entitlement to supplemental income benefits. The appeals court determined that the 20% impairment rating was invalid as it relied on an invalid Division Advisory, rendering judgment for a 5% impairment rating. Consequently, Poehler was largely found not entitled to supplemental income benefits for most quarters, with the exception of Quarter 1 due to procedural default, and the attorney's fees award was reversed and remanded for a jury determination.

Workers' CompensationImpairment RatingSupplemental Income BenefitsJudicial ReviewAppellate ProcedureAttorney's FeesMedical ImpairmentTexas Labor CodeSpinal Fusion SurgeryDivision Advisory
References
13
Case No. 07-04-0349-CV
Regular Panel Decision
Sep 29, 2005

American Home Assurance Company v. Edward Vaughn

American Home Assurance Company, the appellant and workers' compensation insurer, challenged the trial court's award of attorney's fees to Edward Vaughn, the appellee. American had previously filed a petition for judicial review of a Texas Workers' Compensation Commission (TWCC) decision that found Vaughn suffered a compensable injury. However, American later filed a nonsuit, leading to the trial court granting Vaughn's amended motion for attorney's fees as a 'prevailing party'. The appellate court affirmed the trial court's judgment, holding that American's nonsuit rendered the TWCC's decision in favor of Vaughn final and enforceable, thereby establishing Vaughn as the prevailing party entitled to attorney's fees under the Texas Labor Code.

Attorney's FeesPrevailing PartyNonsuitJudicial ReviewAppellate PracticeTexas LawStatutory InterpretationInsurance LitigationEmployer LiabilityClaim Resolution
References
10
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