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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

Austin Co. v. Royal Insurance Co.

The Austin Company, an insured party, appealed a Chancellor's decision that its insurer, Royal Insurance Company, was authorized to settle a claim in good faith. Under a "retrospective premium" liability policy, Austin Company was responsible for claims up to $250,000, while Royal investigated and administered them. A key dispute arose from a clause requiring Royal to "consult with" Austin Company before settlements exceeding a certain amount, which Austin Company interpreted as granting it veto power. Royal settled an automobile accident judgment against Austin Company for $170,000, despite Austin Company's strong objections to appealing the original $152,000 judgment (which grew to nearly $190,000 with interest). The appellate court affirmed the Chancellor's ruling, finding the policy unambiguously gave Royal the right to settle, not Austin Company veto power, and that Royal's actions, including filing an appeal to keep options open and seeking indemnity for an appeal, were reasonable and in good faith. The court rejected Austin Company's argument that the burden of proof for good faith rested with the insurer, citing Tennessee precedents.

Insurance policyRetrospective premiumLiability insuranceSettlement authorityGood faithBad faithContract interpretationInsurer's rightsInsured's rightsAppeals
References
5
Case No. 13-00-137-CV
Regular Panel Decision
Aug 06, 2001

Cann, Katheryn v. Royal Indemnity Company

Katheryn Cann appealed a summary judgment granted in favor of Royal Indemnity Company, the workers' compensation carrier for her employer, the Victoria Advocate. Royal moved for summary judgment arguing Cann was an independent contractor, not an employee, and thus not entitled to workers' compensation benefits for on-the-job injuries. Cann contended there was a question of fact regarding her employment status, asserting that the Advocate's refusal to let her change her delivery route indicated control over her work, effectively making her an employee. The trial court had granted summary judgment for Royal. The appellate court found conflicting summary judgment evidence regarding the Advocate's right to control Cann's work, making her employment status a question of fact not suitable for summary judgment. Therefore, the appellate court reversed the trial court's decision and remanded the case.

independent contractoremployee statusworkers' compensationsummary judgmentright of controlTexas lawappellate reviewmaterial factscope of employmentemployer liability
References
14
Case No. MISSING
Regular Panel Decision
Nov 16, 2004

Bovis Lend Lease LMB, Inc. v. Royal Surplus Lines Insurance

This case involves an insurance coverage dispute between National Union Fire Insurance Company of Pittsburgh, PA (National Union), The Trustees of Columbia University in the City of New York (Columbia), and Bovis Lend Lease LMB, Inc. (Bovis) against Royal Surplus Lines Insurance Company (Royal). The core issue is whether Royal's disclaimer of liability under Insurance Law § 3420 (d) was timely. The court found that Royal's disclaimer to Bovis and Columbia was untimely as a matter of law because its internal staffing issues were not a reasonable excuse for the delay. However, the court also ruled that § 3420 (d) does not apply to disclaimers between co-insurers, thus Royal's disclaimer was timely as to National Union. Furthermore, the court determined that Royal's "New Residential Work or Products Exclusion" did not apply to Millennium's work on a mixed-use building, thus obligating Royal to defend and indemnify Bovis and Columbia, and Royal was ordered to reimburse National Union for defense costs incurred from March 3, 2003.

Insurance CoverageDisclaimer of LiabilityDenial of CoverageInsurance Law § 3420 (d)Timeliness of DisclaimerInternal Staffing IssuesCo-Insurer LiabilityAdditional InsuredPolicy ExclusionNew Residential Work Exclusion
References
22
Case No. MISSING
Regular Panel Decision
Feb 04, 2004

HRH Construction Interiors, Inc. v. Royal Surplus Lines Insurance

This case involves HRH Construction Interiors, Inc. (HRH) and National Union Fire Insurance Company (National) seeking to establish Royal Surplus Lines Insurance Company's (Royal) obligation to defend HRH in an underlying action and reimburse legal fees. The Supreme Court, New York County, initially ruled that Royal was obligated to defend HRH and reimburse legal fees from December 30, 1999. Upon appeal, this order was modified to change the reimbursement start date to November 22, 2000, and otherwise affirmed. The court rejected Royal's argument that a specific endorsement overrode a general blanket additional insured endorsement, which Royal claimed would make them coprimary insurers with National. The duty to defend was clarified to be triggered upon the commencement of the underlying action against HRH.

Insurance disputeGeneral contractor liabilityAdditional insured endorsementDuty to defendInsurance reimbursementSummary judgmentPolicy interpretationConstruction site accidentPrimary insuranceOther insurance clause
References
0
Case No. MISSING
Regular Panel Decision

Federal Insurance Company a/s/o Robert and Joanie Emerson v. Martin Edward Winters, d/b/a Winters Roofing Company

The defendant contractor, Martin Winters of Winters Roofing Company, entered an agreement to replace a roof for homeowners Robert and Joanie Emerson. After the newly installed roof developed leaks, a subcontractor hired by Winters to make repairs caused a fire, resulting in over $871,069 in damages. Federal Insurance Company, as subrogor to the Emersons' rights, sued Winters for negligence and breach of contract. The trial court initially granted summary judgment for the defendant, but the Court of Appeals reversed this decision. This Court affirmed the Court of Appeals' ruling, holding that the defendant had an implied non-delegable contractual duty to perform the roofing services in a careful, skillful, diligent, and workmanlike manner, a duty which was not discharged by delegating the work to a subcontractor. The case was remanded to the trial court for further proceedings.

Contract LawNon-delegable DutySubcontractor LiabilityBreach of ContractImplied DutyWorkmanlike MannerConstruction ContractsRoofing ServicesSummary JudgmentAppellate Review
References
46
Case No. MISSING
Regular Panel Decision

Paradissis v. Royal Indemnity Company

Chris Paradissis, an employee, suffered a back injury and was deemed permanently disabled, with Royal Indemnity Company, his employer's workmen's compensation carrier, responsible for payments and medical care. Paradissis later sued Royal Indemnity for damages, alleging negligent refusal to provide necessary medical and psychiatric services, claiming this exacerbated his condition. The suit was dismissed by the trial court, a decision affirmed by the Court of Civil Appeals. The Supreme Court of Texas further affirmed the dismissal, holding that claims of negligence against a workmen's compensation carrier for medical services fall exclusively under the state's workmen's compensation laws. Therefore, the District Court lacked jurisdiction as Paradissis had not exhausted his administrative remedies through the Industrial Accident Board, which provides the sole avenue for such disputes.

Workmen's CompensationPersonal InjuryNegligenceJurisdictionExclusive RemedyIndustrial Accident BoardMedical ServicesPsychoneurosisCommon Law TortInsurance Carrier Liability
References
15
Case No. W2019-00271-COA-R3-CV
Regular Panel Decision
Jul 20, 2020

Cook's Roofing, Inc. v. Hartford Underwriters Insurance Company

This appeal concerns retrospective insurance premiums for an assigned risk workers’ compensation insurance policy. The insured employer, Cook's Roofing, Inc., sued Hartford Underwriters Insurance Company after an audit revealed additional premiums were owed due to an uninsured subcontractor. Cook's Roofing alleged negligence, promissory estoppel, and consumer protection violations. Hartford counterclaimed for the unpaid premiums. The trial court granted summary judgment to Hartford. The Court of Appeals affirmed in part, reversed in part regarding the 2006-2007 policy period premium, and remanded for further proceedings, including reconsideration of a motion to amend and the issue of piercing the corporate veil.

Workers' CompensationInsurance PremiumsAssigned Risk PolicySubcontractor LiabilitySummary Judgment AppealNegligence ClaimPromissory EstoppelTennessee Consumer Protection ActBreach of ContractPrejudgment Interest
References
59
Case No. 01-00-00586-CV
Regular Panel Decision

Ranger Insurance Company and Swift Energy Company v. American International Specialty Lines Insurance Company, Flournoy Production Company, and Flournoy Drilling Company

This case involves indemnity and insurance claims arising from oilfield litigation. Appellants, Ranger Insurance Company and Swift Energy Company, appealed a summary judgment granted to appellees, American International Specialty Lines Insurance Company, Flournoy Production Company, and Flournoy Drilling Company. The trial court had ruled that mutual indemnity provisions in an oil and gas drilling contract were void under the Texas Oilfield Anti-Indemnity Act. The Court of Appeals reversed and remanded the judgment, holding that the contract was enforceable up to the extent of mutual coverage and dollar limits, and that its indemnity provisions were conspicuous.

Oilfield LitigationIndemnityInsurance ClaimsTexas Oilfield Anti-Indemnity ActSummary JudgmentContract InterpretationMutual Indemnity ObligationConspicuousnessAppellate ReviewWell Blowout
References
18
Case No. 13-05-065-CV
Regular Panel Decision
Feb 15, 2007

Phoenix Assurance Company of New York v. Dallas Fire Insurance Company and Anthony Brown

This appeal arises from a summary judgment granted in favor of Dallas Fire Insurance Company (Dallas Insurance) and against Phoenix Assurance Company of New York (Phoenix Assurance) in a workers' compensation case. The core issue revolves around determining whether Staff Force, Inc. or Roofing Supply of Corpus Christi was the employer of Anthony Brown for workers' compensation purposes, which dictates the responsible insurer. The trial court initially granted summary judgment to Dallas Insurance, identifying Roofing Supply as the employer. However, the appellate court found a genuine issue of material fact regarding the existence of an agreement for workers' compensation coverage between Staff Force and Roofing Supply. Consequently, the appellate court reversed the trial court's judgment and remanded the case for further proceedings to resolve this factual dispute.

Workers' CompensationSummary JudgmentJudicial EstoppelEmployer-Employee RelationshipInsurance Carrier LiabilityTemporary Staffing AgencyBorrowed Servant DoctrineFact IssueRemandAgreement Interpretation
References
20
Case No. 03-08-00532-CV
Regular Panel Decision
Jan 27, 2010

Severiano DeLeon v. Royal Indemnity Company

This is a workers’ compensation case where the insurance carrier, Royal Indemnity Company, contested the impairment rating assigned to the claimant, Severiano DeLeon, by the Texas Department of Insurance, Division of Workers’ Compensation. The impairment rating was based on advisories issued by the Division, which were subsequently determined by the Court of Appeals to be invalid. The district court held that the assigned impairment rating was invalid, and the Court of Appeals affirmed this judgment. The court concluded that the 20% impairment rating assigned to DeLeon was invalid because it was improperly based on the invalid and withdrawn Division Advisories.

Workers' CompensationImpairment RatingSpinal FusionAMA GuidesMaximum Medical ImprovementAdministrative LawJudicial ReviewUltra Vires ActMedical EvaluationTexas Labor Code
References
9
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