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

Case No. 3-93-672-CV
Regular Panel Decision
Oct 12, 1994

Employers Casualty Company Focus Healthcare Management, Inc. Genesys Cost Management Systems, Inc. Corporate Systems, Ltd. Employers National Risk Management Services, Inc. And Havis Wayne Dortch v. Texas Association of School Boards Workers' Compensation Self Insurance Fund El Paso I.S.D. Irving I.S.D. Hico I.S.D. And Aransas Pass I.S.D.

This is an interlocutory appeal from a district court order granting class certification. The Texas Association of School Boards Workers' Compensation Self-Insurance Fund and several independent school districts (appellees) sued Employers Casualty Company and other entities (appellants) alleging misrepresentation and breach-of-contract related to workers' compensation benefits and medical cost containment services. Appellants raised seven points of error regarding standing, the certification hearing, and the requirements of Texas Rule of Civil Procedure 42. The Court of Appeals affirmed the district court's order, finding that the Fund had standing, the class certification hearing was proper, and the class satisfied the prerequisites and maintenance criteria of Rule 42, particularly under Rule 42(b)(4) for predominance and superiority of common issues.

Class ActionClass CertificationInterlocutory AppealStandingNumerosityCommonalityTypicalityRepresentativenessRule 42Predominance
References
22
Case No. 12-19-00032-CV
Regular Panel Decision
Jun 28, 2019

City of Dallas, a Self-Insured Employer, Appellant/Cross-Appellee v. Gregory D. Thompson, Appellee/Cross-Appellant

This is an interlocutory appeal from a trial court’s ruling on a plea to the jurisdiction in a suit for judicial review of a Texas Department of Insurance, Division of Workers’ Compensation (DWC) decision. The City of Dallas, a self-insured employer, challenged counterclaims filed by Gregory D. Thompson, a former employee who claimed workers’ compensation benefits. Dallas asserted the trial court lacked jurisdiction over Thompson’s counterclaims due to untimely filing. Thompson cross-appealed the dismissal of his counterclaim for attorney’s fees based on governmental immunity. The Court of Appeals affirmed the trial court's decision, ruling that the forty-five-day deadline for judicial review is not jurisdictional and upholding governmental immunity for the City of Dallas regarding attorney's fees.

Workers' Compensation BenefitsJudicial Review of Administrative DecisionsPlea to JurisdictionTimeliness of FilingsGovernmental Immunity DoctrineAttorney's Fees ClaimInterlocutory Appeal TexasLabor Code ViolationsSelf-Insured EntitiesAppellate Court Rulings
References
11
Case No. NO. 12-19-00036-CV
Regular Panel Decision
Mar 25, 2020

City of Dallas, a Self-Insured Employer v. Gregory D. Thompson

The City of Dallas, a self-insured employer, appealed a trial court's partial summary judgment related to Gregory D. Thompson's workers' compensation claim. Thompson, a former firefighter, was diagnosed with testicular cancer in 2010, attributed to carcinogen exposure. Dallas initially denied liability, and the case proceeded through DWC administrative review. An Administrative Law Judge (ALJ) determined Thompson suffered a compensable injury but failed to file a claim within one year, though Dallas waived this defense. The trial court affirmed the ALJ's decision regarding waiver. This appellate court affirmed the trial court's ruling, concluding Dallas did not meet its burden to show the ALJ erroneously added the waiver issue and that the defense was not raised within a reasonable time.

Workers' CompensationOccupational DiseaseFirefighter CancerTimely Claim FilingWaiver DefenseJudicial ReviewSummary JudgmentAppellate ReviewTexas Labor CodeAdministrative Law Judge
References
18
Case No. 03-22-00241-CV
Regular Panel Decision
Oct 31, 2023

Texas Political Subdivisions Joint Self-Insurance Fund v. Texas Department of Insurance - Division of Workers' Compensation and Commissioner Cassie Brown in Her Official Capacity

The Texas Political Subdivisions Joint Self-Insurance Fund (TPS Fund) appealed the denial of its plea to the jurisdiction and summary-judgment motion by the 455th District Court of Travis County. The TPS Fund, a self-insured governmental entity, was assessed administrative penalties totaling $132,500 by the Texas Department of Insurance–Division of Workers’ Compensation for violations of the Texas Labor Code related to nonpayment or late payment of workers’ compensation benefits. The TPS Fund asserted governmental immunity from these penalties. The Court of Appeals reviewed the legislative history and prior common law, including Texas Workers’ Comp. Comm’n v. City of Eagle Pass, to determine if immunity was waived. It concluded that the 2019 amendment to Labor Code Section 504.053(e) merely codified existing law, which had already established a clear waiver of immunity for such regulatory actions against self-insured political subdivisions. Therefore, the appellate court affirmed the trial court’s order, holding that the TPS Fund’s governmental immunity is waived for the administrative penalties.

Workers' CompensationGovernmental ImmunityAdministrative PenaltiesTexas Labor CodeSelf-InsurancePolitical SubdivisionsStatutory InterpretationAppellate ReviewRegulatory AuthoritySovereign Immunity
References
13
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. 07-01-0322-CV
Regular Panel Decision
Sep 19, 2002

Texas Worker's Compensation Insurance Fund v. Alisha Byrd, Beneficiary of Melvin R. Byrd, Richard Walters and Pacific Employers Insurance Company

The Texas Workers’ Compensation Insurance Fund appealed a summary judgment that favored Alisha Byrd, Richard Walters, and Pacific Employers Insurance Company. The Fund sought to overturn decisions by the Texas Workers’ Compensation Commission’s Appeals Panel regarding the employment status of Melvin Byrd and Richard Walters at the time of their injuries. The core dispute revolved around whether Elliott Machine Shop or Entergy/Gulf States was the employer under the "borrowed servant" doctrine. The trial court affirmed the Commission’s finding that Elliott was the employer. The Court of Appeals found no inconsistency in the contractual provisions concerning employer control and deemed PEIC’s summary judgment evidence sufficient to negate the "borrowed servant" claim. Consequently, the appellate court affirmed the trial court’s judgment, overruling all of the Fund’s issues.

Borrowed Servant DoctrineSummary Judgment ReviewEmployer Liability DisputeInsurance Coverage ClaimAppeals Panel DecisionsContract InterpretationRight of Control TestEmployee Status DeterminationAppellate AffirmationTexas Civil Procedure
References
7
Case No. MISSING
Regular Panel Decision

Illinois Employers Insurance Co. of Wausau v. Lewis

This appellate case addresses a default judgment entered against defendants, Illinois Employers Insurance Company of Wausau and Employers Mutual Liability Insurance Company of Wisconsin, in a worker's compensation suit. The trial court struck the defendants' pleadings for failing to answer interrogatories and denied their request for a jury trial on damages. The appellate court ruled that the trial court abused its discretion by imposing such harsh sanctions without a prior order compelling discovery. It also found error in denying the jury trial on unliquidated damages. Consequently, the judgment was reversed, and the cause was remanded for further proceedings.

Worker's CompensationDefault JudgmentDiscovery SanctionsInterrogatoriesTexas Civil ProcedureAbuse of DiscretionRight to Jury TrialDamagesAppellate ReviewRemand
References
14
Case No. MISSING
Regular Panel Decision

Place v. Ryder

Claimant, who received workers' compensation benefits from a self-insured employer, settled a third-party action. A dispute arose regarding whether the employer had waived its statutory offset rights against the claimant's net recovery from the third-party action, as there was no written agreement. The Workers' Compensation Board affirmed a Workers' Compensation Law Judge's decision, finding that the self-insured employer had reserved its offset rights. The appellate court affirmed the Board's decision, concluding that the employer's attorney's correspondence provided substantial evidence to support the Board's finding that offset rights were explicitly reserved.

Workers' CompensationOffset RightsThird-Party SettlementEmployer's LienStatutory WaiverAttorney CorrespondenceAppellate ReviewSubstantial EvidenceWorkers' Compensation BoardNew York
References
7
Case No. MISSING
Regular Panel Decision
Apr 14, 2010

Employers Insurance Co. of Wausau v. Penn-America Insurance Co.

This federal insurance dispute involves Employers Insurance Co. of Wausau seeking reimbursement from Penn-America Insurance Company and Prestige Oysters, Inc. Wausau settled claims for a restaurant customer injured by contaminated oysters, whose initial suit involved Bon Secour Fisheries and Shamrock Foods Company. Wausau argues for reimbursement based on Prestige Oysters' contractual and statutory indemnity obligations, while defendants assert Texas law precludes subrogation and allege Bon Secour's independent negligence. The court denied both parties' motions for summary judgment, finding that Texas law does not inherently bar Wausau's subrogation claim, but the record is insufficient to establish Bon Secour's independent liability. A status conference is scheduled to address unresolved issues.

Insurance DisputeSubrogationIndemnificationProducts LiabilityOystersNegligenceContractual IndemnityStatutory IndemnitySummary JudgmentTexas Law
References
30
Case No. 03-93-00512-CV
Regular Panel Decision
Aug 16, 1995

Albert G. Banks v. Texas Employers' Insurance Association

Albert Banks appealed a take-nothing summary judgment that denied his claims against the Texas Employers' Insurance Association (TEIA) for mishandling his workers' compensation claim. Banks sustained a shoulder injury while working for Burnet Consolidated Independent School District, which was self-insured and utilized TEIA to adjust claims. After initial benefits, payments ceased despite a second surgery. Banks sued, alleging breach of good faith and fair dealing, as well as violations of the Deceptive Trade Practices Act (DTPA) and the insurance code. The appellate court affirmed the summary judgment, ruling that TEIA, as an adjusting firm, did not owe Banks a duty of good faith and fair dealing, and that his claims under the insurance code and DTPA were not actionable based on controlling supreme court precedent.

Workers' Compensation ClaimSummary Judgment AppealDuty of Good Faith and Fair DealingInsurance Claims HandlingDeceptive Trade Practices ActInsurance Code ViolationsClaims Adjuster LiabilityAppellate Court DecisionEmployment InjuryTexas Civil Procedure
References
5
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