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Case No. 15-25-00134-CV
Regular Panel Decision
Jul 30, 2025

Texas Association of School Boards Risk Management Fund // Southwest Texas Junior College v. Southwest Texas Junior College // Cross-Appellee, Texas Association of School Boards Risk Management Fund

This case involves an intergovernmental contract dispute between the Texas Association of School Boards Risk Management Fund (Appellant) and Southwest Texas Junior College (Appellee). The College is seeking replacement cost value benefits under a self-insurance contract for property damage allegedly sustained during an April 2021 hailstorm. The College claims a waiver of the Fund’s governmental immunity under TEX. LOC. GOV’T CODE § 271.152, asserting equitable theories of waiver and unconscionability, and intentional torts of fraud and bad faith to expand coverage beyond the express terms of the agreement. The Fund argued that its governmental immunity had not been waived for these claims and damages, emphasizing that statutory waivers are to be narrowly construed. The trial court partially granted the Fund's jurisdictional plea, dismissing claims for exemplary, consequential, or treble damages, but denied the plea regarding the College's equitable and intentional tort theories, viewing them as defensive in nature. The Fund appeals this partial denial, arguing that the Act's narrow immunity waiver does not extend to these theories which attempt to create coverage where none explicitly exists in the written contract.

Governmental ImmunityContract DisputeSelf-Insurance PoolRisk ManagementEquitable DoctrinesIntentional TortsWaiverUnconscionabilityTexas LawAppellate Review
References
14
Case No. 2-08-266-CV
Regular Panel Decision
Mar 05, 2009

Jane Doe, Individually and as Next Friend for Sally Doe, a Minor v. Texas Association of School Boards, Inc. and Texas Association of School Boards Risk Management Fund

Appellant Jane Doe, individually and as next friend for her daughter Sally Doe, a minor, appealed the trial court's order granting summary judgment motions of appellees Texas Association of School Boards, Inc. (TASB, Inc.) and Texas Association of School Boards Risk Management Fund (TASB RMF). The case originated from sexual assaults committed by a school bus driver, John Paul Emenhiser, against Sally Doe. Appellant later sued appellees seeking a declaration that Emenhiser was an insured under their coverage to the Denton Independent School District (DISD), which would obligate appellees to satisfy a $5,000,000 judgment appellant obtained against Emenhiser. The Court of Appeals affirmed the trial court's summary judgment, concluding that an indemnity clause in a prior settlement agreement between appellant and DISD precluded appellees' responsibility to pay the judgment, thereby rendering the coverage issue moot.

Sexual MisconductSummary JudgmentIndemnity AgreementThird-Party BeneficiaryContract InterpretationMinor's RightsQuasi-EstoppelAppellate ProcedureCoverage DisputeSchool Liability
References
39
Case No. 04-25-00316-CV
Regular Panel Decision

Texas Association of School Boards Risk Management Fund v. Southwest Texas Junior College

This case involves an intergovernmental contract dispute between the Texas Association of School Boards Risk Management Fund (appellant) and Southwest Texas Junior College (appellee). The College seeks additional self-insurance benefits for hailstorm property damage, alleging a waiver of the Fund's governmental immunity under TEX. LOC. GOV’T CODE § 271.152. The College aims to equitably modify the contract and recover consequential damages. The Fund argues that the Act provides only a narrow immunity waiver, limited to enforcing express contract terms and excluding consequential damages or non-specified equitable relief. The trial court denied the Fund's plea to the jurisdiction and granted the College's motion for summary judgment, prompting this appeal, where the Fund seeks reversal of these orders.

Governmental ImmunityWaiver of ImmunityIntergovernmental ContractSelf-Insurance FundProperty Damage ClaimHailstorm DamageBreach of ContractEquitable ReliefConsequential DamagesStatutory Interpretation
References
40
Case No. 03-15-00314-CV
Regular Panel Decision
Aug 07, 2015

California Insurance Guarantee Association, Oklahoma Property and Casualty Insurance Guaranty Association, and Texas Property and Casualty Insurance Guaranty Association v. Hill Brothers Transportation, Inc.

The appellants, California Insurance Guarantee Association (CIGA), Oklahoma Property and Casualty Insurance Guaranty Association (OPCIGA), and Texas Property and Casualty Insurance Guaranty Association (TPCIGA), collectively "Guaranty Associations," are appealing a summary judgment granted in favor of the appellee, Hill Brothers Transportation, Inc. ("Hill Bros."). The suit was filed on March 31, 2009, alleging Hill Bros. failed to reimburse the Guaranty Associations for payments of workers' compensation benefits and claim handling expenses within the deductible limits of a policy issued by the insolvent Legion Insurance Company ("Legion"). The District Court granted summary judgment to Hill Bros. based on the statute of limitations, ruling that the cause of action accrued on April 1, 2002. The Guaranty Associations argue that the accrual date is incorrect, as their statutory obligations had not been triggered, payments had not been made, and demand for reimbursement had not occurred by that date. They also contend that their compliance with Pennsylvania law (the "Pennsylvania Act") in seeking reimbursement through Legion in Liquidation constitutes a mitigating circumstance for any delay, making reasonableness a fact question. Furthermore, they assert the policy was a continuing contract, and the statute of limitations should not have accrued until full performance on April 28, 2009. Alternatively, they argue that claims for deductible payments made within four years of filing suit (March 31, 2005) are not barred.

Workers' CompensationInsurance Guaranty AssociationStatute of LimitationsBreach of ContractDeductible ReimbursementInsolvencyInsurance PolicyContinuing ContractPennsylvania ActTravis County
References
21
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. 03-17-00352-CV
Regular Panel Decision
Aug 22, 2018

Vista Medical Center Hospital Vista Healthcare, Inc. And Surgery Specialty Hospital, Inc.// State Office of Risk Management v. State Office of Risk Management// Vista Medical Center Hospital Vista Healthcare, Inc. And Surgery Specialty Hospital, Inc.

This case involves cross-appeals stemming from a dispute over the appropriate reimbursement for medical services provided by Vista Medical Center Hospital and its affiliates to injured employees covered by the State Office of Risk Management (SORM) under Texas workers’ compensation statutes. The district court had affirmed 23 administrative orders that required SORM to make additional payments to Vista, a decision which SORM challenged on appeal citing insufficient evidence. Vista, in turn, cross-appealed the district court's denial of prejudgment interest. The appellate court found substantial evidence supported the administrative law judges' conclusion that SORM's original reimbursement model was unfair and unreasonable, and that Vista's proposed methodology was valid. Consequently, the court affirmed the district court's judgment but modified it to include the prejudgment interest that Vista was statutorily entitled to.

Workers' CompensationMedical ReimbursementAdministrative LawAppellate ReviewSubstantial EvidencePrejudgment InterestTexas LawHealthcare ProvidersInsurance DisputesFee Guidelines
References
23
Case No. MISSING
Regular Panel Decision

STATE OFFICE OF RISK MANAGEMENT v. Berdan

The State Office of Risk Management (SORM) appealed a summary judgment and associated orders favoring Maria L. Berdan in a workers' compensation case. SORM's appeal was based on alleged non-compliance with the Texas Labor Code, claiming the judgment was void. However, the court determined that the relevant statutory provision, Section 410.258, does not apply to judgments rendered after fully adversarial proceedings. Consequently, the judgment was not rendered void. The court ultimately dismissed SORM's appeal for lack of jurisdiction, finding its motion for new trial and notice of appeal untimely, and further ruling that several other contested post-judgment orders were not independently appealable.

Workers' CompensationAppeal DismissalJurisdictionTimeliness of AppealSummary JudgmentAttorney's FeesTexas Labor CodeStatutory InterpretationFinal JudgmentInterlocutory Order
References
33
Case No. NO. 14-05-00819-CV
Regular Panel Decision
May 15, 2007

Norma Hunt v. State Office of Risk Management

Norma Hunt appealed a judgment in a workers' compensation case where a jury found she did not sustain a compensable psychological injury. Hunt had previously suffered physical injuries from a fall at work. She later developed depression and panic attacks, arguing these psychological conditions were compensable as a result of her original physical injury. The State Office of Risk Management disputed the compensability of the psychological component. The trial court rendered judgment in favor of Risk Management, and the appellate court affirmed, concluding that the evidence was legally and factually sufficient to support the jury's verdict that Hunt's compensable injury did not include a psychological component.

Workers' CompensationPsychological InjuryDepressionPanic AttacksCompensabilityPreexisting ConditionFactual SufficiencyLegal SufficiencyDirected VerdictCausation
References
8
Case No. 07-05-0268-CV
Regular Panel Decision
Apr 11, 2006

State Office of Risk Management v. Rachel Herrera and Texas Municipal League Intergovernmental Risk Pool

The State Office of Risk Management (SORM) appealed the dismissal of its attempt to judicially review a Texas Worker’s Compensation Commission appeals panel ruling. The trial court had dismissed SORM's petition for lack of jurisdiction, asserting it was not timely filed within 30 days. SORM argued that the dispute concerned compensability, which allowed for a 40-day filing period under the Labor Code. The Court of Appeals determined that the core issue of identifying the responsible employer for death benefits, thereby defining the course and scope of employment, constituted a matter of compensability. Consequently, SORM had 40 days to file. The appellate court reversed the trial court’s order of dismissal and remanded the case for further proceedings.

Worker's CompensationJudicial ReviewJurisdictionTimelinessCompensabilityCourse and Scope of EmploymentDeath BenefitsTexas Labor CodeGovernment CodeAppeals Court
References
3
Case No. 07-12-00232-CV
Regular Panel Decision
Jan 08, 2013

Wendell H. Taylor v. Lubbock Regional MHMR & JI Texas Risk Management and Texas Department of Insurance Division of Workers' Compensation

Wendell H. Taylor, an employee of Lubbock Regional MHMR, sustained a compensable injury in 2009. His subsequent claim for chronic pain and related conditions was denied by the Workers' Compensation Division's appeals panel. Taylor filed suit in district court seeking judicial review and alleging intentional torts, bad faith, and other claims against MHMR, JI Specialty Services, Texas Council Risk Management Fund, and the Division. The trial court dismissed most of Taylor's claims against all defendants based on a lack of jurisdiction and governmental immunity. On appeal, the court affirmed the dismissals for MHMR, the Risk Management Fund, and the Division, citing failure to exhaust administrative remedies and sovereign/governmental immunity for tort claims. However, the court reversed the dismissal against JI Specialty Services, Inc., concluding it had not established its claim to governmental immunity. The case was remanded for further proceedings regarding JI Specialty Services.

Interlocutory AppealPlea to the JurisdictionSovereign ImmunityGovernmental ImmunityTort ClaimsAdministrative Remedies ExhaustionSelf-insured EntityThird-Party Administrator LiabilityWorkers' Compensation BenefitsTexas Appeals Court
References
28
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