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

Case No. GRO 27301, GRO 28637
Regular
Feb 11, 2008

HERMAN DENNLER vs. TIMEC CO., INC., ST. PAUL TRAVELERS, OPEN WAVES SYSTEMS, LUMBERMAN'S MUTUAL CASUALTY COMPANY

This Workers' Compensation Appeals Board opinion corrects a clerical error in a previous decision, specifically removing the incorrect statement that St. Paul Travelers was adjusted by Broadspire. The case involves two injuries sustained by Herman Dennler in 2002, with awards of permanent disability indemnity and future medical treatment granted against Timec Co., Inc. (insured by St. Paul Travelers) and Open Wave Systems (insured by Lumberman's Mutual Casualty Company). The correction clarifies that St. Paul Travelers was the insurance carrier for Timec Co., Inc. and was not adjusted by Broadspire.

Workers' Compensation Appeals Boardclerical errorreconsiderationaward correctionpermanent partial disabilitytemporary disability indemnitymedical treatmentattorney's feeslienTimec Co.
References
0
Case No. MISSING
Regular Panel Decision

St. Paul Guardian Insurance Co. v. Luker

Paul and Teri Luker sued St. Paul Guardian Insurance Company after their claim for lost household goods in a fire was denied under a homeowner's policy issued to Kim's father, Emmett Luker. St. Paul denied the claim, alleging arson by the Lukers and misrepresentation, despite a prior stipulation agreeing to coverage for the Lukers' personal effects. A jury awarded the Lukers contractual damages for property loss and tort damages for bad faith and mental anguish. On appeal, the court affirmed the contractual damages, finding St. Paul owed a duty of good faith and fair dealing to the Lukers as third-party beneficiaries due to the stipulation. However, the court reversed the awards for exemplary damages and bad faith tort damages, remanding the bad faith claim for a new trial, citing insufficient evidence that St. Paul acted in bad faith or with conscious indifference in denying the claim.

Insurance disputeArson defenseBad faith claimContractual damagesTort damagesThird-party beneficiaryStipulation in litigationExemplary damages reversedMental anguish claimProperty loss
References
31
Case No. MISSING
Regular Panel Decision

I. Appel Corp. v. St. Paul Fire & Marine Insurance Co.

This appeal concerns the trial court's grant of summary judgment in favor of St. Paul insurance company, which held that St. Paul had no duty to defend its insured, I. Appel. The underlying lawsuit involved Brenda Kelley, who alleged retaliatory discharge and intentional infliction of emotional distress against I. Appel, stemming from an incident with Mike Landreth. St. Paul denied coverage based on policy exclusions for intentional acts and injuries to fellow employees. The appellate court affirmed the trial court's judgment, finding that the policy's exclusionary language clearly applied to I. Appel's alleged intentional acts, thereby relieving St. Paul of its defense obligation.

Insurance contractDuty to defendSummary judgmentPolicy exclusionIntentional bodily injuryRetaliatory dischargeEmotional distressCommercial general liabilityExcess liabilityInsurer obligations
References
5
Case No. MISSING
Regular Panel Decision

St. Paul Fire & Marine Insurance Co. v. Texas Workers' Compensation Commission

St. Paul Fire and Marine Insurance Company ("St. Paul's") challenged the constitutionality of the immediate payment and reimbursement scheme of the Texas Workers’ Compensation Act, specifically sections 409.023(a), 410.032, 410.169, and 410.205. This dispute arose from separate claims made by Martha Oviedo and Phillip Williams for workers' compensation benefits, which St. Paul disputed. St. Paul argued that the omission of a reimbursement provision for funds paid under a contested-case decision that is later reversed violates several provisions of the Texas and U.S. Constitutions. The court ultimately concluded that the case did not present a justiciable controversy because St. Paul had not established imminent harm, as the contested-case hearing officers' decisions had not been modified or reversed. Therefore, the trial court’s judgment was vacated, and the cause was dismissed.

Constitutional LawWorkers' Compensation ActDue ProcessJusticiabilityDeclaratory JudgmentInjunctive ReliefAdvisory OpinionReimbursement SchemeAppellate JurisdictionTexas Law
References
7
Case No. MISSING
Regular Panel Decision
Jun 18, 1992

Shelton Insurance Agency v. St. Paul Mercury Insurance Co.

This case involves an appeal by Shelton Insurance Agency and John M. Roberts against St. Paul Mercury Insurance Company regarding the alleged mishandling of an insurance claim. Shelton Agency initially sued St. Paul for violations of the DTPA, Texas Insurance Code, breach of contract, and breach of the duty of good faith and fair dealing after St. Paul denied coverage to its customer, Frio Drilling Company. A jury found in favor of Shelton Agency, awarding actual and exemplary damages, but the trial court granted St. Paul's motion for judgment n.o.v. The appellate court affirmed the trial court's judgment on the DTPA, insurance code, breach of good faith, and punitive damages claims. However, it reversed and rendered the judgment on the breach of contract claim, ruling that Shelton Agency was entitled to recover $34,000 for premiums it wrote off.

Insurance LawAgency LiabilityBreach of ContractGood Faith and Fair DealingDTPATexas Insurance CodeDenial of CoverageInsurance Bad FaithPunitive DamagesJudgment N.O.V.
References
30
Case No. MISSING
Regular Panel Decision
Feb 21, 2008

Indemnity Insurance Co. of North America v. St. Paul Mercury Insurance

In this insurance coverage dispute, IICNA, Romano's excess insurer, sought reimbursement from St. Paul (Yonkers' insurer) and Yonkers (general contractor) for a $2 million payment made to settle an underlying personal injury suit involving Eugene Flood. Flood, a Yonkers employee, was injured due to a cable left by subcontractor Romano. IICNA settled the underlying action without St. Paul's consent, believing St. Paul's policy was primary and Yonkers was contractually obligated to indemnify. The court denied IICNA's claims, finding St. Paul was not bound by the non-consented settlement and had properly tendered defense to Romano. Furthermore, IICNA's subrogation claim against Yonkers was barred by the antisubrogation rule, as Yonkers was an additional insured under IICNA's policy.

Insurance CoverageReimbursementSubrogationAntisubrogation RuleAdditional InsuredIndemnification AgreementLabor LawSummary JudgmentAppellate ReviewSettlement Consent
References
8
Case No. MISSING
Regular Panel Decision

St. Paul Surplus Lines Ins. Co., Inc. v. Dal-Worth Tank

St. Paul Surplus Lines Insurance Co. (St. Paul) appealed a judgment in favor of Dai-Worth Tank Co. (Dai-Worth) and Mission Butane Gas Co., raising fifty-six points of error concerning a "Mary Carter agreement," insufficient evidence, and damage awards. Dai-Worth cross-appealed for exemplary damages. The appellate court affirmed many of the jury's findings, including St. Paul's negligence, breach of good faith, deceptive practices, and unconscionable actions, finding St. Paul had actual knowledge of the lawsuit and was estopped from denying coverage. However, the court reversed the award for future lost profits due to insufficient evidence, necessitating a recalculation of actual damages, treble damages, prejudgment interest, and attorney's fees. The case was remanded to the trial court for these computations, upholding the principle that exemplary damages and statutory treble damages cannot both be recovered for the same acts.

Insurance LawAppellate ProcedureMary Carter AgreementDeceptive Trade Practices Act (DTPA)Bad Faith InsuranceNegligenceBreach of ContractLost ProfitsDefault JudgmentAgency Law
References
104
Case No. MISSING
Regular Panel Decision
Sep 11, 1989

In re the Arbitration Between St. Paul Fire & Marine Insurance

St. Paul Fire & Marine Insurance Company petitioned for a stay of arbitration sought by James D. Brown, Jr. and for a declaration that Richard Faulkner's vehicle was covered by Aetna Casualty & Surety Company's policy issued to Empire Preferred Commercial Operations. Faulkner, an Empire employee, was involved in an accident with Brown while driving his own car for business purposes, despite making a stop to pick up his son en route to a job inspection site. Brown made a claim against the uninsured motorist provision of his policy with St. Paul. The lower court found Faulkner's vehicle was used "in connection with" Empire's business, and this finding was upheld on appeal. The court concluded that picking up his son was not a deviation from employment. Therefore, the judgment granting St. Paul's petition and affirming Aetna's coverage for Faulkner's vehicle was unanimously affirmed.

Insurance CoverageAutomobile AccidentScope of EmploymentNon-Owned AutomobilesArbitration StayDeclaratory JudgmentEmployer LiabilityEmployee TravelBusiness Use of VehicleDeviation from Employment
References
3
Case No. 07-10-0466-CV
Regular Panel Decision
Sep 26, 2011

Robert Smith v. City of Lubbock and St. Paul Fire and Marine Insurance Company

Robert Smith appealed summary judgments against the City of Lubbock and St. Paul Fire and Marine Insurance Company. Smith, an employee, sought damages from his employer (the City) under an underinsured/uninsured motorist policy after a work-related injury caused by an intoxicated driver, despite already receiving workers' compensation benefits. The appellate court affirmed the summary judgment for the City, ruling that the Texas Labor Code's exclusive remedy provision bars additional recovery against an employer for work-related injuries, even for contractual claims. However, the court reversed the summary judgment in favor of St. Paul and remanded that aspect for further proceedings, accepting St. Paul's concession for reversal.

Texas LawWorkers CompensationUnderinsured MotoristExclusive Remedy DoctrineContract LawEmployer LiabilityInsurance CoverageSummary Judgment AppealAppellate CourtStatutory Interpretation
References
15
Case No. MISSING
Regular Panel Decision

St. Paul Mercury Insurance v. Lexington Insurance

This case involves a declaratory judgment action between four insurance companies: St. Paul Mercury Insurance Company and Centennial Insurance Company (Applicants), and Lexington Insurance Company and Landmark Insurance Company (Defendants). The dispute centers on the priority of coverage and obligations for a $4.8 million settlement in an underlying personal injury case, the 'Foret Case'. The District Court adopted the Magistrate Judge's Recommendation, ruling that waiver and estoppel claims by the defendants were not applicable between insurers. It determined that both primary policies (Landmark and Centennial) must be exhausted first, with defense costs prorated. For the excess policies (Lexington and St. Paul), liability was also to be prorated. Additionally, the court granted summary judgment in favor of St. Paul and Centennial on the negligence claims brought by Landmark and Lexington.

Insurance Coverage DisputeSummary JudgmentDeclaratory JudgmentOther Insurance ClausesExcess InsurancePro Rata InsuranceEscape ClausesWaiver and EstoppelEquitable SubrogationProration of Liability
References
42
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