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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Hart v. Aetna Casualty & Surety Co.

Karen Hart, an emergency medical technician, was exposed to chlorine gas. Aetna Casualty and Surety Company's adjuster, Marianna Grimes, contacted the Harts, who subsequently signed a release of liability for $1,500. The Harts sued to set aside the release, alleging Grimes made material misrepresentations regarding Aetna's liability, the need for an attorney, and other parties' settlements. The trial court granted an instructed verdict for Aetna, finding no fiduciary duty existed between Aetna and the Harts as injured third parties, and that the alleged misrepresentations were either statements of opinion or immaterial to the Harts' decision to sign the release. The appellate court affirmed the trial court's judgment.

Instructed VerdictRelease of LiabilityFiduciary DutyMaterial MisrepresentationFraudUndue InfluenceInsurance AdjusterAppellate ReviewBreach of DutyCivil Procedure
References
7
Case No. 2-04-233-CV
Regular Panel Decision
Jan 06, 2005

Texas Mutual Insurance Company v. Surety Bank, N.A. Individually and D/B/A Surety Premium Finance

Appellant Texas Mutual Insurance Company challenged a provision in a temporary injunction obtained by Appellee Surety Bank, N.A., alleging it constituted an unconstitutional prior restraint on speech. The temporary injunction prohibited Texas Mutual from communicating or implying to insurance agents or customers that Surety Bank was in financial trouble or unfit to finance insurance premiums. The Court of Appeals for the Second District of Texas in Fort Worth held that the challenged provision was unconstitutional under article one, section eight of the Texas Constitution, finding it to be an overly broad prior restraint on speech and not the least restrictive means to address the alleged harm. Consequently, the court modified the trial court's temporary injunction by deleting the offending provision and affirmed the injunction as modified.

Prior RestraintFreedom of SpeechTexas ConstitutionFirst AmendmentTemporary InjunctionCommercial SpeechBusiness DisparagementTortious InterferenceAppellate ReviewConstitutional Law
References
14
Case No. 03-97-00285-CV
Regular Panel Decision
Apr 02, 1998

the Aetna Casualty & Surety Company v. Texas Workers' Compensation Insurance Facility

The Aetna Casualty & Surety Company appealed a declaratory judgment that found an indemnification provision in its servicing agreement with the Texas Workers' Compensation Insurance Facility unenforceable. Aetna had sought indemnification for sums paid to defend and settle claims by Jane Craft, alleging Aetna mishandled her workers' compensation claim with bad faith and gross negligence. The trial court's ruling, affirmed by the appellate court, determined that the indemnification clause did not expressly cover Aetna's own misdeeds. The court applied the "express negligence rule" and extended it to bad faith, gross negligence, and other alleged statutory violations, emphasizing that such liabilities must be explicitly stated in indemnity clauses. The court also addressed and rejected Aetna's arguments regarding agency, res judicata, and vested rights.

Indemnification ClauseExpress Negligence RuleBad Faith ClaimGross NegligenceDeclaratory JudgmentWorkers' Compensation InsuranceServicing AgreementInsurance Code ViolationsDeceptive Trade Practices ActContract Interpretation
References
8
Case No. MISSING
Regular Panel Decision
Dec 22, 1992

Aetna Casualty & Surety Co. v. Greater New York Mutual Insurance

This case involves an appeal concerning an insurer's claim for contribution. Aetna Casualty & Surety Company, the liability insurer for Trio Drug Corporation and additional insured 58 Realopp Corporation, sought contribution from Greater New York Mutual Insurance Company, Trio's workers' compensation carrier. Aetna had settled an underlying injury action where it represented both Realopp and Trio, and subsequently sued for 50% of the settlement amount. The Supreme Court affirmed the denial of Aetna's summary judgment motion and the granting of Greater New York's cross-motion for summary judgment. The appellate court applied the anti-subrogation rule, finding that Aetna could not assert a subrogated claim against its own insured, Trio, due to potential conflicts of interest arising from its dual representation in the underlying action.

anti-subrogation ruleconflict of interestsummary judgmentcontributionworkers' compensationliability insurancethird-party claimcommon law indemnityappellate reviewinsurer dispute
References
3
Case No. MISSING
Regular Panel Decision

Tri-State Employment Services, Inc. v. Mountbatten Surety Co.

The United States Court of Appeals for the Second Circuit certified a question to the New York Court of Appeals regarding whether a professional employer organization (PEO) may be a proper claimant under a labor and materials surety bond. Plaintiff Tri-State Employment Services, Inc., a PEO, provided employee leasing services to Team Star Contractors, Inc. for a construction project, covering payroll, taxes, and insurance. When Team Star failed to pay, Tri-State filed a claim with the surety, Mountbatten Surety Company, Inc., which was dismissed by the District Court. The New York Court of Appeals determined that a PEO's primary role as an administrative services provider and payroll financier creates a presumption that it does not provide labor for the purpose of a payment bond claim. The Court found that Tri-State failed to overcome this presumption by demonstrating sufficient direction and control over the workers. Consequently, the Court answered the certified question in the negative, ruling that Tri-State Employment Services, Inc. is not a proper claimant under the surety bond in the circumstances presented.

Professional Employer OrganizationSurety BondLabor and Materials BondClaimant StatusEmployee LeasingPayroll ServicesAdministrative ServicesConstruction ContractCertified QuestionNew York Law
References
16
Case No. MISSING
Regular Panel Decision

National Union Fire Insurance v. Aetna Casualty & Surety Corp.

Plaintiff National Union Fire Insurance Company (National) sought a declaratory judgment against defendant Aetna Casualty and Surety Corporation (Aetna), asserting Aetna was a co-insurer for defense and indemnity obligations owed to an insured. The dispute arose from an underlying personal injury action where an employee of Karl Wrecking Company sued the Metropolitan Transportation Authority (MTA), for whom Karl provided wrecking services. National insured MTA under an owner's liability policy and Karl under a general liability policy, while Aetna provided Karl's workers' compensation policy, excluding contractual liability. The court found that National, controlling MTA's defense, strategically omitted a contractual indemnification claim against Karl, instead pursuing common law indemnification, to trigger Aetna's liability. The court denied National's request, ruling that National had manipulated the litigation for its own benefit, thereby placing its interests above those of its insureds and violating public policy against insurers subrogating against their own insureds.

Declaratory JudgmentInsurance DisputeCo-InsuranceIndemnificationCommon Law IndemnificationContractual IndemnificationInsurer DutiesConflict of InterestSubrogationBad Faith
References
8
Case No. MISSING
Regular Panel Decision

State Ex Rel. Pope v. United States Fire Insurance Co.

The intervenors, former employees of North American Royalties, Inc. (NAR), appealed a decision regarding the liability of surety companies that issued bonds to NAR, a self-insured employer. NAR ceased paying workers' compensation claims and filed for bankruptcy, prompting the State of Tennessee to seek payment from the sureties. The core dispute was whether the sureties' liability was cumulative for each year a bond was in effect or limited to the penal amount on the face of the bonds. The trial court and Court of Appeals ruled in favor of the sureties, limiting their liability. The Tennessee Supreme Court affirmed, interpreting Tennessee Code Annotated section 50-6-405(b) to mean that the bonds were continuous, single-term obligations, thus capping liability at the penal sum, and found no statutory or contractual basis for cumulative liability.

Surety BondsSelf-Insured EmployersWorkers' Compensation LiabilityStatutory InterpretationCumulative LiabilityPenal AmountAppellate ProcedureTennessee LawInsurance LawBankruptcy Claims
References
19
Case No. ADJ1817205 (RIV 0076837) ADJ2824273 (RIV 0076838)
Regular
Jul 02, 2014

SONNY LOVELESS vs. NEWPORT FARMS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, ZURICH AMERICAN INSURANCE CO., VIRGINIA SURETY INSURANCE COMPANY

This case involves a dispute over reimbursement for workers' compensation benefits paid by CIGA. The Appeals Board affirmed an arbitrator's decision granting CIGA full reimbursement from Virginia Surety and Zurich for benefits paid to the applicant. Virginia Surety's arguments that the cumulative trauma periods should be reevaluated and that CIGA was liable for the first period were rejected. The Board found Virginia Surety is bound by prior stipulations establishing two cumulative trauma periods, making its coverage "other insurance" under Insurance Code § 1063.1(c)(9) and thus excluding CIGA's liability for those benefits.

Workers' Compensation Appeals BoardSonny LovelessNewport FarmsCalifornia Insurance Guarantee Association (CIGA)Superior NationalZurich American Insurance Co.Virginia Surety Insurance Companycumulative traumastipulated awardreimbursement
References
4
Case No. VNO 0457283
Regular
Aug 28, 2007

GREGORY BRIDGES vs. FILM PAYMENT SERVICES, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for LEGION INSURANCE COMPANY, in liquidation, by BROADSPIRE, KELLEY PRODUCTIONS, INC., NATIONAL SURETY CORPORATION now FIREMAN'S FUND

The Workers' Compensation Appeals Board (WCAB) rescinded a previous award and returned the case for further proceedings to determine if the special employer's insurer, National Surety Corporation, provides "other insurance" under Insurance Code section 1063.1(c)(9). The WCAB ruled that a prior appellate decision did not collaterally estop CIGA from asserting this issue and found that the National Surety Corporation policy may constitute such "other insurance." The case now requires a determination on the merits of whether National Surety Corporation's policy is available to applicant, impacting CIGA's liability.

CIGALegion Insurance CompanyNational Surety CorporationFireman's Fundgeneral employerspecial employerjointly and severally liableother insuranceInsurance Code section 1063.1(c)(9)collateral estoppel
References
26
Case No. MISSING
Regular Panel Decision

Employers' Liability Assur. Corp. v. Williams

J. H. Williams, an employee, sustained an injury in September 1924 while working for American Construction Company, an insured employer under the Texas Employers’ Liability Act. He initially received weekly compensation payments from Employers’ Liability Assurance Corporation, Limited. After payments ceased, Williams sought a lump sum award from the Industrial Accident Board, which was granted in June 1925. The assurance corporation subsequently sued in the district court of Galveston county to set aside this award. Williams cross-petitioned for total and permanent disability and a lump sum payment due to manifest hardship. A jury found Williams totally and permanently disabled, and the court sided with Williams, awarding him and his attorneys, Morris, Sewell & Morris, a lump sum of $6,032.15. The assurance corporation appealed this judgment, contesting the finding of total permanent disability and the lump sum award. The appellate court affirmed the lower court's decision, finding sufficient evidence to support the jury's findings and noting the appellant's failure to follow legal procedures regarding a surgical operation demand.

Workers' CompensationTotal Permanent DisabilityLump Sum SettlementIndustrial Accident BoardAppellate ReviewMedical Expert TestimonyJury FindingsEmployer LiabilitySurgical InterventionManifest Hardship
References
6
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