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

Case No. E2009-01288-COA-R3-CV
Regular Panel Decision
Jun 28, 2010

James Erwin v. Travelers Property Casualty Company of America

Plaintiff James Erwin appealed an attorney's fee award in a medical malpractice action where his employer's workers' compensation carrier, Travelers Property Casualty Company of America, intervened to recover its subrogation interest. The Trial Court awarded a specific amount to Erwin's attorney for services rendered in recovering Travelers' subrogation interest, which Erwin contended was inadequate. The Court of Appeals of Tennessee at Knoxville affirmed the Trial Court's judgment, finding the fee and expense award reasonable. The appellate court reviewed the Trial Court's apportionment of fees, noting that Erwin's counsel primarily focused on the malpractice claim for Erwin, necessitating Travelers to hire its own counsel. The decision highlighted the importance of a trial judge's discretion in evaluating attorney services during a trial.

Attorney's feessubrogationworkers' compensationmedical malpracticeappellate reviewpro ratalitigation expensesintervenorcontingency feetrial court discretion
References
3
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. MISSING
Regular Panel Decision

Continental Casualty Company v. Theraco, Inc.

Continental Casualty Company and Travelers Property Casualty Company of America sued Theraco, Inc. for additional workers’ compensation premiums, disputing the classification of physical therapists as independent contractors. Theraco’s insurance contracts with CNA and Travelers included provisions for premiums based on employees or persons posing a risk of workers’ compensation liability. The Department of Commerce and Insurance and the trial court initially sided with Theraco, ruling the physical therapists were independent contractors and not liable for additional premiums. However, upon appeal, this Court affirmed the independent contractor status but reversed the decision regarding the "risk of loss" provision. The Court concluded that the insurers were exposed to the risk of defending potential lawsuits, even if only to litigate the therapists' employment status. Consequently, Theraco was found liable for retrospective premiums totaling $44,089 to CNA and $97,522 to Travelers.

Workers' Compensation PremiumsIndependent Contractor StatusEmployer-Employee RelationshipRisk of Loss ProvisionInsurance Contract InterpretationRetroactive Premium AssessmentPhysical TherapistsAppellate ReviewAdministrative Agency DecisionStatutory Employee
References
17
Case No. 01-08-00770-CV
Regular Panel Decision
May 13, 2010

MEMC Electronic Materials, Inc., and MEMC Pasadena, Inc. v. Albemarle Corporation, Lexington Insurance Company, and Travelers Property Casualty Group

This appeal concerns whether a party to an indemnification agreement can obtain indemnification for a dispute regarding the scope and meaning of the indemnification agreement, specifically, whether the agreement provides for indemnification of another matter. Appellants MEMC Electronic Materials, Inc. and MEMC Pasadena, Inc. appealed the trial court’s rendition of summary judgment in favor of appellees Albemarle Corporation, Lexington Insurance Company, and Travelers Property Casualty Group. MEMC sought attorney's fees and expenses from Albemarle for Albemarle’s prosecution of an Excluded Obligation, arguing that the trial court erred by denying MEMC’s motion for summary judgment and granting Albemarle’s motion. The Court of Appeals affirmed the trial court's judgment, concluding that the Asset Purchase Agreement did not provide for indemnification of “good faith” claims between MEMC and Albemarle concerning the scope and meaning of the agreement, and therefore, MEMC was not entitled to attorney’s fees.

Indemnification AgreementAttorney's FeesBreach of ContractSummary JudgmentExcluded ObligationAsset Purchase AgreementContract InterpretationAppellate ReviewGood Faith DisputeTexas Law
References
12
Case No. E2006-02679-COA-R3-CV
Regular Panel Decision
Aug 29, 2007

Travelers Property Casualty Company of America v. Unitrac Railroad Materials, Inc.

Travelers, a workers' compensation insurer, sought subrogation from Unitrac for benefits paid to an injured employee, Calvin Jones. Jones, an employee of Labor Headquarters, was injured while working for Unitrac. Travelers alleged Unitrac's negligence and breach of a service agreement between Labor and Unitrac. The Trial Court dismissed Travelers' claim, finding Unitrac was a co-employer of Jones, thus invoking workers' compensation tort immunity. The Court of Appeals affirmed, concluding that Unitrac met the criteria for a special employer and that Travelers was not an intended third-party beneficiary of the contract between Labor and Unitrac.

Subrogation ClaimWorkers' Compensation ExclusivityCo-employment DoctrineTort ImmunityThird-Party BeneficiaryIndemnification AgreementService Contract DisputeAppellate AffirmationContract InterpretationLoaned Employee Doctrine
References
14
Case No. 03-01-00084-CV
Regular Panel Decision
Nov 07, 2002

John W. Berkel and John W. Berkel, P.C./Texas Property and Casualty Insurance Guaranty Association v. Texas Property and Casualty Insurance Guaranty Association/John W. Berkel and John W. Berkel, P.C.

This case involves cross-appeals from a judgment by the District Court of Travis County. John W. Berkel and John W. Berkel, P.C. (Berkel) sued the Texas Property and Casualty Insurance Guaranty Association (TPCIGA) and a receiver, seeking to enforce a contract for $6,306, which represented a previously approved "covered claim" for legal services. The trial court awarded Berkel the $6,306 but denied claims for statutory attorney's fees, prejudgment, and postjudgment interest. TPCIGA appealed the $6,306 award, arguing the claim was not a covered claim, but the appellate court affirmed this part, holding the Receiver's prior determination was binding. Berkel appealed the denial of attorney's fees and interest, and the appellate court reversed and remanded this part for further proceedings.

Insurance LawReceivershipImpaired InsurerCovered ClaimsStatutory InterpretationAttorney's FeesPrejudgment InterestPostjudgment InterestSummary JudgmentContract Enforcement
References
9
Case No. NO. 03-06-00631-CV
Regular Panel Decision
Mar 26, 2009

Samuel Campos v. Texas Property & Casualty Insurance Guaranty Association for Reliance National Indemnity Company, an Impaired Carrier

Samuel Campos, an employee, was injured on the job, leading to disputes over his impairment rating and reimbursement for travel expenses. The Texas Workers’ Compensation Commission affirmed a designated doctor's 6% impairment rating and denied travel expenses, which Campos challenged in court. The case involved the Texas Property & Casualty Insurance Guaranty Association (TPCIGA) because Campos's employer's insurer became impaired. Initially filed in Winkler County, the case was transferred to Travis County, where TPCIGA was granted summary judgment. The Third District Court of Appeals reversed the summary judgment, ruling that the Workers' Compensation Act's specific mandatory venue provision, which places venue in the county of the employee's residence at the time of injury (Winkler County), overrides the Guaranty Act's general venue provision, which would place it in Travis County. The court remanded the case with instructions to transfer it to Winkler County.

Workers' CompensationVenue DisputeMandatory VenueStatutory ConstructionTexas Labor CodeTexas Insurance CodeImpairment RatingTravel Expenses ReimbursementJudicial ReviewAppellate Procedure
References
12
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. ADJ10447649
Regular
Jan 16, 2018

ALI KENDRICK vs. HOLOGIC, INC.; TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA AND ITS PROPERTY CASUALTY AFFILIATES AND SUBSIDIARIES

The defendant, Travelers Property Casualty Company of America, sought reconsideration of an award based on stipulated facts. They argued that a mutual mistake occurred regarding the date of injury, leading to an overpayment of permanent disability benefits. The Board dismissed the Petition for Reconsideration, finding the petition should be treated as a petition to set aside the award at the trial level. The WCJ will now conduct proceedings to determine if good cause exists to rescind or amend the award due to a mutual mistake of fact.

Workers' Compensation Appeals BoardPetition for ReconsiderationDismissalStipulations with Request for AwardMutual Mistake of FactIndustrial InjuryBilateral ElbowsBilateral WristsPermanent DisabilityIndemnity
References
7
Case No. 03-00-00467-CV
Regular Panel Decision
Feb 28, 2001

Texas Property and Casualty Insurance Guaranty Association, as Receiver for Employers' Casualty v. Texas Workers' Compensation Commission, Subsequent Injury Fund

The Texas Property and Casualty Insurance Guaranty Association (Association) appealed a summary judgment ruling against it in favor of the Texas Workers' Compensation Commission, Subsequent Injury Fund (Fund). The Fund sought to recover death benefits under the Texas Workers' Compensation Act after the Association, acting as receiver for an impaired insurer, terminated payments to the Fund. The Association argued that the Fund's claim was not a 'covered claim', that it was not an 'insurance company' liable for such payments, and that there was no evidence to support a conversion claim. The appellate court rejected all of the Association's contentions, affirming that the Fund had a covered claim and the Association had the obligations of the impaired insurer. The trial court's judgment was affirmed.

Workers' CompensationDeath BenefitsInsurance Guaranty AssociationSubsequent Injury FundStatutory InterpretationSummary Judgment AppealAppellate Court DecisionImpaired Insurer ObligationsCovered ClaimTexas Law
References
15
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