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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
Oct 31, 2003

Coregis Insurance v. McQuade

The petitioner appealed an order from the Supreme Court, Westchester County, which denied a petition to permanently stay arbitration of an underinsured motorist claim. The respondent, Kevin A. McQuade, a sanitation worker, was injured by an underinsured vehicle. The Supreme Court initially held that McQuade was 'occupying' the sanitation truck, thus qualifying him as an insured under the supplementary underinsured motorists endorsement (SUM). However, the appellate court reversed this decision, finding that McQuade was not 'occupying' the vehicle at the time of the accident, as his departure was not incidental to a temporary interruption, nor was he in the immediate vicinity or entering the truck. Consequently, McQuade did not qualify as an insured for the SUM endorsement, and the Supreme Court should have granted the petition to stay arbitration.

Arbitration StayUnderinsured MotoristInsurance PolicyVehicle Occupancy DefinitionAppellate Court DecisionNew York LawSUM EndorsementStatutory InterpretationPersonal Injury ClaimTemporary Interruption
References
4
Case No. E2012-02213-COA-R3-CV
Regular Panel Decision
Jul 10, 2013

Dennis Michael Harris, et ux v. Mickey Deanne Haynes

Dennis Michael Harris, a patrolman, was injured when struck by a vehicle. He and his wife sued the driver, vehicle owner, and Tennessee Risk Management Trust (TRMT) for uninsured/underinsured motorist coverage. TRMT, a governmental self-insurance pool, denied coverage, citing an exclusion for employees receiving workers' compensation. The Trial Court granted summary judgment to TRMT, finding Anderson County was self-insured through TRMT, rendering uninsured/underinsured motorist statutes inapplicable. The appellate court affirmed, upholding that TRMT is not an insurance company, and the Coverage Document's employee exclusion is valid. The court concluded that it is a policy decision for the legislative body of Anderson County, not the court, to decide on providing uninsured/underinsured motorist coverage to its employees.

Workers' Compensation BenefitsUninsured Motorist CoverageUnderinsured Motorist CoverageGovernmental Self-Insurance PoolEmployee ExclusionContract InterpretationSummary Judgment AppealTennessee Court of AppealsRisk Management TrustTort Liability Act
References
18
Case No. MISSING
Regular Panel Decision

United Services Automobile Ass'n v. Hestilow

This case involves an appeal by USAA challenging a judgment that permitted the Hestilows to stack underinsured motorist coverages from two separate USAA policies. Scott Hestilow was injured in an accident caused by an underinsured motorist, Alvino Casarez, who had $15,000 in liability coverage. The Hestilows sought to combine their two $15,000/30,000 USAA policies, resulting in $30,000 in coverage, from which they deducted Casarez's $15,000 payment, claiming USAA owed $15,000. USAA argued against stacking, asserting that the settlement offset each policy separately, leaving no obligation. The trial court ruled in favor of the Hestilows, allowing stacking. The appellate court affirmed, holding that all available underinsured motorist policies must be aggregated to determine if a tortfeasor is underinsured, thereby upholding the trial court's judgment.

Underinsured Motorist CoverageInsurance Policy StackingAutomobile InsuranceTexas Insurance LawAppellate ReviewLegislative IntentStatutory Interpretation"Other Insurance" ClausesDouble OffsetInter-policy Stacking
References
18
Case No. MISSING
Regular Panel Decision

American Motorists Insurance Co. v. Occidental Chemical Corp.

Houston Scale Company, Inc. purchased a comprehensive general liability (CGL) policy and a commercial catastrophe liability policy from American Motorists Insurance Company. Houston Scale failed to name Occidental Chemical Corporation as an additional insured on the CGL policy, despite a contractual obligation. When a personal injury suit was filed against Occidental, it sought coverage under the commercial catastrophe policy, arguing it qualified as an insured due to the contractual obligation. The trial court granted summary judgment for Occidental, awarding damages and attorney's fees. American Motorists appealed, challenging Occidental's status as an insured under the catastrophe policy and the award of attorney's fees. The appellate court affirmed the trial court's judgment, holding that Occidental was indeed an insured under the replacement CGL coverage provisions of the commercial catastrophe policy and that attorney's fees were properly awarded.

Insurance LawCGL PolicyCommercial Catastrophe PolicyAdditional InsuredContractual ObligationSummary JudgmentAttorney's FeesBreach of ContractExcess CoverageReplacement Coverage
References
15
Case No. MISSING
Regular Panel Decision
Sep 13, 2000

AIU Insurance v. American Motorists Insurance

This case concerns an appeal regarding primary liability coverage for HRH Construction Corp. and Hotel Grand Central in an underlying personal injury action. Plaintiffs, including their excess insurer AIU Insurance Co., sought to compel American Motorists Insurance Co. and St. Paul Fire & Marine Ins. Co. to provide primary defense and reimbursement. The court found American Motorists obligated to defend HRH and the Hotel, as their policy covered them as additional insureds for claims "arising out of" work performed by American Motorists' primary insured, Cord Contracting Co. However, St. Paul was not similarly obligated, as the injury did not "arise out of" work by its insured, Forest Electric Corp. Consequently, the court modified the prior declaration, vacating the plaintiffs' favor against St. Paul and dismissing Cord Contracting Co.'s cross-appeal.

Insurance DisputePrimary Liability CoverageExcess InsuranceAdditional InsuredPersonal InjuryConstruction SiteSubcontractorContractual ObligationDuty to DefendIndemnification
References
1
Case No. MISSING
Regular Panel Decision

Texas Farm Bureau Mutual Insurance Co v. Tatum

This case concerns an appeal by an unnamed insurance carrier (Appellant) against a trial court's decision in a one-car accident claim. The Appellant had denied underinsured motorist coverage to the Appellees (Cecil and Ida Tatum, Robert Powell, and Cherie Stanley), who were passengers in the Tatum's vehicle. The trial court had awarded damages, statutory penalties, and attorney's fees to the Appellees. On appeal, the Appellant argued that its policy specifically excluded the insured's vehicle from underinsured coverage, stacking of uninsured provisions was impermissible, and statutory penalties and attorney's fees were inapplicable. The appellate court sustained all three points of error, reversing the trial court's judgment regarding underinsured coverage, penalties, and fees, and rendering judgment that the Appellees take nothing on those claims. The judgment was affirmed in all other respects.

Underinsured motorist coverageinsurance policy exclusionstacking of benefitsstatutory penaltiesattorney's feesTexas Insurance Codeappellate reviewone-car accidentliability insuranceinsured vehicle
References
8
Case No. MISSING
Regular Panel Decision

Erwin v. Rose

This case addresses the liability of a municipality and its agents under the Governmental Tort Liability Act, as well as the liability of an underinsured motorist carrier. Ms. Erwin's parents filed a wrongful death action after their daughter was killed in a high-speed chase involving Deputy Mike Rose of Maury County. The court apportioned fault between Deputy Rose and Tracy Joe Lovell, limiting Maury County's liability to $130,000 and dismissing claims against Deputy Rose. The court affirmed the dismissal of the claim against the underinsured motorist carrier, Tennessee Farmers Mutual Insurance Co., finding that payments from other tort-feasors reduce the carrier's coverage. The appellate court affirmed the lower court's decisions on municipal and agent liability and the dismissal of the underinsured motorist claim, but reversed the award of prejudgment interest as it exceeded the statutory liability limit for the municipality. A petition to rehear was subsequently overruled.

Governmental Tort Liability ActUnderinsured Motorist CoverageWrongful DeathHigh-Speed ChasePolice MisconductMunicipal LiabilityDeputy Sheriff LiabilityPrejudgment InterestInsurance Policy LimitsCivil Rights Violations
References
21
Case No. MISSING
Regular Panel Decision

McDonald v. Southern County Mutual Insurance Co.

Edward Lee McDonald and Bobby J. Robinson, while employed by All Points Holdings, suffered a tire blowout on a tractor-trailer. They parked the rig and walked away to seek help. About five minutes and 50 feet later, they were struck by another vehicle driven by Rangel, an underinsured motorist. McDonald and Robinson filed a claim for uninsured/underinsured motorist (UIM) coverage under Southern County Mutual Insurance Co.'s policy issued to All Points. The policy defined "insured" as someone "occupying" a covered auto, and "occupying" as "in, upon, getting in, on, out or off." The trial court denied coverage, finding that McDonald and Robinson were not "occupying" the vehicle at the time of the accident and that their injuries did not "arise out of the maintenance or use" of the vehicle. The appellate court affirmed this decision, rejecting the appellants' arguments for broader interpretation of "occupying" and "arising out of maintenance or use," citing previous Texas precedent that requires a causative nexus with the vehicle.

Insurance CoverageUninsured/Underinsured MotoristAuto-Pedestrian Accident"Occupying" DefinitionCausative Nexus"Arising Out of Use"Statutory InterpretationAppellate ReviewTexas LawPersonal Injury Protection
References
24
Case No. 14-22-00450-CV
Regular Panel Decision
May 14, 2024

Progressive County Mutual Insurance Company v. Artemiz Freeman

This is a dissenting opinion in a case appealed from the 113th District Court, Harris County, Texas. The majority reversed the trial court's summary judgment, which was granted to Artemiz Freeman. The central issue revolves around the validity of a 'regular use exclusion' in an insurance contract by Progressive County Mutual Insurance Company, and whether it contravenes Texas public policy regarding uninsured/underinsured motorist (UM/UIM) benefits. The dissenting justice argues the majority erred by requiring Freeman to prove worker's compensation benefits, ignoring agreed damages, and subverting UM/UIM coverage's purpose. It asserts that the regular use exclusion, especially for employer-owned vehicles, conflicts with the Texas Insurance Code and public policy, which mandates UM/UIM coverage to 'follow the person' and place the injured claimant in a position as if the financially irresponsible motorist had been insured. The dissent also highlights that worker's compensation benefits are inapplicable for altering the underinsured nature of the claim and are not intended to make an injured party whole.

Uninsured Motorist CoverageUnderinsured Motorist CoverageRegular Use ExclusionTexas Public PolicyInsurance Contract InterpretationSummary Judgment AppealWorkers' Compensation ReimbursementDamages CalculationAppellate Court DecisionInsurance Law
References
38
Case No. MISSING
Regular Panel Decision

Foster v. Truck Insurance Exchange

This case involves Bobby Foster's appeal against two summary judgments. Foster was injured in an accident with a bus while driving his employer's truck. He filed a workers' compensation claim with CIGNA Insurance Company of Texas, which initially denied it but later paid benefits, back-benefits, interest, and attorney's fees after an appeal. Foster also sued Dallas Area Rapid Transit Authority (DART) and the bus driver, and named Truck Insurance Exchange (TIE), his employer's automobile insurance carrier, claiming underinsured motorist coverage. DART settled for $100,000, which was interpleaded. CIGNA intervened to assert subrogation rights. TIE moved for summary judgment, arguing its policy excluded underinsured motorist coverage for government-owned vehicles like the DART bus, which the trial court granted. Foster also disputed CIGNA's right to reimbursement from the interpleaded funds for attorney's fees and interest paid on back-benefits. The trial court sided with CIGNA on both issues, finding these amounts recoverable under CIGNA's subrogation interest. The appellate court affirmed both summary judgments.

Underinsured Motorist CoverageSubrogation RightsWorkers' CompensationSummary JudgmentInsurance Policy ExclusionGovernment-Owned VehicleTexas Tort Claims ActAttorney's FeesInterest on BenefitsDouble Recovery Prevention
References
9
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