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

Case No. MISSING
Regular Panel Decision

Employers Insurance v. General Accident, Fire & Life Assurance Corp.

Employers Insurance of Wausau (Wausau) sought summary judgment for 50% reimbursement of a $500,000 settlement and defense costs. The settlement stemmed from an underlying personal injury action where Frank Rayno, an employee of Sage Garage, was injured on a construction site in 1976. Wausau provided workers' compensation and employer's liability insurance to Sage Garage, while General Accident provided general liability coverage. Wausau paid the full settlement and then pursued General Accident for contribution. General Accident argued for a pro rata contribution based on policy limits. The court granted Wausau's motion for summary judgment, ruling that both insurers should contribute equally up to the limit of the smaller policy, which was General Accident's $500,000 policy, meaning General Accident owed $250,000. The defendants' cross-motion was denied.

Insurance disputeSummary judgmentDeclaratory judgmentContribution among insurersReimbursementPolicy limitsEmployer's liability insuranceGeneral liability insuranceWorkers' compensationPro rata contribution
References
0
Case No. MISSING
Regular Panel Decision

Home Life & Accident Co. v. Wade

This case involves an appeal by the Home Life & Accident Company from an award of the Industrial Accident Board in favor of C. Wade. Wade, an an employee of A. C. MacParlane, sustained injuries while loading steel cranes onto a barge in the navigable Sabine River. The central legal question was whether Wade's maritime injury fell under the Texas Workmen’s Compensation Law or the exclusive admiralty jurisdiction of federal courts. The trial court initially awarded compensation to Wade under state law. However, the appellate court, citing various U.S. Supreme Court precedents and an Attorney General's opinion, concluded that maritime injuries are subject to federal admiralty law, thus precluding state workers' compensation jurisdiction. Consequently, the trial court's judgment was reversed, and the appellate court ruled in favor of the Home Life & Accident Company.

Admiralty lawMaritime jurisdictionWorkers' compensationFederal preemptionState lawInjury at workNavigable watersLongshoremanSabine RiverEmployer liability
References
5
Case No. MISSING
Regular Panel Decision

O'Keefe v. General Accident Insurance

Plaintiff Violet O'Keefe initiated an action against General Accident Insurance Company, alleging disparate treatment and retaliation based on age and sex, violating Title VII, ADEA, and New York Human Rights Law. O'Keefe claimed a discriminatory work environment and unlawful termination following her refusal of a proposed job transfer. The defendant argued O'Keefe's performance was poor and the transfer was a lateral move. The District Court denied the defendant's motion for summary judgment regarding the federal discrimination and retaliation claims, finding a genuine issue of material fact existed as to whether General Accident's reasons for termination were pretextual. However, the Court granted summary judgment for the defendant on the state law claims, declining to exercise pendent jurisdiction.

DiscriminationAge DiscriminationSex DiscriminationTitle VIIADEARetaliationSummary JudgmentEmployment LawPretextPrima Facie Case
References
19
Case No. 13-21-00361-CV
Regular Panel Decision
Oct 12, 2023

Accident Fund General Insurance Company v. Rodrigo Mendiola

Rodrigo Mendiola, a truck driver, suffered severe burns in an accident, leading to an above-the-knee amputation and significant injury to his left hand. His employer's workers' compensation insurer, Accident Fund General Insurance Company, disputed his claim for lifetime income benefits based on the total loss of use of his left hand. The trial court, applying the Travelers Insurance Co. v. Seabolt standard, found sufficient evidence that Mendiola's hand lacked substantial utility, entitling him to benefits. The Court of Appeals affirmed the trial court's judgment, upholding the application of the Seabolt standard and concluding the evidence factually supported the finding of total loss of use.

Workers' CompensationLifetime Income BenefitsTotal Loss of UseBurn InjuriesHand InjuryAmputationMedical EvidenceFactual SufficiencyAppellate ReviewStare Decisis
References
29
Case No. W2008-01771-COA-R3-CV
Regular Panel Decision
Jan 26, 2011

Shelby County Health Care Corporation, d/b/a Regional Medical Center v. John Baumgartner, Elizabeth Baumgartner, a/k/a Daray Baumgartner, Nationwide Mutual Insurance Company, and Hartford Accident and Indemnity

This appeal concerns the impairment of a hospital lien by Shelby County Health Care Corporation (The MED) against John Baumgartner and his insurance providers, Nationwide Mutual Insurance Company and Hartford Accident and Indemnity. Mr. Baumgartner received extensive medical treatment at The MED following an automobile accident, incurring over $500,000 in expenses, for which The MED filed a hospital lien. Subsequently, Nationwide and Hartford settled with the Baumgartners, paying out policy limits of $25,000 and $100,000 respectively, without remitting any funds to The MED. The trial court initially granted partial summary judgment, finding impairment of the lien and awarding damages. On appeal, the Court of Appeals affirmed the finding of lien impairment but reversed the damage awards, concluding that The MED's recovery is limited to one-third of the amounts the insurers paid to the Baumgartners, and remanded the case for further proceedings consistent with this interpretation.

Hospital Lien ActInsurance LawAutomobile AccidentSubrogationMade-Whole DoctrineStatutory InterpretationDamages for ImpairmentConstructive NoticeMedical ExpensesSettlement Agreements
References
33
Case No. MISSING
Regular Panel Decision

Claim of Blanchard v. Eagle Nest Tenancy In Common

Claimant's decedent, a superintendent for Eagle Nest Tenancy In Common, died in an unwitnessed one-car motor vehicle accident on the employer's premises. His widow filed a claim for workers' compensation benefits, arguing his death was causally related to his employment. Both the Workers' Compensation Law Judge and the Board affirmed this finding, prompting an appeal by the employer's insurance carrier. The carrier contested that the accident occurred "in the course of employment," despite testimony suggesting the decedent intended to address maintenance issues after returning home. The Appellate Division affirmed the Board's amended decision, finding sufficient evidence to support that the accident occurred in the course of employment, especially given the presumption afforded to unwitnessed accidents within the scope of employment under Workers' Compensation Law § 21.

Workers' Compensation BenefitsEmployment CausalityMotor Vehicle FatalityOn-Premises AccidentWorkers' Compensation Board AppealScope of EmploymentUnwitnessed Accident PresumptionJudicial ReviewAppellate Division AffirmationInsurance Carrier Appeal
References
6
Case No. MISSING
Regular Panel Decision
Apr 01, 1982

Claim of Srp v. Grow Kiewit MK

The case involves an appeal from a Workers’ Compensation Board decision concerning the death of Frank Srp, who died from a 500-foot fall down a water shaft. The decedent was working to install grout pipes when he fell through an opening. The employer and its insurance carrier argued that the accident was not compensable because the decedent allegedly violated specific instructions by working in a prohibited area, thereby removing himself from the scope of employment. However, the Board found no credible evidence that the decedent violated known specific instructions and concluded it was a fatal unwitnessed accident. The court affirmed the Board's decision, agreeing that the presumption under section 21 of the Workers’ Compensation Law applies to unwitnessed accidents, and there was no evidence to rebut this presumption.

Workers' CompensationUnwitnessed AccidentScope of EmploymentProhibited ActPresumption of CompensabilitySection 21 WCLFatal AccidentBoard Decision AffirmationAppellate ReviewGrout Pipes Installation
References
4
Case No. MISSING
Regular Panel Decision
Jun 22, 1983

Claim of McCabe v. Peconic Ambulance & Supplies, Inc.

The claimant, an employee of Peconic Ambulance & Supplies, Inc., sustained severe injuries in an unwitnessed ambulance accident on November 7-8, 1980, while on call. Rendered comatose, the claimant could not testify. The Workers' Compensation Board affirmed a referee's award of benefits, finding the accident arose out of and in the course of employment, relying on the Workers' Compensation Law § 21 presumption for unwitnessed accidents. The carrier appealed, challenging the compensability finding, the credibility of the claimant's brother's testimony, and the denial of a hearing transfer for a coemployee's testimony. The court affirmed the Board's decision, upholding the application of the presumption, the Board's role as the sole judge of witness credibility, and ruling no abuse of discretion in denying the transfer due to the coemployee's repeated failure to honor subpoenas.

Workers' CompensationUnwitnessed AccidentCourse of EmploymentPresumption of CompensabilityWitness CredibilitySubpoena EnforcementAppellate ReviewBoard DecisionAmbulance ServiceIndustrial Accident
References
6
Case No. MISSING
Regular Panel Decision
Feb 15, 1950

Hartford Accident & Indemnity Co. v. Christensen

O. L. Christensen filed two consolidated suits after losing his right eye: one for common-law damages against Q. J. Aaberg and Passmore, and another for workmen's compensation against Hartford Accident and Indemnity Co., Aaberg's insurer. The core dispute was whether Aaberg's workmen's compensation policy with Hartford covered Christensen, especially as Aaberg claimed he did not intend to cover employees in the specific welding shop where Christensen was injured. The trial court and Court of Civil Appeals initially found coverage, but the Supreme Court of Texas reversed this, ruling that Aaberg did not contract with Hartford to provide compensation coverage for Christensen's employment. Consequently, the judgment in the compensation suit was rendered in favor of Hartford, and Christensen's common-law action for damages was remanded to the trial court.

Workers' CompensationInsurance CoverageEmployee StatusIndependent ContractorCommon-Law DamagesConsolidated CasesEmployer LiabilityEye InjuryTexas LawPolicy Interpretation
References
3
Case No. 814 S.W.2d 389
Regular Panel Decision
Dec 31, 1992

Hartford Accident & Indemnity Co. v. Abascal

This is a dissenting opinion by Justice Butts concerning the imposition of severe discovery sanctions against Hartford Accident and Indemnity Company in a workers' compensation action initiated by Raul Flores, Jr. The trial court struck Hartford's affirmative defenses and ordered a $10,000 payment for discovery abuse, a decision which the majority of the appellate court affirmed. Justice Butts argues that this sanction is unjust and violates constitutional due process principles outlined in *TransAmerican Natural Gas Corp. v. Powell*. He contends that such extreme sanctions, which preclude a party from presenting its case, are only warranted by flagrant bad faith or refusal to produce material evidence, a condition not met as Hartford ultimately complied with discovery orders. The dissent asserts that lesser sanctions would have been more appropriate and that the majority's holding could foster 'sanctions gamesmanship'.

Discovery SanctionsDue ProcessWorkers' CompensationAffirmative DefensesTrial Court DiscretionMandamusAppellate ReviewFlagrant Bad FaithTexas LawCivil Procedure
References
25
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