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

Case No. 03 Civ. 0332(AKH)
Regular Panel Decision
Oct 29, 2004

In Re September 11th Liability Insurance Coverage Cases

This opinion and order addresses two Rule 12(c) motions regarding insurance coverage for the World Trade Center properties following the September 11, 2001, attacks. The Port Authority of New York and New Jersey sought a declaration that it is an "Additional Insured" under Zurich American Insurance Company's policies, while World Trade Center Properties LLC (WTCP) sought a declaration that Zurich is obligated to cover defense costs. The court, presided over by District Judge Hellerstein, denied both motions. It found ambiguity in the binder regarding the Port Authority's "Additional Insured" status, stating that the issue was premature without further discovery. Furthermore, the court held that New York Insurance Regulation 107 does not require rewriting Zurich's binder and policies to include defense costs, considering the unique circumstances, the sophistication of the insured, and the fact that Zurich explicitly excluded defense costs, which Silverstein (WTCP's affiliate) accepted after failing to secure conventional coverage. The court also affirmed supplemental jurisdiction over the insurance claims due to their close relation to the underlying September 11th liability cases.

Insurance CoverageSeptember 11 AttacksWorld Trade CenterRule 12(c) MotionDeclaratory ReliefAdditional Insured StatusDefense CostsInsurance BinderNew York Insurance LawRegulation 107
References
48
Case No. 15-25-00134-CV
Regular Panel Decision
Jul 30, 2025

Texas Association of School Boards Risk Management Fund // Southwest Texas Junior College v. Southwest Texas Junior College // Cross-Appellee, Texas Association of School Boards Risk Management Fund

This case involves an intergovernmental contract dispute between the Texas Association of School Boards Risk Management Fund (Appellant) and Southwest Texas Junior College (Appellee). The College is seeking replacement cost value benefits under a self-insurance contract for property damage allegedly sustained during an April 2021 hailstorm. The College claims a waiver of the Fund’s governmental immunity under TEX. LOC. GOV’T CODE § 271.152, asserting equitable theories of waiver and unconscionability, and intentional torts of fraud and bad faith to expand coverage beyond the express terms of the agreement. The Fund argued that its governmental immunity had not been waived for these claims and damages, emphasizing that statutory waivers are to be narrowly construed. The trial court partially granted the Fund's jurisdictional plea, dismissing claims for exemplary, consequential, or treble damages, but denied the plea regarding the College's equitable and intentional tort theories, viewing them as defensive in nature. The Fund appeals this partial denial, arguing that the Act's narrow immunity waiver does not extend to these theories which attempt to create coverage where none explicitly exists in the written contract.

Governmental ImmunityContract DisputeSelf-Insurance PoolRisk ManagementEquitable DoctrinesIntentional TortsWaiverUnconscionabilityTexas LawAppellate Review
References
14
Case No. MISSING
Regular Panel Decision

Houston General Insurance Co. v. Association Casualty Insurance Co.

This case involves an appeal stemming from a dispute between two workers' compensation insurance carriers, Houston General Insurance Company (Appellant) and Association Casualty Insurance Company (Appellee), regarding which carrier is obligated to pay compensation benefits to an injured employee, Johnnie Featherston, of Mallory Propane, Inc. Houston General initially paid the benefits and then sought judicial review after adverse administrative rulings. The core issue is whether Houston General waived its right to contest coverage by not disputing the claim within 60 days, as per Tex. Lab. Code Ann. § 409.021(c). Houston General argued that the issue was "coverage" rather than "compensability" and that waiver and estoppel do not create an insurance contract where none existed. The trial court granted summary judgment in favor of Association Casualty. The appellate court reversed the trial court's summary judgment, concluding that the issue was one of coverage, not compensability, and that waiver or estoppel could not extend coverage. However, the appellate court also denied Houston General's motion for summary judgment regarding equitable subrogation due to a need for a balancing of equities. The case was reversed and remanded for further proceedings.

Workers' CompensationInsurance CarriersCoverage DisputeWaiverEstoppelEquitable SubrogationSummary JudgmentTexas LawAppellate ReviewRemand
References
10
Case No. MISSING
Regular Panel Decision

Ben Bolt-Palito Blanco Consolidated Independent School District v. Texas Political Subdivisions Property/Casualty Joint Self-Insurance Fund

This case addresses an insurance coverage dispute between Ben Bolt-Palito Blanco Consolidated Independent School District (Ben Bolt) and the Texas Political Subdivisions Property/Casualty Joint Self-Insurance Fund (the Fund). Ben Bolt sued the Fund after a claim for extensive water and mold damage was denied, leading the Fund to assert governmental immunity. The Supreme Court of Texas determined that the Fund is a distinct governmental unit, thereby entitled to governmental immunity. However, the Court concluded that Section 271.152 of the Local Government Code provides a clear and unambiguous statutory waiver of the Fund’s immunity from suit for breach of contract claims in this context. Consequently, the Supreme Court reversed the court of appeals' judgment and remanded the case to the trial court for further proceedings.

Governmental ImmunityInsurance CoverageSelf-Insurance FundPolitical SubdivisionsInterlocal Cooperation ActBreach of ContractStatutory WaiverTrial Court JurisdictionDe Novo ReviewTexas Law
References
15
Case No. MISSING
Regular Panel Decision

McLaughlin v. Midrox Insurance

This case involves an appeal concerning an insurance coverage dispute. Plaintiffs sought to compel Midrox Insurance Company to indemnify the Blodgett Brothers Partnerships for a $1 million judgment in an underlying personal injury action. The accident involved a motorcycle operated by plaintiff Charles R. McLaughlin and a pickup truck driven by Ronald Blodgett. Midrox had disclaimed coverage, arguing the accident occurred off insured premises and involved a registered vehicle. The court affirmed the lower court's decision, ruling that the farmowner's policy did provide coverage. The court determined that public roadways used for transporting materials between farm parcels could be considered 'insured premises' and that the pickup truck's agricultural registration did not negate coverage given its exclusive use for farming purposes.

Personal InjuryFarmowner's InsuranceInsurance CoverageAgricultural TruckPolicy InterpretationOff-Premises AccidentPublic RoadwaysSummary JudgmentIndemnificationVehicle and Traffic Law
References
5
Case No. MISSING
Regular Panel Decision

In re the Liquidation of Midland Insurance

Policyholders New York Dock Railway (NYDR) and Brooklyn Eastern District Terminal (BEDT), joined by claimants Buividas and Romacho, moved to confirm a referee's report that found coverage for their claims by the Stock Workers' Compensation Security Fund. The Superintendent of Insurance, as liquidator of Midland Insurance Company, cross-moved to disaffirm the report, arguing against Security Fund coverage based on his interpretation of relevant statutes. The court reviewed the referee's decision, finding it erroneous due to a misinterpretation of legislative history and intent regarding security fund coverage limitations, particularly concerning Chapter 801 amendments. Upholding the Superintendent's rational interpretation, the court denied the motion to confirm and granted the cross-motion to disaffirm, affirming the denial of security fund coverage.

Workers' Compensation Security FundInsurance Coverage DisputeMidland Insurance Company LiquidationFederal Employers' Liability ActJones ActLongshoremen's and Harbor Workers' Compensation ActStatutory InterpretationLegislative HistoryThird-Party IndemnificationEmployer's Liability
References
6
Case No. MISSING
Regular Panel Decision

U. P. Iron Works v. Investors Insurance

Plaintiff insured brought a declaratory judgment action against their insurer, who issued both workers' compensation and general liability policies. The dispute arose after a partner was injured, leading to a third-party products liability action against the partnership. The insurer disclaimed coverage, citing lack of coverage for a direct suit by a partner and late notice of the accident. The court found that coverage existed for the third-party claim, extending it to a partner similar to an employee. Furthermore, the court determined that the notice provided by the insured, though three years after the accident, was not unreasonably late given the complexities involved. Consequently, the court declared the policy to be in full force and effect for the accident.

Declaratory JudgmentInsurance CoverageWorkers' Compensation PolicyGeneral Liability PolicyThird-Party ClaimPartner InjuryEmployee ExclusionLate Notice DisclaimerDuty to DefendSummary Judgment Motion
References
2
Case No. MISSING
Regular Panel Decision

Hayden v. S & W Meat & Poultry

Claimant, a partner in S & W Meat & Poultry, sustained a serious injury. A workers' compensation claim was filed, but the carrier contested coverage, arguing that claimant, as a partner, had not formally elected coverage under Workers' Compensation Law § 54 (8). The Workers' Compensation Board applied estoppel, finding the carrier failed to advise the employer of the election requirement. On appeal, the court reversed this decision, holding that the employer's insurance broker, the Fear agency, was notified of the lack of coverage, and this knowledge is imputed to the employer. The court found insufficient evidence for estoppel and remitted the matter to the Board for further proceedings.

Workers' CompensationEstoppelInsurance CoveragePartnershipAgent LiabilityImputed KnowledgePremium RefundAppellate ReviewRemittalWorkers' Compensation Law § 54 (8)
References
5
Case No. MISSING
Regular Panel Decision

Bowker v. NVR, Inc.

Defendant-third-party plaintiff NVR, Inc. appealed an order denying its motion for summary judgment against second third-party defendant New York State Insurance Fund (SIF). NVR had contracted with K-Wall Dry Wall (Harmon), whose employee, Joseph S. Bowker, was injured. NVR sought indemnification from Harmon, who defaulted, leading to an interim judgment. SIF, Harmon's insurer, disclaimed coverage based on a policy exclusion for 'liability assumed under a contract,' contending Workers' Compensation Law § 11 required a 'grave injury' finding for coverage. The appellate court determined that the applicability of Workers' Compensation Law § 11 relates to the merits of the third-party action, not merely the scope of insurance coverage. As SIF improperly disclaimed coverage by conflating contractual liability with waiver of defense, the order was reversed, and SIF was declared obligated to indemnify Harmon.

Personal InjurySummary JudgmentIndemnificationWorkers' Compensation Law § 11Insurance Law § 3420Contractual LiabilityGrave InjuryDisclaimer of CoverageThird-Party ActionAppellate Review
References
4
Case No. MISSING
Regular Panel Decision

Texas Workforce Commission v. Olivas

Ms. Maria Elena Olivas, a former employee of the Texas Workforce Commission, filed a workers' compensation claim after developing injuries in March 2008. She was subsequently dismissed from employment in May 2009, leading her to file a suit against the Commission for retaliatory discharge. The Commission filed a plea to the jurisdiction, asserting sovereign immunity and arguing that Section 311.034 of the Texas Government Code mandated an unequivocal waiver of immunity, which it claimed was absent in the anti-retaliation provisions of Chapter 451. The trial court denied the Commission's plea. On appeal, the Commission contended that Section 311.034 abrogated existing Texas Supreme Court precedent (*Kerrville State Hosp. v. Fernandez*) that recognized a waiver of sovereign immunity for such claims against state agencies. The appellate court affirmed the trial court's denial, holding that the State Applications Act (SAA) still provides a clear and unambiguous waiver of sovereign immunity for retaliation claims against state agencies, and that neither Section 311.034 nor the *Travis Central Appraisal District v. Norman* decision altered this established legal analysis.

Sovereign ImmunityRetaliatory DischargeWorkers' Compensation ClaimPlea to JurisdictionAppellate ReviewGovernment CodeLabor CodeLegislative WaiverState AgenciesStatutory Construction
References
4
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