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Case Law Database

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

Case No. 3-94-122-CV
Regular Panel Decision
Jan 18, 1995

Texas Workers' Compensation Insurance Facility v. State Board of Insurance, Aetna Casualty & Surety Company, Hartford Accident & Indemnity Company, Houston General Insurance Company, Liberty Mutual Fire Insurance Company, United States Fire Insurance Company

The Texas Workers' Compensation Insurance Facility (Facility) appealed a district court judgment that affirmed an order by the State Board of Insurance. The Board had ordered the Facility to indemnify several servicing companies for legal expenses incurred in litigation brought by Standard Financial Indemnity Company (SFIC). The Facility argued that Article 5.76-2, section 2.05(i) of the Texas Insurance Code, which states the Facility 'may not indemnify the servicing companies,' terminated the servicing companies' right to indemnification. The appellate court affirmed the trial court's judgment, holding that the servicing companies had a vested contractual right to indemnification which arose when they entered into servicing company agreements, and that section 2.05(i) could not be applied retroactively to impair these vested rights. The court found that the law existing at the time the contracts were made, which included the Facility's bylaws allowing for indemnification, was incorporated into the agreements.

Workers' CompensationInsurance LawContractual RightsVested RightsRetroactive Application of LawIndemnificationStatutory InterpretationAdministrative LawAppellate ReviewTexas Insurance Code
References
32
Case No. 03-00-00427-CV
Regular Panel Decision
Aug 30, 2001

All American Life Insurance Company American General Life Insurance Company American National Insurance Company American National Life Insurance Company of Texas IDS Life Insurance Company And USLIFE Life Insurance Company v. Carole Keeton Rylander, Comptroller of Public Accounts of Texas And John Cornyn, Attorney General of Texas

Several insurance companies appealed a district court judgment affirming the Comptroller's assessment of premium and maintenance taxes on 'internal rollover' transactions, where policyholders transfer accumulation values within the same company for new policies. The Texas Court of Appeals, Third District, At Austin, reviewed the construction of Texas Insurance Code articles 4.11 and 4.17 de novo. The court determined that 'internal rollovers' do not involve funds being 'received' or 'collected' by the insurance companies, as the funds remain within the company. Therefore, these transactions are not subject to the premium and maintenance taxes. The judgment of the district court was reversed in part, and the case was remanded for a determination of the refund amounts owed to the companies.

Insurance LawTax LawPremium TaxInternal RolloversStatutory ConstructionTexas Court of AppealsInsurance CompaniesComptrollerGross PremiumsTax Refund
References
9
Case No. 04-25-00040-CV
Regular Panel Decision
Nov 26, 2025

Enrique Cantu and Bridgefield Casualty Insurance Company v. Javier A. Libson, Nosbil, Inc., Jose Luis Ramirez, Utica National Insurance Group, Utica National Insurance Company of Texas, Utica Mutual Insurance Company, and Republic Franklin Insurance Company

Appellants Enrique Cantu and Bridgefield Casualty Insurance Company appealed a no-evidence summary judgment. Cantu's claims of negligence per se, negligent hiring, training, retention, and negligent entrustment were affirmed. However, the summary judgment for Cantu's ordinary negligence claims was reversed and remanded. Additionally, the judgment favoring the insurance defendants (Utica National Insurance Group, Utica National Insurance Company of Texas, Utica Mutual Insurance Company, and Republic Franklin Insurance Company) was also reversed, as their motion for summary judgment was not properly heard. The case involved a collision between Cantu and Jose Luis Ramirez, an employee of Nosbil, Inc., in foggy conditions, leading to Cantu suing for negligence and insurance claims.

NegligenceAutomobile AccidentSummary JudgmentAppellate ReviewProximate CauseDuty of CareBreach of DutyCausationInsurance ClaimsVicarious Liability
References
36
Case No. 05-16-00875-CV
Regular Panel Decision
Jul 20, 2018

Peerless Indemnity Insurance Company, America First Insurance Company, the Netherlands Insurance Company, and America First Lloyds Insurance Company A.K.A. America First Insurance Company v. GLS Masonry, Inc.

The case involves an appeal by several insurance companies (Appellants) against GLS Masonry, Inc. (Appellee) after a take-nothing judgment in their suit to collect unpaid insurance premiums. The dispute centered on whether GLS's masonry workers were independent contractors or employees for premium calculation purposes, particularly for workers' compensation and general liability policies. The Appellants argued that GLS owed additional premiums due to audits reclassifying workers as employees and based on a lack of liability insurance for subcontractors. The trial court sided with GLS, finding that the insurance companies failed to establish the applicability of certain labor code provisions and did not sufficiently prove that GLS owed additional premiums, especially considering evidence that the workers were independent contractors and payments were made on policies. The Court of Appeals affirmed the trial court's judgment.

Insurance DisputeUnpaid PremiumsCommercial General LiabilityPremium AuditIndependent Contractor StatusEmployee ClassificationBreach of ContractTexas Appellate LawFactual Sufficiency ReviewSworn Account Claim
References
12
Case No. 01-00-00586-CV
Regular Panel Decision

Ranger Insurance Company and Swift Energy Company v. American International Specialty Lines Insurance Company, Flournoy Production Company, and Flournoy Drilling Company

This case involves indemnity and insurance claims arising from oilfield litigation. Appellants, Ranger Insurance Company and Swift Energy Company, appealed a summary judgment granted to appellees, American International Specialty Lines Insurance Company, Flournoy Production Company, and Flournoy Drilling Company. The trial court had ruled that mutual indemnity provisions in an oil and gas drilling contract were void under the Texas Oilfield Anti-Indemnity Act. The Court of Appeals reversed and remanded the judgment, holding that the contract was enforceable up to the extent of mutual coverage and dollar limits, and that its indemnity provisions were conspicuous.

Oilfield LitigationIndemnityInsurance ClaimsTexas Oilfield Anti-Indemnity ActSummary JudgmentContract InterpretationMutual Indemnity ObligationConspicuousnessAppellate ReviewWell Blowout
References
18
Case No. 14-09-00860-CV
Regular Panel Decision
May 26, 2011

Weingarten Realty Management Company and Scottsdale Insurance Company v. Liberty Mutual Fire Insurance Company

This case involves an appeal from a trial court's summary judgment in an insurance-coverage dispute. Appellants Weingarten Realty Management Company and Scottsdale Insurance Company sought to compel appellee Liberty Mutual Fire Insurance Company to defend Weingarten Management in an underlying lawsuit where it was mistakenly identified as a lessor. The appellate court affirmed the trial court's decision, allowing the consideration of extrinsic evidence as a narrow exception to the eight-corners rule. This exception applies when an insurer proves, using extrinsic evidence, that the party seeking defense is a stranger to the policy and could not be entitled to coverage under any circumstances, without touching on the merits of the underlying claim. The court concluded that Weingarten Management was not an actual lessor and therefore not an insured under Liberty Mutual's policy.

Insurance CoverageDuty to DefendEight-Corners Rule ExceptionExtrinsic EvidenceSummary Judgment ReviewAppellate Court DecisionInsurance Policy InterpretationLessor StatusContractual DisputesTexas Civil Procedure
References
30
Case No. 03-07-00682-CV
Regular Panel Decision
Nov 13, 2008

Texas Mutual Insurance Company, Liberty Mutual Insurance Company, Zenith Insurance Company and Zurich American Insurance Company v. Vista Community Medical Center, LLP, D/B/A Vista Medical Center Hospital Christus Health Gulf Coast And the Texas Department of Insurance, Division of Workers' Compensation

This appeal concerns a challenge to the validity and interpretation of Rule 134.401, promulgated by the Texas Department of Insurance, Division of Workers’ Compensation, which governs hospital fee reimbursement for inpatient services to injured workers. The trial court had ruled that the 'Stop-Loss Exception' applied solely if audited charges exceeded $40,000 and deemed the 2005 Staff Report an invalid rule. The appellate court reversed, holding that eligibility for stop-loss reimbursement requires proof of both audited charges exceeding $40,000 and unusually costly and extensive services. The court also reversed the declaration that the 2005 Staff Report was an invalid rule, affirming the trial court's stance on auditing implantable charges.

Workers' Compensation LawAdministrative Rule ChallengeHospital Fee ReimbursementStop-Loss ExceptionRule InterpretationMedical Cost ControlDeclaratory Judgment ActionAppellate ReviewTexas Labor CodeTexas Government Code
References
39
Case No. 18-0216
Regular Panel Decision
Jun 26, 2020

Texas Mutual Insurance Company, Hartford Underwriters Insurance Company, Tasb Risk Management Fund, Transportation Insurance Company, Truck Insurance Exchange, Twin City Fire Insurance Company, Valley Forge Insurance Company v. Phi Air Medical, LLC

This concurring opinion addresses whether the Texas Workers' Compensation Act is shielded from federal preemption by the McCarran–Ferguson Act. The core issue is whether the Texas Act, which dictates how insurance carriers pay claimants like air-ambulance services, constitutes the 'business of insurance.' Justice Bland argues that the Act was indeed enacted for regulating the business of insurance, particularly given Texas's reliance on private insurers for workers' compensation. Therefore, its provisions should be protected from federal encroachment, leading to the reversal of the court of appeals' judgment.

McCarran-Ferguson ActFederal PreemptionState Insurance RegulationTexas Workers' Compensation ActBusiness of InsuranceAir-ambulance ServicesInsurance CarriersPolicyholder RiskThird-Party BeneficiaryAntitrust Exemption
References
19
Case No. 03-07-00429-CV
Regular Panel Decision
Dec 12, 2008

Texas Health Insurance Risk Pool v. Southwest Service Life Insurance Company and Regal Life of America Insurance Company

Southwest Service Life Insurance Company and Regal Life of America Insurance Company (Appellees) brought a declaratory-judgment action against the Texas Health Insurance Risk Pool (Appellant) to challenge assessments levied against them, arguing their policies qualified as 'other limited benefit coverage' under the Texas Insurance Code. The trial court granted summary judgment in favor of the Appellees and awarded attorney's fees. The Pool appealed, contending the summary judgment was erroneous and the attorney's fee award should be reversed. The appellate court affirmed the trial court's judgment, holding that the policies issued by Southwest and Regal were indeed covered by the 'limited benefit coverage' exception, and thus the summary judgment and attorney's fee award were proper.

Insurance LawHealth InsuranceStatutory ConstructionDeclaratory JudgmentSummary JudgmentAttorney's FeesTexas Insurance CodeLimited Benefit CoverageHIPAAAdministrative Law
References
15
Case No. 14-02-00860-CV
Regular Panel Decision
Feb 23, 2006

Lennar Corporation, Lennar Homes of Texas Land and Construction, Limited, and Lennar Homes of Texas Sales and Marketing, Limited, D/B/A Village Builders v. Great American Insurance Company, American Dynasty Surplus Lines Insurance Company, Markel American Insurance Company Gerling America Insurance Company, RLI Insurance Company, Insurance Company of the State of Pennsylvania and Westchester Fire Ins Company

This case concerns an insurance coverage dispute between homebuilder Lennar Corporation and its CGL insurance carriers over damages caused by defective stucco (EIFS) applied to homes. The court analyzed whether negligently defective construction constitutes an "occurrence" and distinguished between covered costs (repairing actual water damage) and non-covered costs (preventative EIFS replacement, overhead). While affirming summary judgment for several insurers due to unmet self-insured retentions based on individual homes as separate occurrences, the court reversed for American Dynasty and Markel, citing unresolved factual issues regarding "known loss" and policy conditions. Lennar's extra-contractual claims against American Dynasty were ultimately denied for lack of proven damages or statutory violations.

Insurance Policy InterpretationConstruction DefectsCommercial Liability InsuranceProperty Damage ClaimsStucco DefectsDuty to IndemnifySelf-Insured RetentionsKnown Loss PrincipleSubcontractor LiabilityTexas Law
References
96
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