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

Case No. CA 10-00545
Regular Panel Decision
Feb 10, 2011

HAHN AUTOMOTIVE WAREHOUSE, INC. v. AMERICAN ZURICH INSURANCE COMPANY

Hahn Automotive Warehouse, Inc. (plaintiff) initiated a breach of contract action against American Zurich Insurance Company and Zurich American Insurance Company (defendants), contending that bills issued under insurance contracts were time-barred. Defendants counterclaimed for damages stemming from plaintiff's alleged breach of these contracts. The Supreme Court partially granted plaintiff's cross-motion, deeming counterclaims for debts arising over six years prior as time-barred. Concurrently, it permitted defendants to utilize a $400,000 letter of credit to satisfy any outstanding debt, including those deemed time-barred. On appeal, the Appellate Division affirmed the use of the letter of credit for time-barred debts, reasoning that the statute of limitations only bars the remedy, not the underlying obligation. The court also affirmed that defendants' counterclaims for debts over six years old were time-barred, as the right to demand payment accrued earlier. Finally, the court modified the order to dismiss plaintiff's second through fourth causes of action. A dissenting opinion argued that the counterclaims were not time-barred, asserting that the cause of action accrued upon demand and refusal of payment, not merely when the right to demand payment existed.

Breach of contractInsurance contractsStatute of limitationsLetter of creditSummary judgmentAppellate reviewContract interpretationTime-barred claimsAccrual of cause of actionRetrospective premiums
References
23
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. 06-1030
Regular Panel Decision
Aug 29, 2008

Zurich American Insurance Company, Federal Insurance Company, and National Union Fire Insurance Company v. Nokia, Incorporated

This is a dissenting opinion from Justice Hecht of the Supreme Court of Texas, joined by Justice Brister, concerning a petition for review by various insurance companies (Zurich American, Federal, National Union Fire) against Nokia, Inc. The central issue is whether the insurers have a duty to defend Nokia in class action lawsuits. These lawsuits allege "biological injury" from cellphone radiation but meticulously avoid claiming "bodily injury," instead seeking damages for the lack of provided headsets. Justice Hecht argues that despite a liberal interpretation rule for pleadings, these class action complaints do not trigger the insurers' duty to defend, as the damages claimed are not for personal injury and class counsel explicitly denied seeking personal injury compensation. He concludes that the majority's decision, which implies a duty to defend, rewards ambiguous pleading.

Insurance LawDuty to DefendClass ActionBodily InjuryBiological InjuryPleading InterpretationCellphone RadiationAppellate ReviewDissenting OpinionTexas Supreme Court
References
11
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
Case No. 01-05-00988-CV
Regular Panel Decision
Jul 26, 2007

Gilbane Building Company and Zurich American Insurance Company v. Keystone Structural Concrete, Ltd. and Royal Insurance Company of America

Gilbane Building Company and Zurich American Insurance Company appealed a trial court's summary judgment in favor of Keystone Structural Concrete, LTD. The core issues involved a contractual indemnity claim and several breach of contract claims stemming from an injury to a Keystone employee on a construction project. Gilbane sought to recover a $1 million settlement it paid. The Court of Appeals affirmed the lower court's decision, ruling that the indemnity agreement was unenforceable due to its failure to satisfy the express negligence test. Furthermore, the court found no breach regarding insurance priorities, safety obligations, or a duty to inform Gilbane about an additional insurance policy, thereby denying Gilbane's attempts to reform the contract or recover damages.

Contractual IndemnityBreach of ContractSummary Judgment ReviewExpress Negligence RuleInsurance Coverage DisputeSubrogationContract ReformationMutual MistakeTexas Labor CodeConstruction Subcontract
References
29
Case No. M2013-00872-COA-R3-CV
Regular Panel Decision
Jul 31, 2014

Zurich American Insurance Company v. State of Tennessee

This case concerns an appeal by Zurich American Insurance Company and American Guarantee & Liability Insurance Company challenging Tennessee's calculation of retaliatory tax on foreign insurance companies. The insurance companies disputed the inclusion of six New York workers’ compensation surcharges in the tax calculation, arguing they were passed on to policyholders and not directly imposed on the insurers. The Tennessee Claims Commission initially ruled in favor of the state. On appeal, the Court of Appeals of Tennessee found that four of the six surcharges should be included in the retaliatory tax calculation, while two (Fire Insurance Fee and Motor Vehicle Law Enforcement/Theft Fund Charges) should not, as they constituted a direct "pass-through" to policyholders. The court also rejected the claimants' constitutional challenges based on due process, Uniform Administrative Procedures Act, Full Faith and Credit, Equal Protection, Commerce Clause, and Uniformity Clause.

Retaliatory TaxInsurance TaxationWorkers' Compensation SurchargesStatutory InterpretationTax Refund ClaimsConstitutional LawDue ProcessEqual Protection ClauseFull Faith and CreditCommerce Clause
References
32
Case No. 01-12-01094-CV
Regular Panel Decision
Dec 03, 2012

in Re Zurich American Insurance Company

On December 3, 2012, Zurich American Insurance Company, as relator, filed a petition for writ of mandamus with the Court of Appeals for the First District of Texas at Houston. The court has issued an order requesting Linda M. Green, the real party in interest, to file a response to the petition. The deadline for this response is Wednesday, January 2, 2013. This original proceeding stems from an underlying case, Linda M. Green v. Zurich American Insurance Co. v. Texas Department of Insurance-Division of Workers’ Compensation, case number 2010-25688, heard in the 133rd District Court of Harris County, Texas.

MandamusWrit PetitionProcedural OrderTexas CourtsCourt of AppealsInsurance CompanyWorkers' CompensationRelatorReal Party in Interest
References
1
Case No. 01-11-00816-CV
Regular Panel Decision
Jul 12, 2012

in Re American Zurich Insurance Company

Cathryn Thompson sued American Zurich Insurance Company and Fai Hensel for wrongful denial and delay of workers' compensation benefits, alleging violations of the Insurance Code, Deceptive Trade Practices Act, and breach of good faith and fair dealing. Zurich sought mandamus relief from a trial court order compelling discovery of monthly operational reports. The Court of Appeals, citing Texas Mutual Insurance Co. v. Ruttiger, conditionally granted mandamus relief, concluding that Ruttiger forecloses claims under Insurance Code sections 541.060 and 542.003 and common-law breach of good faith and fair dealing against workers' compensation carriers. The court further held that the requested operational reports were not relevant to Thompson’s remaining claims of misrepresentation under section 541.061 of the Insurance Code and DTPA, as they did not relate to her specific claim or the interpretation of the insurance policy.

TexasMandamusWorkers' CompensationInsurance CodeDeceptive Trade Practices ActDiscovery ScopeAbuse of DiscretionClaim DenialGood Faith and Fair DealingInsurance Misrepresentation
References
10
Case No. M2011-01266-COA-R3-CV
Regular Panel Decision
Jul 27, 2012

American Zurich Insurance Company v. MVT Services, Inc., d/b/a Mesilla Valley Transportation

This appeal involves a dispute over retrospective workers' compensation insurance premiums between American Zurich Insurance Company and MVT Services, Inc., a trucking company. MVT initially classified its Tennessee-resident over-the-road drivers as Texas employees, excluding them from the Zurich policy and not paying premiums. Following a retrospective audit that identified MVT's exposure to risk for these drivers, Zurich demanded additional premiums, which MVT refused, leading to policy cancellation and a lawsuit. The trial court granted summary judgment for Zurich, concluding that the drivers presented a risk of loss to the insurer. The Court of Appeals affirmed this decision, asserting that under the insurance policy and workers' compensation law, Zurich was potentially liable for these employees.

Retrospective PremiumsWorkers' Compensation InsuranceInsurance Policy AuditEmployer LiabilityTennessee LawTexas Occupational Benefit PlanNCCI GuidelinesSummary JudgmentContract InterpretationInterstate Employment
References
19
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
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