Justia Texas Supreme Court Opinion Summaries

Respondent injured his back while working, and his employer's workers' compensation insurer, Texas Mutual Insurance Company (TMIC), accepted the injury as compensable. Three years later when it was discovered that Respondent had herniated lumbar intervertebral discs, TMIC disputed whether they were causally related to the original injury. The Texas Department of Insurance Division of Workers' Compensation determined that the disc herniations were related to the original injury and ordered TMIC to pay medical benefits, which it did. Respondent later sued TMIC for damages caused by its delay in paying benefits. The trial court rendered judgment for Respondent, and the court of appeals affirmed. Based on the Court's recent decision in Texas Mutual Insurance Co. v. Ruttiger, the Supreme Court reversed and rendered judgment for TMIC. View "Tex. Mut. Ins. Co. v. Morris" on Justia Law

At issue in this case was whether a non-hurricane windstorm case could be joined as a tag-along to a previously created pre-trial Hurricane Ike multidistrict litigation (MDL) court. A single pretrial judge remanded this case because it did not arise from a hurricane. The Supreme Court granted the motion for rehearing and vacated the single pretrial judge's order of remand, holding (1) the case was related to the MDL litigation because the issue of whether State Farm covered shingle damage arising from wind events during the period between 2008 and 2010 was common to all cases; and (2) transfer would promote efficiency and serve the convenience of parties and witnesses. View "In re State Farm Lloyds Hurricane Litig." on Justia Law

An employee (Employee) of the Austin Independent School District (AISD), a self-insured governmental entity, was injured on the job. AISD acknowledged that Employee had been injured but disputed whether the compensable injury extended to two alleged conditions. A hearing officer sided with Employee on the contested issues, as did the administrative appeals panel. In the district court, Employee filed a counterclaim seeking attorney fees. AISD filed a nonsuit, leaving only the counterclaim for fees. After a jury trial, Employee won a judgment on the verdict that included pre-nonsuit and post-nonsuit attorney fees. The court of appeals found (1) the evidence was sufficient to support the pre-nonsuit fee award, but (2) the post-nonsuit fee award could not stand. AISD brought a petition for review in the Supreme Court, arguing for the first time that governmental immunity from suit barred the award of attorney fees. The Supreme Court reversed in part, holding (1) the defense of sovereign immunity may be raised for the first time on appeal; and (2) AISD was immune from Employee's claim for attorney fees. View "Manbeck v. Austin Indep. Sch. Dist." on Justia Law

An injured employee (Employee) sought workers' compensation benefits for a work-related injury. A claims adjuster with Employer's workers' compensation insurer's (Insurer) third party administrator denied the claim. The Division of Workers' compensation determined that Employee was entitled to medical and temporary income benefits. Employee subsequently brought a bad faith action against Insurer, its third party administrator, and the claims adjuster (Defendants). During discovery, Employee sought communications made between Insurer's lawyer and Employer during the administrative proceedings. Defendants argued that the attorney-client privilege protected the communications. The trial court held that the privilege did not apply. The court of appeals subsequently denied mandamus relief. The Supreme Court affirmed, holding that the attorney-client privilege did not protect the communications between Insurer and its insured. View "In re XL Specialty Ins. Co." on Justia Law

This suit was filed by a daughter against an organ donation charity when she discovered that the charity - contrary to an earlier representation to her - would allegedly profit from harvesting her deceased mother's tissues. The charity requested a defense from its insurer, and the insurer denied a defense. The insurer's subsequent suit against the charity resulted in two certified questions from the Fifth Circuit Court of Appeals. The Supreme Court held (1) the insurance policy provision for coverage of "personal injury" does not include coverage for mental anguish, unrelated to physical damage to or disease of the daughter's body; and (2) the insurance policy provision for coverage of "property damages," does not include coverage for the underlying plaintiff's loss of use of her deceased mother's tissues, organs, bones, and body parts. View "Evanston Ins. Co. v. Legacy of Life, Inc." on Justia Law

Employee suffered an injury during the course of his employment that was compensable under the Texas Workers' Compensation Act. Petitioner insurance company provided workers' compensation coverage to Employee's employer. Petitioner disputed the impairment rating of twenty percent assigned by the doctor in the administrative proceedings. A hearing officer issued a decision finding that Employee had an impairment rating of twenty percent. The Division of Workers' Compensation upheld the decision. Petitioner appealed. The trial court granted Employee's plea to the jurisdiction and dismissed the case. The court of appeals affirmed. At issue on appeal was whether a reviewing court lacks subject matter jurisdiction to resolve an impairment rating appeal if the only rating presented to the agency was invalid. The Supreme Court reversed, holding that the absence of a valid impairment rating does not deprive the court of jurisdiction. Remanded. View "Am. Zurich Ins. Co. v. Samudio" on Justia Law

The parties to the appeal disagreed about whether an employer who self funded a health-benefit plan for its employees was an "insurer" under the Texas Insurance Code, and therefore should be treated as a reinsurer when purchasing stop-loss insurance. The court of appeals concluded that an employer's self-funded plan was clearly an insurer under the Code and that a plan's purchase of stop-loss insurance was also clearly reinsurance beyond the regulatory scope of the Texas Department of Insurance. The court accordingly reversed the trial court's judgment, which held that the agency's regulation of the stop-loss policies at issue as direct insurance. Because the regulatory agency did not clearly err in its regulation of these stop-loss policies, however, the court reversed the court of appeals' judgment and rendered judgment for the agency. View "TX Dept. of Ins., et al. v. American National Ins. Co., et al." on Justia Law

This appeal stemmed from litigation between a homeowner, its insurer, and the company hired to restore the home after a series of storms caused damage to the home. A jury found in the restoration company's favor and the trial court rendered judgment against the homeowner and its insurer, jointly and severally. The court of appeals affirmed in part and reversed in part. The court affirmed the court of appeals' judgment with respect to the homeowner's state Deceptive Trade Practices Act (DTPA), Tex. Bus. & Com Code 17.50, claim because the homeowner was not a prevailing party and he was not a entitled to an order restoring all amounts paid under the contracts without deducting the value received under those agreements. The court also affirmed the restoration company's charge error complaint. The court reversed the court of appeals' judgment as to the insurer where the insurer received direct consideration for its promise to pay for the dehumidification and the court of appeals erred in concluding otherwise. The court remanded for that court to consider the insurer's remaining arguments, which included challenges to the factual sufficiency of the evidence supporting the jury findings. View "Dr. Erwin Cruz v. Andrews Restoration, Inc., et al." on Justia Law

Rafael Casados suffered a fatal, work-related injury while working for two employers that both had workers' compensation coverage. Casados' parents sued one of the employers. At issue was whether workers' compensation was the exclusive remedy to Casados' parents, which would bar their suit against Port Elevator. Because Port Elevator had a workers' compensation policy, Casados was an employee, he suffered a work-related injury, and the jury failed to find Port Elevator grossly negligent, the Texas Workers' Compensation Act (TWCA), Tex. Lab. Code 406, provided that the exclusive remedy was against the employer's insurer - not the employer. Accordingly, the claim at issue in this appeal was barred. The court reversed the judgment of the court of appeals and rendered judgment for Port Elevator. View "Port Elevator-Brownsville, L.L.C. v. Casados, et al." on Justia Law

This case concerned an arbitration provision that allowed each party to appoint one arbitrator to a panel, subject to certain requirements. At issue was whether Americo wavied its objection to the removal of the arbitrator it selected. The underlying dispute concerned the financing mechanism for Americo's purchase of several insurance companies from Robert Myer. Pursuant to the financing agreement, Americo and Myer submitted their dispute to arbitration under American Arbitration Association (AAA) rules. The arbitrators found in favor of Myer, and Americo filed a motion to vacate the award. The trial court granted the motion, holding that Americo was entitled to any arbitrator that met the requirements set forth in the financing agreement and that the arbitrator removed by the AAA met those requirements. The court of appeals reversed, holding that Americo had waived these arguments by not presenting them to the AAA. Because the record demonstrated otherwise, the court rejected the court of appeals' judgment and remanded the case to that court for further proceedings. View "Americo Life, Inc., et al. v. Myer, et al." on Justia Law