Alvarado v. Old Republic Insurance

951 S.W.2d 254, 1997 WL 528634
CourtCourt of Appeals of Texas
DecidedNovember 6, 1997
Docket13-96-189-CV
StatusPublished
Cited by16 cases

This text of 951 S.W.2d 254 (Alvarado v. Old Republic Insurance) is published on Counsel Stack Legal Research, covering Court of Appeals of Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Alvarado v. Old Republic Insurance, 951 S.W.2d 254, 1997 WL 528634 (Tex. Ct. App. 1997).

Opinion

OPINION

FEDERICO G. HINOJOSA, Jr., Justice.

This is an appeal from the grant of a summary judgment. By three points of error, appellants, Steve Alvarado, Homero Torres, and Alejandro Martinez, contend that issues of material fact exist, that appellee, Old Republic Insurance Company, did not sustain its burden of showing it was entitled to summary judgment, and that appellants’ claims were not barred by res judicata, collateral estoppel, release, or accord and satisfaction. We affirm.

On March 15,1989, appellants were traveling from Corpus Christi to Edinburg in a van owned by U.S. Home Corporation. They were injured when a vehicle traveling the wrong way on U.S. Highway 77 collided with the van. On or about May 9, 1989, appellants filed workers’ compensation claims with Old Republic seeking medical and indemnity benefits. On May 29, 1989, 1 Old Republic denied appellants’ claims on the basis that they were not employees of its insured, U.S. Home. Appellants filed suit claiming breach of the duty of good faith and fair dealing.

Old Republic moved for summary judgment on the following grounds:

1) there was no breach of the duty of good faith and fair dealing as a matter of law because there was evidence showing appellants were not U.S. Home employees, thus there was a reasonable basis for denying appellants’ claims;
2) the claims were barred by res judicata, collateral estoppel, release, and/or accord and satisfaction; and
3) there was no valid claim for actual damages, thus there was no basis in law for a claim for exemplary damages.

Appellants responded that (1) there was some evidence showing the absence of a reasonable basis to deny appellants’ claims, (2) the claims were not barred, and (3) the claim for exemplary damages was valid. The trial court granted Old Republic’s motion for sum *258 mary judgment on February 28, 1996. This appeal followed.

By their first point of error, appellants contend that the trial court erred in granting summary judgment to Old Republic on appellants’ claims of bad faith because there is a fact question concerning whether there was a reasonable basis for denying or delaying appellants’ claims.

The rules related to the burden undertaken by a defendant seeking summary judgment are well-known. Lear Siegler, Inc. v. Perez, 819 S.W.2d 470, 471-72 (Tex.1991). The function of summary judgment is not to deprive a litigant of the right to a full hearing on the merits of any real issue of fact but to eliminate patently unmeritorious claims and untenable claims. See Gulbenkian v. Penn, 151 Tex. 412, 252 S.W.2d 929, 931 (Tex.1952). A defendant who moves for summary judgment may meet the burden of showing that the plaintiff has no cause of action by either (1) negating at least one essential element of each theory of recovery, or (2) conclusively proving all the elements of an affirmative defense. Wornick Co. v. Casas, 856 S.W.2d 732, 733 (Tex.1993); H.S.M. Acquisitions, Inc. v. West, 917 S.W.2d 872, 877 (Tex.App.—Corpus Christi 1996, writ denied). Once the movant establishes that it is entitled to summary judgment, the burden shifts to the nonmovant to show why summary judgment should be avoided. Casso v. Brand, 776 S.W.2d 551, 556 (Tex.1989); Neuhaus v. Richards, 846 S.W.2d 70, 77 (Tex.App.—Corpus Christi 1992), judgment set aside, 871 S.W.2d 182.

The trial court’s order granting the motion for summary judgment does not state the specific grounds on which it was granted. Therefore, the summary judgment must be affirmed if the appellee sustains its burden of proof on any one of its theories. State Farm Fire & Cas. Co. v. S.S., 858 S.W.2d 374, 380 (Tex.1993); Matlock v. Kittleman, 865 S.W.2d 543, 544 (Tex.App.—Corpus Christi 1993, no writ).

Appellants based their cause of action for breach of good faith and fair dealing on allegations that Old Republic had no reasonable basis for denying their claims. See Arnold v. National County Mut. Fire Ins. Co., 725 S.W.2d 165, 167 (Tex.1987). In Universe Life Ins. Co. v. Giles, 950 S.W.2d 48 (Tex.1997), the Supreme Court articulated a new standard, declaring that an insurer acts in bad faith when denying or delaying payment of a claim if it should have been “reasonably clear” that the claim was covered. Id. at 54-56. The Court directed that the new standard should be applied by reviewing courts immediately, even though a case arose and was argued under the previous “no reasonable basis” standard. See State Farm Lloyds v. Nicolau, 951 S.W.2d 444 (Tex.1997) (applying new standard on same day of pronouncement).

Under the new standard, the proponent of a bad faith claim has the burden of proving that the insurer knew or should have known that it was reasonably clear that the claim was covered. As movant for summary judgment, the insurer may negate an essential element of the appellants’ claim by showing that its liability was not reasonably clear, i.e., that there was a reasonable basis for believing a claim was not covered. See Nicolau, 951 S.W.2d at 446; Lyons v. Millers Casualty Ins. Co., 866 S.W.2d 597, 601 (Tex.1993); Aranda v. Insurance Co. of N. Am., 748 S.W.2d 210, 213 (Tex.1988) (carriers retain right to deny invalid or questionable claims without being subject to bad faith liability for erroneous denial of a claim).

For purposes of eligibility for workers’ compensation benefits, Texas law defines an employee as “a person, other than an independent contractor or the employee of an independent contractor, who is engaged in construction, remodeling, or repair work for the employer at the premises of the employer.” Tex. Labor Code Ann. § 401.012(b)(2) (Vernon 1996). The meaning of the word “employee” is the same in the context of a common-law liability claim. Gulf States Underwriters of Louisiana, Inc. v. Wilson, 753 S.W.2d 422, 426 (Tex.App.—Beaumont 1988, writ denied); Northwestern Nat’l Life Ins. Co. v. Black, 383 S.W.2d 806, 810 (Tex.Civ.App.—Texarkana 1964, writ ref'd n.r.e.). An insurance carrier is liable for compensation only to employees of the insured company. *259 Tex. LaboR Code Ann. § 406.031 (Vernon 1996).

Old Republic contends it determined that appellants were independent contractors and not employees of its insured, U.S. Home, and for that reason appellants’ claims for workers’ compensation benefits were denied.

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Bluebook (online)
951 S.W.2d 254, 1997 WL 528634, Counsel Stack Legal Research, https://law.counselstack.com/opinion/alvarado-v-old-republic-insurance-texapp-1997.