Campos v. Texas Property & Casualty Insurance Guaranty Ass'n for Reliance National Indemnity Co.

282 S.W.3d 226, 2009 Tex. App. LEXIS 2060, 2009 WL 790234
CourtCourt of Appeals of Texas
DecidedMarch 26, 2009
Docket03-06-00631-CV
StatusPublished
Cited by15 cases

This text of 282 S.W.3d 226 (Campos v. Texas Property & Casualty Insurance Guaranty Ass'n for Reliance National Indemnity Co.) 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
Campos v. Texas Property & Casualty Insurance Guaranty Ass'n for Reliance National Indemnity Co., 282 S.W.3d 226, 2009 Tex. App. LEXIS 2060, 2009 WL 790234 (Tex. Ct. App. 2009).

Opinion

OPINION

G. ALAN WALDROP, Justice.

We withdraw our prior opinion and judgment in this case and substitute the following opinion and judgment in their place. We overrule appellee’s motion for rehearing.

Appellant Samuel Campos was injured on the job. The Texas Workers’ Compensation Commission determined that Campos’s impairment rating was properly assigned by the designated doctor and that Campos was not entitled to reimbursement of travel expenses for visits to his treating doctor. Campos sought judicial review of the Commission’s determination by bringing suit against appellee Texas Property and Casualty Insurance Guaranty Association (“TPCIGA”) in Winkler County district court. The Winkler County district court transferred the action to Travis County district court, which subsequently granted TPCIGA’s motion for summary judgment on all claims. We conclude that, in accordance with section 410.252(b) of the Texas Labor Code, the proper venue for Campos’s suit is in Winkler County. We reverse the Travis County district court’s judgment and remand, with instructions to transfer the case to the 109th District Court in Winkler County.

*228 Factual and Procedural Background

This case involves the Texas Property and Casualty Insurance Guaranty Act (the “Guaranty Act”). 1 Samuel Campos was injured in an accident at work on November 13, 1999. Reliance National Indemnity Company was the workers’ compensation carrier for Campos’s employer. In October 2001, Reliance was designated an impaired insurer, 2 triggering the statutory obligation of TPCIGA to pay Reliance’s covered claims. 3

Two disputes arose between Campos and TPCIGA. After Campos’s treating doctor assigned a 30% impairment rating, TPCIGA disputed the methodology used by the treating doctor and requested that a designated doctor be assigned. The designated doctor assigned a 6% impairment rating. Campos disputes the 6% impairment rating. In addition, Campos sought reimbursement for travel expenses incurred during 2002 to visit his treating doctor, whose office in Odessa was approximately 45 miles from Campos’s residence in Kermit. TPCIGA refused Campos’s request for reimbursement, contending that medical treatment was reasonably available within 20 miles of Campos’s residence. A contested case hearing was held on June 12, 2003, before the Texas Workers’ Compensation Commission, Hearings Division. 4 The hearing officer determined that the designated doctor’s impairment rating of 6% was correct and that Campos was not entitled to the reimbursement of travel expenses. Campos sought review by an appeals panel of the Commission, which affirmed the hearing officer’s determinations on November 14, 2003.

Campos filed suit in Winkler County district court on December 22, 2003, seeking judicial review of the Commission’s decision on the two disputed issues. TPCIGA filed a motion to transfer venue to Travis County, which the Winkler County district court granted on June 28, 2004. In the Travis County district court, TPCI-GA filed a no evidence motion for summary judgment on Campos’s entire cause of action, which the district court granted on September 20, 2006.

Venue

On appeal, Campos contends that venue was proper in Winkler County and, *229 therefore, the Winkler County district court erred in transferring venue to Travis County. TPCIGA, in response, contends that venue was proper in Travis County and the transfer of venue should be affirmed. Campos relies on the venue provision of the Workers’ Compensation Act, and TPCIGA relies on the venue provision of the Texas Property and Casualty Insurance Guaranty Act.

We agree with TPCIGA that the venue provision of the Guaranty Act, if viewed in isolation, would apply to the present lawsuit. The Guaranty Act states, “Venue in a suit by or against the commissioner or association relating to an action or ruling of the commissioner or association under this chapter is in Travis County.” Tex. Ins.Code Ann. § 462.017(b) (West 2008).

Campos submits that the plain language of the Guaranty Act’s venue provision does not apply here because he challenges a ruling of the Commission, not an “action or ruling” of the commissioner of insurance or TPCIGA. This assertion overlooks the reality that, absent an adverse “action or ruling” by TPCIGA, Campos would not have initiated the Commission’s administrative proceedings in the first place. The Guaranty Act’s venue provision applies to a suit that relates to TPCIGA’s action or ruling. It is not limited to a direct appeal of such an action or ruling. Under the Guaranty Act, TPCIGA was obligated to “investigate and adjust, compromise, settle, and pay covered claims to the extent of the association’s obligation and deny all other claims.” Id. § 462.301(a) (West 2008) (emphasis added). The Workers’ Compensation Act’s administrative proceedings take place in order to settle disputes between the parties. See Tex. Lab.Code Ann. § 410.021 (West 2006) (purpose of benefit review conference is to resolve disputed issues by agreement of the parties), § 410.025(b) (West 2006) (contested case hearing scheduled if disputed issues not resolved at benefit review conference). Therefore, Campos’s suit relates to an action or ruling of TPCIGA under the Guaranty Act.

However, we also agree with Campos that the Workers’ Compensation Act’s venue provision for judicial review of an appeals panel decision, if viewed in isolation, would apply to the present lawsuit. The Workers’ Compensation Act states:

The party bringing suit to appeal the decision must file a petition with the appropriate court in: (1) the county where the employee resided at the time of the injury or death, if the employee is deceased; or (2) in the case of an occupational disease, in the county where the employee resided on the date disability began or any county agreed to by the parties.

Id. § 410.252(b) (West 2006).

TPCIGA submits that section 410.252(b) does not apply here because TPCIGA is not an “insurance carrier.” TPCIGA points out that it is not, in general, considered to “stand in the place of an impaired insurer,” Tex. Ins.Code Ann. § 462.102 (West 2008), and chapter 410 of the labor code governs the proceedings— administrative and judicial — that “determine the liability of an insurance carrier for compensation for an injury or death” under the Workers’ Compensation Act, Tex. Lab.Code Ann. § 410.002 (West 2006) (emphasis added).

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282 S.W.3d 226, 2009 Tex. App. LEXIS 2060, 2009 WL 790234, Counsel Stack Legal Research, https://law.counselstack.com/opinion/campos-v-texas-property-casualty-insurance-guaranty-assn-for-reliance-texapp-2009.