Cortez v. Liberty Mutual Fire Insurance Co.

885 S.W.2d 466, 1994 Tex. App. LEXIS 2028, 1994 WL 417623
CourtCourt of Appeals of Texas
DecidedJune 2, 1994
Docket08-93-00280-CV
StatusPublished
Cited by41 cases

This text of 885 S.W.2d 466 (Cortez v. Liberty Mutual Fire Insurance 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
Cortez v. Liberty Mutual Fire Insurance Co., 885 S.W.2d 466, 1994 Tex. App. LEXIS 2028, 1994 WL 417623 (Tex. Ct. App. 1994).

Opinion

OPINION

LARSEN, Justice.

Martin Cortez appeals the trial court’s summary judgment favoring Liberty Mutual Fire Insurance Co. in this action for breach of the duty of good faith and fair dealing, stemming from Liberty Mutual’s cessation of weekly worker’s compensation benefits. We affirm.

FACTS

Martin Cortez worked as a machine operator for Eureka Company, riveting carpet nozzles to vacuum cleaner frames. He developed a repetitious trauma injury which caused him to lose work starting August 31, 1989. He underwent a carpal tunnel release with Dr. Vierra in May 1990. Liberty Mutual paid him weekly compensation benefits from September 1989 to November 1991.

In June 1991, Mr. Cortez saw Dr. David Capen for an independent medical examination. After this exam, Dr. Capen opined that:

My impression is that this man has reached maximum medical improvement.... I feel that he can return to work as a machine operator and simply would recommend that they fix the machine so that it doesn’t stick to the nozzle, therefore he would not have to bang it with his hands and he could operate the machine in an appropriate fashion without harming himself. I feel that Dr. Vierra has appropriately treated him since his surgery and now can release him to go back to work.

Based upon this narrative, Liberty Mutual requested a prehearing conference to determine if there was a reasonable medical basis for suspending weekly benefits. It suspended benefits after the conference in November 1991.

In response to an inquiry from Mr. Cortez’s counsel, Dr. Capen wrote another letter addressing the case in December 1991. In that letter, he stated that, as an independent medical evaluation (IME) doctor, he was not in a position to release Mr. Cortez to return to work, that remaining the prerogative of Dr. Vierra as treating physician. In that letter, however, Dr. Capen also stated:

The man is suitable for work without restrictions. He can lift what he needs to lift in order to perform his job as a material assembler. My only restriction was, that the machine that he was working be fixed....
Mr. Cortez has had adequate time to recover from his surgery and is now physically ready to go back to work.

In October 1992, Mr. Cortez settled his worker’s compensation lawsuit. The agreed judgment in that cause contained the following recitations:

On the date below, the Court heard the merits of this suit in the presence of all parties and counsel.
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The Court finds that this suit involves disputed issues of liability, that the existence, duration and extent of Martin Cortez’s injuries and resulting incapacities and loss of use are uncertain, and Martin Cortez’s need for health care and services as well as other issues of fact, are undeter-minable.
The Court further finds that this is a settlement of a disputed claim, and that the payment herein acknowledged is not an admission of liability by any party released herein, by whom all liability is expressly denied, and that such payment is made only to buy peace.

Liberty Mutual filed its motion for summary judgment in the bad faith case, urging that: (1) reasonable basis for suspension of benefits was shown as a matter of law; (2) collateral estoppel barred the bad faith action; *469 and (3) judicial admission barred the bad faith action. The trial court granted summary judgment without stating which of these three grounds it relied upon in doing so.

STANDARD OF REVIEW

The standard of review of a summary judgment on appeal is:

1. The movant for summary judgment has the burden of showing that there is no genuine issue of material fact and that it is entitled to judgment as a matter of law;
2. In deciding whether there is a disputed material fact issue precluding summary judgment, evidence favorable to the nonmovants will be taken as true; and
3. Every reasonable inference must be indulged in favor of the nonmovants and any doubts resolved in their favor. Nixon v. Mr. Property Management Company, Inc., 690 S.W.2d 546, 548-49 (Tex. 1985).

Where defendant is movant, we limit our review to whether the summary judgment proof establishes as a matter of law that there is no genuine issue of fact as to one or more of the essential elements of plaintiffs’ cause of action. Gibbs v. General Motors Corporation, 450 S.W.2d 827, 828 (Tex.1970); Zep Manufacturing Company v. Harthcock, 824 S.W.2d 654, 658 (Tex.App.— Dallas 1992, n.w.h.). Because it is plaintiffs’ burden to establish each element of the cause of action, if defendant submitted summary judgment evidence disproving at least one element of the plaintiffs case, then the defendant’s summary judgment was properly granted. Bradley v. Quality Service Tank Lines, 659 S.W.2d 33, 34 (Tex.1983); Rayos v. Chrysler Credit Corporation, 683 S.W.2d 546, 547 (Tex.App. — El Paso 1985, no writ). In short, a summary judgment entered in favor of a defendant is proper only if the plaintiff could not succeed on any theory pleaded, as a matter of law. Delgado v. Bums, 656 S.W.2d 428, 429 (Tex.1983); Gibbs, 450 S.W.2d at 828.

Where a summary judgment does not state the grounds upon which it is granted, as here, an appellant must show on appeal that each of the independent grounds alleged in the motion is insufficient to support the summary judgment. Southerland v. Northeast Datsun, Inc., 659 S.W.2d 889 (Tex.App. — El Paso 1983, no wilt).

REASONABLE BASIS FOR SUSPENDING BENEFITS

In his first point of error, Mr. Cortez asserts that the trial court erred in entering summary judgment because Dr. Capen’s IME did not constitute a reasonable basis for the cessation of Mr. Cortez’s compensation benefits.

A worker’s compensation claimant asserting that a carrier has breached its duty of good faith and fair dealing must establish: (1) the absence of a reasonable basis for delaying or denying payment of the benefits of the policy; and (2) that the earner knew or should have known that there was not a reasonable basis for denying the claim or delaying payment of the claim. Aranda v. Insurance Co. of North Amenca, 748 S.W.2d 210, 213 (Tex.1988).

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Cite This Page — Counsel Stack

Bluebook (online)
885 S.W.2d 466, 1994 Tex. App. LEXIS 2028, 1994 WL 417623, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cortez-v-liberty-mutual-fire-insurance-co-texapp-1994.