Daniels v. Indemnity Insurance Co. of North America

345 S.W.3d 736, 2011 Tex. App. LEXIS 5464, 2011 WL 2772304
CourtCourt of Appeals of Texas
DecidedJuly 18, 2011
Docket05-09-00975-CV
StatusPublished
Cited by6 cases

This text of 345 S.W.3d 736 (Daniels v. Indemnity Insurance Co. of North America) 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
Daniels v. Indemnity Insurance Co. of North America, 345 S.W.3d 736, 2011 Tex. App. LEXIS 5464, 2011 WL 2772304 (Tex. Ct. App. 2011).

Opinion

OPINION

Opinion By

Justice MORRIS.

In this appeal, we determine whether the trial court erred in granting a take-nothing summary judgment in Dan Daniels’s bad-faith lawsuit against Indemnity Insurance Company of North America. We also review the trial court’s sanctions award against Daniels’s attorney, Donald McLeaish. For the reasons that follow, we conclude the trial court’s summary judgment in favor of Indemnity was proper and further conclude the trial court did not abuse its discretion in sanctioning McLeaish. Accordingly, we affirm the trial court’s judgment.

I.

This case arises out of a claim for workers’ compensation benefits Daniels filed after he was injured on the job in 2003 while working for ThyssenKrupp Elevator Corporation. Indemnity was the workers’ compensation carrier for ThyssenKrupp and paid Daniels both temporary benefits and impairment benefits based on a nineteen-percent impairment rating. In November 2005, the Division of Workers’ Compensation notified Daniels that he was eligible for supplemental income benefits from November 26, 2005 through February 24, 2006. 1 Indemnity, however, disputed Daniels’s entitlement to these benefits asserting (1) he did not make a good faith effort to look for work commensurate with his ability to work and (2) Daniels sustained an unrelated, intervening injury. Indemnity requested a contested case hearing with the Division. After a hearing in October 2006, the hearing officer found that Daniels had made a good faith effort to look for work commensurate with his ability but failed to establish his earnings were now less than eighty percent of his weekly wage at ThyssenKrupp. Accordingly, the hearing officer ruled that Daniels was not entitled to supplemental income benefits. An appeals panel affirmed the hearing officer’s determination in January 2007. Daniels filed a lawsuit against Indemnity in Johnson County appealing the Division’s determination denying him supplemental income benefits. Among the issues Daniels presented for decision in that lawsuit were (1) his average weekly wage and (2) whether he was entitled to supplemental income benefits. According to appellants’ brief, that lawsuit is still pending.

Daniels also filed a lawsuit against Thys-senKrupp and Indemnity in Dallas County in January 2007 alleging, among other things, that Indemnity wrongfully delayed or denied his benefits and acted in bad faith in adjusting his compensation claim. He further alleged ThyssenKrupp failed to provide a true record of his income before the accident when completing the “Employer’s Wage Statement” required by the labor code. Daniels asserted claims against Indemnity for breach of contract, violations of the Deceptive Trade Practices Act, violations of the Texas Insurance Code, and breach of the duty of good faith and fair dealing. In October 2007, Daniels filed a nonsuit with respect to the Dallas *739 County lawsuit the day before the defendants’ motions for summary judgment were scheduled to be heard. About one month later, on November 6, 2007, Daniels filed the lawsuit from which this appeal arises. The present lawsuit sets forth the same factual allegations as the case that was previously dismissed and asserts causes of action against Indemnity for breach of the duty of good faith and fair dealing, violations of the Texas Insurance Code, and violations of the Deceptive Trade Practices Act 2 .

Indemnity filed a traditional motion for summary judgment asserting multiple grounds with respect to the various claims against them. 3 The trial court granted the motion without specifying the grounds. Indemnity then moved for sanctions against appellants. After a hearing on the motion, the trial court awarded Indemnity $8,750 against Daniels’s attorney, Donald McLeaish. This appeal followed.

II.

We begin our analysis with appellants’ challenges to the trial court’s summary judgment ruling. Where, as here, the summary judgment movant asserts multiple grounds and the trial court’s order granting the summary judgment does not specify the grounds upon which the order was based, the party appealing the order must negate all possible grounds upon which the order could have been based. Shih v. Tamisiea, 306 S.W.3d 939, 944-45 (Tex.App.-Dallas 2010, no pet.).

At the heart of Daniels’s lawsuit is his allegation that he was wrongfully denied supplemental income benefits based on an incomplete Employer’s Wage Statement furnished by ThyssenKrupp to Indemnity and presented at the contested case hearing. Daniels asserts the wage statement did not include information with respect to his fringe benefits, specifically, health insurance premiums. He further complains of Indemnity’s initial denial of supplemental income benefits based on an intervening injury, failure to investigate his pre-injury wages, and its questioning of him at the contested case hearing that suggested his use of a state-owned vehicle in his current job was a personal benefit. Daniels asserts that, as a result of Indemnity’s actions, he has lost income he was to have been paid, suffered mental anguish, loss of credit, and severe damage to his personal life.

Among the grounds raised in its summary judgment motion, Indemnity asserted that the Division’s determination that Daniels was not entitled to supplemental income benefits conclusively established that it cannot be held liable for any damages resulting from its refusal to pay Daniels supplemental income benefits. Daniels counters that the Division’s denial of supplemental income benefits does not conclusively negate the causation elements of his claims because of Indemnity’s failure to present to the Division a properly completed Employer’s Wage Statement that *740 included the health insurance premiums paid for his benefit by ThyssenKrupp.

A compensation claimant cannot prosecute a lawsuit against a carrier to recover damages resulting from a denial of benefits without a previous determination by the Division that such benefits are due him. See Am. Motorists Ins. Co. v. Fodge, 63 S.W.3d 801, 802 (Tex.2001). Here, the summary judgment evidence conclusively establishes that the Division determined that Daniels was not entitled to supplemental income benefits. Daniels attempts to circumvent the holding of Fodge by arguing that the Division’s denial of supplemental income benefits “does nothing to negate an allegation” that Indemnity caused an erroneous decision adverse to Daniels “by presenting evidence it knew was false, or by withholding relevant evidence of the insurance premiums paid by ThyssenKrupp.” Daniels’s argument misses the mark. A review of the hearing officer’s decision that was ultimately affirmed by the appeals panel reveals that the question of Daniels’s average weekly wage was directly before the hearing officer. The hearing officer acknowledged that Daniels’s paychecks indicated the existence of a health plan but that Daniels made no attempt to show that Thyssen-Krupp paid the premiums for this plan or the value of such premiums, if any.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Wayne M. English v. Parcel Express, Inc.
Court of Appeals of Texas, 2022
Aubrey v. Aubrey
523 S.W.3d 299 (Court of Appeals of Texas, 2017)
in Re Rebecca Gallardo
Court of Appeals of Texas, 2015

Cite This Page — Counsel Stack

Bluebook (online)
345 S.W.3d 736, 2011 Tex. App. LEXIS 5464, 2011 WL 2772304, Counsel Stack Legal Research, https://law.counselstack.com/opinion/daniels-v-indemnity-insurance-co-of-north-america-texapp-2011.