Derr v. Argonaut Underwriters Insurance Company

339 S.W.2d 718, 1960 Tex. App. LEXIS 2577
CourtCourt of Appeals of Texas
DecidedOctober 19, 1960
Docket10796
StatusPublished
Cited by7 cases

This text of 339 S.W.2d 718 (Derr v. Argonaut Underwriters Insurance Company) 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
Derr v. Argonaut Underwriters Insurance Company, 339 S.W.2d 718, 1960 Tex. App. LEXIS 2577 (Tex. Ct. App. 1960).

Opinion

ARCHER, Chief Justice.

This is an appeal from an order of the Trial Court granting an instructed verdict in a suit filed by appellant against appellee to recover benefits under the Texas Workmen’s Compensation Insurance Act, V.A. T.S. Insurance Code, art. 5.55 et seq.

The trial was had with the aid of a jury and after plaintiff had closed his case and rested and prior to defendant’s submission of any testimony, defendant filed a motion for an instructed verdict which was granted hy the court.

The motion for instructed verdict, in substance, alleged that plaintiff had not proved that he had good cause for not filing his claim in time, and that plaintiff had filed a third party action and thereby abandoned his rights to Workmen’s Compensation by filing a common law action against a third party.

The appeal is based on two points assigned as error and read as follows:

“1. The Trial Court erred in instructing a verdict in favor of the Defendant for the reason that the Plaintiff had produced some evidence of good cause for the late filing of his claim for compensation.
“2. The Trial Court erred in instructing a verdict in favor of the Defendant for the reason that the Plaintiff had not made an election to abandon his rights to workmen’s compensation benefits.”

Plaintiff alleged that on June 27, 1956 he was employed as a truck driver for the Refrigerated Transport Company driving a trailer type truck and that his employer had in force a policy of Workmen’s Compensation Insurance with the defendant, and that during the early morning of June 27, 1956, plaintiff was involved in a highway accident while in the course of his employment and was seriously injured, resulting in hospitalization for a long period and received medical treatment, the total hospital and medical bills aggregated $4,-370.08, all of which were paid by defendant. That on March 7, 1958 the defendant notified the hospital that it would not be lia-, ble for future bills.

Plaintiff’s employer paid him wages during the time he was unable to work.

Plaintiff employed attorneys in December, 1957 to represent him in his common law claim for damages against Earnest Lloyd, a third party. Conversations were had with reference to a nonwaiver of plaintiff’s compensation rights. No waiver was ever secured.

The suit against Lloyd, a third party, was filed on February 5, 1958. The attorneys sent a copy of the petition to Tom Flynn, an employee of the Stoddard Smith Agency, the defendant’s general agent in Texas. Stoddard Smith informed K. L. Breeden, who testified that he was in charge of handling Workmen’s Compensation matters at *720 Refrigerated Transport Company, that defendant would not consent to plaintiff pursuing the third party common law action, and took the position that plaintiff had abandoned his compensation rights; following the receipt of such information plaintiff filed his claim for Workmen’s Compensation on March 15, 1958 and non-suited in his pending third party action.

Appellee admits that plaintiff was injured and the payment of $4,370.08 for medical and hospital expenses up until January 31, 1958, and believing that plaintiff had a good cause of action against the third party, and also not desiring to raise their rates, plaintiff’s employer instructed the defendant not to make any payments for compensation benefits.

The fact that appellant’s employer paid the employee wages does not, as a matter of law, constitute good cause for late filing of his claim.

Texas Employers’ Insurance Association v. Doss, Tex.Civ.App., 301 S.W.2d 473, er. ref. and cases cited therein.

The primary point for consideration by this Court is whether under the facts before the Trial Court there was any evidence of good cause for plaintiff’s failure to file his claim for Workmen’s Compensation within six months after the occurrence of his injuries.

Article 8307, Sec. 4a, Vernon’s Ann.Civ. St., provides that a claim for compensation should be made within six months after the occurrence of the injury, but it is provided in the Article that “for good cause the Board may, in meritorious cases, waive the strict compliance with the foregoing limitations as to notice, and the filing of the claim before the Board” and it must be also shown that the event which is asserted to constitute good cause for the late filing of a claim continue up to the time the claim is in fact filed.

Consolidated Casualty Ins. Co. v. Perkins, 154 Tex. 424, 279 S.W.2d 299.

We then will determine if the payment of medical expenses arising as a result of the injuries through January 31, 1958 totaling $4,370.08 and subsequent refusal to make further payments, and that plaintiff knew that defendant was paying the medical expenses, constitute some evidence on which a person of ordinary prudence under the same or similar circumstances would have exercised, and had used the degree of diligence required in prosecuting his claim with ordinary diligence. If there is some evidence of good cause up to the time of filing the claim, the fact issue should be submitted to a jury to find if the plaintiff was justified in his belief that it was not necessary for him to file his claim earlier than he did.

The Compensation Act provides for care and medical treatment of injured persons, and is not limited to weekly payment for lost time or disability and for payment of such medical treatment and hospital services. Defendant would not be liable for medical payments unless liable for compensation payments.

The defendant, appellee herein, says that the question of medical payments alone as constituting good cause is rather a new and novel proposition and that appellee has not been able to find any cases directly in point, but that in this instant case defendant was not only discharging its obligation under the policy by payment of additional medical payments, but was also discharging its liability under an endorsement on the policy providing for a greater amount of medical payment and an additional premium of $15.00 collected. The endorsement is as follows:

“It is agreed that:
“I. In addition to any medical benefits provided in the Texas Workmen’s Compensation Law, the company will also pay the reasonable cost of any additional medical, surgical, nurse or hospital services, medical or surgical apparatus or appliances and medicines which in the opinion of the company *721 are reasonably necessary for the treatment of bodily injury sustained by any person who is entitled, on account of such injury, to the compensation and other benefits required of the insured by such law and afforded by the policy under coverage A or who is entitled to such benefits under other terms of the policy.”

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Bluebook (online)
339 S.W.2d 718, 1960 Tex. App. LEXIS 2577, Counsel Stack Legal Research, https://law.counselstack.com/opinion/derr-v-argonaut-underwriters-insurance-company-texapp-1960.