East Texas Educational Insurance Association v. Sanford Jones and James Thomas Lyle, as Independent of the Estate of Mary Louise Jones, and Next Friend of J.L., a Minor

CourtTexas Court of Appeals, 9th District (Beaumont)
DecidedMay 28, 2026
Docket09-24-00191-CV
StatusPublished

This text of East Texas Educational Insurance Association v. Sanford Jones and James Thomas Lyle, as Independent of the Estate of Mary Louise Jones, and Next Friend of J.L., a Minor (East Texas Educational Insurance Association v. Sanford Jones and James Thomas Lyle, as Independent of the Estate of Mary Louise Jones, and Next Friend of J.L., a Minor) is published on Counsel Stack Legal Research, covering Texas Court of Appeals, 9th District (Beaumont) primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

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East Texas Educational Insurance Association v. Sanford Jones and James Thomas Lyle, as Independent of the Estate of Mary Louise Jones, and Next Friend of J.L., a Minor, (Tex. Ct. App. 2026).

Opinion

In The

Court of Appeals

Ninth District of Texas at Beaumont

________________

NO. 09-24-00191-CV ________________

EAST TEXAS EDUCATIONAL INSURANCE ASSOCIATION, Appellant

V.

SANFORD JONES AND JAMES THOMAS LYLE, AS INDEPENDENT EXECUTOR OF THE ESTATE OF MARY LOUISE JONES, DECEASED, AND NEXT FRIEND OF J.L., A MINOR, Appellees ________________________________________________________________________

On Appeal from the 60th District Court Jefferson County, Texas Trial Cause No. 24DCCV0369 ________________________________________________________________________

MEMORANDUM OPINION

East Texas Educational Insurance Association (“ETEIA” or “carrier”), a

workers’ compensation carrier, appeals the trial court’s Orders to Determine Lien

Amounts and Severance Order awarding it funds for its subrogation interest after

paying benefits on behalf of Mary Louise Jones (individually, “Jones” or

“Decedent”), who later died. Sanford Jones and James Thomas Lyle, as Independent

Executor of the Estate of Mary Louise Jones, Deceased, and Next Friend of J.L., a

1 Minor (collectively, the “Jones Plaintiffs” or “Appellees”) intervened in a lawsuit

initiated by other plaintiffs who were injured in the same accident and sued Toyota

for products liability, among other things. In the lawsuit against Toyota, ETEIA also

intervened seeking subrogation for various workers’ compensation indemnity and

medical benefits it paid to or on behalf of Jones. The Jones Plaintiffs acknowledge

in their First Amended Petition in Intervention that “various workers compensation

and medical benefits have been paid to or for plaintiff-intervenors.”

The Jones Plaintiffs filed two motions central to this appeal: (1) Motion to

Approve Apportionment of Global Settlement Offer; and (2) Motion to Determine

Amount of Workers’ Compensation Lien. Later, the trial court signed an Order

granting the Jones Plaintiffs Motion to Sever Claims in Intervention and for Entry

of Final Judgment in Severed Action. In seven issues, ETEIA asserts that the trial

court’s award failed to include $350,000.00 in medical benefits it paid to Jones’s

medical insurance carrier that had been established as a matter of law, or in the

alternative, that the trial court improperly adjudicated ETEIA’s subrogation interest

at a hearing rather than a trial on the merits and summarily put ETEIA to trial. ETEIA

asks us to reverse the trial court’s judgment and render judgment awarding it the

additional $350,000 for the medical benefits paid, or alternatively, to reverse the trial

court’s judgment and remand the matter for a new trial on the amount of its

subrogation interest paid.

2 We hold the trial court abused its discretion by misapplying the law to the

facts of this case when it summarily adjudicated ETEIA’s subrogation claim during

a settlement hearing and effectively denied its right to “first money” reimbursement

of medical benefits paid without a trial on the merits or summary-judgment

proceedings. We reverse and remand the matter for further proceedings consistent

with this opinion as discussed below.

BACKGROUND AND PROCEDURAL HISTORY

Automobile Accident

Jones worked as a teacher for Little Cypress-Mauriceville Consolidated

Independent School District (LCM). In May 2008, she was part of a group of

teachers who traveled to Mexico for a Spanish immersion program. While in

Mexico, she and others were seriously injured in an automobile accident on an

excursion when a Mexican national driving the Toyota Hiace van they were in left a

mountain roadway. In November 2008, Jones died because of her injuries; several

other teachers also died. Other members of the group sued Toyota in District Court

in Jefferson County, Texas in cause number B-184,121 (“Jefferson County

Lawsuit”), and the Jones Plaintiffs intervened in that lawsuit. We outlined the

background facts leading to the underlying products liability litigation in an earlier

opinion involving a separate appeal. See Toyota Motor Co. v. Cook, 581 S.W.3d 278,

281–82 (Tex. App.—Beaumont 2019, no pet.).

3 Orange County Lawsuit: Workers’ Compensation Dispute

Initially, ETEIA challenged the compensability of Jones’s injuries, asserting

she was on an excursion and left the course and scope of her employment. The

Division of Workers’ Compensation (“DWC”) ruled against ETEIA on its

compensability challenge and determined that Jones’s injuries were compensable.

ETEIA appealed the DWC compensability determination by filing a lawsuit in

Orange County District Court numbered B-090427-C (“Orange County Lawsuit”).

In the Orange County lawsuit, TRS-Active Life as managed by Blue Cross Blue

Shield (BCBS), which was Jones’s health insurer, and ETEIA entered into a written

settlement agreement that called for ETEIA to pay the Jones Plaintiffs indemnity

benefits and to reimburse TRS-ActiveCare $350,000 for medical benefits paid

related to the accident.

Ultimately, the parties submitted an Agreed Judgment in the Orange County

Lawsuit, which ETEIA signed, and the Jones Plaintiffs’ counsel signed based on the

parties’ settlement agreement. 1 On October 25, 2008, the trial court signed the

1 The Jones Plaintiffs make much of the fact in their Brief that the copy of the settlement agreement in the record was not signed by all parties. Even so, the copy in the record shows that both Sanford Jones and James Thomas Lyle signed it, along with a representative of Blue Cross Blue Shield (BCBS). Additionally, the Agreed Judgment the trial court signed, was also signed by ETEIA and attorneys for the Jones Plaintiffs and referenced the settlement agreement. 4 Agreed Final Judgment in the Orange County Lawsuit. As relevant here, that Agreed

Final Judgment provided that

ETEIA’s payment in the amount of $350,000 to TRS-ActiveCare and $50,000 to Roebuck & Thomas, PLLC for attorney fees satisfies ETEIA’s obligation to reimburse the Teachers Retirement System of Texas (TRS) and Blue Cross Blue Shield (BCBS) for the medical bills and expenses that they paid to the health care providers who rendered and provided medical treatment to [Jones] for her May 22, 2008 compensable injury. TRS and BCBS will be entitled to no other monies for the medical bills it paid or for any other medical bills submitted to it for medical treatment received by [Jones] as a result of her May 22, 2008 compensable injury.

Jefferson County Lawsuit and ETEIA’s Subrogation Claim

The record before us shows that on January 23, 2017, the Jones Plaintiffs filed

their First Amended Petition in Intervention in the Jefferson County Lawsuit, and on

June 28, 2021, ETEIA filed its Second Amended Petition in that same lawsuit. 2 The

Jones Plaintiffs assert that Intervenor ETEIA should be required to prove all the

benefit payments, and if the Jones Plaintiffs recover anything as a result of the

lawsuit, that Intervenor ETEIA “should pay an attorney fee up to 33 and 1/3% of

such recovery to plaintiffs’ counsel, and pay a proportionate share of expenses

incurred by plaintiff in prosecution of this suit, as permitted by the Texas Labor

Code.” In its Second Amended Petition in Intervention, ETEIA pleads that its total

lien amount is $820,065.59, which includes: $17,221.45 in temporary income

2 These are the only petitions in intervention in the record. 5 benefits (TIBs) to Jones’s estate; $402,594.14 in death income benefits (DIBs) to

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East Texas Educational Insurance Association v. Sanford Jones and James Thomas Lyle, as Independent of the Estate of Mary Louise Jones, and Next Friend of J.L., a Minor, Counsel Stack Legal Research, https://law.counselstack.com/opinion/east-texas-educational-insurance-association-v-sanford-jones-and-james-txctapp9-2026.