Gonzalez v. CIGNA Insurance Co. of Texas

924 S.W.2d 183, 1996 WL 207573
CourtCourt of Appeals of Texas
DecidedMay 16, 1996
Docket04-95-00590-CV
StatusPublished
Cited by8 cases

This text of 924 S.W.2d 183 (Gonzalez v. CIGNA Insurance Co. of Texas) 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
Gonzalez v. CIGNA Insurance Co. of Texas, 924 S.W.2d 183, 1996 WL 207573 (Tex. Ct. App. 1996).

Opinion

OPINION

STONE, Justice.

This is an appeal from a summary judgment. Appellant, Jose F. Gonzalez, seeks judicial review and reversal of a Texas Workers’ Compensation Commission (“the Commission”) Appeals Panel decision which denied him benefits under the 1989 Act when it ruled that the policy of appellee, CIGNA Insurance Company of Texas (“CIGNA”), was no longer in effect on the date of his injury. This decision reversed the finding of the Commission’s contested case hearing officer who ordered that appellant receive workers’ compensation benefits because he found that workers’ compensation insurance coverage existed between appellant’s employer, Eagle Pass Golden Crossing, Inc., doing business as Golden Fried Chicken (“Golden”), and CIGNA and was in effect on the date of appellant’s injury. Appellant complains on appeal that the trial court erred in: 1) granting summary judgment for the insurance carrier and 2) denying the plaintiff employee’s amended motion for summary judgment and his motion for new trial. We disagree, and affirm the decision of the trial court.

Timeline

May 3, 1991 Golden sent a letter to the Commission which stated that it was canceling workers’ compensation insurance coverage effective Sunday, May 5, 1991. This letter was received by the Commission on May 6, 1991. The letter gave Golden’s name, address, policy number, and carrier’s name, and stated that an Employer notice of “No Coverage” was being posted at the place of business and that each employee was being notified that coverage had been terminated by means of written notice.

May 6, 1991 Date stamps on copies of the transmittal letter and Golden’s Notice of No Coverage indicate that CIGNA received these documents on May 6, 1991. The May 3, 1991 letter and copy of Employer Notice of No Coverage were also sent via facsimile from Golden to CIGNA on May 3, 1991.

*185 May 30, 1991 The Commission received CIGNA’s first cancellation or non-renewal notice for workers’ compensation insurance which gave June 12, 1991 as the date of cancellation. The reason for cancellation was failure to pay interim audit for the period of March 1, 1991 through April 12, 1991. The notice also stated that Golden’s policy continued in effect for 10 days after the notice was mailed to Golden or until the date the policy is canceled, whichever is later. The Cancellation Notice indicates it was sent by certified mail on May 28, 1991.

June 10, 1991 Appellant slipped, fell, and hurt his back while working for Golden at Golden’s place of business. Appellant testified that he immediately notified his supervisor of his injury and received medical treatment for his injury that same day.

June 17, 1991 The Commission received CIGNA’s second cancellation or non-renewal notice for workers’ compensation insurance dated June 13, 1991 which again showed June 12, 1991 as the date of cancellation. This time the reason for cancellation was “at the insured’s request.” The notice also stated: “Your policy continues in effect for [ ] 10 days [ ] 30 days after this notice was mailed to you or until this policy is canceled, whichever is later.” However, the notice did not indicate whether the 10 day or 30 day period applied.

July 11, 1991 The Commission received CIGNA’s third cancellation or non-renewal notice for workers’ compensation insurance dated July 9, 1991 which showed the date of cancellation as May 5, 1991. Again, the reason for cancellation was “at the insured’s request.” The third notice also contained the statement: “Your policy continues in effect for [] 10 days [] 30 days after this notice was mailed to you or until this policy is canceled, whichever is later.” However, the notice did not indicate whether the 10 day or 30 day period applied.

In two points of error, appellant contends that the trial court erred both in granting CIGNA’s summary judgment and in denying his amended motion for summary judgment and his motion for new trial. Appellant claims the sole issue on appeal, as stated by the Commission’s appeals panel, is whether Golden had workers’ compensation insurance coverage on June 10, 1991, the date when appellant suffered his work-related injury.

Appellant contends that Golden’s coverage continued until CIGNA gave notice of cancellation of Golden’s policy under the provisions of Tex.Lab.Code Ann. § 406.008 (Vernon Supp.1996). The Commission’s appeals panel found that Section 406.008 did not apply because the insurance policy was effectively terminated by Golden on June 5, 1991 under the provisions of Texas Labor Code § 406.006, and therefore, CIGNA’s attempts ed cancellation of the policy after that date had no legal effect. The Commission found that: “[CIGNA] could not cancel a policy that had already been canceled by the Employer.” Tex. Workers’ Comp. Comm’n, Appeal of CIGNA from Contested Case Hearing Officer’s Determination of Workers’ Compensation Insurance Coverage, Appeal No. 91086, pages 6-7. (Div. of Hearings and Rev. Jan. 10, 1992) (final order determining coverage). After independent review, we agree that Section 406.008 does not apply.

The Commission’s appeals panel found that appellant was not entitled to workers’ compensation benefits based upon Tex.Lab.Code Ann. § 406.007 (Vernon Supp.1996), which reads as follows:

(a) An employer who terminates workers’ compensation insurance coverage obr tained under this subtitle shall file a written notice with the commission by certified mail not later than the 10th day after the date on which the employer notified the insurance carrier to terminate the coverage. The notice must include a statement certifying the date that notice was provided or will be provided to affected employees under Section 406.005.
(b) The notice required under this section shall be filed with the commission in accordance with Section 406.009.
(c) Termination of coverage takes effect on the later of:
*186 (1) the 30th day after the date of filing of notice with the commission under Subsection (a); or
(2) the cancellation date of the policy.
(d) The coverage shall be extended until the date on which the termination of coverage takes effect, and the employer is obligated for premiums due for that period.

Id. (emphasis added). Golden filed written notice by certified mail with the Commission on May 6, 1991 which notified the Commission that Golden was canceling its workers’ compensation insurance coverage effective May 5, 1991. Further, Golden instructed CIGNA via facsimile on May 3, 1991 to terminate its coverage effective May 5, 1991. Golden complied with 406.007(a) by filing a written notice with the Commission by certified mail within ten days after it notified CIGNA to terminate the coverage. Appellant does not contest that these procedures were followed.

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Cite This Page — Counsel Stack

Bluebook (online)
924 S.W.2d 183, 1996 WL 207573, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gonzalez-v-cigna-insurance-co-of-texas-texapp-1996.