Group Hospital Service Inc. v. State Farm Insurance Co.

517 S.W.2d 897, 1974 Tex. App. LEXIS 2873
CourtCourt of Appeals of Texas
DecidedDecember 20, 1974
Docket4754
StatusPublished
Cited by4 cases

This text of 517 S.W.2d 897 (Group Hospital Service Inc. v. State Farm 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
Group Hospital Service Inc. v. State Farm Insurance Co., 517 S.W.2d 897, 1974 Tex. App. LEXIS 2873 (Tex. Ct. App. 1974).

Opinion

WALTER, Justice.

Group Hospital Service, Inc. and Group Life & Health Insurance Company brought suit against State Farm Insurance Company to enforce their contractual subrogation rights under an applicable Blue Cross-Blue Shield insurance policy. The only evidence introduced in their non-jury trial was the following stipulation:

“Comes now Group Hospital Service, Inc. and Group Life & Health Insurance Company, hereinafter referred to as Plaintiffs, and State Farm Insurance Company, hereinafter referred to as Defendant and both Plaintiffs and Defendant being hereinafter referred to as the *898 parties, would respectfully show to the Court that they stipulate and agree that the following facts are true and correct in every respect, to-wit:
1. That Group Hospital Service, Inc., is an insurance company licensed to do business in the State of Texas.
2. That Group Life and Health Insurance Company is an insurance company licensed to do business in the State of Texas.
3. That Group Hospital Service, Inc. does business in the State of Texas under the name Blue Cross of Texas and writes hospitalization insurance.
4. That Group Life and Health Insurance Company does business in the State of Texas under the name Blue Shield of Texas and writes insurance covering medical payments.
5. That prior to August 21, 1971, Plaintiffs issued their Joint Certificate of Coverage No. 436-30-6861 to James E. Teer.
6. That such certificate was issued pursuant to the terms of a policy of group insurance issued by Plaintiff to Ling-Temco-Vought, Inc., which policy, under the General Provisions, paragraph P of Article XI states:
‘P. SUBROGATION: The Carrier shall be subrogated to all rights of recovery which any insured person may acquire against any person or organization for negligence or any willful act resulting in illness or injury for which benefits are provided hereunder, but only to the extent of the benefits so provided. Any insured person, by receiving benefits hereunder in such case, shall be deemed to have assigned such rights of recovery to the Carrier and to have agreed to do whatever may be necessary to secure the recovery, including execution of all appropriate papers.’
7. That the premiums for said policy are fully paid by Ling-Temco-Vought, Inc.
8. That prior to August 21, 1971, James E. Teer duly enrolled his wife, Helen L. Teer, for the coverage under and in accordance with the terms of said policy.
9. That on August 21, 1971, Plaintiffs’ Joint Certificate No. 436-30-6861 was in effect with respect to said Helen L. Teer.
10. That on August 21, 1971, an automobile driven by Helen L. Teer was involved in a collision with an automobile driven by John Thomas Bowers.
11. That the automobile driven by Mrs. Teer and involved in such collision was a 1969 Mercury Montego 4-door sedan.
12. That Mrs. Teer was the owner of said automobile.
13. That the automobile driven by Bowers and involved in such collision was a 1969 Ford XL 2-door sedan.
14. That Bowers was the owner of said automobile.
15. That on August 21, 1971, said automobile owned by Bowers was covered by a policy of liability insurance issued by Defendant State Farm Insurance Company.
16. That the accident in question occurred in the 2400 block of West Marshall Street in the City of Grand Prairie, Tarrant County, Texas.
17. That the accident in question between the vehicle driven by John Thomas Bowers and the vehicle of Helen L. Teer resulted solely from the negligent conduct of John Thomas Bowers.
18. That the negligence of John Thomas Bowers on the occasion in *899 question was the proximate cause of the accident in question and resulting injuries sustained by Helen L. Teer.
19. That Helen L. Teer was injured as a result of said collision.
20. That as a result of the injuries sustained in said collision, Mrs. Teer was hospitalized and required medical treatment.
21. That James E. Teer filed a claim with Plaintiffs for payment of expenses incurred in connection with the hospitalization and medical treatment of his wife.
22. That the amount of such expenses paid by Plaintiffs pursuant to said claim filed by James E. Teer was $2,433.80.
23. That the amount of expenses paid by Plaintiffs for the hospital and medical treatment of Helen L. Teer were reasonable and necessary as a result of the accident brought about by the negligence of John Thomas Bowers.
24. That on November 11, 1971, the Plaintiffs by mail advised the Defendant of its reservation of its right to subrogation under its contract and placed the Defendant on notice of their subrogation interest and asked that the Defendant protect its subrogation interests in any settlement made on behalf of the Defendant’s insured with Helen L. Teer.
25. That by letter of November 18, 1971, the Defendant advised the Plaintiffs that it would not honor their sub-rogation claim.
26. That subsequent to November 18, 1971, and in spite of the fact that the Defendant was on notice of the subrogation claim asserted by the Plaintiffs, the Defendant paid to James E. Teer and Helen L. Teer a sum of money in full and final settlement of the claim of Helen L. Teer against James Thomas Bowers for injuries sustained in the collision referred to in stipulation 10 above and received a full release of further liability therefor.
27.That the sum of money paid by the Defendant to James E. Teer and Helen L. Teer in settlement of her claim against James Thomas Bowers was in excess of $2,433.80.”

The Court concluded that the subrogation provision in the insurance policy was'void and rendered a take nothing judgment against the plaintiffs. They have appealed.

We agree with appellants’ contentions that their right of subrogation is valid and enforceable and the enforcement of same is not against public policy. Appellee relies on United States Fidelity & Guaranty Co. v. Valdez, 390 S.W.2d 485 (Tex.Civ.App.-Houston 1965, writ ref. n. r. e.). The court said:

“ . . . the Court held that the statutory right of subrogation did not apply to the carrier under a policy of voluntary Workman’s Compensation, and that it was not therefore subrogated to the rights of the injured party against the third party tort-feasor.”

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Cite This Page — Counsel Stack

Bluebook (online)
517 S.W.2d 897, 1974 Tex. App. LEXIS 2873, Counsel Stack Legal Research, https://law.counselstack.com/opinion/group-hospital-service-inc-v-state-farm-insurance-co-texapp-1974.