Hermann Hospital v. National Standard Insurance Co.

776 S.W.2d 249, 1989 Tex. App. LEXIS 1887, 1989 WL 80719
CourtCourt of Appeals of Texas
DecidedJuly 20, 1989
Docket01-88-00854-CV
StatusPublished
Cited by47 cases

This text of 776 S.W.2d 249 (Hermann Hospital v. National Standard 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
Hermann Hospital v. National Standard Insurance Co., 776 S.W.2d 249, 1989 Tex. App. LEXIS 1887, 1989 WL 80719 (Tex. Ct. App. 1989).

Opinion

OPINION

WARREN, Justice.

This is an appeal from a summary judgment granted against appellant, Hermann Hospital.

Appellant sued appellees, alleging three causes of action: (1) misrepresentation and deceptive trade practices under art. 21.21 of the Texas Insurance Code; (2) negligent misrepresentation under Texas common law; and (3) estoppel. Appellees moved for summary judgment, based on the pleadings, which was granted by the trial court. On appeal, appellant contends that the trial court erred in granting summary judgment as to each of its causes of action.

On June 17, 1978, Jose Carreon was stabbed by a fellow worker while working for his employer, Cafeterias, Inc. d/b/a Romano Cafeteria # 7. He was taken to, and treated at, Memorial Hospital. In September 1978, Memorial Hospital sought to transfer Carreon to Hermann Hospital (appellant) for further care and treatment. Appellees paid Memorial for its services. Three months after Carreon was injured, on September 18 and 20, 1978, and prior to accepting the transfer of Carreon, appellant verified insurance coverage with appel-lees’ agents, employees, or representatives for its care and treatment of Carreon. On September 20, 1978, after verifying coverage, appellant accepted the transfer of Car-reon. Appellant again verified insurance coverage with appellees on October 16, 1978. Thereafter, later in October 1978, appellees denied that there was insurance coverage for the injury sustained by Car-reon and refused to pay appellant for the expenses incurred. Appellant asserts that it relied on the representation of coverage in accepting the transfer of Carreon and that it incurred expenses of $217,444.90 in its care and treatment of Carreon.

Appellees dispute the nature of their communications with appellant, specifically, whether appellees advised appellant that Carreon had sustained a compensable injury or merely that he was an employee of its covered insured. Appellees contend that they never told appellant that the injury sustained by Carreon was a compensar ble injury, or that they would assume any responsibility for the consequent medical bills. Because this is an appeal from a summary judgment, evidence that favors the movant’s position will not be considered unless it is uncontroverted. Great American Reserve Ins. Co. v. San Antonio Plumbing Supply Co., 391 S.W.2d 41, 47 (Tex.1965).

Appellees moved for summary judgment contending that: (1) appellant did not have standing under the Deceptive Trade Practices — Consumer Protection Act, Tex.Bus. & Com.Code Ann., sec. 17.41 et seq. (Vernon Supp.1989) (“DTPA”) or the Texas Insurance Code, art. 21.21 (Vernon 1981); (2) the misrepresentations made by appellees after the sale of the insurance policy to Carreon’s employer are “post-loss” misrepresentations and therefore, are not actionable under art. 21.21; (3) there was no legal duty flowing from appellees to appellant; and (4) “estoppel,” by itself, is not a viable cause of action.

A defendant who moves for summary judgment has the burden of showing, as a matter of law, that no material issue of fact exists as to the plaintiff’s cause of action. Griffin v. Rowden, 654 S.W.2d 435, 435-36 (Tex.1983). This may be accomplished by showing that at least one element of each of the plaintiff’s causes of action has been established conclusively against the plaintiff. Gray v. Bertrand, 723 S.W.2d 957 (Tex.1987). Once the defendant has negated, as a matter of law, such elements of plaintiff’s cause of action, the plaintiff has the burden of introducing *251 evidence that raises issues of fact with respect to the elements negated by the defendant’s summary judgment evidence. Federated Dep’t Stores, Inc. v. Houston Lighting & Power Co., 646 S.W.2d 509, 511 (Tex.App.—Houston [1st Dist.] 1982, no writ). As the summary judgment order does not state the specific grounds upon which it is granted, appellant must show that each of the independent arguments alleged in the motion is insufficient to support the order. Tilotta v. Goodall, 152 S.W.2d 160, 161 (Tex.App.—Houston [1st Dist.] 1988, writ denied).

We first address appellant’s argument under the Texas Insurance Code, which requires us to decide whether appellant has standing to bring a cause of action, under art. 21.21, sec. 16(a) of the Texas Insurance Code Annotated. In its first point of error, appellant complains that the trial court erred in rendering summary judgment against it, and in dismissing its claim under the art. 21.21 of the Texas Insurance Code. Specifically, appellant argues that: (1) it is not required to establish “consumer” status to obtain standing under art. 21.21, as argued by appellees in their motion for summary judgment 1 ;(2) appellees’ violations of art. 21.21 were actionable deceptive or unfair acts or practices; and (3) appellant has a private cause of action for appellees’ violation of State Board of Insurance Rules and Regulations.

In its second amended petition, appellant asserted a cause of action against appellees for unfair or deceptive acts or practices pursuant to Tex.Ins.Code Ann. art. 21.21.:

Sec. 16(a) Any person who has been injured by another’s engaging in any of the practices declared in Section 4 of this Article or in rules or regulations lawfully adopted by the Board under this Article to be unfair methods of competition and unfair and deceptive acts or practices in the business of insurance or m any practice defined by Section 17.46 of the Business and Commerce Code, as amended, as an unlawful deceptive trade practice may maintain an action against the company or companies engaging in such acts or practices.

(Emphasis ours). Appellant alleged that it was a corporation and argues that sec. 16(a) provides a remedy for “any person” injured by the conduct of one in the insurance business. Person is defined in section 2 of the Act:

Sec. 2. When used in this Act:
(a) “Person” shall mean any individual, corporation, association, partnership, reciprocal exchange, inter-insurer, Lloyds insurer, fraternal benefit society, and any other legal entity engaged in the business of insurance including agents, brokers, adjusters and life insurance counselors.

The Texas Supreme Court, in 1978, held that this statute does not require that the injured party be a person who is engaged in the business of insurance. Ceshker v. Bankers Commercial Life Ins. Co., 568 S.W.2d 128, 129 (Tex.1978). More recently, it held that the statute does not require the injured party be a consumer of goods or services before he can recover under this statute. Aetna Casualty & Surety Co. v. Marshall, 724 S.W.2d 770, 772 (Tex.1987). Nevertheless, appellees contend appellant has no standing, citing Chaffin v. Transamerica Ins. Co.,

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Bluebook (online)
776 S.W.2d 249, 1989 Tex. App. LEXIS 1887, 1989 WL 80719, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hermann-hospital-v-national-standard-insurance-co-texapp-1989.