in Re Bison Building Materials, Ltd.

CourtCourt of Appeals of Texas
DecidedJune 26, 2008
Docket01-07-00003-CV
StatusPublished

This text of in Re Bison Building Materials, Ltd. (in Re Bison Building Materials, Ltd.) 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
in Re Bison Building Materials, Ltd., (Tex. Ct. App. 2008).

Opinion

Opinion issued June 26, 2008



In The

Court of Appeals

For The

First District of Texas





NO. 01-07-00003-CV





IN RE BISON BUILDING MATERIALS, LTD., Relator





Original Proceeding on Petition for Writ of Mandamus





* * *

NO. 01-07-00029-CV





BISON BUILDING MATERIALS, LTD., Appellant


V.


TRACY SAMBRANO, Appellee





On Appeal from the 212th District Court

Galveston County, Texas

Trial Court Cause No. 06CV0148





MEMORANDUM OPINION


          Bison Building Materials, Ltd. (Bison) moved to compel arbitration in the trial court and has challenged denial of that request as an abuse of discretion by interlocutory appeal and by petition for a writ of mandamus. See Tex. Civ. Prac. & Rem. Code Ann. § 171.098(a)(1) (Vernon 2005) (authorizing appeal of interlocutory order denying motion to compel arbitration pursuant to Texas General Arbitration Act (TGAA) in accordance with chapter 171 of Civil Practice and Remedies Code, Tex. Civ. Prac. & Rem. Code § 171.001–.098 (Vernon 2005)); In re D. Wilson Constr. Co., 196 S.W.3d 774, 780 (Tex. 2006) (exercising mandamus jurisdiction over order denying motion to compel arbitration pursuant to Federal Arbitration Act (FAA)). Tracy Sambrano is the real-party-in-interest in Cause No. 01-07-00003-CV and the appellee in Cause No. 01-07-00029-CV. Sambrano was an at-will employee of Bison who was injured on the job in early August 2004. Though she received benefits under Bison’s welfare-benefit plan, Sambrano sued Bison, claiming that its negligence caused her injuries. Bison moved to compel arbitration of Sambrano’s claims and now challenges the trial court’s ruling denying that motion.

          We conditionally grant mandamus relief in accordance with FAA preemption and dismiss the interlocutory appeal for lack of jurisdiction.

Background

          Bison is a nonsubscriber under the Workers’ Compensation Act, having elected not to provide workers’ compensation benefits to its employees. See Tex. Lab. Code Ann. § 406.002 (Vernon 2006). Bison chose to adopt, instead, the “Bison Building Materials, Ltd.’s Workplace Injury Plan” (Plan), an employee welfare-benefit plan for its workers. As an employee hired after September 1, 2001, when the Plan became effective, Sambrano was eligible to participate in the Plan on hiring.

          Sambrano applied for at-will employment at Bison on January 29, 2002. On February 13, 2002 she acknowledged receipt of the 15-page “Summary Plan Description” of the Plan. As stated in the summary, the Plan provided for lost income, medical care, and accidental death and dismemberment benefits to workers who sustained “occupational injuries.” The Plan required no contributions by Bison employees, but placed maximum limits on recovery of benefits.


A.      The Plan

          1. General Considerations

          The first page of the Plan summary stated in bold face that the Plan was not a policy of workers’ compensation insurance. The Plan defined eligibility for Plan benefits as “contingent on . . . fulfilling all [Plan] requirements for benefits” and specified that only limited benefits would be payable unless the employee “complied with all of the requirements of the [Plan].” Payment of benefits was further conditioned on the employee’s having sustained an “Occupational Injury,” as defined in the Plan summary. The Plan summary set out the requirements for recovery of the three types of payable benefits, specifically, lost time (income); medical-care; and accidental death, dismemberment, or paralysis.

2. Medical-Care Benefits


          Regarding medical-care benefits, the Plan summary imposed several prerequisites to eligibility for benefits, including the following: “You must sign the Post Injury Waiver and Release in order to be eligible to receive Medical Care Benefits . . . .” This requirement was repeated in a different section of the Plan summary, under the heading “REQUIREMENTS YOU MUST FULFILL FOR BENEFITS” (emphasis in original), which set out five requirements that had to be fulfilled “in order to receive any benefits related to [an employee’s] Occupational Injury.” The third of these requirements was to “Sign a Post Injury Waiver and Release form” (post-injury litigation waiver). By signing a post-injury litigation waiver, an injured employee surrendered the “right to file a legal action against [Bison] for the injury.” The fifth requirement stated in the Plan summary was to “Comply with all the other provisions and rules of the [Plan].”

          3.       Claims Procedures

          The CLAIMS PROCEDURES provisions of the Plan summary also included the requirement to sign the post-injury litigation waiver, under the heading, “1. Making Your Claim” (all emphasis in original). Under the heading, DISQUALIFICATIONS/EXCLUSIONS, the Plan summary listed 13 reasons that would result in lack of benefits. These included both failure to comply with Plan requirements and

[F]il[ing] a legal action against [Bison], the Claims Administrator, the Plan Administrator, or the PLAN for damages related to an Occupational Injury for which the PLAN is providing or may be obligated to provide benefits.

4. Arbitration Sole Remedy for Employees Dissatisfied with Plan Benefits

          Also under the heading, “CLAIMS PROCEDURES” (emphasis in original), the Plan summary outlined a five-step process, from making a claim, acceptance of the claim, or, alternatively, denial of a claim, through mediation and final review. In accordance with the exclusion or disqualification for filing “a legal action,” addressed above, the fifth and final review provisions states,

5.

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