in Re: Home State County Mutual Insurance Company
Opinion
NO. 12-07-00033-CV
IN THE COURT OF APPEALS
TWELFTH COURT OF APPEALS DISTRICT
TYLER, TEXAS
§
IN RE: HOME STATE COUNTY
MUTUAL INSURANCE COMPANY, § ORIGINAL PROCEEDING
RELATOR
MEMORANDUM OPINION
Home State County Mutual Insurance Company (“Home State”) filed a petition for writ of mandamus challenging the trial court’s denial of its motion to compel real party in interest, George Horn, Jr., to produce medical records related to Medicare/Medicaid1 payments, if any, he received. We conditionally grant the petition.2
Background
Horn was severely injured in a single vehicle automobile accident. Horn was the passenger. The driver was killed. Prior to filing suit with regard to the automobile accident, Horn’s attorney sent a letter dated June 10, 1999 to Home State, the driver’s insurance provider, in which he offered to settle Horn’s claim for policy limits. He also promised to fully release the insured from all liability and satisfy the hospital lien(s), provided the settlement check was received in his office on or before 5:00 p.m. on June 25, 1999. The letter further stated that Horn’s hospital bills as of the date of the letter totaled $213,971.55.
Home State sent a settlement check to Horn’s attorney, which he refused to accept claiming that it was not received by the deadline set forth in the June 10 letter. Horn subsequently caused an administrator to be appointed for the driver’s estate, sued the administrator, and ultimately recovered a judgment for $10,231,844.06.
Two years later, Horn, as assignee of the administrator of the driver’s estate, sued Home State for unfair settlement practices alleging that it negligently failed to settle a Stowers3 claim. The administrator later joined in the suit. In the course of litigation, Home State sought to conduct discovery concerning, among other things, whether any medical services provided to Horn on or before the June 25, 1999 payment deadline were covered by Medicare.
On February 8, 2006, Home State’s attorney sent a letter to Horn’s attorney requesting that Horn execute a medical records authorization form so that it could determine whether Medicare had paid any of Horn’s medical bills prior to June 25, 1999. On March 10, 2006, Horn filed the following objections to Home State’s letter request: (1) a letter from a party requesting the other party to sign an authorization is not a proper discovery request under the discovery rules; (2) even if Home State’s letter were construed as a production request, Texas Rule of Civil Procedure 196 does not authorize a party to request that another party sign such a medical records authorization form; (3) Texas Rule of Civil Procedure 194, which provides that a party may sign a medical records authorization, is inapplicable to the instant case and does not authorize discovery of Medicare payments of medical records and bills; and (4) the request that Horn sign authorizations for Home State to unilaterally obtain Medicare payment records deprived Horn and the administrator of their right to cross examine the custodian of the records.
On April 5, 2006, Home State filed a motion to compel, in which it outlined its theory of relevance with regard to the medical records it sought. The trial court denied Home State’s motion on April 19, 2006. Thereafter, Home State filed its first petition for writ of mandamus, which this court denied.
While the first petition for writ of mandamus was pending, Home State sent a request for production of documents to Horn. By its request, Home State sought production of, among other things, Horn’s medical records to determine if Medicare had made any payments on his behalf before the June 25 deadline Horn imposed in his settlement offer. In July 2006, Horn initially responded to the requests by stating, “See response to Defendant’s Deposition on Written Questions to the Custodian of Records of Memorial Medical Center of East Texas.”
Apparently dissatisfied with Horn’s response to its request, Home State filed a motion to compel arguing that the information sought was relevant because if Medicare covered any medical services provided to Horn, it would have a claim that amounted to a lien against Horn’s settlement proceeds. Therefore, Home State contended, since Horn’s offer to settle did not offer to satisfy Medicare’s claim, it failed to offer a full release from all potential claims and, thus, did not impose a Stowers duty on Home State.4
In December 2006, Horn amended his responses to include several objections. Specifically, Horn objected that the requests were not timely and constituted a fishing expedition. The trial court conducted a hearing on Home State’s motion to compel on December 8, 2006 and denied the motion on that same day. Home State then filed the instant petition for writ of mandamus.5
Availability of Mandamus
Mandamus will issue to correct a clear abuse of discretion where there is no adequate remedy by appeal. In re Cerberus Capital Mgmt., L.P., 164 S.W.3d 379, 382 (Tex. 2005); Walker v. Packer, 827 S.W.2d 833, 839–40 (Tex. 1992). The trial court abuses its discretion if it reaches a decision so arbitrary and unreasonable as to amount to a clear and prejudicial error of law or if it clearly fails to correctly analyze or apply the law. Id.
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