Northwinds Abatement v. Employers Ins Wausau

CourtCourt of Appeals for the Fifth Circuit
DecidedJuly 27, 2001
Docket00-20380
StatusPublished

This text of Northwinds Abatement v. Employers Ins Wausau (Northwinds Abatement v. Employers Ins Wausau) is published on Counsel Stack Legal Research, covering Court of Appeals for the Fifth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Northwinds Abatement v. Employers Ins Wausau, (5th Cir. 2001).

Opinion

Revised July 27, 2001

UNITED STATES COURT OF APPEALS FOR THE FIFTH CIRCUIT

_______________________

No. 00-20380

NORTHWINDS ABATEMENT, INC.

Plaintiff-Appellee,

versus

EMPLOYERS INSURANCE OF WAUSAU,

Defendant-Appellant.

______________________________________________________________

Appeal from the United States District Court for the Southern District of Texas _________________________________________________________________

July 11, 2001

Before KING, Chief Judge, REAVLEY and JONES, Circuit Judges.

EDITH H. JONES, Circuit Judge:

In the second appearance of this case before us on

appeal, Employers Insurance of Wausau (“Wausau”) appeals a jury

verdict in favor of Northwinds Abatement, Inc. (“Northwinds”) and

the resulting judgment of nearly $1.1 million, including actual and

treble damages, attorney’s fees, interest and costs. Wausau

asserts that, as a servicing company, it was an agent of the Texas

Workers’ Compensation Insurance Facility (the “Facility”) and

therefore exempt from liability claims pursuant to now-superseded Article 5.76-2, § 2.12 of the Texas Insurance Code. We disagree,

and affirm the district court’s holding that Wausau is not an agent

of the Facility. Wausau also argues that the claims underlying the

jury verdict are all invalid as a matter of law. Wausau is in part

correct, but under Texas law both the Texas Deceptive Trade

Practices Act (“DTPA”) and Insurance Code claims are viable, and we

must affirm the judgment on these extra-contractual claims.

Finally, although the award of statutory attorneys’ fees to

Northwinds is high, it is not reversible. The judgment is

AFFIRMED.

BACKGROUND

Northwinds is a corporation engaged in the hazardous

business of asbestos abatement, remediation and removal work.

Unable to obtain workers’ compensation insurance on the open

market, it applied for and received coverage through the Texas

Workers Compensation Insurance Facility, a private, nonprofit,

unincorporated association of insurers created by statute with the

purpose, inter alia, of providing coverage for employers who are

unable to obtain insurance in the voluntary insurance market.1 The

1 The Texas statutes establishing an insurer of last resort for workers compensation insurance have been the subject of frequent revision and redrafting. The Facility was formerly known as the Texas Workers’ Compensation Assigned Risk Pool, with the Facility replacing the Risk Pool on January 1, 1991. See Tex. Ins. Code Ann. art. 5.76-2 (Vernon 1991)(amended 1993 and repealed 1997, now Tex. Ins. Code Ann. art. 21.28-C (Vernon 2000)). On January 1, 1994, the Texas Workers’ Compensation Insurance Fund replaced the Facility as the insurer of last resort. See id. (1993 revision). While the Fund retained its name, the statutes governing

2 Facility designated Wausau as the primary “servicing company” for

Northwinds and Wausau subsequently issued Northwinds a workers’

compensation policy.2

In 1993 Northwinds filed suit against Wausau for alleged

mishandling of workers’ compensation claims filed by four

Northwinds employees. Northwinds alleged that Wausau paid these

four claims without properly investigating them, thereby causing

increased insurance premiums for Northwinds and a loss of business

due to the customer perception that Northwinds was a safety risk.

Northwinds characterized its claims as raising fraudulent and bad

faith settlement practices, breach of contract, negligence,

violations of the Texas DTPA and violations of the Texas Insurance

Code.

again changed in 1997. See Tex. Ins. Code Ann. art. 5.76-3 and art. 21.28-C §§ 26, 27. (Vernon 2000). 2 The servicing company contracts with the Facility to issue policies evidencing the insurance coverage provided and to service the risk. While the servicing company is the issuer of the policy, the Facility itself is the insurer. The members of the Facility collectively reinsure each policy it issues, dividing reinsurance liability in proportion to premiums received by each member. Notwithstanding its limited liability, the servicing company still performs many of the traditional functions of an insurer. The servicing company issues the policy; investigates, reports, and pays claims; inspects and classifies risks; and provides legal support as required by the policy. See Tex. Ins. Code Ann. art. 5.76-2. The operational mechanics of the Facility are discussed at length in the earlier appeal of this case. See Northwinds Abatement, Inc. v. Employers Insurance of Wausau, 69 F.3d 1304, 1305-06 (5th Cir. 1996)(Northwinds I).

3 Northwinds’ suit was removed to federal court, where

Wausau filed a motion to dismiss for lack of subject matter

jurisdiction, citing Northwinds’ failure to exhaust its

administrative remedies through the Facility and the Texas

Department of Insurance. The district court denied this motion.

Wausau then moved for summary judgment, contending that it was not

liable to Northwinds because it was only a servicing company for

the Facility and not Northwinds’ insurer. When the district court

granted this motion, Northwinds appealed. On appeal, Wausau

renewed its challenge to the district court’s jurisdiction.

This court determined that, pursuant to the doctrine of

primary jurisdiction, the district court had jurisdiction because

the remedies sought by Northwinds could not be provided

administratively. See Northwinds Abatement, Inc. v. Employers

Insurance of Wausau, 69 F.3d 1304 (5th Cir. 1995) (Northwinds I).

However, this court also determined that the district court should

abstain from resolving Northwinds’ claims until certain factual

determinations were made in the administrative proceedings.

Rejecting Northwinds’ claim for breach of the duty of good faith

and fair dealing, the court nevertheless reversed the summary

judgment as to all other claims. See Northwinds I, 69 F.3d at

1311-12.

In September 1998, the district court held that

Northwinds had exhausted all avenues of administrative review, and

the case approached trial. Wausau filed a last-minute motion for

4 summary judgment, asserting that it was an agent of the Facility

and, as such, protected from liability under Article 5.76-2, § 2.12

of the Texas Insurance Code. After supplemental briefing on the

issue, the district court denied the motion, and the case went to

trial.

The jury returned a verdict in favor of Northwinds on all

claims except that for breach of contract. The jury awarded actual

damages of $19,234.95 for the increased premiums Northwinds was

forced to pay, $55,335.49 for attorneys’ fees incurred in defending

the lawsuit initiated against it by the Facility at Wausau’s

urging, and $712,000 in attorneys’ fees incurred in the federal

suit against Wausau. The district court entered a judgment

awarding Northwinds $74,570 in actual damages, $223,711.32 in

treble damages, $712,000 in attorneys’ fees, prejudgment interest

on the actual damages, post-judgment interest, and costs. Wausau

now appeals.

WAUSAU AS AN “AGENT” OF THE FACILITY

Wausau first argues that as a servicing company, it is an

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