Pain Control Institute, Inc. v. Geico General Insurance Company

447 S.W.3d 893, 85 U.C.C. Rep. Serv. 2d (West) 53, 2014 Tex. App. LEXIS 11877, 2014 WL 5474777
CourtCourt of Appeals of Texas
DecidedOctober 29, 2014
Docket05-13-01418-CV
StatusPublished
Cited by10 cases

This text of 447 S.W.3d 893 (Pain Control Institute, Inc. v. Geico General Insurance Company) 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
Pain Control Institute, Inc. v. Geico General Insurance Company, 447 S.W.3d 893, 85 U.C.C. Rep. Serv. 2d (West) 53, 2014 Tex. App. LEXIS 11877, 2014 WL 5474777 (Tex. Ct. App. 2014).

Opinion

OPINION

Opinion by Justice Fillmore

This appeal arises from a lawsuit brought by Pain Control Institute, Inc. (PCI) directly against GEICO General Insurance Company (GEICO), the automobile liability insurer of a driver who allegedly injured PCI’s patient in a motor vehicle accident. PCI seeks payment for chiropractic treatment provided to its patient. Neither the driver of the vehicle nor PCI’s patient are parties to this lawsuit. PCI asserts GEICO violated the Texas Uniform Commercial Code (the UCC) by failing to make payment to PCI pursuant to a partial assignment of rights to PCI by its patient. The trial court granted summary judgment in favor of GEICO and denied PCI’s motion for summary judgment. Because Texas is not a direct action state, we affirm the trial court’s judgment.

Background

On May 21, 2009, Jeanette Hooper was involved in a motor vehicle accident with David Cluck. GEICO issued an automobile liability insurance policy to Cluck that was in force on the date of the accident.

Hooper received chiropractic treatment at PCI for injuries she allegedly sustained in the motor vehicle accident. On May 21, 2009, prior to commencing treatment, Hooper signed a “Partial Assignment of the Causes of Action, Assignment of Proceeds Contractual Lien & Authorization” (Assignment). The Assignment provides in part:

I hereby assign to [PCI], insofar as permitted by law, but only to the extent of my Charges, all of my rights, remedies, and benefits relating to any Payer, including ... my right to receive Proceeds from any Payer now or in the future, and any and all causes of action that I might have against any Payer now or in the future, the right to prosecute such causes of action either in my name or in [PCI] ’s name, and the right to settle or otherwise resolve such causes of action as [PCI] sees fit. I further grant a contractual lien to [PCI] with respect to my Charges. I further intend for this Agreement to create a secured interest under the applicable Uniform Commercial Code and hereby direct [PCI] to file the form(s) normally filed with the secretary of state or other governmental agency in order to perfect such lien. Consistent with these provisions, I hereby direct any and all Payers, to pay the Proceeds directly to, immediately to, and exclusively in the name of, [PCI] to the extent of my Charges.

*895 In the Assignment, the term “Payer” is defined as “any insurance carrier, ... at-fault party, individual, and any other entity, which may elect or be obligated to pay or disburse Proceeds to me, either now or in the future, for any reason,” and the term “Proceeds” is defined to “include ... the proceeds from any settlement, judgment, or verdict....”

On May 28, 2009, PCI attempted to perfect the security interest referred to in the Assignment by filing a UCC Financing Statement (the Financing Statement) with the Texas Secretary of State. The Financing Statement identifies Hooper as the debtor and PCI as the secured party. The Financing Statement indicates it “covers the following collateral: Insurance proceeds as defined by law and personal intangibles (including without limit, settlement proceeds) as defined by law.”

In correspondence from PCI to GEICO dated June 2, 2009, PCI advised it was “currently treating [Hooper] for injuries sustained in an automobile accident with your insured. We understand that you are the third-party liability carrier and we will be sending copies of our patient’s medical records and bills to your attention for final settlement.” According to the correspondence, a copy of the Assignment and the Financing Statement “that was filed to perfect our medical lien and various notices regarding our right to direct payment under Texas law” were enclosed.

On August 18, 2009, December 16, 2009, and October 25, 2010, PCI forwarded correspondence to GEICO advising PCI had completed treatment of Hooper for injuries she allegedly sustained in the motor vehicle accident with Cluck. According to those letters, copies of medical and billing records for Hooper’s treatment were enclosed “for final settlement,” and the Financing Statement was also enclosed.

In exchange for consideration of $7,000, Hooper signed a “Release in Full of All Claims” (Release) on April 13, 2011, releasing and discharging Cluck and GEICO from any claim of injury or cause of action arising out of the May 21, 2009 motor vehicle accident. In the Release, Hooper acknowledged that liability for the motor vehicle accident was denied by Cluck and GEICO, and she agreed that the Release and settlement were not to be construed as an admission of liability on the part of Cluck or GEICO.

On April 16, 2012, PCI sent correspondence to GEICO stating its understanding that GEICO had settled with Hooper and paid settlement proceeds directly to Hooper’s attorney without including PCI’s name on the settlement check “in spite of the fact that [PCI has] a lien on this case.” In the correspondence, PCI advised it had unsuccessfully attempted to collect payment for Hooper’s medical treatment from Hooper’s attorney. PCI asserted its belief that GEICO’s actions constituted a breach of an assignment and lien under the UCC. PCI demanded payment of $6,550.72, the “outstanding balance” for treatment rendered to Hooper. In GEICO’s April 24, 2012 telecopied response to PCI, it stated, “Please be advised that this case has resolved with [Hooper]’s attorney and the statatue [sic] of limitations has run.”

On September 4, 2012, PCI filed suit against GEICO asserting GEICO violated the UCC by making payment directly to Hooper and failing to make payment to PCI. 1 PCI sought damages of $6,550.72 *896 and attorney’s fees. In a verified pleading, GEICO denied it was liable to PCI in the capacity in which it had been sued. In that pleading, GEICO also asserted as affirmative defenses the two-year statute of limitations, and a statutory bar under sections 146.002 and 146.003 of the civil practice and remedies code resulting from PCI’s failure to timely bill Medicare for the medical services it rendered to Hooper.

PCI filed a combined traditional and no-evidence motion for summary judgment, contending GEICO violated section 9.406(a) of the UCC by failing to make payment of insurance proceeds to PCI under a valid and enforceable assignment. PCI asserted in its traditional motion for summary judgment that there was no genuine issue of material fact regarding each and every element of its cause of action, and that it was entitled to judgment as a matter of law. PCI’s traditional motion also claimed that “[a]n assignee may sue the insurance carrier directly for a violation of an assignment.” PCI asserted in its no-evidence motion for summary judgment that GEICO “failed to offer any evidence to support its denial that it is not liable in the capacity in which it has been sued.”

GEICO also moved for summary judgment.

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447 S.W.3d 893, 85 U.C.C. Rep. Serv. 2d (West) 53, 2014 Tex. App. LEXIS 11877, 2014 WL 5474777, Counsel Stack Legal Research, https://law.counselstack.com/opinion/pain-control-institute-inc-v-geico-general-insurance-company-texapp-2014.