Performance Insurance Co. v. Frans

902 S.W.2d 582, 1995 WL 147052
CourtCourt of Appeals of Texas
DecidedMay 19, 1995
Docket01-93-00314-CV
StatusPublished
Cited by14 cases

This text of 902 S.W.2d 582 (Performance Insurance Co. v. Frans) 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
Performance Insurance Co. v. Frans, 902 S.W.2d 582, 1995 WL 147052 (Tex. Ct. App. 1995).

Opinion

OPINION

LEE DUGGAN, Jr., Justice (Retired) * .

This appeal involves a workers compensation insurance carrier, which paid death benefits to a covered employee’s survivors and beneficiaries and thereafter intervened in a suit filed by the survivors and beneficiaries against alleged third party tortfeasors. The carrier appeals the trial court’s judgment approving a settlement and apportioning the settlement proceeds. In three points of error, the carrier complains that the trial court’s apportionment (1) improperly reduced the carrier’s subrogation recovery and statutory credit; (2) improperly allowed a transfer from one beneficiary to another; and (3) improperly awarded attorney’s fees.

We reverse and remand.

Summary of Facts

The facts are undisputed. Appellant and intervenor below, Performance Insurance Company (the carrier), is the successor in *584 interest to Texas Employers Insurance Association, the workers compensation carrier for Western Electric, the employer of Michael D. Frans, deceased. Mr. Frans was initially injured in the course and scope of his employment. He ultimately died, allegedly from complications following back surgery performed by two physicians, the settling defendants in the underlying medical malpractice case.

Appellee, Shirley Frans, individually and as guardian and next friend of Michael D. Frans, Jr., a minor, and as administratrix and personal representative of the Estate of Michael D. Frans, Sr., Deceased, is the settling plaintiff who represents the deceased worker’s statutory beneficiaries in the underlying suit against the two doctors. At the time of settlement, the carrier’s workers compensation lien was $104,404, of which $61,751 was attributable to Ms. Frans and $42,652 was attributable to her son.

At the settlement hearing, and over the objection of the carrier, the trial court approved a proposed settlement of $200,000 from the defendant physicians, and apportioned the settlement proceeds between Ms. Frans and Michael, Jr., before reimbursing the carrier. At the request of Ms. Frans, her attorney, and the settling defendants’ attorney, the trial court approved an apportionment of $180,000 to Ms. Frans in her individual capacity and as representative of the estate of Michael D. Frans, Sr., and $20,000 to Michael in his individual capacity.

Attorneys for Ms. Frans and the defendants characterized the payment as “two settlements.” The attorney for the defendants stated, “I have a settlement of $20,000 with the minor. I have a settlement of $180,000 with the estate and with the widow. I do not have one settlement, I have two settlements _” As a part of the settlement, Ms. Frans testified that she planned to pay $4,000 of her recovery into a chapter 142 trust 1 for Michael, Jr.’s benefit, along with $16,000 to be paid into the trust by one of the attorneys from his attorney’s fees.

Apportionment of Settlement Funds

By its first point of error, Performance Insurance asserts the trial court erred in apportioning the settlement in a manner that reduced the carrier’s statutory lien.

The events in this cause of action are governed by former Tex.Rev.Civ.Stat.Ann. art. 8307, § 6a(a). 2 Section 6a(a), provides in pertinent part that:

If the claimant is a beneficiary under the death benefits provisions ... a judgment shall not constitute an election but the amount of such recovery shall first pay costs and attorney’s fees and then reimburse the association, and if there be any excess it shall be paid to the beneficiaries in the same ratio as they received death benefits and the association shall suspend further payments of benefits until the suspended benefits shall equal the amount of such excess at which time benefits shall be resumed.

Article 8307, section 6a(a) allows an injured employee to proceed against a third-party tortfeasor without precluding a claim against the employer’s compensation carrier. Watson v. Glens Falls Ins. Co., 505 S.W.2d 793, 795 (Tex.1974); Home Indem. Co. v. Pate, 866 S.W.2d 277, 280 (Tex.App.—Houston [1st Dist.] 1993, no writ); Home Indem. Co. v. Pate, 814 S.W.2d 497, 498 (Tex.App.—Houston [1st Dist.] 1991, writ denied). The claimant, however, is prevented from obtaining a double recovery because the carrier is entitled to recoup its claim to the extent of all compensation paid. Fort Worth Lloyds v. Haygood, 151 Tex. 149, 246 S.W.2d 865, 869 (1952); Pate, 814 S.W.2d at 498.

The carrier has a statutory right to reimbursement from the first monies paid to an injured employee or his representatives by a third-party tortfeasor, up to the amount of compensation paid, and can recover the amount from the employee or the third-party tortfeasor. Watson, 505 S.W.2d at 795; Fort Worth Lloyds, 246 S.W.2d at 870, Pate, 814 *585 S.W.2d at 498. The employee or his representatives have no right to any of the funds received from the third-party tortfeasor until the carrier receives payment in full. Capitol Aggregates, Inc. v. Great Am. Ins. Co., 408 S.W.2d 922, 923 (Tex.1966); Insurance Co. of North America v. Wright, 886 S.W.2d 337, 341 (Tex.App.—Houston [1st Dist.] 1994, no writ). When a third-party tortfeasor pays a settlement or judgment to an employee who has been receiving workers’ compensation benefits, the tortfeasor and the employee are jointly and severally liable to the compensation carrier for its entire subrogation claim. Watson, 505 S.W.2d at 795.

The statutory scheme reduces the burden of insurance to the employer and to the public by preventing an employee from retaining proceeds from a settlement in addition to his compensation benefits while the carrier is only partially reimbursed for what it has paid. Wright, 886 S.W.2d at 341. A workers compensation carrier’s right to reduce its liability because of the payment of a third party must not be compromised. Id.

Mrs. Frans and Michael, Jr. are “claimants” and “beneficiaries” under the death benefits provisions of article 8307, section 6a(a). In addition, Mrs. Frans acted as the deceased employee’s “representative” in the settlement by the third parties for the deceased employee’s injuries. See Capitol Aggregates, Inc., 408 S.W.2d at 923. As such, under the clear language of section 6a(a), she obtained a “recovery” which the statute says “shall first pay costs and attorney’s fees and then reimburse the association,

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Cite This Page — Counsel Stack

Bluebook (online)
902 S.W.2d 582, 1995 WL 147052, Counsel Stack Legal Research, https://law.counselstack.com/opinion/performance-insurance-co-v-frans-texapp-1995.