Rebecca Gallardo v. Insurance Company of the State of Pennsylvania

Court of Appeals of Texas·Decided February 19, 2015·No. 13-14-00132-CV·Published

Opinion

NUMBER 13-14-00132-CV

COURT OF APPEALS

THIRTEENTH DISTRICT OF TEXAS CORPUS CHRISTI - EDINBURG REBECCA GALLARDO, Appellant, v.

INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA, Appellee.

On appeal from the County Court at Law No. 2 of Nueces County, Texas.

MEMORANDUM OPINION

Before Justices Benavides, Perkes, and Longoria Memorandum Opinion by Justice Benavides Rebecca Gallardo, proceeding pro se, appeals a summary judgment rendered

against her regarding her entitlement to supplemental income benefits. In a separate opinion issued this same date, we have determined that part of the summary judgment order is void and have directed the trial court to withdraw that part of the summary

judgment order. See In re Gallardo, No. 13-14-00203-CV, 2015 WL ___, at *_ (Tex. App.—Corpus Christi Jan. _, 2015, orig. proceeding) (mem. op.). We affirm the remainder of the summary judgment order in this appeal.

I. BACKGROUND

On June 2, 2008, Gallardo sustained a work-related injury for which she sought workers’ compensation benefits. Insurance Company of the State of Pennsylvania (“ICSOP”) was Gallardo’s employer’s workers compensation insurance carrier. Through a series of contested case hearings, the Texas Department of Insurance, Division of Workers’ Compensation (“Division”), concluded that Gallardo was not entitled to receive supplemental income benefits.1 In February 2011, Gallardo filed a suit for judicial review of the Division’s decisions on her first, second, third, and fourth-quarter supplemental income benefits. This case was filed in cause number 2011-CCV-60284-A in County Court at Law Number One of Nueces County, Texas. Gallardo and ICSOP settled the claims in that case by Rule 11 agreement dated February 1, 2012. See TEX. R. CIV. P. 11 (“Unless otherwise provided in these rules, no agreement between attorneys or parties touching any suit pending will be enforced unless it be in writing, signed and filed with the papers as part of the record, or unless it be made in open court and entered of record.”). The settlement agreement provided, in relevant part:

1 Supplemental income benefits provide long-term disability compensation. See TEX. LAB. CODE ANN. § 408.142 (West, Westlaw through 2013 3d C.S.); Rodriguez v. Serv. Lloyds Ins. Co., 997 S.W.2d 248, 253 (Tex. 1999). To be entitled to supplemental income benefits, the claimant has the burden of establishing that the claimant: (1) has an impairment rating of fifteen percent or more from a compensable injury; (2) has not returned to work or has returned to work earning less that eighty percent of the claimant's average weekly wage as a direct result of the impairment; (3) has not elected to commute a portion of the impairment income benefit under section 408.128; and (4) has complied with the work search requirements adopted under section 408.1415. TEX. LAB. CODE ANN. § 408.142(a); Daniels v. Indem. Ins. Co. of N. Am., 345 S.W.3d 736, 740 n.4 (Tex. App.—Dallas 2011, no pet.).

The parties have agreed as follows:

1. Plaintiff is entitled to Supplemental Income Benefits for the first quarter, second quarter[,] and third quarter.

2. Plaintiff is not entitled to Supplemental Income Benefits for the fourth, fifth, sixth, seventh[,] or eighth quarter.

3. Plaintiff’s attorney[‘s] fees and expenses are capped at $12,500.00[.]

4. The Parties agree to cooperate with each other in order to ensure that all necessary paperwork, including a DWC-24 [benefit dispute agreement] covering the 5, 6, 7[,] and 8th quarters, is timely submitted and approved by TDI-DWC.

On April 12, 2012, the trial court signed a final judgment in accordance with the settlement agreement. The judgment provided, in relevant part, that Gallardo was entitled to supplemental income benefits for the first, second, and third quarters, but was not entitled to benefits for the fourth quarter. The judgment did not address Gallardo’s entitlement to the fifth, sixth, seventh, or eighth quarter benefits. ICSOP paid Gallardo first, second, and third quarter supplemental income benefits.

Pursuant to the agreement, the parties executed a proposed DWC-24 Form on February 6, 2012, and submitted it to the Division for review on May 10, 2012. On May 15, 2012, the Division’s Benefit Review Officer denied approval of the DWC-24 benefit dispute agreement by correspondence to the parties stating:

Please take notice that I have denied the DWC-24 as submitted on 05/10/12 by the parties. The agreement as submitted includes SIBS quarters 5th, 6th, 7th and 8th. The 5th and 6th quarters have previously been scheduled for a BRC, but not the 7th and 8th quarters. In addition, the agreement is signed 02/06/12 and I note that attorney Daniel Home [sic] no longer represents the Claimant. A party should request dispute resolution so all quarters noted herein can be addressed, and that the Division may be assured that these are the terms agreed to by all parties.

I realize the 02/06/12 DWC-24 was part of another agreement outside the Division jurisdiction; therefore, if the parties wish to sign another

agreement, all issues can be properly resolved at a BRC.

In July 2012, ICSOP filed suit against Gallardo and her former counsel in trial court cause number 2012-CCV-61313-2 in the Court at Law No. 2 of Nueces County, alleging that Gallardo and her former counsel breached the settlement agreement because they refused to cooperate in executing a new DWC-24 for submission to the Division.2 This trial court proceeding gave rise to this appeal and the related petition for writ of mandamus. ICSOP’s causes of action against Gallardo and her counsel included breach of contract, conversion, and fraud in the inducement. ICSOP further sought specific performance of the settlement agreement. Gallardo filed an original answer to ICSOP’s petition which included a plea to the jurisdiction, a counterclaim, and a motion for sanctions.

ICSOP filed a motion for traditional and no-evidence summary judgment seeking specific performance of the settlement agreement or the return of the settlement funds. See generally TEX. R. CIV. P. 166a. On December 12, 2013, the trial court held a hearing on ICSOP’s motion for summary judgment, and, on January 24, 2014, the trial court signed an “Order Granting Final Summary Judgment” in favor of ICSOP. In the order granting summary judgment, the trial court concluded that Gallardo breached the settlement agreement and granted specific performance of the settlement agreement. The judgment specifically recites that: (1) Gallardo is entitled to supplemental income benefits for the first, second, and third quarters; (2) Gallardo is not entitled to supplemental income benefits for the fourth, fifth, sixth, seventh, or eighth quarters; (3) Gallardo’s attorney’s fees and expenses were capped at $12,500.00; and (4) Gallardo

2 Gallardo’s former counsel was ultimately non-suited from this case and is not a party to this appeal.

“shall cooperate with ICSOP in order to ensure that all necessary paperwork, including a [DWC-24] covering the fifth, sixth, seventh, and eighth quarters, is timely submitted and approved” by the Division. According to the order, the trial court retained jurisdiction “to enforce the terms of this decree of specific performance through further appropriate proceedings and orders, including, as and if needed, findings and orders of contempt.”

Gallardo appealed the summary judgment in this cause on February 24, 2014 and filed a separate petition for writ of mandamus contending that the trial court lacked jurisdiction over the proceedings on April 1, 2014.

II. STANDARD OF REVIEW

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