St. Paul Insurance Co. v. McPeak

641 S.W.2d 284, 1982 Tex. App. LEXIS 4978
CourtCourt of Appeals of Texas
DecidedAugust 19, 1982
DocketC2981
StatusPublished
Cited by36 cases

This text of 641 S.W.2d 284 (St. Paul Insurance Co. v. McPeak) 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
St. Paul Insurance Co. v. McPeak, 641 S.W.2d 284, 1982 Tex. App. LEXIS 4978 (Tex. Ct. App. 1982).

Opinions

MILLER, Justice.

This appeal arises from a suit brought under the Workers’ Compensation Act, Tex. Rev.Civ.Stat.Ann. art. 8306, et seq. (Vernon 1967) (hereafter Act), and Article 21.21, § 16 of the Texas Ins.Code (Vernon 1981) (hereafter Section 16). The trial court overruled appellant’s motion to sever the workers’ compensation claim from the other causes of action, and the case proceeded to trial. The jury found appellee totally and permanently disabled under his workers’ compensation claim. The jury also found that appellant had violated the provisions of Article 21.21 by its unfair practices in the business of insurance. The trial court then awarded appellee three times the value of the statutory total and permanent workers’ compensation benefits based on the provisions of Section 16, and attorney’s fees. Judgment was entered and appellant gave timely notice of appeal. We hold that the trial court erred in entering judgment on the authority of Article 21.21 of the Insurance Code, and we reverse.

Appellee sustained a work related injury on March 18, 1980, when the scaffold upon which he was standing collapsed. Appellee consulted a physician who diagnosed the injury as a herniated lumbar disc of the lower back. As a result of the accident and the injury received, appellee filed a claim for disability benefits with appellant, his employer’s compensation carrier. Based on the physician’s report appellant commenced paying weekly disability benefits and medical expenses.

After several months of compensation payments appellant had appellee’s claim reviewed by a private rehabilitation service. Appellee was interviewed by the rehabilitation service and agreed to be examined by an orthopedic surgeon recommended by appellant. This second physician examined appellee and concluded he' had no disability based on the industrial injury. Shortly after receiving this second report appellant terminated the weekly compensation payments and refused to further compensate appellee for any additional medical expenses. The case was brought to the Industrial Accident Board, but could not be resolved at that level. Suit was filed in the District Court, where, in addition to his compensation claim, appellant asserted the cause of action for unfair practices in the termination of his benefits.

[286]*286Appellant and appellee have well briefed and argued this case. They raise the issue of applying a concept of unfair or bad faith settlement practices to the Workers’ Compensation Act. We recently considered this issue in Leroy Massey v. Armco Steel Co., 685 S.W.2d 596 (1982), where a common-law cause of action for bad faith settlement practices in the processing of a workers’ compensation claim was asserted against an employer. This Court found it unnecessary to address the ultimate issue because of the exclusivity clause of the Act which bars a cause of action against employers. This decision was not reached, however, without a vigorous dissent in favor of finding a cause of action.

In the case at bar we are presented with a similar issue asserted through a different mechanism. Here, appellee did not attempt to find a cause of action for unfair/bad-faith practices in the common law, but rather asserted a statutory remedy against the compensation carrier. A statutory cause of action for unfair practices, however, is not found in the Act, so appellee asserted certain “applicable” provisions of the Insurance Code. This commingling of the provisions of the Act and Code forms the basis for appellant’s complaints on appeal, and causes this Court equal concern.

Appellant raises numerous points of error on appeal, none of which concern the jury finding of total and permanent disability. First, appellant claims Article 21.21 does not apply to unfair claims practices and that the acts found by the jury to be unfair did not violate Article 21.21 or the Deceptive Trade Practices — Consumer Protection Act (DTPA), Tex.Bus. & Comm.Code Ann. § 17.41 et seq. (Vernon Supp.1982). Appellant also claims the alleged unfair practices did not cause injury to appellee. Although appellant urges we base our opinion in this area, it presents other points of error which must be first considered, and, if determini-tive, will render a consideration of the first points of error unnecessary.

Through its second point of error, appellant argues the trial court erred in trebling the award of total and permanent disability benefits because actions under the Act and Article 21.21 have separate statutory bases, and the measure for awarding benefits under a workers’ compensation claim and damages under an unfair practices suit are independent and unrelated. The thrust of this argument is that the trial court erred in allowing unfair practice issues to be presented to the jury along with the traditional total and permanent disability issues. Furthermore, appellant argues the trial court erred in taking the statutory award for total and permanent disability and trebling it as damages under Section 16.

The purpose behind the Workers’ Compensation Act is well established. The Act was designed to compensate an injured worker for his loss of earning capacity, and nothing more. Lumbermen’s Mutual Casualty Co. v. Villalpando, 605 S.W.2d 705, 709 (Tex.Civ.App.—Corpus Christi 1980, no writ); Employers Reinsurance Corp. v. Holland, 162 Tex. 394, 347 S.W.2d 605 (1961). It was not intended to compensate an employee for his lost earnings or the injury itself. Id.; Electric Mutual Liability Insurance Co. v. White, 579 S.W.2d 946, 947 (Tex.Civ.App.—Houston [1st Dist.] 1979, no writ). “The object of the statute was to do away with the employer’s common law defenses and to fix the amount recoverable by the employee free from any uncertainty ... The statute, on the one hand, takes away from the subscribing employer his common law defenses, and, on the other, it limits the amount of compensation recoverable by the employee.” Hazelwood v. Mandrell Industries Co., 596 S.W.2d 204, 206 (Tex.Civ.App.—Houston [1st Dist.] 1980, writ ref’d n.r.e.). Whenever this balance is tipped so one party has had its rights under the Act substantially reduced, the “clear intent of the legislature” is thwarted and the case must be reversed as violative of public policy. Id. Therefore, under a workers’ compensation claim the award of the court for a finding of total and permanent disability is meant to be a recompensation to the employee. The employee’s recovery is intentionally limited by statute, and any deviation is a threat to the public policy underlying the Act.

[287]*287We believe the action of the trial court in trebling the award of total and permanent disability benefits was incorrect for several reasons. First, the statutory award of benefits for appellee’s disability did not amount to actual damages as required by Section 16. Section 16 provides that a claimant who prevails on a suit for unfair or deceptive acts or practices in the business of insurance may obtain three times the amount of actual damages incurred.

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Bluebook (online)
641 S.W.2d 284, 1982 Tex. App. LEXIS 4978, Counsel Stack Legal Research, https://law.counselstack.com/opinion/st-paul-insurance-co-v-mcpeak-texapp-1982.