Standard Fire Insurance Co. v. Stephenson

963 S.W.2d 81, 1997 WL 867763
CourtCourt of Appeals of Texas
DecidedMarch 19, 1998
Docket09-96-033CV
StatusPublished
Cited by25 cases

This text of 963 S.W.2d 81 (Standard Fire Insurance Co. v. Stephenson) 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
Standard Fire Insurance Co. v. Stephenson, 963 S.W.2d 81, 1997 WL 867763 (Tex. Ct. App. 1998).

Opinion

OPINION

HILL, Justice (Assigned).

The Standard Fire Insurance Company appeals from a judgment resulting from a *84 jury trial in which the jury found Standard Fire breached its duty of good faith and fair dealing by denying and delaying payment of a death benefits claim under the Texas Workers Compensation Act. Joy Lenderman Stephenson, appellee, is the widow of Douglas Stephenson, who died suddenly of a heart attack while working for Champion, Inc. The judgment awarded Mrs. Stephenson actual damages in her bad faith claim, consisting of mental anguish damages and her attorney’s fees in the underlying workers’ compensation claim; exemplary damages; and attorney’s fees pursuant to her DTPA claim. Standard Fire presents seventeen points of error.

For reasons set forth in this opinion, we sever Mrs. Stephenson’s claim for attorney’s fees under the DTPA, reverse the judgment with respect to that claim, and remand that claim to the trial court for further proceedings. With respect to Mrs. Stephenson’s bad faith claim, we reform the judgment to delete exemplary damages, the award of attorney’s fees under the DTPA, and any prejudgment interest attributable to either the exemplary damages or the DTPA attorney’s fee award, and we affirm the judgment as reformed.

SUFFICIENCY OF THE EVIDENCE: BAD FAITH

Standard Fire contends in point of error one that because neither legally nor factually sufficient evidence supports the jury’s finding that Standard Fire breached the duty of good faith and fair dealing, the trial court erred in overruling Standard Fire’s motion for judgment notwithstanding the verdict and its motion for new trial.

Legal Sufficiency

In considering and determining legal sufficiency or no evidence points of error, we must only consider the evidence, and the inferences therefrom, tending to support the jury’s findings, disregarding all evidence and inferences to the contrary. Havner v. E-Z Mart Stores, Inc., 825 S.W.2d 456, 458 (Tex. 1992).

Doug Stephenson was an employee of Champion Paper Mill in Lufkin and in charge of a paper-making machine. He was a very dedicated employee. On the morning of August 30, 1989, Stephenson encountered a problem with a paper machine that was costing his company close to $10,000 per hour. Except for a thirty-minute break, he and a co-worker, Michael Parks, worked to fix the problem. Around part of the machine where Stephenson was working the temperature was about 100 degrees with approximately 100% humidity. The effective heat index was roughly 130 degrees or beyond. The air in a part of the machine where Stephenson would not ordinarily have been working was stagnant and extremely hot. Sam Ellis, Jr., a former employee of Champion, described it as absolutely horrendous. Another part of the machine where Stephenson was working was described as the “hell hole.” Ellis described the heat there as absolutely stifling, like walking into a blast furnace. He said the humidity in the area was so high and the air so still that sweating had no cooling effect on the body.

Stephenson skipped a lunch break to continue trying to fix the problem, saying, “We’re going to do this first.” Parks testified Stephenson appeared to be feeling flustered because the machine was not doing what he wanted. About five minutes after coming from a hot area, Stephenson bent down to attach a hose to a foam machine for another foaming operation. Stephenson stood up, then fell backwards. The death certificate listed the cause of his death as an acute myocardial infarction, a heart attack.

Dr. Craig Pratt, a professor of medicine at Baylor University College of Medicine, testified he is board certified in internal medicine and cardiovascular disease and is an internationally recognized authority on the cause of sudden cardiac death. He stated it was his opinion that, based upon Stephenson’s elevated emotional stress, the work he was doing, and the heat conditions, the working conditions and his job environment would have been a major cause of Stephenson’s death. He said it could not be argued by any reasonable person that Stephenson’s death was not, at least in part, caused by the working conditions.

Karen Baker Waddill, the adjuster for the Stephenson claim, but who is no longer with *85 Standard Fire, testified Standard Fire basically approached heart attack claims by conducting an investigation that would disprove the claim. She said there were discussions indicating that from the beginning of the claim there was an intentional, deliberate effort upon the part of the insurance company to deny the claim. She indicated she conducted an investigation to disprove the compensability of the claim, as opposed to trying to approve it, in accordance with instructions from her supervisors.

Ms. Waddill interviewed Michael Parks, Stephenson’s co-worker, shortly after Stephenson’s death. A review of the interview reveals Ms. Waddill showed little interest in the heat or stress level of what Stephenson was doing leading up to his heart attack. Instead, it centered on what he was doing at the time of the attack, along with his general attitude and lack of complaints during the week and immediately preceding the attack. When Parks mentioned the heat they encountered the morning of the attack, she did not follow up with any questions except to seek to establish Stephenson could have showered had he chosen to. Waddill was aware the family was contending Stephenson’s death was caused by the heat, stress, and exertion at his job. A co-worker reviewing her file inquired how specifically the complaints had been about heat problems and inquired how hot it was where Stephenson was working. She suggested medical followup with a doctor and attorney was needed. There was no follow-up in accordance with this suggestion. No doctor was contacted for an opinion as to whether Stephenson’s death might have resulted from his working conditions until after the claim had already been controverted by Standard Fire.

There was testimony the file was closed despite the incompleteness of the1 investigation, because it was felt after speaking with personnel at the paper mill that Mrs. Stephenson would not pursue her claim. Ms. Waddill testified that at the time the insurer denied the claim it had not conducted a reasonable and thorough investigation upon which to deny the claim and that in her opinion it violated its duty of good faith and fair dealing.

An insurer breaches its duty of good faith and fair dealing when the insurer fails to attempt to effectuate a settlement where its liability has become reasonably clear. The Universe Life Ins. Co. v. Giles, 950 S.W.2d 48, 55 (Tex.1997) (citing Tex. Ins. Code Ann. art. 21.21, § 4(10)(a)(ii) (Vernon 1981 & Supp.1997)). The insurer may also breach its duty of good faith and fair dealing when it fails to reasonably investigate a claim in order to determine whether its liability is reasonably clear. Id. at 56 n. 5.

Prior to the opinion in Giles,

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Bluebook (online)
963 S.W.2d 81, 1997 WL 867763, Counsel Stack Legal Research, https://law.counselstack.com/opinion/standard-fire-insurance-co-v-stephenson-texapp-1998.