STATE EX REL. DEPT. OF TRANSP. v. Esquivel

92 S.W.3d 17
CourtCourt of Appeals of Texas
DecidedMay 23, 2002
Docket08-01-00199-CV
StatusPublished
Cited by1 cases

This text of 92 S.W.3d 17 (STATE EX REL. DEPT. OF TRANSP. v. Esquivel) 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
STATE EX REL. DEPT. OF TRANSP. v. Esquivel, 92 S.W.3d 17 (Tex. Ct. App. 2002).

Opinion

92 S.W.3d 17 (2002)

The STATE of Texas By and Through the TEXAS DEPARTMENT OF TRANSPORTATION, Appellant,
v.
Priscilla M. ESQUIVEL and Rudy Diaz, Appellees.

No. 08-01-00199-CV.

Court of Appeals of Texas, El Paso.

May 23, 2002.

*19 Hector J. Flores, Asst. Atty. Gen., Austin, for appellant.

Kurt Paxson, Steven L. Hughes, Mounce, Green, Myers, Safi & Galatzan, El Paso, for appellee.

Before Panel No. 2 BARAJAS, C.J., McCLURE, and CHEW, JJ.

OPINION

RICHARD BARAJAS, Chief Justice.

This is an appeal from a workers' compensation subrogation case. For the reasons stated, we affirm.

I. SUMMARY OF THE EVIDENCE

In July 1998, Hector I. Jaquez, a Texas Department of Transportation employee, was rear-ended by Appellee, Priscilla Esquivel. Esquivel was driving an automobile owned by Appellee, Rudy Diaz. Appellant, the Texas Department of Transportation, filed its workers' compensation subrogation claim to recover its workers' compensation monies paid on behalf of Jaquez totaling $2,897.50 in medical benefits and $4,346.76 in indemnity benefits. Appellant also sought the recovery of its attorney fees and court costs.

After Jaquez testified at trial, Appellees moved for directed verdict on the grounds that (1) Appellant did not offer any evidence that Jaquez' medical expenses were reasonable or necessary; (2) Appellant was not entitled to recover indemnity benefits as an element of damages in a motor vehicle case; (3) Appellant did not offer any evidence of attorney's fees; and (4) Appellant's claims against Diaz were barred by the statute of limitations.

The trial court allowed Appellant to make a bill of exceptions concerning the additional evidence it intended to submit. Appellant called Priscilla Martinez, the legal representative for Appellant. Martinez testified to the total amount of Jaquez' medical expenses and indemnity benefits from a summary sheet. On voir dire, Martinez admitted she was not a doctor or healthcare provider. She also testified that she was not qualified to audit bills to determine whether they complied with the medical fee guidelines. Finally, Martinez stated that she was not qualified to calculate the actual impairment rating assessed to Jaquez. Appellant then stipulated that Martinez' testimony was all of the evidence it intended to offer. Thereafter, the court granted Appellees' directed verdict on all four grounds asserted. This appeal follows.

II. DISCUSSION

Appellant presents five issues on appeal attacking the granting of directed verdict. We begin with a discussion of the standard of review.

A. Directed Verdict

A directed verdict is proper when (1) the opponent's pleadings are defective and insufficient to support a judgment; (2) the evidence conclusively proves a fact that establishes the movant's right to judgment as a matter of law, or negates the right of the nonmovant to judgment; or (3) the evidence offered is insufficient to raise a fact issue on the cause of action at issue. ITT Consumer Financial Corp. v. Tovar, 932 S.W.2d 147, 159 (Tex.App.-El Paso 1996, writ denied). In reviewing the granting of a directed verdict by the trial court on an evidentiary basis, we determine *20 whether there is any evidence of probative force to raise fact issues on the material questions presented. Id. at 159, (citing Collora v. Navarro, 574 S.W.2d 65, 68 (Tex.1978)). We consider all of the evidence in a light most favorable to the party against whom the verdict was instructed and disregard all contrary evidence and inferences arising therefrom. White v. Southwestern Bell Telephone Co., Inc., 651 S.W.2d 260, 262 (Tex.1983); ITT Consumer Financial Corp., 932 S.W.2d at 159-60. If there is any conflicting evidence of probative force on any theory of recovery, the issue is for the jury; an instructed verdict is improper and the case must be reversed and remanded for the jury's determination on that issue. White, 651 S.W.2d at 262; ITT Consumer Financial Corp., 932 S.W.2d at 160. Where no evidence of probative force on an ultimate fact element exists or where the probative force of the testimony is so weak that only a mere surmise or suspicion is raised as to the existence of essential facts, the trial court has the duty to instruct the verdict. White, 651 S.W.2d at 262; ITT Consumer Financial Corp., 932 S.W.2d at 160.

1. Reasonable and Necessary Medical Expenses

In Issue No. One, Appellant argues that the trial court erred in granting directed verdict by ruling that Appellant must present evidence as to the reasonableness and necessity of its medical expenses. Appellees argue that Appellant's claim is derivative of Jaquez' claim and must therefore prove exactly what Jaquez would have been required to prove. We agree.

Appellant brought suit under Section 417.002(a) of the Labor Code which provides:

(a) The net amount recovered by a claimant in a third-party action shall be used to reimburse the insurance carrier for benefits, including medical benefits, that have been paid for the compensable injury.

TEX. LAB.CODE ANN. § 417.002(a) (Vernon 1996). The Texas Supreme Court has made it clear that a workers' compensation insurer who asserts a subrogation claim asserts a claim that belongs to the employee. Franks v. Sematech, Inc., 936 S.W.2d 959, 960 (Tex.1997) (per curiam) (emphasis added). The carrier's subrogation claim is derivative of the employee's claim. Franks, 936 S.W.2d at 960. There is but one cause of action against the third-party tortfeasor, and it belongs to the employee. Id.; Guillot v. Hix, 838 S.W.2d 230, 232 (Tex.1992). This is true irrespective of whether the insurer sues in its own name or the employee's name. Sematech, 936 S.W.2d at 960. Thus, the third-party tortfeasor in a workers' compensation subrogation action may assert defenses he would have had in a suit brought directly by the employee, such as a limitations defense. Guillot, 838 S.W.2d at 232-33. Further, because the State is self-insured, it is considered its own "insurance carrier" for purposes of the Workers' Compensation Act. Tex. Lab.Code Ann. § 401.011(27)(C) (Vernon Supp.2002).

Appellant relies on Texas Workers' Compensation Ins. Fund v. Serrano, for the proposition that the carrier is entitled to reimbursement without proving that the amounts paid to or on behalf of the worker were reasonable and necessary.[1]Texas *21 Workers' Compensation Ins. Fund v. Serrano, 962 S.W.2d 536, 537 (Tex.1998). In Serrano, the third-party tortfeasor was sued by the injured employee and the carrier intervened to assert its subrogation rights for medical and indemnity benefits paid to or on behalf of Serrano. Id. at 537.

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92 S.W.3d 17, Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-ex-rel-dept-of-transp-v-esquivel-texapp-2002.