Texas Employers' Ins. Ass'n v. Crain

259 S.W.2d 905, 1953 Tex. App. LEXIS 1896
CourtCourt of Appeals of Texas
DecidedJune 12, 1953
Docket15437
StatusPublished
Cited by17 cases

This text of 259 S.W.2d 905 (Texas Employers' Ins. Ass'n v. Crain) 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
Texas Employers' Ins. Ass'n v. Crain, 259 S.W.2d 905, 1953 Tex. App. LEXIS 1896 (Tex. Ct. App. 1953).

Opinion

BOYD, Justice.

This is an appeal by Texas Employers’ Insurance Association from a judgment of the District Court of Wichita County, based upon a jury verdict in a workmen’s compensation case, granting appellee Archie Crain compensation for total and permanent incapacity, redeemable in a lump sum.

Appellant’s first point is that the court erred in overruling its motion for judgment non obstante veredicto, contending that, as a matter of law, appellee did not show good cause for his failure to file a claim for compensation with the Industrial Accident Board within six months from the date of the injury, as required by Art. 8307, sec. 4a, Texas Civil Statutes.

Appellee was injured on July 27, 1951, was placed under the care of appellant’s physician, paid five weeks’ compensation, and, on September 8, 1951, on the advice of the physician and appellant’s district claims manager, he resumed work for his former employer, performing lighter duties but receiving substantially the same wages as before the injury. He continued in that employment until on or about April 10, 1952, when his condition became so serious that his foreman sent .him back to the physician. Compensation payments were resumed. Appellee underwent surgery, but was not thereafter able to work. Claim was forwarded on June 4, 1952, and received by the Board on June 6, and compensation was paid weekly until July 3.

Appellee 'alleged and the jury found that after he was paid the first five weeks’ compensation, and prior to the time he resumed work, appellant’s district claims manager, who had authority to make compensation payments, told him that if they owed him any more money they would pay him, and that appellee relied on such promise, and the promise and his reliance thereon constituted good cause; that the acts and conduct of appellant in paying compensation led ap-pellee to believe that appellant would take care of all necessary matters with reference to his claim for compensation, and constituted good cause; and that appellee believed that so long as he was on the payroll of his employer he was not entitled to draw compensation, and that such belief and the fact that appellant resumed compensation payments constituted good cause.

Good cause for failure to file a claim with the Board is ordinarily a question of fact. Williamson v. Texas Indemnity Ins. Co., 127 Tex. 71, 90 S.W.2d 1088; Aetna Casualty & Surety Co. v. Rhine, 5 Cir., 152 F.2d 368. Since the statute does not define the good cause that will excuse the failure to file the claim within six months, each case involving the issue of good cause must turn on its own facts. The test is that of ordinary prudence. American General Ins. Co. v. American, Tex.Civ.App., 187 S.W.2d 912, refused, w. m.; Lacour v. Continental Casualty Co., Tex.Civ.App., 163 S.W.2d 676, refused, w. m.; Watson v. Texas Indemnity Ins. Co., 147 Tex. 40, 210 S.W.2d 989; Texas Indemnity Ins. Co. v. Cook, Tex.Civ.App., 87 S.W.2d 830, writ refused. The issue may be determined against a claimant as a matter of law only when the evidence admits of no other reasonable conclusion. Hawkins v. Safety Casualty Co., 146 Tex. 381, 207 S.W.2d 370; Lacour v. Continental Casualty Co., supra; Texas Indemnity Ins. Co. v. Cook, supra; Pacific Employers Ins. Co. v. Gage, Tex.Civ.App., 199 S.W.2d 537, refused, n. r. *907 e. « * * * jf ⅛£1-6 is any evidence in the record to sustain the findings made by the jury or the trial court, the Court of Civil Appeals is not justified in substituting its findings of fact for the findings made by the trial court and the jury, and render final judgment thereon. First State Bank v. Metropolitan Casualty Ins. Co. [125 Tex. 113], 79 S.W.2d 835, 98 A.L.R. 1256, and cases cited.” Williamson v. Texas Indemnity Ins. Co., supra [127 Tex. 71, 90 S.W.2d 1089]. Although the burden is on the claimant to allege and prove the existence of good cause up to the time of the filing of his claim, and not merely during the first six months, courts are liberal with compensation claimants in upholding jury verdicts finding given states of fact to show good cause. Williamson v. Texas Indemnity Ins. Co., supra; Petroleum Casualty Co. v. Dean, 132 Tex. 320, 122 S.W.2d 1053; National Surety Co. v. Roberts, Tex.Civ.App., 217 S.W.2d 894.

The first ground for good cause presents a novel and interesting question. While appellee was receiving compensation he was justified in believing that the payments would continue. Fidelity & Casualty Co. of New York v. Ener, Tex.Civ.App., 97 S.W.2d 267. But there was a seven months’ period, while he was gainfully employed, when no compensation payments were made. They were resumed when he again became unable to work. While we have been cited to no authority exactly in point, and have found none, we believe that when an injured employee receives compensation and medical treatment from the insurer for five weeks, and the insurer’s physician then advises him that he can do light work, and its claims manager tells him that if they owe him any more money they will pay it, and relying on that promise and the physician’s advice the workman returns to the service of his former employer and for seven months receives substantially the' same wages as before the injury, and thereupon becoming unable to do further work, his employer sends him back to the insurer’s physician for further medical treatment, which is furnished him by the insurer, and compensation payments are resumed and regularly paid for eight or nine weeks before the claim is filed and for two or three weeks after it is filed, the issue of good cause is raised by the evidence.

To hold that as a matter of law good cause is not thereby shown is to hold that there is no evidence to support the jury’s finding that the test of ordinary prudence has been met. If there is any evidence of care and prudence in the prosecution of appellee’s rights, the sufficiency of that evidence is a question for the jury. Texas & N. O. R. Co. v. Blake, Tex.Civ.App., 175 S.W.2d 683, writ refused; Wichita Valley Ry. Co. v. Fite, Tex.Civ.App., 78 S.W.2d 714; Gifford v. Ft. Worth & D. C. Ry. Co., Tex., 249 S.W.2d 190.

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259 S.W.2d 905, 1953 Tex. App. LEXIS 1896, Counsel Stack Legal Research, https://law.counselstack.com/opinion/texas-employers-ins-assn-v-crain-texapp-1953.