Texas Mutual Insurance Co. v. Morris

287 S.W.3d 401, 2009 Tex. App. LEXIS 4363, 2009 WL 1677856
CourtCourt of Appeals of Texas
DecidedJune 4, 2009
Docket14-06-00651-CV
StatusPublished
Cited by17 cases

This text of 287 S.W.3d 401 (Texas Mutual Insurance Co. v. Morris) 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 Mutual Insurance Co. v. Morris, 287 S.W.3d 401, 2009 Tex. App. LEXIS 4363, 2009 WL 1677856 (Tex. Ct. App. 2009).

Opinion

SUBSTITUTE OPINION ON REHEARING

KEM THOMPSON FROST, Justice.

The court issued a unanimous opinion in this case on August 26, 2008. Appellant *405 Texas Mutual Insurance Company moved for rehearing. After receiving a response from appellee P. Lance Morris, the court grants the motion for rehearing in part, withdraws the earlier opinion, vacates the earlier judgment, and issues this substitute opinion and new judgment in their place.

I. Introduction

A workers’ compensation carrier appeals from a final judgment in favor of a workers’ compensation claimant. In six issues, the carrier contends that (1) the evidence is legally insufficient to sustain the jury’s finding that the carrier engaged in unfair or deceptive acts or practices in violation of the Texas Insurance Code, (2) the evidence is legally insufficient to sustain the jury’s finding that the carrier did so knowingly, (3) the evidence is legally insufficient to support the award of damages for loss of credit reputation, (4) the evidence is legally insufficient to support the award of mental-anguish damages, (5) the trial court erred in submitting broad-form liability questions containing both valid and invalid theories of liability, and (6) the judgment cannot be sustained on the alternative claim of breach of the duty of good faith and fair dealing because no such claim is recognized in the context of a workers’ compensation claim. In a cross-appeal, the claimant requests that this court modify the trial court’s judgment to increase the award of additional damages for the carrier’s knowing violation of the Texas Insurance Code.

We conclude that the evidence is legally sufficient to support the jury’s findings that the carrier engaged in unfair or deceptive acts or practices in violation of the Texas Insurance Code and that it did so knowingly. We also conclude that legally sufficient evidence suppoife the award of mental-anguish damages, and that no Cas-teel 1 problem requires reversal. However, we conclude that no evidence supports the award for loss of credit reputation. We further conclude that the claimant’s cross-appeal lacks merit. We therefore modify the judgment to delete that portion awarding the claimant damages for loss of credit reputation and to reduce the additional damages accordingly. Further, because we are reducing the actual damages awarded to the claimant, we also reverse the portion of the judgment awarding attorney’s fees, and remand this case for retrial of that issue and for the recalculation of pre-judgment and post-judgment interest. We affirm the remainder of the judgment.

II. Factual and Procedural Background

Appellee/cross-appellant P. Lance Morris brought this suit against appellant/cross-appellee Texas Mutual Insurance Company, alleging that the company acted in bad faith and violated the Texas Insurance Code because it failed to properly investigate Morris’s claim for workers’ compensation benefits, and that it delayed paying workers’ compensation benefits due him. Morris alleged that, on June 12, 2000, while working for the Justin Volunteer Fire Department he received an on-the-job injury to his spine (the “2000 Injury”). Then, in March 2003, Morris required emergency treatment for his back injury. According to Morris, Texas Mutual initially promised to pay for surgery on his back, but only days after the surgery, the company reneged on this promise. Morris alleged that the requested treatment for his injury was reasonable and necessary, but Texas Mutual delayed and denied payment for the previously pre-authorized medical treatment, with significant adverse consequences to him. Morris *406 also alleged that the Texas Workers’ Compensation Commission (hereinafter the “Commission”) 2 adjudicated that Texas Mutual wrongfully denied his claim for benefits. Morris claimed that Texas Mutual violated the Texas Insurance Code, breached its common-law duty of good faith and fair dealing, and violated the Deceptive Trade Practices Act (“DTPA”). 3

Texas Mutual answered the suit and later amended its answer to add a counterclaim for fraud. In the counterclaim, Texas Mutual alleged that Morris strained or sprained his back in 1998; two years before the 2000 Injury, and that he falsely represented to the Commission that he did not have a pre-existing back injury. Texas Mutual claimed that Morris knew this representation was false when he made it, and that Texas Mutual relied upon it and was injured by having to pay for benefits that would not have been due if the extent of Morris’s back problems had been, disclosed fully.

In the March 2006 trial, the jury returned a 10-2 verdict in Morris’s favor on his claims for common-law bad faith and statutory violations. The jury awarded Morris $50,000 for past mental anguish; $25,000 for past damage to his credit reputation; $50,000 for future damage to his credit reputation; and $120,000 for attorney’s fees. The jury also awarded Morris $500,000 in additional damages because it found that Texas Mutual knowingly violated the Texas Insurance Code. The jury declined to find that Texas Mutual acted with malice or that Moms defrauded Texas Mutual. On May 18, 2006, the trial court signed a final judgment for Morris, awarding the amounts found by the jury, except for the $500,000 in additional damages, which the trial court reduced to $250,000. On appeal, Texas Mutual raises six issues, and Morris raises one issue in his cross-appeal.

III. Issues PResented by the Carrier

In its first four issues, Texas Mutual contends the evidence is legally insufficient to support:

• the jury’s finding that Texas Mutual engaged in unfair or deceptive acts or practices in violation of the Texas Insurance Code,
• the jury’s finding that Texas Mutual violated the Texas Insurance Code knowingly, and
• the jury’s damage awards for mental anguish and lost credit reputation.

In its fifth issue, Texas Mutual contends that the trial court erroneously instructed the jury on both valid and invalid theories of liability. In its sixth issue, Texas Mutual contends that no cognizable claim exists for breach of the duty of good faith and fair dealing against a workers’ compensation carrier, or alternatively, any such claim should be abolished.

A. Legal Sufficiency of Evidence Supporting Jury’s Finding that the Carrier Engaged in Unfair or Deceptive Acts or Practices in Violation of the Texas Insurance Code

In its first issue, Texas Mutual contends that no evidence supports the jury’s finding that Texas Mutual engaged in unfair or deceptive acts or practices in violation of the Texas Insurance Code because no evi *407 dence shows that it misrepresented the policy or failed to explain the basis for the dispute, and no evidence shows that it knew or should have known that coverage was reasonably clear. Texas Mutual also contends that the evidence conclusively shows that it had a reasonable basis to dispute Morris’s claim.

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Cite This Page — Counsel Stack

Bluebook (online)
287 S.W.3d 401, 2009 Tex. App. LEXIS 4363, 2009 WL 1677856, Counsel Stack Legal Research, https://law.counselstack.com/opinion/texas-mutual-insurance-co-v-morris-texapp-2009.