Texas Workers' Compensation Insurance Fund v. Serrano

985 S.W.2d 208, 1999 Tex. App. LEXIS 94, 1999 WL 6663
CourtCourt of Appeals of Texas
DecidedJanuary 7, 1999
Docket13-95-482-CV
StatusPublished
Cited by7 cases

This text of 985 S.W.2d 208 (Texas Workers' Compensation Insurance Fund v. Serrano) 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 Workers' Compensation Insurance Fund v. Serrano, 985 S.W.2d 208, 1999 Tex. App. LEXIS 94, 1999 WL 6663 (Tex. Ct. App. 1999).

Opinion

OPINION

CHAVEZ, Justice.

In this case the Texas Worker’s Compensation Insurance Fund (the Fund) argues that its subrogation interest in a settlement received by a worker’s compensation beneficiary and his family from a third-party tort-feasor was circumvented by the manner that the settlement was apportioned among the family. The issue before us is whether there was legally and factually sufficient evidence to support the trial court’s apportionment of the settlement proceeds among the appellees. We hold that legally and factually sufficient evidence was present, and affirm the judgment of the trial court.

This case comes to us on remand from the Texas Supreme Court. The first time this case was before us we held that the Fund had failed to offer sufficient evidence to establish a subrogation interest in medical expenses for the insured. Therefore, we affirmed the trial court’s judgment denying a subrogation interest in those expenses. Texas Worker’s Compensation Ins. Fund v. Serrano, No. 13-95-482-CV, — S.W.2d - (Tex.App. — Corpus Christi January 7, 1997) (not designated for publication). Because of that holding, we did not reach appellant’s arguments regarding the apportionment of the settlement. The Texas Supreme Court reversed our decision and remanded the ease to us to consider those arguments. Texas Workers’ Compensation Ins. Fund v. Serrano, 962 S.W.2d 536 (Tex.1998).

Jose Serrano, a Mexican citizen, was severely injured while working as a migrant farm worker in Texas. Serrano was standing next to a truck trailer cleaning cabbages *210 and loading them into the trailer when another track backed into him and pinned him between the track and the trailer. Serrano was hospitalized for over a month and was paralyzed from the waist down as a result of the accident. His accident was covered by worker’s compensation insurance with the Fund. The Fund had paid $247,602.20 for Serrano’s medical bills and $3200.14 for lost wages by the time of trial.

Serrano and his wife, Graciela Chairez Serrano, individually and as next friend of their three minor children, sued Mares, the driver of the track that backed into him, Saenz, the owner of the truck, and Ruiz, the owner of the trailer. Saenz and Mares settled with the Serranos for $750,000, and the Fund intervened to protect its subrogation interest in the Serranos’ recovery. The trial judge approved the settlement and apportioned the proceeds as $250,000 for Jose Serrano, $200,000 for his wife, and $100,000 for each of his three minor children.

The workers’ compensation carrier has a statutory right to reimbursement from the first monies paid to an injured employee or his representatives by a third-party tortfeasor, up to the amount of compensation paid, and can recover the amount from the employee or the third-party tortfeasor. Tex. LABOR Code Ann. §§ 417.001, 417.002 (Vernon 1996); U.S. Fire Ins. v. Hernandez, 918 S.W.2d 576, 578 (Tex.App.—Corpus Christi 1996, writ denied). The carrier’s right to reduce its liability from a payment of a third-party must not be compromised. Hernandez, 918 S.W.2d at 578. However, the carrier has subrogation rights only over that portion of an award or settlement which represents the interest of a workers’ compensation beneficiary. Id. at 579. A trial court may not enter a judgment which arbitrarily compromises the carrier’s right to subrogation by structuring the award so that a non-beneficiary recovers, but a beneficiary does not. Id. For purposes of determining the carrier’s reimbursement interest, the proper division of a settlement between beneficiaries and non-beneficiaries presents an issue for the trier of fact based on the relative merits and worth of the claims involved. Id.

When reviewing a challenge to the legal sufficiency of evidence, we consider all the evidence in the record in a light most favorable to the party in whose favor the verdict has been rendered and indulge every reasonable inference in that party’s favor. Formosa Plastics Corp. USA v. Presidio Eng’rs and Contractors, Inc., 960 S.W.2d 41, 48 (Tex.1998). If the finding is supported by probative evidence, then we overrule the point and uphold the finding. Southern States Transp., Inc. v. State, 774 S.W.2d 639, 640 (Tex.1989). However, “[w]hen the evidence offered to prove a vital fact is so weak as to do no more than create a mere surmise or suspicion of its existence, the evidence is no more than a scintilla and, in legal effect, is no evidence.” Kindred v. Con/Chem, Inc., 650 S.W.2d 61, 63 (Tex.1983). When confronting a factual sufficiency challenge, we overturn findings only if they are so against the great weight and preponderance of the evidence as to be clearly wrong and unjust. Ortiz v. Jones, 917 S.W.2d 770, 772 (Tex.1996).

Appellant acknowledges that all of the appellees have suffered as a result of Mr. Serrano’s injuries, but it argues that the evidence was insufficient to support the trial court’s apportionment of the settlement, which gave twice as much money to Mr. Serrano’s family as it gave to Mr. Serrano himself. Because only Mr. Serrano is a beneficiary of worker’s compensation insurance, only his portion is available for subrogation by the Fund.

At trial, appellees presented evidence that Mr. Serrano was paralyzed from the waist down as a result of his accident. He spent over one month in the intensive care unit of the hospital in Lubbock, and then approximately three months in a rehabilitation facility in Colorado. During his hospital stays, his wife and infant daughter stayed in the hospital with him, while his two sons lived with their aunt in Amarillo. Mr. Serrano’s wife and children had been at their home in rural Mexico when the accident occurred, and traveled to the United States when news of the accident reached them. None of them spoke English or were familiar with customs or lifestyles in the United States. The two *211 older children were detained at the border for approximately one week because they did not have appropriate birth certificates to show the immigration authorities. While they were living in Amarillo they were only able to visit their parents during their two week break from school over the winter holidays.

Evidence was presented that the boys were significantly affected by their experiences. Previously they had been happy and “wild,” but after the accident they became sad and withdrawn. There was evidence that the younger boy did not fully understand what had happened to his father, and was “angry” at his father for not being able to do things he previously could do. Both had taken on significant responsibilities involved in caring for their father, which took up much of their time outside of school. Mr.

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985 S.W.2d 208, 1999 Tex. App. LEXIS 94, 1999 WL 6663, Counsel Stack Legal Research, https://law.counselstack.com/opinion/texas-workers-compensation-insurance-fund-v-serrano-texapp-1999.