Texas Workers' Compensation Insurance Fund v. Travis

912 S.W.2d 895, 1995 Tex. App. LEXIS 3265, 1995 WL 762334
CourtCourt of Appeals of Texas
DecidedDecember 28, 1995
Docket02-94-203-CV
StatusPublished
Cited by27 cases

This text of 912 S.W.2d 895 (Texas Workers' Compensation Insurance Fund v. Travis) 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. Travis, 912 S.W.2d 895, 1995 Tex. App. LEXIS 3265, 1995 WL 762334 (Tex. Ct. App. 1995).

Opinion

OPINION

RICHARDS, Justice.

Texas Workers’ Compensation Insurance Fund (Appellant) appeals from the trial court’s judgment and distribution of settlement proceeds. Appellant intervened in the case below to recover monies owed because of a workers’ compensation lien. The Appel-lees include the injured employee, his beneficiaries, and the third-party tortfeasor from the case below.

In a single point of error, Appellant asserts the trial court erred in apportioning the third-party recovery from the settlement between Boyd Travis (Travis), his beneficiaries, and Appellant such that Appellant was denied its full statutory right to a lien on the Travis’ recovery in order to recoup the costs of future benefit payments. In a single cross-point, the attorney ad litem claims he should recover attorney’s fees and costs for the post-trial and appeals process.

We sustain Appellant’s point of error because the settlement apportionment circumvents the intent of the applicable workers’ compensation statute. We overrule the cross-point of the attorney ad litem. We reverse the judgment of the trial court.

FACTUAL AND PROCEDURAL BACKGROUND

Appellant is the workers’ compensation carrier for James Lane Air Conditioning, the employer of Travis. On February 23, 1993, Travis was injured in an automobile accident involving Lillian Thoele while Travis was in the course and scope of his employment. Appellant paid workers’ compensation benefits and medical expenses to Travis.

On May 5, 1994, Travis, his wife and his two minor children filed a friendly suit against Thoele, alleging she was negligent in the operation of her vehicle. The Appellees had arranged a settlement with Thoele for $100,000.00. It is undisputed that the purpose of filing the lawsuit was to obtain court approval for the minor children’s settlement with Thoele.

On the same day the suit was filed, the court held a settlement conference and approved the previously negotiated agreed settlement in connection with the case. The court apportioned the previously agreed-to settlement of $100,000.00 between the plaintiffs and included Appellant. The apportionment allocated $659.24 to Travis, $59,500.00 to his wife, $250.00 to each of his two children, and $39,340.76 to Appellant. There is no dispute that Appellant was aware of a settlement conference being conducted; however, there is a dispute among the parties on whether Appellant was aware of the nature of the settlement conference.

Appellant filed a petition for intervention, a motion to set aside the judgment, and a motion for new trial. Appellant now appeals the apportionment of the settlement proceeds. Travis filed a response to Appellant’s appeal. Travis’ wife, however, did not file a brief on appeal. The attorney ad litem, who was appointed at trial to represent Travis’ two minor children, did file a brief on appeal. The ad litem’s brief does not address the substance of Appellant’s appeal, but does assert a claim for attorney ad litem fees for the post-trial and appellate process.

PROPRIETY OF SETTLEMENT STRUCTURE

In its sole point of error, Appellant argues the apportionment between Travis and his wife eliminated Appellant’s statutory credit against Travis’ excess recovery, forcing Appellant to continue paying Travis’ medical expenses as a result of the collision. Appellant points out that a disproportionate percentage of the settlement, $59,500.00, was given to Travis’ wife, whereas Travis, as the injured party, received only $659.24. The issue is whether this apportionment unlawfully reduced the amount of Appellant’s lien for future benefits, which is permitted by statute, thereby denying Appellant’s full statutory credit.

As a preliminary matter, we address the issues of what statute applies under the facts of this case. Both parties have as *897 sumed the new Workers’ Compensation Act applies; however, the plain language of the enabling legislation and Texas case law provide otherwise. In particular, Appellant assumed in this appeal that section 417.002 of the new Texas Workers’ Compensation Act applied to this case. Tex.Lab.Code Ann. § 417.002 (Vernon Pamph.1996). However, the effective date of this Act was September 1, 1993. Act of May 12, 1993, 73rd Leg., R.S., ch. 269, § 8, 1993 Tex.Gen.Laws 987, 1273. Moreover, the case of Guillot v. Hix, 838 S.W.2d 230, 235 (Tex.1992) holds that the workers’ compensation carrier’s subrogation claim accrues at the same time the employee’s action against the third party accrues.

Appellant’s claim in this case, then, accrued as of the date of Travis’ injury, February 23, 1993. Therefore, the new Texas Workers’ Compensation Act does not apply to the facts of the instant case. Rather, the prior statute controls. 1 Neither party presents contrary authority, therefore, we are bound to follow the law as expressed by the legislature and will use the law as it existed prior to its 1993 amendment. For purposes of this appeal, then, we construe Appellant’s arguments in light of the applicable statute. 2

Appellant complains about the manner in which the settlement in this case was structured, citing subsections 417.002(a) and (b) of the new Texas Workers’ Compensation Act. 3 We therefore review whether a settlement can be structured in this manner under the applicable section of the former Workers’ Compensation Act, which read:

If at the conclusion of a third party action, a workers’ compensation claimant is entitled to compensation, the net amount recovered by the claimant from the third party action shall be applied to reimburse the insurance carrier for past benefits and medical expenses paid. Any amount in excess of past benefits and medical expenses shall be treated as an advance against future benefit payments of compensation that the claimant is entitled to receive under this Act. If the advance is adequate to cover all future compensation and medical benefit payments as provided by this Act, the insurance carrier is not required to make further payments. If the advance is insufficient, the insurance carrier shall resume the payments when the advance is exhausted. The reasonable and necessary medical expenses incurred by the claimant because of the injury shall be deducted from the advance in the same manner as benefit payments.

Act of December 11,1989, 71st Leg., 2d C.S., ch. 1, § 4.05, 1989 Tex.Gen.Laws 1, 33 (amended 1993).

In light of the statutory requirements, we look to the case law regarding a workers’ compensation carrier’s rights to subrogation where a third-party tortfeasor is involved. The right of a workers’ compensation insurer is statutory. See Gautreaux v. City of Port Arthur, 406 S.W.2d 531, 534 (Tex.Civ.App.—Beaumont 1966, writ refd n.r.e.).

Free access — add to your briefcase to read the full text and ask questions with AI

Related

RELIANCE INSURANCE COMPANY v. Hibdon
333 S.W.3d 364 (Court of Appeals of Texas, 2011)
Elliott v. Hollingshead Ex Rel. Hollingshead
327 S.W.3d 824 (Court of Appeals of Texas, 2010)
Hodges v. Indiana Mills & Mfg
474 F.3d 188 (Fifth Circuit, 2006)
Texas Mutual Insurance Co. v. Ledbetter
192 S.W.3d 912 (Court of Appeals of Texas, 2006)
Texas Workers' Compensation Insurance Fund v. Knight
61 S.W.3d 91 (Court of Appeals of Texas, 2001)
Foreman ex rel. Fromme v. Security Insurance Co. of Hartford
15 S.W.3d 214 (Court of Appeals of Texas, 2000)
Texas Workers' Compensation Insurance Fund v. Serrano
22 S.W.3d 341 (Texas Supreme Court, 1999)
Estrada v. Wausau Insurance Co.
985 S.W.2d 480 (Court of Appeals of Texas, 1998)

Cite This Page — Counsel Stack

Bluebook (online)
912 S.W.2d 895, 1995 Tex. App. LEXIS 3265, 1995 WL 762334, Counsel Stack Legal Research, https://law.counselstack.com/opinion/texas-workers-compensation-insurance-fund-v-travis-texapp-1995.