Thomas Duran D/B/A Duran Ins. Brokerage and Duran Ins. Brokerage, Inc. v. Entrust, Inc.

CourtCourt of Appeals of Texas
DecidedMarch 25, 2010
Docket01-08-00589-CV
StatusPublished

This text of Thomas Duran D/B/A Duran Ins. Brokerage and Duran Ins. Brokerage, Inc. v. Entrust, Inc. (Thomas Duran D/B/A Duran Ins. Brokerage and Duran Ins. Brokerage, Inc. v. Entrust, Inc.) 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
Thomas Duran D/B/A Duran Ins. Brokerage and Duran Ins. Brokerage, Inc. v. Entrust, Inc., (Tex. Ct. App. 2010).

Opinion

Opinion issued March 25, 2010





In The

Court of Appeals

For The

First District of Texas





NO. 01-08-00589-CV





TOMAS DURAN d/b/a DURAN INSURANCE BROKERAGE AND DURAN INSURANCE BROKERAGE, INC., Appellants


V.


ENTRUST, INC., Appellee





On Appeal from the 151st District Court

Harris County, Texas

Trial Court Cause No. 2003-49982





MEMORANDUM OPINION


          Appellants, Tomas Duran d/b/a Duran Insurance Brokerage and Duran Insurance Brokerage, Inc. (“Duran”), appeal the trial court’s final judgment denying his breach of contract counter-claim and declaring that appellee, Entrust, Inc. (“Entrust”), did not owe Duran a portion of the fees Entrust received for processing “run-out claims” for the City of Corpus Christi (“the City”). In five issues, Duran contends that: (1) the trial court erred in denying his motion to transfer venue from Harris County to Nueces County; (2) the trial court erred in denying his motion for summary judgment on his breach of contract counter-claim; (3) he is entitled to a trial on the merits of his reasonable, necessary, and customary attorney’s fees; (4) the trial court erred in granting Entrust’s motion for summary judgment on its declaratory judgment claim because fact issues existed regarding Duran’s right to receive a share of the fees under their letter agreement; and (5) the trial court erred in granting Entrust’s motion for summary judgment because fact issues existed regarding Duran’s right to a share of the fees under standard practice in the industry.

          We affirm.

Background

          Entrust is in the business of providing third-party medical benefit plan administrative services to governmental entities and other organizations. Duran was an insurance broker. Entrust bid for a contract to provide medical benefit plan administrative services to the City. The City accepted Entrust’s bid and requested that Duran serve as an intermediary between the City and Entrust.

          On January 15, 1999, Entrust and Duran signed a letter agreement that provided:

Entrust, Inc., hereby agrees to split evenly the monthly administrative fees paid to it by the City of Corpus Christi with Duran Insurance Brokerage. It is agreed that the City of Corpus Christi shall pay the fees outlined on [sic] the Administrative Contract between it and Entrust, Inc., directly to Entrust, Inc. Upon receipt of these monies, Entrust, Inc., shall prepare and have delivered a check to Duran Insurance Brokerage. It is understood that the Plan Document preparation and printing costs and the 25% of negotiated savings for out-of-network claims, as identified in the Administration Contract, shall not be split and shall be retained wholly by Entrust, Inc.

. . . .

The split of monthly administration fees and expenses shall continue for as long as the City of Corpus Christi and Entrust, Inc. are parties to an administration contract. In the event of early termination of the administration contract or the extension or replacement of such contract, the term of this Letter of Agreement will coincide with the actual term of the contractual relationship described above.

On February 10, 1999, Entrust and the City executed their contract for Entrust to provide third-party administration services for City health care claims. The contract was effective for a four-year term from March 1, 1999 to February 28, 2003 and provided that Entrust would provide “group health third-party administration services” for the City. Entrust agreed to perform a wide variety of services, including Entrust agreeing to:

        establish a customer service office in Corpus Christi and hire staff to provide customer service on claims, eligibility, and benefit issues to City insured;

        provide a toll-free number for claims inquiries and customer service questions;

        supply and prepare checks and drafts for claims and payments to medical service providers and other vendors;

        conduct monthly balancing and reconciliation of a City-administered checking account and transmit electronically a monthly check register for the account and provide other financial services;

        generate and mail the Forms 1099 to vendors and service providers as required by the Internal Revenue Code;

        provide and maintain a comprehensive pharmacy network that includes at least two major pharmacy chains and a chiropractic care network that includes at least five chiropractors in the Corpus Christi area if such networks were unavailable through the PPO Network;

        forward to the City copies of all memoranda provided to it by the Texas Department of Insurance regarding rule changes and revisions to the law;

        train customer service representatives in accordance with rule changes and revisions to the law; and

        report claims information to the reinsurance carrier in accordance with reporting criteria established by that carrier.

The administration agreement also provided that Entrust “will name one (1) individual as coordinator to resolve all problems that may arise during the length of this Contract. This individual will have his office located in Corpus Christi, Texas to facilitate ease of operation.” The coordinator was to be available “one month prior to the Starting Date of this Contract and one month after termination of this contract” to help with the transition between carriers.

          On February 27, 2003, just before the expiration of the original contract, Entrust and the City signed an “Extension to the Contract to Provide Administration Services.” The extension provided that “both Entrust and the City wish to extend the Contract for 5 months starting on March 1, 2003 and expiring midnight July 31, 2003” and that “all other terms of the Contract will remain same [sic] and will remain in full force and effect until the new expiration date of midnight July 31, 2003.” The extension also provided:

[U]pon the July 31, 2003 expiration of the Contract, Entrust agrees to process, for a minimum period of three (3) months, all claims incurred before the new expiration date.

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Thomas Duran D/B/A Duran Ins. Brokerage and Duran Ins. Brokerage, Inc. v. Entrust, Inc., Counsel Stack Legal Research, https://law.counselstack.com/opinion/thomas-duran-dba-duran-ins-brokerage-and-duran-ins-texapp-2010.