TML Intergovernmental Employee Benefits Pool v. Prudential Insurance Company of America

CourtCourt of Appeals of Texas
DecidedMay 13, 2004
Docket03-03-00605-CV
StatusPublished

This text of TML Intergovernmental Employee Benefits Pool v. Prudential Insurance Company of America (TML Intergovernmental Employee Benefits Pool v. Prudential Insurance Company of America) 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
TML Intergovernmental Employee Benefits Pool v. Prudential Insurance Company of America, (Tex. Ct. App. 2004).

Opinion

TEXAS COURT OF APPEALS, THIRD DISTRICT, AT AUSTIN




NO. 03-03-00605-CV

TML Intergovernmental Employee Benefits Pool, Appellant



v.



Prudential Insurance Company of America, Appellee



FROM THE DISTRICT COURT OF TRAVIS COUNTY, 200TH JUDICIAL DISTRICT

NO. GN100134, HONORABLE MARGARET A. COOPER, JUDGE PRESIDING

O P I N I O N


In this case we must decide whether, when a governmental entity brings suit for declaratory relief, the defendant as the prevailing party may recover attorney's fees from the governmental entity. Appellant TML Intergovernmental Employee Benefits Pool ("the Pool") contends in one issue that governmental immunity bars the award of attorney's fees to appellee Prudential Insurance Company of America. Because we hold that the Pool's initiation of suit waived immunity from suit and that its request for declaratory relief under the Uniform Declaratory Judgments Act ("UDJA") waived immunity from liability for attorney's fees, we affirm the order of the district court.



BACKGROUND

The pertinent facts of this case are not in dispute. The Pool was created to provide health benefits coverage to employees of political subdivisions. See Tex. Gov't Code Ann. ch. 791 (West 1994 & Supp. 2004); Tex. Loc. Gov't Code Ann. ch. 172 (West 1999 & Supp. 2004). On September 29, 1998, the City of Denison changed its health benefits coverage for its employees from Prudential to the Pool. Prudential's contract with the City provided for an extension of health care benefits beyond the termination of the contract, for a maximum of three months, to a person who is totally disabled and under a doctor's care.

At the time of this transition in coverage, an employee of the City of Denison was hospitalized and in need of a heart transplant. She remained hospitalized for several months and received the transplant in April 1999. Both Prudential and the Pool paid the employee's medical expenses for the last three months of 1998. The Pool filed a claim for its payments with its excess loss insurance coverage carrier, Life Insurance Company of North America ("LINA"). See Tex. Loc. Gov't Code Ann. § 172.008(a) (West 1999) ("A risk pool may purchase excess loss coverage or reinsurance to insure a pool against financial losses that the pool determines might place the solvency of the pool in financial jeopardy."). LINA denied the claim.

In January 2001, the Pool filed suit against LINA and Prudential, asserting that LINA had breached its contract and requesting a declaration that the extension of benefits clause in Prudential's policy with the City "does not provide insurance coverage for [the employee's] claim." The Pool also sought attorney's fees pursuant to its request for declaratory relief. At the time it filed suit, the Pool deposited into the registry of the court approximately $348,000 that the hospital returned as an overpayment. In June and August 2001, the parties agreed to distribute $220,000 to the hospital and the remaining $128,000 to Prudential, which represented the amount that Prudential paid toward the employee's medical expenses for the last three months of 1998.

In February 2002, the Pool filed an amended petition, requesting a declaration of whether Prudential's policy "does or does not provide insurance coverage for [the employee's] claim." Prudential then filed a motion for summary judgment, seeking a declaration that its policy does not provide coverage. The Pool and LINA filed motions for partial summary judgment seeking a declaration that Prudential's policy does provide coverage. In June 2002, Prudential filed an amended answer in which it asserted a claim for attorney's fees pursuant to the UDJA.  Tex. Civ. Prac. & Rem. Code Ann. § 37.009 (West 1997).

The district court granted Prudential's motion for summary judgment and denied the Pool's and LINA's motions. Soon afterward, Prudential filed a motion to recover attorney's fees from the Pool on the ground that it was the prevailing party in the declaratory judgment action. The Pool responded that as a political subdivision of the State, it is immune from liability. The Pool also asserted that because it had acted in good faith, the district court should exercise its discretion and not award attorney's fees. Prudential responded that the Pool waived immunity from liability by seeking a declaration of its rights under the UDJA, initiating suit against Prudential, and failing to plead the affirmative defense of immunity from liability. After a hearing on the motion and response, the district court granted Prudential's motion and ordered that the Pool pay Prudential's attorney's fees in part. It is from this order that the Pool appeals. (1)

ANALYSIS

In one issue, the Pool contends that the district court erred in awarding attorney's fees to Prudential under the UDJA because the Pool, as a political subdivision, is immune from paying a money judgment. Whether the Pool is entitled to immunity is a question of law. Harris County v. Louvier, 956 S.W.2d 106, 107 (Tex. App.--Houston [14th Dist.] 1997, no pet.). We review questions of law de novo. Texas Dep't of Transp. v. Needham, 82 S.W.3d 314, 318 (Tex. 2002). In our analysis of this issue, we are mindful of two matters that are not in dispute. First, the parties agree the Pool's UDJA action was within the district court's subject matter jurisdiction. Second, the parties agree that Prudential prevailed on the merits of the Pool's action for declaratory relief.

Governmental immunity encompasses two principles: immunity from suit and immunity from liability. Texas Natural Res. Conservation Comm'n v. IT-Davy, 74 S.W.3d 849, 853 (Tex. 2002). The Pool asserts immunity on both grounds, and we will address them individually. Immunity from suit bars a suit against the State unless the legislature expressly consents to the suit. Id. An exception to this rule is when the State initiates suit. Id. at 861 (Hecht, J., concurring) ("[I]t has long been held that the State can waive immunity by filing suit."); State v. Fidelity & Deposit Co. of Md., 127 S.W.3d 339, 344 (Tex. App.--Austin 2004, pet. filed) ("It is well established that the State's initiation of suit is an exception to sovereign immunity from suit clearly recognized by Texas courts."). When a governmental entity brings suit, it "waives immunity from suit for any claim that is 'incident to, connected with, arises out of, or is germane to the suit or controversy brought by the State.'" Reata Constr. Corp. v. City of Dallas, 47 Tex. Sup. Ct. J. 408, 2004 Tex. LEXIS 303, at *7 (Apr. 2, 2004) (quoting State v. Martin, 347 S.W.2d 809, 814 (Tex. Civ. App.--Austin 1961, writ ref'd n.r.e.)). Here, the Pool asserted, among its causes of action, a request for declaratory relief. In response, Prudential requested attorney's fees under the UDJA.

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TML Intergovernmental Employee Benefits Pool v. Prudential Insurance Company of America, Counsel Stack Legal Research, https://law.counselstack.com/opinion/tml-intergovernmental-employee-benefits-pool-v-pru-texapp-2004.