law-workers-comp-insured-vs-carrier | worker's comp appeals

law-workers-comp-insured-vs-carrier   | administrative dispute of worker impairment rating | workers
compensation appeals | judicial review suits under the Workers Compensation Act | Houston Workers Comp
Cases on Appeal | law-workers-comp-impairment-rating | administrative dispute of worker impairment rating |
workers compensation appeals | judicial review suits under the Workers Compensation Act | Houston Workers
Comp Cases on Appeal |

Effective September 1, 2005 the legislature abolished the Texas Workers' Compensation Commission (the
Commission), and transferred its responsibilities to the Texas Department of Insurance, Division of Workers'
Compensation (the Division). Act of May 29, 2005, 79th Leg. R.S., ch. 265 §§ 8.001(b), 8.004(a), 2005 Tex.
Sess. Law Serv. 608. Although both the Commission and the Division were in operation during the time relevant
to this dispute, for consistency we will refer to the Commission and the Division as the Division only.
American Zurich Ins. Co. v. Samudio (Tex.App.- Houston [1st Dist.] Feb. 11, 20 10)(Alcala)
(carrier loses workers compensation appeal over worker's impairment rating, plea to the jurisdiction in judicial
review suit affirmed, attorney fees award for prevailing claimant workers comp appeal)
AFFIRM TC JUDGMENT: Opinion by Justice Alcala
Before Chief Justice Radack, Justices Alcala and Higley
01-08-00233-CV American Zurich Insurance Company v. Daniel Samudio
Appeal from 127th District Court of Harris County
Trial Court Judge: Hon. Sharolyn P. Wood

WORKERS' COMPENSATION LITIGATION

Finally, we reject Methodist's suggestion it should have recourse because Zurich bore no risk when handling
Methodist's funds. To the contrary, along with its discretion in handling claims, Zurich, as insurance carrier,
was the party who faced potential liability to the employee with respect to claims-handling. See Aranda v. Ins.
Co. of N. Am., 748 S.W.2d 210, 211-12 (Tex. 1988) (recognizing workers' compensation insurance carrier owes
employee duty of good faith and fair dealing in processing compensation claims). Methodist certainly does not
admit it was personally liable to its employees for the manner in which claims were handled. Consequently, we
decline to approve a scenario in which Methodist indirectly retained discretion over Zurich's handling and
settlement of claims, yet Zurich, not Methodist, was potentially liable to an employee for claims-related
decisions.
The Methodist Hospital v. Zurich American Inc. Co. (Tex. App. - Houston [14th Dist.] Jul. 7, 2009) (Seymore)
(INSURANCE LITIGATION: insured's suits against worker's compensation carrier alleging wrongful payment of
noncompensable injury claims within the deductible)(insurer's duty of good faith and fair dealings, negligent
claims handling, express warranty claim, breach of warranty - elements, conclusory affidavit)
AFFIRMED: Opinion by Justice Seymore
Before Justices Frost, Seymore and Guzman
14-07-00663-CV The Methodist Hospital v. Zurich American Insurance Company, Tamera McKinney and Mary
Vu
Appeal from 280th District Court of Harris County
CONCURRING: Concurring Opinion by Justice Frost (highlighting applicable binding Supreme Court precedent)


In sum, the trial court properly concluded that, as a matter of law, Methodist had no cause of action for breach
of contract or negligence against Zurich.

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