Source: http://www.thestreetlawfirm.com/index.php?option=com_organizer&task=view&id=147
Timestamp: 2017-09-25 13:18:16
Document Index: 142643711

Matched Legal Cases: ['Art. 5', 'Art. 5', '§ 601', 'Art 5', 'Art. 5', '§ 601', 'art. 21', '§2', 'Art. 5', 'art. 5069', '§ 6', '§ 5', '§ 417']

In spite of mandatory liability insurance laws in 47 of the 50 states, the Insurance Research Council estimates that U. S. drivers have a 14% chance of being hit by an uninsured driver. The odds vary significantly from state to state. Texas, for instance, is ranked 9 th in overall numbers of uninsured drivers. It is estimated that 21% of all motorists on Texas streets and highways are uninsured. ( Colorado has the dubious distinction of being number 1 with 34% uninsured. Our neighbors New Mexico, Oklahoma, Arkansas and Louisiana have 27%, 19%, 12% and 12%, respectively.) (Insurance Research Council, Uninsured Motorists, 1999). The Texas Department of Insurance estimated in 2001 that the uninsured motorist population in Texas actually ranges from 21% to 28% (from county to county), with even higher percentages along the border with Mexico. (Testimony of Texas Insurance Commissioner Jose Montemayor to the Border Affairs Interim Committee of the Texas Legislature, March 6, 2001). With the NAFTA-driven growth of commerce and ever-increasing travel across the border, an estimated 1.6 million daily crossings (400 million annually) are occurring, with perhaps the majority of these vehicles being uninsured. ( Id.) Texas currently has no insurance verification program, as some 27 states do. In states that have insurance verification programs, the rate of uninsured drivers has decreased on average from 25.85% to 9.39%, an improvement of 63.68% (HB 3588 Feasibility Study of an Interface Motor Vehicle Financial Responsibility Verification System, October 18, 2004).
It has long been the intention of the Texas Legislature and the Courts that all motorists carry liability insurance to pay for damages caused to other motorists. Forty-seven states, including Texas, have mandatory liability insurance laws. Texas passed its Motor Vehicle Safety Responsibility Act in 1981 to reduce the number of uninsured drivers, which had been steady at around 25% for several years. Passage of the legislation resulted in a sharp decrease in the number of uninsured motorists from 26.9% in 1981 to 8.5% in 1982. However, the rates slowly climbed again, and by only 1987 the rate had climbed to over 21% (Senate Interim Committee on Civil Justice: Report on Uninsured Motorists and Tort Reform Savings, October, 1998). The enactment of Art. 5.06-1 of the Texas Insurance Code (originally enacted in 1967 to provide for uninsured motorist protection and amended in 1977 to add underinsured motorist coverage) mandated that all automobile insurance companies doing business in Texas offer UM/UIM coverage as a part of the standard Texas Personal Automobile Insurance Policy, with the purpose being to protect those so insured against the negligent acts of “financially irresponsible” motorists (Member Mutual Ins. Co. v. Hermann Hospital, 664 S. W. 2d 325 (Tex.1984)). In effect, by purchasing UM/UIM coverage, the policyholder was purchasing liability insurance for the uninsured or underinsured motorist (Sikes v. Zuloaga, 830 S. W. 2d 752 ( Tex. App.—Austin 1992, no writ)).
COVERAGE OF PERSONS, VEHICLES AND INJURIES
The limits of coverage were set at the statutory minimum liability limits (at the time, $10,000/$20,000/$5,000, but currently $20,000/$40,000/$15,000) but may be increased above the statutory minimum by payment of an additional premium. However, the UM limits may not be increased above the limits of liability coverage. (TEX. INS. CODE ANN., Art. 5.06-1(3)). A 20/40/15 policy will pay up to $20,000 for bodily injury to any one person with a total of $40,000 paid for all persons involved, with no more than $20,000 paid to any one person; and a total of $15,000 for the property damage of all claimants combined. (TEX. TRANS. CODE § 601.072).
The bodily injury portion of the UM policy is designed to pay without deductibles for past and future medical bills; funeral expenses; lost wages; loss of wage earning capacity; physical pain; mental anguish; disfigurement; and permanent or partial disability. The property damage portion pays for repairs to the insured’s automobile if the cost of repairs does not exceed fair market value; the fair market value of the insured vehicle if the cost of repairs exceeds fair market value; damage to items in the car; and damage caused by the insured to the property of others (light poles, etc.) not due to negligence on the part of the insured; and rental car expenses. The deductible on property damage is set by statute at $250.00 per occurrence.
“Stacking” means collecting from more than one policy on the same claim. Nineteen states either allow, or do not prohibit, stacking of UM/UIM benefits. In Texas, stacking is allowed (Stracener v. United States Automobile Association, 777 S. W. 2d 378 (Tex. 1989)) except where specifically prohibited by the policy. (Upshaw v. Trinity Companies, 842 S. W. 2d 631 (Tex. 1992)). However, only “inter-policy” stacking is allowed in Texas (the aggregation of coverage under more than one policy). For example, if one is injured by an uninsured motorist while one is occupying a vehicle with uninsured motorist coverage, one may collect on both the policy for the vehicle one is occupying and on one’s own personal uninsured motorist policy. (American Liberty Ins. Co. v. Ranzau, 481 S. W. 2d 793 (Tex. 1972)). “Intra-policy” stacking (the aggregation of limits for each car covered under one policy) is not allowed in Texas. (State Farm Mutual Ins. Co. v. Conn, 842 S. W. 2d 350 (Tex. App.—Tyler 1992, writ denied)). In other words, insuring two cars on one policy with $20,000 in coverage on each one will not yield $40,000 of UM/UIM coverage in Texas. Also, one cannot exhaust the liability limits of a policy and then recover UM/UIM benefits under the same policy. (Farmers Texas County Mutual Ins. Co. v. Griffin, 868 S. W. 2d 861 (Tex. App.—Dallas 1993, writ denied)).
Insurance carriers often attempt to prevent their policy holders from collecting uninsured motorist benefits under the “other insurance” clause of the policy (sometimes called the “coordination of benefits” clause or “non-duplication of benefits” clause) that holds that “the insurance . . . shall apply only as excess insurance over any other similar insurance available to such insured and applicable to such automobile as primary insurance." The courts in Texas have fairly uniformly rejected this premise, holding that the UM statute "precludes the use of 'other insurance' clauses to limit the recovery of actual damages caused by an uninsured motorist." The courts have held that "if coverage exists under two or more policies, liability on the policies is joint and several to the extent of plaintiff's actual damages , subject to the qualification that no insurer may be required to pay in excess of its policy limits." Note that “when multiple UM coverages exist, which together exceed the insured's actual damages, the total amount of UM benefits paid to the insured is limited to the insured's actual damages.” (American Motorists Ins. Co. v. Briggs, 514 S. W. 2d 233, ( Tex. 1974))
A carrier may take a credit (“offset”) for Personal Injury Protection (“PIP”) benefits it has paid under the same policy, if the policy contains a “non-duplication of benefits” provision (and they all now do). (Mid-Century Ins. Co. of Texas v. Kidd, 997 S. W. 2d 265 (Tex. 1999)). However, the offset is not allowed if it would result in the reduction of the UM/UIM coverage to an amount below the statutorily-mandated minimum, or, if the actual damages of the insured, less the PIP credit, still exceed the UM/UIM limits, no offset is allowed. (Dabney v. Home Ins. Co., 643 S. W. 2d 386 (Tex. 1982)). At least one court, however, (the Austin Court of Appeals in Laurence v. State Farm Mut. Auto. Ins. Co. , 984 S. W. 2d 351 ( Tex. App.—Austin [3 rd Dist.] 1999, pet. ref’d)) has held that the carrier may take an offset against UM benefits for any PIP benefits pay if the actual damages of the insured do not exceed the combined PIP and UM limits.
That same Austin Court in Laurence (Id.) also held that “an insurer paying uninsured motorist (UM) benefits has a right of subrogation from the proceeds of any settlement or judgment resulting from the payee's exercising a right of recovery against anyone legally responsible for her injury.”
There were 10,747 hit-and-run accidents reported within the city limits of Dallas in 2002 (almost 30 per day), and 9,491 in 2003 (26 per day). In each year, more than 500 of these involved serious bodily injuries or death. ( North Dallas People Newspaper, February 29, 2004). Since the definition of “uninsured motorist” includes “unidentified motorist,” a hit-and-run driver is, by definition, an uninsured motorist under the terms of the insurance policy. The uninsured motorist policy will pay for damages caused by a hit-and-run driver only if the insured promptly reports the accident to the police.
“Underinsured Motorist” refers to a driver of a motor vehicle with liability insurance, but with not enough coverage to pay for the damages caused in the accident. An underinsured motorist is defined as a motorist operating an insured vehicle “on which there is valid and collectible liability insurance coverage with limits of liability for the owner or operator which were originally lower than, or have been reduced by payment of claims arising from the same accident to, an amount less that the limit of liability stated in the underinsured coverage of the insured’s policy.” (TEX. INS. CODE ANN., Art 5.06-1 (2) (b)).
The statutes and policy provisions regarding coverage of persons, vehicles and injuries for underinsured motorists are the same as for uninsured motorists. Thus, the statutory minimum limits of coverage are currently $20,000/$40,000/$15,000 and may be increased above the statutory minimum by payment of an additional premium. However, the UIM limits may not be increased above the limits of liability coverage. (TEX. INS. CODE ANN., Art. 5.06-1(3)). A 20/40/15 policy will pay up to $20,000 for bodily injury to any one person with a total of $40,000 paid for all persons involved, with no more than $20,000 paid to any one person; and a total of $15,000 for the property damage of all claimants combined. (TEX. TRANS. CODE § 601.072).
The bodily injury portion of the UIM policy is designed to pay without deductibles for past and future medical bills; funeral expenses; lost wages; loss of wage earning capacity; physical pain; mental anguish; disfigurement; and permanent or partial disability. The property damage portion pays for repairs to the insured’s automobile if the cost of repairs does not exceed fair market value; the fair market value of the insured vehicle if the cost of repairs exceeds fair market value; damage to items in the car; and damage caused by the insured to the property of others (light poles, etc.) not due to negligence on the part of the insured; and rental car expenses. The deductible on property damage is set by statute at $250.00 per occurrence.
Uninsured and underinsured motorist coverage applies to the named insured and his/her “family members” residing in the same household, regardless of whether they are traveling in the insured vehicle or a vehicle owned or operated by another person; passengers in the insured vehicle; and anyone driving the insured vehicle with the permission, whether express or implied, of the owner. “Family member” is defined as a person who is a member of the named insured’s household and is related to the insured by blood, marriage, or adoption. A person may have more than one residence, especially when that person is a minor. A child may be considered a member of both parents’ household in the case of divorce, and may therefore be covered under both parents’ underinsured motorist policies. (Hartford Casualty Ins. Co. v. Phillips, 575 S. W. 2d 62 (Tex. Civ. App.—Texarkana 1978, no writ)). Coverage is also provided for the named insured or any family member injured by an uninsured or underinsured motorist while the insured or family member is a pedestrian, bicyclist, or otherwise, as long as the bodily injury evolved from coming into physical contact with the uninsured or underinsured vehicle.
This exclusion applies only if the governmental employee were in the course and scope of his employment at the time of the occurrence.
The question as to whether an insurance company is liable for punitive damages under a UM or UIM claim has never been answered by the Texas Supreme Court, and the Texas Courts of Appeal are split on the issue. In two older decisions, the appellate courts held that UM coverage did include punitive damages. (Dairyland County Mutual Ins. Co. v. Wallgren, 477 S. W. 2d 341 (Tex. App.—Fort Worth 1972, writ ref’d n. r. e.) and Home Indemnity Co. v. Tyler, 522 S. W. 2d 594 (Tex. App.—Houston [14 th Dist.] 1975, writ ref’d n. r. e.)). While the Dairyland case has never been reversed, the ruling in the Tyler case was explicitly abandoned by the Houston [14 th Dist.] Court in Milligan v. State Farm Mut. Auto. Ins. Co. , 940 S. W .2d 228 (Tex. App.—Houston [14 th Dist.] 1997) and both cases have been criticized and distinguished more than once.
Since the Texas Legislature has occupied itself mostly with “tort reform” legislation, primarily in the area of medical malpractice (and laying the groundwork through Proposition 12 to be able to cap non-economic damages in all personal injury claims), no significant legislation regarding UM/UIM claims has been passed in the last several sessions. HB 3588, passed during the 78 th Legislative Session, charged the Department of Public Safety and the Department of Insurance to jointly conduct a study to determine the feasibility, affordability, and practicability of using a database interface software system for the verification of liability insurance on motor vehicles in Texas. The task force announced its intentions to present its findings to the 79 th Legislative Session and urge passage of statutes strengthening the mandatory liability insurance laws in Texas (HB 3588 Feasibility Study of an Interface Motor Vehicle Financial Responsibility Verification System, October 18, 2004). Overshadowed by school financing woes, the legislature apparently never got around to considering the findings (if any) of the task force.
Allstate Insurance Company v. Rhonda Bonner, 51 S. W. 3d 289 ( Tex. 2001)—Rhonda Bonner had an automobile insurance policy with Allstate containing both PIP and UM/UIM provisions. Bonner was injured in an accident, incurred $1,802.00 in chiropractic bills, and submitted these bills with an application for PIP benefits, which Allstate acknowledged within 15 days as required by Tex. Ins. Code art. 21.55 §2. Allstate reduced the bills to $1,619.00 and paid Bonner this amount. After receiving that money, Bonner submitted notice of a UM claim to Allstate. Allstate did not acknowledge the UM claim until 36 days after receipt. Allstate later denied Bonner’s UM claim and Bonner sued Allstate to recover UM benefits. The jury awarded Bonner $1,000.00 compensation for her chiropractic care and nothing for physical pain or mental anguish. The jury also awarded $7,500.00 for Bonner’s attorney’s fees. Because Bonner’s policy contained a nonduplication-of-benefits provision, and because the $1,619.00 PIP payment exceeded the $1,000.00 UM damage award, the trial court rendered judgment that Bonner take nothing. The court also declined to award the attorney’s fees and taxed costs of court against Bonner, who appealed. The court of appeals affirmed the take-nothing judgment for the UM benefits but reversed the trial court’s denial of attorney’s fees and assessed all costs of court for trial and appeal to Allstate. The Supreme Court reversed the court of appeals, holding that, even though Allstate failed to acknowledge Bonner’s UM claim within 15 days as required by statute, Bonner did not present a claim for which Allstate is liable. Allstate’s payment of $1,619.00 in PIP benefits served as a policy defense to the UM claim, since Allstate paid Bonner more than her UM damages. By doing so, Allstate completely defeated Bonner’s UM claim and, under the terms of the policy, was not liable to her. Thus, no attorney’s fees were awardable.
As to point (2), that the waiver of coverage made by Mrs. Sanchez (not a named insured) was binding upon Mr. Sanchez (the only named insured), the court held that Art. 5.06-1 (1) of the Texas Insurance Code states that all automobile insurance policies shall provide UM coverage except where “any insured named in the policy shall reject the coverage in writing.” Since Mrs. Sanchez was not an insured named in the policy, her rejection of PIP and UM/UIM benefits was not binding upon Mr. Sanchez. This point was specifically reversed and rendered in favor of the insurer by the Texas Supreme Court in Old Am. County Mut. Fire Ins. Co. v. Sanchez , 149 S. W. 3d 111 ( Tex. 2004), holding that “the legislature intended to equate the phrase ‘any insured named in the policy’ with ‘the named insured’ as found in Tex. Ins. Code Ann. Arts. 5.06-1 (1), 5.06-3 (a) for UM and PIP coverage respectively. The spouse, therefore, was a ‘named insured’ and thus ‘an insured named in the policy’ as contemplated by the legislature in enacting the articles. As such, she had statutory authority to reject UM and PIP coverages, and the appellate court erred in holding otherwise.” The Court stated, “We find it difficult to conceive that the Legislature intended for a husband to be (i) covered under a policy obtained exclusively by his wife but admittedly for his benefit; (ii) entitled to recover from the insurer under the terms and policy limits set by the wife; yet, (iii) not bound with respect to one aspect of the policy—the rejection of UM and PIP coverages—because his wife was not authorized to reject coverages.”
Sharon Menix v. Allstate Indemnity Co., 83 S. W. 3d 877 ( Tex. App.—Eastland 2002, writ denied)—This case is important because it defines the two types of prejudgment interest and when they are awardable. The court coined the phrases “Cavnar-type” prejudgment interest [due to its genesis in Cavnar v. Quality Control Parking, Inc., 696 S. W. 2d 549 ( Tex. 1985), where the court adopted a rule allowing recovery of prejudgment interest on personal injury, wrongful death, and survival actions, reasoning that prejudgment interest was due as additional damages from the tortfeasor because the “primary objective of awarding damages in civil actions has always been to compensate the injured plaintiff, rather than to punish the defendant”] and “Henson-type” prejudgment interest [defined in Henson v. Southern Farm Bureau Casualty Ins. Co., 17 S. W. 3d 652, 43 Tex. Sup. Ct. J. 622 ( Tex. 2000), distinguishing prejudgment interest based on the tortfeasor’s obligations from that based upon the insurance companies’ obligations. In Henson, the damages awarded by the jury against the tortfeasor greatly exceed the UIM policy limit, thus obviating the necessity to calculate Cavnar-type prejudgment interest.] In Menix, (as opposed to the facts in Henson) the UIM policy limit exceeded the amount of actual damages the tortfeasor caused. Therefore, the prejudgment interest that Menix was entitled to from the tortfeasor would be payable as Cavnar-type “additional damages” under Menix’s UIM policy, to the extent that such additional damages did not exceed Menix’s policy limit.
[Note: With regard to Cavnar-type prejudgment interest, the legislature in 1987 added section 6 to article 5069-1.05 (TEX. REV. CIV. STAT. art. 5069-1.05, § 6(a)), shortening the time period during which prejudgment interest accrues. Instead of beginning six months after the date of the incident, section 6 provides that prejudgment interest generally begins to accrue on the earlier of (1) 180 days after the date the defendant receives written notice of a claim, or, (2) the day the suit is filed. Because of this legislation, the Supreme Court in Johnson & Higgins v. Kenneco Energy , 962 S. W .2d 507 ( Tex. 1998) effectively set aside Cavnar as it relates to personal injury, wrongful death, and survival action cases.]
Trinity Universal Ins. Co. v. Lilith Brainard, et al., 153 S. W. 3d 508 ( Tex. App.— Amarillo 2004, no writ)—Edward Brainard, II, was killed in a head-on collision with a piece of heavy equipment. When it was discovered by the attorney for the heirs that Premier, the owner of the equipment, had only a $1,000,000.00 liability policy limit, a claim was made under the deceased UIM policy issued by Trinity Universal Insurance Company (“Trinity”). A lawsuit was filed against Premier and Trinity was brought in by 3 rd Amended Petition. Among other issues, the heirs claimed Trinity had breached its contract for failing to pay benefits and that it was also liable for Plaintiffs’ attorney’s fees. Premier subsequently tendered its policy limits and was dismissed from the suit, which continued to trial against Trinity. Following a jury trial in which the jury awarded $1,010,000 in actual damages and $100,000.00 in attorney’s fees, the court applied an offset of $1,005,000.00 (for PIP and the amount of the Premier settlement), leaving a judgment against Trinity for $5,000.00, plus the $100,000.00 in attorney’s fees, but denied Plaintiffs’ request for prejudgment interest. Trinity appealed. The appellate court reversed the trial court’s judgment awarding attorney’s fees and rendered a judgment that no attorney’s fees were to be awarded. The reasoning of the court was based on Sprague v. State Farm Mut. Auto. Ins. Co., 880 S. W. 2d 415 (Tex. App.—Houston [14 th Dist.] 1993, writ denied), and Sikes v. Zuloaga, 830 S. W. 2d 752 (Tex. App.—Austin 1992, no writ) wherein the courts held that attorney’s fees were not recoverable before determination of the fault of the underinsured motorist and the amount of damages. [Note that a contrary finding was made in Allstate Ins. Co. v. Lincoln, 976 S. W. 2d 873 (Tex. App.—Waco 1998, no pet.); Whitehead v. State Farm Mut. Auto. Ins. Co., 952 S. W. 2d 79 ( Tex. App.— Texarkana 1997, rev’d on other grounds, 988 S. W. 2d 744 ( Tex. Sup. Ct. J. 404 (Tex. 1999); Novasad v. Mid-Century Ins. Co., 881 S. W. 2d 546 (Tex. App.—San Antonio 1994, no writ)]; and State Farm Mut. Auto. Ins. Co. v. Nickerson, Id.] The court affirmed the trial court’s denial of prejudgment interest on the basis that the insurance contract obligates the insurer to pay damages because of “bodily injury or property damage” but does not obligate the insurer to pay interest on damages or the amount of a judgment if obtained against the underinsured motorist.
In a hit-and-run claim, the insured must prove that “actual physical contact . . . occurred between the motor vehicle operated by such unknown person and the person or property of the insured.” (TEX. INSUR. CODE, § 5.06-1 (2) (d)). However, the Courts have interpreted the “physical contact” requirement to be satisfied by indirect contact. For instance, if the uninsured motorist hits another car and propels it into the insured, this will constitute physical contact. (Latham v. Mountain States Mutual Casualty Co., 482 S. W. 2d 655 ( Tex. App.— Houston [1 st Dist.] 1972, writ ref’d n. r. e.). This indirect contact rule applies only where the unidentified motorist has hit another vehicle and started a chain reaction. (Guzman v. Allstate Ins. Co., 802 S. W. 2d 877 ( Tex. App.—Eastland 1991, no writ). Contrast this with the situation where the unidentified (thus, “uninsured”) vehicle cuts in front of the insured, causing the insured to strike another car while trying to evade the uninsured motorist. In this instance, the courts have ruled there was no contact and, thus, no coverage. (Goen v. Trinity Universal Ins. Co., 715 S. W. 2d 124 ( Tex. App.— Texarkana 1986, no writ; Mayer v. State Farm Mut. Auto. Ins. Co. , 870 S. W. 2d 623 (Tex. App.—Houston [1 st Dist.] 1994)). Other examples of the “physical contact” rule not being satisfied: (a) when the insured was the third vehicle in a series rear-ender when the first vehicle slammed on brakes while attempting to avoid furniture dropped on the roadway by an unidentified truck; (Republic Ins. Co. v. Stoker, 867 S. W. 2d 74 (Tex. App.—El Paso 1993) (b) a drive-by shooting; (Collier v. Employers Nat’l Ins. Co., 861 S. W. 2d 286 (Tex. App.—Houston [14 th Dist.] 1993, writ denied) and (c) an object falling from an unidentified vehicle and striking the insured. (Williams v. Allstate Ins. Co., 849 S. W. 2d 859 ( Tex. App.— Beaumont 1993, no writ). Contrast the Collier decision, however, with Mid-Century Ins. Co. of Texas v. Lindsey , 942 S. W. 2d 140 ( Tex. App.—Texarkana, 1997) where the appellate court upheld the trial court’s ruling in favor of an underinsured motorist benefits claimant who was injured when a gun accidentally discharged in an adjacent vehicle.
Because automobile insurance policies are written contracts (albeit unilateral), attorney’s fees are generally recoverable in lawsuits concerning issues raised by the contract. (Barnett v. Aetna Life Ins. Co., 723 S. W. 2d 663 ( Tex. 1987) UM/UIM claims and disputes based upon those claims are contract claims and attorney’s fees are recoverable. (Allstate Ins. Co. v. Lincoln, 976 S. W. 2d 873 ( Tex. App.— Waco 1998, reh. denied). Language in the policy restricting damages to those the insured is “legally entitled to recover” generally prevents the recovery of attorney’s fees without a judicial determination of the amount of damages. (Novasad v. Mid-Century Ins. Co., 881 S. W. 2d 546 (Tex. App.—San Antonio 1994, no writ)). However, in a recent Court of Appeals decision (State Farm Mut. Auto. Ins. Co. v. Nickerson, 130 S. W. 3d 487 ( Tex. App.—Texarkana 2004) (Pet. for Review Granted 2005) the Court held that, in the context of a UM lawsuit, an award of attorney’s fees to a plaintiff recovering on a valid claim founded on a written contract, preceded by proper presentment, is mandatory. The Court reasoned that such a claim is “simply a claim on a contract, outside typical insurance liability contexts, and that, where a valid claim existed, and proper presentment was made, there was no reason to treat the claim any differently than any other contract claim.” The elements required for recovery of attorney’s fees under Section 38.001 are: (1) recovery of a valid claim in a suit on a written or oral contract; (2) representation by an attorney; (3) presentment of the claim to the opposing party; and (4) failure of the opposing party to tender payment of the just amount owed within thirty days of presentment. State Farm argued that there was no breach of contract, and that when it was determined that they were liable, they paid; therefore, no attorney’s fees are owed. State Farm based its argument on Henson v. S. Farm Bureau Cas. Ins. Co., 17 S. W. 3d 652, 43 Tex. Sup. Ct. J. 622 ( Tex. 2000) that holds that neither filing a claim nor filing suit triggers an obligation to pay the UM claim. Therefore, State Farm reasoned that no amount owing could exist until a judicial determination of liability is made. The Nickerson Court states, “We find that argument unpersuasive. If Section 38.002 (3) is so read, then attorney’s fees cannot be recovered in any contractual dispute that results in litigation, providing the losing party promptly pays after the ‘just amount owed’ is determined through litigation. That is not the meaning of the term.” The section states that, to recover attorney’s fees, “payment for the just amount owed must not have been tendered before the expiration of the 30 th day after the claim is presented.” The Court found that “the phrase ‘claim is presented’ is not equivalent to ‘judgment is rendered.’”
Workers’ Compensation Liens are authorized under the Texas Labor Code § 417.001 and provides subrogation rights to the workers’ comp carrier whenever the injured worker has the right to collect from a third party who is or becomes liable for the employee’s injuries. The lien is enforceable against the worker, the third party, the third party’s insurer, and the worker’s own attorney, to the extent the attorney received any benefits. (Home Indemnity Co. v. Pate, 866 S. W. 2d 277 ( Tex. App.— Houston [1 st Dist.] 1993, no writ). However, the lien does not attach to UM/UIM benefits. (Bogart v.Twin City Fire Ins. Co., 473 F.2d 619 (5 th Cir. 1973)).
Bogart v.Twin City Fire Ins. Co., 473 F.2d 619 (5 th Cir. 1973)
Collier v. Employers Nat’l Ins. Co., 861 S. W. 2d 286 (Tex. App.—Houston [14 th Dist.] 1993, writ denied)
Home Indemnity Co. v. Pate, 866 S. W. 2d 277 (Tex. App.—Houston [1 st Dist.] 1993, no writ)
Home Indemnity Co. v. Tyler, 522 S. W. 2d 594 (Tex. App.—Houston [14 th Dist.] 1975, writ ref’d n. r. e.)
Johnson & Higgins v. Kenneco Energy , 962 S. W .2d 507 ( Tex. 1998)
Laurence v. State Farm Mut. Auto. Ins. Co. , 984 S. W. 2d 351 ( Tex. App.—Austin [3 rd Dist.] 1999, pet. ref’d)
Mayer v. State Farm Mut. Auto. Ins. Co. , 870 S. W. 2d 623 (Tex. App.—Houston [1 st Dist.] 1994)
Mid-Century Ins. Co. of Texas v. Lindsey , 942 S. W. 2d 140 ( Tex. App.—Texarkana, 1997)
Milligan v. State Farm Mut. Auto. Ins. Co., 940 S. W. 2d 288 (Tex. App.—Houston [14 th Dist.] 1997)
Senate Interim Committee on Civil Justice: Report on Uninsured Motorists and Tort Reform Savings, October, 1998
Sprague v. State Farm Mut. Auto. Ins. Co., 880 S. W. 2d 415 (Tex. App.—Houston [14 th Dist.] 1993, writ denied)
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