Court Opinion

ID: 9774778
Source: CourtListenerOpinion
Date Created: 2023-08-29 18:33:19.126678+00
Date Added: 2024-06-11T07:32:15.597487
License: Public Domain

GILBERTO HINOJOSA Justice,
dissenting.
I respectfully dissent. I would affirm the jury’s award of $4 million in punitive damages and $500,000 in future medical costs to Corina Saenz.
I. Facts
Saenz suffered a severe head injury when she fell over backwards in a chair at work. She was diagnosed with “post-concussion syndrome,” and her physician, Dr. Humberto Tijerina, concluded that Saenz’ condition would require medical attention “indefinitely.” Saenz sought to recover workers’ compensation benefits from Fidelity & Guaranty Underwriters Insurance Company, her employer’s workers’ compensation carrier.
Gisela Armstrong was the adjuster for Saenz’ workers’ compensation claim and handled all day-to-day contacts with her. Armstrong testified that everything she did on the Saenz file was approved by her supervisor, Stan Lawson. Lawson had been with Fidelity for twenty-five years, and also supervised one or two other adjusters. Fidelity’s corporate representative, Barbara Mat*120thews, testified that in Lawson’s capacity as Armstrong’s supervisor, it was his responsibility to supervise the Saenz claim. She stated that to her knowledge Lawson was aware of what Armstrong did in the handling of the Saenz claim. Lawson did not testify at trial.
In February, 1987, Fidelity requested a prehearing conference with the Industrial Accident Board (IAB). A letter to Armstrong from Trey Gillespie, an attorney for Fidelity, states: “Obviously this is a potentially dangerous ease in the valley ... it appears that the claimant’s complaints with regards [sic] to seizures and headaches are legitimate.” Gillespie also stated that Saenz’ employer had indicated that it would not permit Saenz to return to work. Gillespie expressed his desire to reach a reasonable settlement in the prehearing conference, “without scaring the claimant off to an attorney.” He then stated, “If the claimant has some motivational problems, it would probably be to your benefit to try to work out a settlement within the next couple of months.”
Armstrong called Saenz before the pre-hearing conference. She offered Saenz $65,-000 cash and an additional five years of open medical, but Saenz declined because she was concerned about future medical costs. Saenz testified that she specifically inquired into the possibility of obtaining lifetime medical, and that Armstrong replied that the maximum workers’ compensation benefit she could receive was five years of medical care. Saenz understood that this offer was the most that Fidelity would pay. Saenz testified that Armstrong told her that she would not need an attorney at the prehearing conference, because the settlement amount would be the same, except that she would have to pay a lawyer 25% out of the settlement amount.
At the prehearing conference on April 8, 1987, Saenz accepted Fidelity’s settlement offer of $65,000 cash and five years open medical care. Fidelity was represented by an attorney, Jimmie Ross Weaver. Saenz was not represented by an attorney. After the settlement agreement was reached, Weaver sent a post-hearing report to Armstrong in which he noted that the Saenz file was “obviously a very dangerous case and one that we might well end up having to pay out weekly for the full period of total disability.” He observed that, “by settling the case at this time, [Fidelity] avoided the possibility that this lady’s condition could deteriorate and eventually result in a condition of imbecility which would cause [Fidelity] to pay statutory lifetime compensation benefits in addition to lifetime medical benefits.”
Saenz sued Fidelity on the theories of fraud and breach of the duty of good faith and fair dealing in the settlement of her workers’ compensation claim. The jury found that Armstrong maliciously, fraudulently and knowingly misrepresented the benefits provided under the workers’ compensation insurance policy carried by Saenz’ employer, and that such misrepresentation was a proximate and producing cause of Saenz’ damages. The jury also found that Fidelity breached its duty of good faith and fair dealing in handling Saenz’ claim and that the breach was a proximate cause of Saenz’ damages. Furthermore, the jury found that Fidelity ratified the acts and representations made by Armstrong. The actual damages award was comprised of $50,000 for past mental anguish, $200,000 for future mental anguish, and $500,000 for reasonably necessary medical care after the expiration of the five years of open medical benefits. Upon a finding that both Armstrong and Fidelity acted with conscious indifference, the jury awarded $250,000 in punitive damages against Armstrong and $4 million in punitive damages against Fidelity.
I would affirm each and every one of the jury’s findings, including the finding that Fidelity breached its duty of good faith and fair dealing in settling Saenz’ workers’ compensation claim. However, because the damages awards were not assigned to a particular ground of recovery, the majority’s upholding of the jury’s finding that Fidelity defrauded Saenz is dispositive of the case. Accordingly, although the particularly egregious facts of this case support the jury’s finding that Fidelity breached its duty of good faith and fair dealing, I will not address the issue.
*121II. Future Medical Costs
I would affirm the jury’s award of $500,000 in future medical costs to Saenz. The majority holds that no evidence supports the $500,-000 future medical costs awarded to Saenz because the only evidence supporting the figure was Dr. Richard Moore’s testimony that Saenz would require $1.6 million in lifetime medical expenses as a result of her work-related head injury. They conclude that article 8307 of the Texas Workers’ Compensation Act precludes consideration of these future medical expenses. Thus, the issue to be decided is whether the medical expenses presented at trial, which were originally necessitated by Saenz’ work-related head injury, can be considered in the calculation of damages flowing from Fidelity’s fraudulent misrepresentations. I would hold that they can.
The $500,000 in future medical costs were awarded to Saenz to compensate her for Fidelity’s fraudulent misrepresentations. This is not a cause of action by Saenz to recover for injuries she received in the work place. Saenz is not suing her employer for negligently allowing her head injury to occur; nor is Saenz suing the workers’ compensation carrier to increase her benefits. The majority acknowledges the distinction between a cause of action based upon Fidelity’s fraudulent misrepresentations and a cause of action based upon a work-related injury when it holds that Saenz was not required to bring suit to rescind the CSA to recover damages.
The majority states:
We agree that this is not an action for additional workers’ compensation benefits. Rather, it is a suit filed asking for recovery of damages completely unrelated to the workers’ compensation injury. The actionable injury complained about here results from Fidelity’s alleged misrepresentation of recoverable medical benefits. We conclude that the court was not required to submit issues to the jury about rescission of the IAB-approved CSA.
That the fraud in this case is a tort which exists separate and apart from the workers’ compensation system is consistent with current case law. In Aranda v. Insurance Co. of N.A., 748 S.W.2d 210, 212-13 (Tex.1988), the Supreme Court of Texas recognized that an insurance company’s breach of the duty of good faith and fair dealing was a tort which existed separate and apart from a claim under the workers’ compensation system, even though the bad faith claim would not exist if the underlying work-related injury had not occurred. Accordingly, I believe that, if Saenz elects to pursue a fraud cause of action, she should be entitled to recover whatever damages flow from the fraud.
The policy underlying the tort compensation system is to compensate an injured party for the damage he or she has suffered. Prosser, LAW OF TORTS, 7 (4th edition 1971). The goal is to restore the injured party to the place he or she would have been “but for” the tortfeasor’s harmful conduct. Thus, the measure of damages in a fraud action is the actual amount of loss resulting directly and proximately from the fraud practiced upon the claimant. Kneip v. UnitedBank-Victoria, 774 S.W.2d 757, 759 (Tex.App.—Corpus Christi 1989, no writ).
The amount recoverable in Saenz’ fraud action is the amount of medical benefits she would have received “but for” Armstrong’s fraudulent misrepresentations. This amount is represented by the difference between the fraudulently induced settlement amount, which was five-years of open medical benefits, and the medical benefits which Saenz will require for the rest of her life as a result of her head injury. Dr. Moore’s testimony was relevant to establish the latter figure. His $1.6 million “life care plan” was the amount of medical expenses to which Saenz was initially entitled.
The majority adopts Saenz’ argument that her cause of action for fraud is not a Bran-non-type rescission claim, in which a party is seeking to increase compensation for a work-related injury. See Brannon v. Pacific Employers Ins. Co., 148 Tex. 289, 224 S.W.2d 466, 469 (1949). If Saenz’ cause of action were one in which she sought to increase the compensation she was awarded under the Workers’ Compensation Act, then I would agree with the majority’s conclusion that Dr. Moore’s testimony regarding the necessity of a $1.6 million “life care plan” is precluded by article 8307 of the Workers’ Compensation *122Act. However, as the majority acknowledges, Saenz’ fraud cause of action is separate and apart from any work-related injury. Thus, I do not believe that Dr. Moore’s $1.6 million “life care plan” is precluded by article 8307. Dr. Moore’s testimony simply establishes the amount of medical benefits Saenz would have received “but for” Fidelity’s fraudulent misrepresentations. In other words, Dr. Moore’s testimony establishes that Saenz’ injury required life-time medical benefits rather than the five year cap that was misrepresented to her by Armstrong. Those were her damages for the fraud and that is what she is entitled to recover under the well-settled law pertaining to the measure of damages for fraud. See Kneip, 774 S.W.2d at 759.
The majority’s reliance on the Workers’ Compensation Act to deny Saenz’ recovery for future medical expenses is misplaced. The Act does not cover intentional torts such as fraud. Porter v. Downing, 578 S.W.2d 460, 461 (Tex.Civ.App.—Texarkana 1979, writ ref'd n.r.e.); Aetna Ins. Co. v. Hart, 315 S.W.2d 169, 172 (Tex.Civ.App.—Houston 1958, writ ref'd n.r.e.). Moreover, the Act applies to “damage or harm to the physical structure of the body,” Tex.Rev.Civ.Stat. Ann. Art. 8306, sec. 20 (Vernon 1967), and not to injuries which are pecuniary in nature, such as those flowing from fraudulent misrepresentations.
If the majority is correct then the only actual damages recoverable in a case of this nature would be nonpecuniary damages such as mental anguish. An insurance company, such as the one here, could therefore defraud claimants with impunity with the knowledge that, if caught, and a fraud or duty of good faith and fair dealing action is brought, it could keep the benefits of its fraudulent conduct,1 and may be required to pay only non-pecuniary damages such as mental anguish.2 That this is true is evidenced by the fact that the majority’s holding reduces Saenz’ recovery of actual damages from $750,000 to $250,-000, even though it acknowledges that Saenz was defrauded when she only received five years of medical benefits for her work-related injury and there was evidence that she was entitled to lifetime benefits. I hardly see the justice in such a holding. Moreover, it would be inconsistent .with the supreme court’s holding in Aranda which permits the recovery of pecuniary damages for breach of the duty of good faith and fair dealing, even though the cause of action tangentially depends, as it does here, on a work-related injury.
III. Punitive Damages
In addition to future medical costs, I would affirm the jury’s award of $4 million in punitive damages against Fidelity. The majority concludes that no evidence supports the jury’s finding that Stan Lawson was a managerial agent, as that term was defined in the charge. They also conclude that, even if Lawson were a managerial agent, no evi-*123denee supports the jury’s finding that Lawson authorized Armstrong’s misrepresentations. I disagree.
The majority has already enumerated the standard of review on a factual sufficiency challenge. However, the majority does not acknowledge the limitation underlying an appellate court’s review of the record, which is that an appellate court is not a fact finder, and cannot substitute its judgment for that of the jury, even if a different answer could be reached on the evidence. Houston Lighting and Power Co. v. Sue, 644 S.W.2d 835, 843 (Tex.App.—Corpus Christi 1982, writ ref'd n.r.e.). When conflicting testimony is given, it is the exclusive province of the jury to judge the credibility of witnesses and to determine the weight to be given their testimony. Fruehauf Corp. v. Ortega, 687 S.W.2d 777, 782 (Tex.App.—Corpus Christi 1985, no writ). Upon weighing the evidence before them, jurors have a right to use their common knowledge and life experience. Maryland Casualty Co. v. Hearks, 144 Tex. 317, 190 S.W.2d 62, 64 (1945).
Circumstantial evidence is every bit as probative as direct evidence in a sufficiency of the evidence challenge. An ultimate fact may be conclusively shown by wholly circumstantial evidence. Walter Baxter Seed Co. v. Rivera, 677 S.W.2d 241, 244 (Tex.App.—Corpus Christi 1984, writ ref'd n.r.e.). A fact is established by circumstantial evidence when it may be fairly and reasonably inferred from other facts proved in the case. Id. Circumstantial evidence is sufficient to establish the authorization of, participation in, or ratification of the acts of an agent that make a principal liable for exemplary damages growing out of the agent’s acts. Connell v. Rosales, 419 S.W.2d 673, 677 (Tex.Civ.App.—Texarkana 1967, no writ). Moreover, a presumption of ratification will arise from only slight evidence when the act done by an agent is plainly for the benefit of a principal. National Resort Communities, Inc. v. Cain, 512 S.W.2d 367, 372 (Tex.Civ.App.—Austin 1974), rev’d on other grounds, 526 S.W.2d 510 (Tex.1975).
The two issues to decide are whether sufficient evidence exists to affirm the jury’s findings that Lawson was 1) a managerial agent _ for Fidelity, 2) who authorized the doing and the manner of Armstrong’s fraudulent acts. Armstrong testified that everything she did on the Saenz file was approved by Lawson, who was the supervisor for two or three adjustors that each handled approximately 100 claims per week. She also stated that Lawson had been with Fidelity for twenty-five years. Matthews, Fidelity’s corporate representative, testified that, to her knowledge, Lawson was aware of what Armstrong did in the handling of Saenz’ claim.
With respect to managerial agent, the majority states that Lawson only “reviewed files for two or three telephone adjustors,” and that this testimony does not describe a managerial agent as defined in the charge. The majority also states that the record does not reveal Lawson’s formal title, or position, with Fidelity, other than that he was a supervisor.
However, titles are not conclusive. To prove that Lawson was a “managerial agent,” Saenz needed only to satisfy the definition of managerial agent provided in the charge, i.e., that Lawson had the “authority to hire, fire and direct employees of the corporation, or ... the authority to manage the entire corporation or a department or division of its business.” The jury found that Lawson was a managerial agent, and I believe that sufficient circumstantial evidence exists to support the jury’s finding.
That many supervisors, particularly ones who have been with a company for twenty-five years, have the power to direct, hire and fire employees is within the common knowledge and experience of persons who serve on a jury. Both Armstrong and Matthews testified that Lawson either approved, or was aware of, everything Armstrong did on the Saenz file. I believe that it would be reasonable to infer that Lawson had the power to direct, hire and fire the three adjustors that he supervised. Few other reasons exist to justify Lawson’s approval of the adjustors’ files. That this is proved circumstantially does not negate its probative value. To hold otherwise, just because direct evidence was unavailable, encroaches upon the jury’s province as trier of fact. The jury was at trial, and we were not, to observe Armstrong’s and *124Matthews’ demeanor and assign the weight to be given their testimony.
With respect to authorization, the majority states that the only evidence connecting Fidelity to Armstrong’s misrepresentation was Armstrong’s testimony that Lawson approved everything she did, and that there is no evidence that Armstrong told Lawson about the misrepresentation. However, it is doubtful that there would ever be direct evidence of the ratification of fraudulent acts. Moreover, circumstantial evidence is sufficient to establish the authorization of an agent’s acts. Connell, 419 S.W.2d at 677. One can only expect to see a smoking gun, and leave the jury to infer the rest.
I believe that the jury could have reasonably inferred that Lawson knew of and approved Armstrong’s fraudulent misrepresentations. The jury found, and the majority affirmed, that Armstrong made certain fraudulent misrepresentations to Saenz. It is reasonable to assume that the letters from Weaver and Gillespie that instructed Armstrong to settle the case without “scaring” Saenz off to an attorney were kept in the Saenz file and were, therefore, reviewed by Lawson. Because Lawson read the letters, and observed that the object of the letters was obtained — Saenz attended the conference without an attorney and settled her case — it would be reasonable for the jury to infer that Lawson knew of and approved Armstrong’s fraudulent misrepresentations.
If this circumstantial evidence supporting Lawson’s authorization of Armstrong’s fraudulent misrepresentations is not sufficient to affirm the jury’s finding, then this Court is opening wide a window of unaccountability through which even maliciously fraudulent insurance companies would always escape from liability. Ratification is very difficult to prove. That is why a presumption of ratification arises from only slight evidence that the act done by an agent is plainly for the benefit of a principal. Cain, 512 S.W.2d at 372. Weaver’s post-hearing letter is strong evidence that Fidelity greatly benefitted from the fraudulently procured settlement agreement.
Once again, to hold that Lawson did not authorize, approve, or ratify Armstrong’s fraudulent misrepresentations would encroach upon the jury’s province as trier of fact. It was the jury, and not this panel of judges, who was there to observe Armstrong’s demeanor and determine the weight to be given her testimony.
Because I believe that there is sufficient evidence that Lawson was a managerial agent who authorized the doing and the manner of Armstrong’s fraudulent misrepresentations, I would affirm the jury’s award of $4 million in punitive damages against Fidelity.

. Although rescission remains as a remedy, I do not believe that it is a viable one. First, one of the policies underlying the workers’ compensation system is to provide prompt relief to an injured worker. A defrauded claimant electing to pursue rescission of a settlement agreement will have to wait years before full benefits are received. After a work-related injury and settlement before the Industrial Accident Board (IAB), she would have to bring suit for rescission in a district court. If successful, the judgment may be appealed, and, if successful, the defrauded claimant would have to go hack to the IAB and renegotiate a settlement or receive an IAB award, which can again be appealed to the district court and possibly courts of appeals. This whole process could take years to complete and leave an injured worker without the means to support herself or her family, and possibly without badly needed medical care. That Saenz’ settlement agreement granting five years of medical benefits has already expired is evidence that any benefits a claimant receives from a fraudulently induced settlement agreement would probably not support the claimant while the judicial process runs its course.
I would also note that a remedy of rescission in cases such as this is judicially inefficient. We should not burden our judicial system by forcing a claimant back to the IAB, and perhaps to district court, to get the benefits to which he or she was originally entitled, since the same benefits should be bestowed as money damages in the same suit.

. Although punitive damages are available for fraud, they are difficult to recover against a corporation because, unlike actual damages, a plaintiff must prove ratification of such agent’s acts by the corporation which, as the majority opinion bears out, is almost impossible to achieve in this type of a case.