Texas Appellate Court Rules Workers Comp Carrier Did Not Waive Subrogation For Medical Malpractice Claim

The Court of Appeals Fifth District of Texas at Dallas (“Texas Appellate Court”) ruled in its Memorandum Opinion dated October 2, 2020: “The waiver in this case applied only to any “person or organization for whom the Named Insured has agreed by written contract to furnish this waiver.” Without such a contract, there was no evidence to show Texas Mutual waived its subrogation rights. Accordingly, the trial court erred in granting summary judgment in favor of Stevenson.”

The Underlying Facts

In July 2013, Stevenson ruptured his Achilles tendon in the course of his employment with FSTI, Inc.  Texas Mutual, the worker’s compensation carrier for FSTI, paid worker’s compensation benefits to and on behalf of Stevenson for his injuries. Because of alleged mistreatment by his health care providers, Stevenson underwent multiple surgeries to address his injuries. In January 2015, Stevenson filed a Texas medical malpractice lawsuit against his health care providers alleging negligence causes of action.

In February 2018, Texas Mutual filed its original petition in intervention to recover its “subrogation lien for medical and indemnity benefits of $318,551.33 paid to and on behalf of” Stevenson. In May 2018, Stevenson filed a traditional motion for summary judgment against Texas Mutual arguing the applicable workers’ compensation policy contained a waiver of all rights to seek subrogation otherwise allowed under the Texas Workers’ Compensation Act.

The subrogation waiver language provided, in part: “We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule where you are required by a written contract to obtain this waiver from us.”

In July 2018, the trial court signed an order granting Stevenson’s motion for summary judgment and dismissing Texas Mutual’s claims, “including requests for subrogation, reimbursement, and for future credits.” Texas Mutual appealed.

Texas Appellate Court Opinion

The Texas Appellate Court held: “On the issue of whether the trial court erred in granting Stevenson’s motion for summary judgment, the case Stevenson relied on involved a contract between an employer and a third party requiring that the employer’s workers’ compensation policy contain a waiver of subrogation rights. Wedel, 557 S.W.3d at 555. Here, Stevenson conceded at oral argument that the record in this case does not contain a written contract requiring a waiver of subrogation. The waiver in this case applied only to any “person or organization for whom the Named Insured has agreed by written contract to furnish this waiver.” Without such a contract, there was no evidence to show Texas Mutual waived its subrogation rights. Accordingly, the trial court erred in granting summary judgment in favor of Stevenson.”

Source Texas Mutual Insurance Company v. Stevenson, No. 05-18-00978-CV.

If you or a loved one may have been injured as a result of medical malpractice in Texas or in another U.S. state, you should promptly find a Texas medical malpractice lawyer, or a medical malpractice lawyer in your state, who may investigate your medical malpractice claim for you and represent you or your loved one in a medical malpractice case, if appropriate.

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This entry was posted on Sunday, November 22nd, 2020 at 5:26 am. Both comments and pings are currently closed.

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