Andrew Patterson v. Transcontinental Insurance Company
01-15-00464-CV
| Tex. App. | Nov 16, 2015Background
- Andrew Patterson (pro se) injured at work in 2002 and applied for Supplemental Income Benefits (SIBs) for multiple quarters; dispute centers on carrier Transcontinental Insurance Co. (TIC) contesting entitlement to subsequent quarters.
- Patterson contends TIC received but withheld SIBs applications (and related documents), failed to timely request Benefit Review Conferences (BRCs) to dispute entitlement, and thereby waived the right to contest SIBs under Tex. Lab. Code §408.147 and related DWC rules.
- The Benefit Review Conference (BRC) hearing officer concluded TIC waived its right to dispute certain SIBs because it did not timely request a BRC; Appeals Panel and trial court proceedings followed.
- TIC obtained summary judgment in district court; Patterson appeals, arguing the trial court erred and that the judgment is void because TIC (as the initiating party for judgment) failed to file its proposed judgment with the TWCC/DWC at least 30 days before entry (Tex. Lab. Code §410.258).
- Patterson also asserts discovery abuses and withholding of evidence (including testimony by an ombudsman who purportedly faxed and certified mailing of SIBs applications) that—if credited—undermine TIC’s factual defenses.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| 1. Waiver of right to dispute SIBs | Patterson: TIC failed to timely request a BRC after receiving SIBs forms and thus waived the right to contest entitlement under §408.147 and DWC rules. | TIC: Denies receiving SIBs applications and maintains it properly disputed entitlement. | Trial court granted summary judgment for TIC; appellant argues this was error and that hearing officer had found waiver. |
| 2. Sufficiency of administrative review / Appeals Panel | Patterson: Appeals Panel ignored evidence that TIC received forms and withheld defenses at BRC/CCH; panel erred in affirming. | TIC: Relies on record and denies receipt; contends administrative decision supported. | Trial court upheld the Appeals Panel decision via summary judgment for TIC. |
| 3. Trial court jurisdiction / procedural filing (§410.258) | Patterson: Judgment is void because TIC (the prevailing party) did not file its proposed judgment with the TWCC/DWC ≥30 days before entry as required. | TIC: Implicitly contends procedural requirements were satisfied (or that recitals in judgment suffice). | Patterson asserts lack of appellate jurisdiction and asks court to set aside the judgment; trial court nonetheless entered final judgment for TIC. |
| 4. Discovery and withholding of evidence | Patterson: TIC withheld pertinent information (contravening 28 Tex. Admin. Code §141.4) and prevented full development of material facts (e.g., ombudsman fax/mail proof). | TIC: Did not produce those documents or disputes their existence/receipt. | Trial court granted summary judgment despite plaintiff's assertions of withheld evidence; Patterson contests that ruling. |
Key Cases Cited
- Johnson v. City of Fort Worth, 774 S.W.2d 563 (Tex. 1989) (statutory construction reviewed de novo)
- Kroger Co. v. Keng, 23 S.W.3d 347 (Tex. 2000) (plain-language statutory interpretation principles)
- Provident Life & Accident Co. v. Knott, 128 S.W.3d 211 (Tex. 2003) (standard for de novo review of summary judgment)
- Insurance Co. of the State of Pa. v. Martinez, 18 S.W.3d 844 (Tex. App.—El Paso 2000) (failure to file proposed judgment with TWCC renders judgment void)
- Insurance Co. of the State of Pa. v. Orosco, 170 S.W.3d 129 (Tex. App.—San Antonio 2005) (discussion of recitals in judgment vs. proof of compliance with filing requirements)