Progressive County Mutual Insurance Co. v. Delgado
335 S.W.3d 689
Tex. App.2011Background
- Delgado sued Bailey and Progressive for negligence and past medical expenses, among other damages, arising from a motor vehicle accident.
- Bailey settled Delgado's claim for policy limits of $25,000; Progressive remained as underinsured motorist insurer.
- Delgado had previously received $2,525 in PIP benefits from Progressive; trial occurred in June 2009.
- Jury awarded Delgado medical expenses totaling $52,968.39 and additional damages for pain, impairment, and earning capacity.
- Delgado moved for entry of judgment using a calculation that deducted PIP and Bailey settlement, then added prejudgment interest; Progressive moved for a take-nothing judgment under Tex. Civ. Prac. & Rem. Code § 41.0105.
- The trial court admitted trial exhibits showing the actual payments by Avantra on Delgado’s behalf were far less than billed amounts, indicating remaining balances could not be collected.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether § 41.0105 limits recovery to amounts actually paid or incurred by Delgado or on his behalf. | Delgado: damages should reflect amounts actually paid or incurred; providers’ write-offs reduce collectible amounts. | Progressive: only amounts actually paid or incurred are collectible; här limits lower than jury awards. | The court held § 41.0105 limits recovery to amounts actually paid or incurred; damages exceedables are offset, yielding take-nothing judgment. |
Key Cases Cited
- Matbon, Inc. v. Gries, 288 S.W.3d 471 (Tex.App.-Eastland 2009) (written-offs not medical expenses actually incurred)
- Garza de Escabedo v. Haygood, 283 S.W.3d 3 (Tex.App.-Tyler 2009) (proper measure of damages; § 41.0105 application)
- Mills v. Fletcher, 229 S.W.3d 765 (Tex.App.-San Antonio 2007) (medical expenses written off if not incurred or paid)
- Tate v. Hernandez, 280 S.W.3d 534 (Tex.App.-Amarillo 2009) (§ 41.0105 interpretation)
