506 S.W.3d 600
Tex. App.2016Background
- On Sept. 5, 2012, Soledad was a passenger in an employer-owned vehicle driven by co-employee Noe; Noe’s negligence caused a single-vehicle crash that injured Soledad while both were working.
- Soledad had a personal auto policy from Texas Farm Bureau (TFB) that provided UM/UIM coverage; she paid premiums personally.
- Schneider (the employer) carried workers’ compensation and liability insurance; Soledad received workers’ compensation benefits for her injuries.
- Soledad claimed UM/UIM benefits from TFB for damages exceeding workers’ compensation; TFB denied the claim.
- Both parties moved for summary judgment; the trial court denied Soledad’s motion and granted TFB’s.
- The court of appeals affirmed, holding the worker’s-compensation exclusive-remedy bar prevented Soledad from being “legally entitled to recover” from the employer or co-employee as required by the UM/UIM policy.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Soledad was “legally entitled to recover” from the owner/operator (employer/co-employee) so as to trigger UM/UIM coverage | Soledad argued she could recover UM/UIM benefits after receiving workers’ comp, pointing to policy language preventing double recovery and asserting coverage should apply when damages exceed workers’ comp | TFB argued the TWCA exclusive-remedy provision bars tort claims against employer/co-employee, so Soledad is not "legally entitled to recover" and policy condition fails | Court held TWCA’s exclusive-remedy provision bars recovery against employer/co-employee, so Soledad was not "legally entitled to recover" and UM/UIM benefits are unavailable; summary judgment for TFB affirmed |
Key Cases Cited
- Valentine v. Safeco Lloyds Ins. Co., 928 S.W.2d 639 (Tex. App.—Houston [1st Dist.] 1996) (employee who recovered workers’ compensation not “legally entitled to recover” against employer for UM/UIM coverage)
- Otterberg v. Farm Bureau Mut. Ins. Co., 696 N.W.2d 24 (Iowa 2005) (exclusive-remedy bar precludes being "legally entitled to recover" from employer/co-employee)
- State Farm Mut. Auto. Ins. Co. v. Royston, 817 P.2d 118 (Haw. 1991) (workers’ compensation exclusivity prevents UM/UIM recovery when tortfeasor is employer)
- Allstate Ins. Co. v. Boynton, 486 So. 2d 552 (Fla. 1986) (policy’s "legally entitled to recover" requires a claim that can be reduced to judgment; immunity defeats that)
- Snyder v. American Family Ins. Co., 871 N.E.2d 574 (Ohio 2007) (UM/UIM provision limiting recovery to amounts insured is "legally entitled to recover" valid even when exclusive-remedy bars tort claim)