Lead Opinion
Plaintiff, Janie Bocanegra, sued Aetna Life Insurance Company on a group medical and hospital policy and recovered judgment upon a jury finding that certain medical and hospital services she needed resulted from a non-occupational disease.
Mrs. Bocanegra began working for Clegg Company in 1965 as a book binder. Her work required her to lift and handle books. As she got out of bed one morning in April of 1975, she experienced a sharp pain in her lower back. She reported for work but did not tell her employer about her pain. On June 3,1975, again on arising from bed, she had another severe pain, but still did not report any job-related injury. On June 29 the pain became so severe that she went to the emergency room of the Baptist Hospital. Her physician, Dr. Larry Miller, prescribed conservative treatment including two weeks in traction. He told Mrs. Boea-negra that she might have hurt her back at work. Failing to get any relief and after extensive tests, on August 11, she underwent surgery for a slipped disc. Dr. William Dossman performed the surgery. Mrs. Bocanegra never gave notice to her employer that she had sustained an occupational injury, but on August 18, after her operation, she filed with the Texas Industrial Accident Board her Notice of Injury or Occupational Disease and Claim for Compensation. In that notice she wrote, “I was lifting telephone books in the course and scope of my employment and injured my back and body generally.” In her accompanying hardship affidavit, she swore, “I was hurt on the job on the above date while working for the above employer.” On July 21, she filed a claim under the Aetna group policy on which she checked the box which
On October 27, Mrs. Bocanegra settled her worker’s compensation claim for a general injury for $12,000 which the compensation carrier paid. The settlement agreement was “solely for lost wages and future impaired earning capacity,” and it expressly excluded any payment for past or future medical or hospital expenses, the items that are here in question.
Mrs. Bocanegra, after her surgery and the settlement of her claim for an occupational injury, commenced these proceedings against Aetna to recover the amount of her medical and hospital bills. She asserted, and the jury found, that the medical and hospital services resulted from a non-occupational injury. She supported this claim by her own testimony that she was not injured on the job but that she did not know that fact until after her operation. At that time Dr. Dossman, her surgeon, told her that her back problem was the result of a degenerative disc disease that pre-dated but lingered after the onset of the initial back pain. She denied that she at any time ever told her doctors that she had sustained an injury on .the job. Dr. Dossman confirmed Mrs. Bocanegra’s testimony and testified that, in his opinion, her disc trouble was not related to her occupation. He testified: “About half of the time in this problem there is no known injury or cause of the problem, it just happens. About half of the time there is a history of some specific injury producing the problem.” The court of civil appeals concluded that Mrs. Bocane-gra’s claim for an occupational injury was, as a matter of law, inconsistent with the state of facts upon which she later relied to obtain a judgment in her suit on the health policy that she had a non-occupational injury. The court rendered judgment that she take nothing.
The doctrine of election, although widely criticized,
A judicial estoppel may arise when a question necessary for the determination of a prior adjudication is decided. It constitutes a bar to a redetermination of that issue in a different cause. Benson v.
The single underlying principle of the election doctrine has not been found. Estoppel in some form, ratification and unjust enrichment have been suggested as the basic reasons for an election, and in many instances they suffice. Schenck v. State Line Telephone Co.,
A similar loosely defined but useful equitable doctrine is the constructive trust. It is unlike other trusts, but equity raised it up in the name of good conscience, fair dealing, honesty, and good morals. Omohundro v. Matthews,
The election doctrine, therefore, may constitute a bar to relief when (1) one successfully exercises an informed choice (2) between two or more remedies, rights, or states of facts (3) which are so inconsistent as to (4) constitute manifest injustice. See Custom Leasing, Inc. v. Texas Bank & Trust Co. of Dallas,
A number of seemingly inconsistent positions do not rise to the level of an election which will bar recovery. One may, for example, plead alternative and inconsistent facts without being barred. Rules 48 and 51, Texas Rules of Civil Procedure, authorize such procedures. One who pleads alter
There is no election, that is, no inconsistency in choices, when one first unsuccessfully pursues a right or remedy which proves unfounded and then pursues the one that is allowed. Poe v. Continental Oil & Cotton Co.,
One’s choice between inconsistent remedies, rights or states of facts does not amount to an election which will bar further action unless the choice is made with a full and clear understanding of the problem, facts, and remedies essential to the exercise of an intelligent choice. Leonard v. Hare,
This present case aptly illustrates the reason that election should not bar a suit when a previous course of action or a settlement for less than the claim was grounded upon uncertain and undetermined facts. The definition of an occupational disease contained in section 20 of article 8306 is itself complex and difficult:
Whenever the term “Occupational Disease” is used in the Workmen’s Compensation Laws of this State, such term shall be construed to mean any disease arising out of and in the course of employment which causes damage or harm to the physical structure of the body and such other diseases or infections as naturally result therefrom. An “Occupational Disease” shall also include damage or harm to the physical structure of the body occurring as the result of repetitious physical traumatic activities extending over a period of time and arising in the course of employment; provided, that the date of the cumulative injury shall be the date disability was caused thereby. Ordinary diseases of life to which the general public is exposed outside of the employment shall not be compensable, except where such diseases follow as an incident to an*853 “Occupational Disease” or “Injury” as defined in this section.
Under that definition, Mrs. Bocanegra’s injury may have been an occupational one which was compensable, it may have been an “ordinary disease of life” which was not, or it may have been both. Tex.Rev.Civ. Stat.Ann. art. 8306, § 22. Many diseases, do not fit neatly within an either/or distribution, and the dispute whether such a condition is compensable or not is an ongoing one. Uncertainty in many complex areas of medicine and law is more the rule than the exception. It would be a harsh rule that charges a layman with knowledge of medical causes when, as in this case, physicians and lawyers do not know them. Mrs. Boca-negra’s first physician, Dr. Miller, was of the opinion that the lifting and bending at the work bench was the cause of an occupational injury. Dr. Dossman advised her to the contrary after the surgery. The settlement agreement that Mrs. Bocanegra made with her compensation carrier showed that the carrier disputed liability, the period of time lost for the claimed occupational disease, and past and future medical expenses for which the carrier paid nothing. Mrs. Bocanegra lacked the requisite knowledge to bind her to an informed election.
Some of the Texas decisions cannot be harmonized, and they need discussion. Seamans Oil Co. v. Guy,
If one having a right to pursue one of several inconsistent remedies makes his election, institutes suit, and prosecutes it to final judgment or receives anything of value under the claim thus asserted, or if the other party has been affected adversely, such election constitutes an es-toppel thereafter to pursue another and inconsistent remedy. And where the right in the subsequent suit is inconsistent with that set up in the former suit, as distinguished from a merely inconsistent remedy, the party is estopped though the former suit may not have proceeded to judgment. But where the inconsistency is in the remedies it is generally considered that there is no estoppel where the former suit was dismissed without trial or before judgment.
The quotation is an early statement of the election doctrine and contains errors. An election may arise short of one’s prosecution of a claim to final judgment. One may also receive something by way of settlement, even of substantial value, under an uncertain claim without making an election which bars recovery against another person. The quotation may be illustrative of some situations which might rise to the level of an election, but it is an unreliable statement of a general rule, and we reject it.
Lomas and Nettleton Co. v. Huckabee,
The court of civil appeals in Metroflight, Inc. v. Shaffer,
In Seamans, Huckabee, and Metroflight, the respective plaintiffs realized most or all of what they claimed by asserting facts about which they were certain. By contrast, however, the fact upon which Mrs. Bocanegra relied in settling with her compensation carrier, the nature of her complex disease, was highly uncertain which was evidenced by the small settlement which included none of her hospital and medical bills.
The judgment of the court of civil appeals is reversed and the judgment of the trial court is affirmed.
Notes
. The court instructed the jury by using a part of the definition in the group policy:
You are instructed that the term “NONOCCUPATIONAL DISEASE” means a disease which does not arise, and which is not caused or contributed to by, or as a consequence of, any disease which arises, out of or in the course of any employment or occupation for compensation or profit.
. It has been criticized because of its lack of any fixed legal underpinnings and called the following: a legal weed that judicial gardeners should root out, Hine, Election of Remedies: A Criticism, 26 Harv.L.Rev. 707, 719 (1913); a legal delusion, Note, Election of Remedies: A Delusion? 38 Colum.L.Rev. 292, 293 (1938); an anachronism, Fraser, Election of Remedies: An Anachronism, 29 Okla.L.Rev. 1 (1976); a problem child of the law, Merrem, Election of Remedies, 8 Sw.L.J. 109 (1954); and a remedy that has no independent viability, LaBay, Election of Remedies: The California Basis, 19 Hastings L.Rev. 1233, 1246 (1968).
. "Without much conscious purpose or plan we have created this shambling creature. It is time to fence it in.” J. Dawson, Unjust Enrichment 26 (1951). “It thus constitutes a fenceless field with hazy boundaries.” 4 R. Powell, Real Property § 593, 565 (1949).
Concurrence Opinion
concurring.
We should not attempt to draw an artificial distinction between this case and the decisions in Huckabee and Metroflight merely to avoid an admission that those decisions were erroneous. The claims in those cases were as uncertain as the claims in this case. Except for uncertainty there would obviously have been no compromise and settlement. This decision establishes a rule of law that whether a settlement with a defendant will be deemed an election barring suit against another defendant, upon facts inconsistent with those asserted to obtain the settlement, will be ultimately determined by this Court’s opinion as to the degree of uncertainty as to the facts inconsistently asserted.
Seamans Oil Co. v. Guy was not decided upon the law of elections but was decided
Settlement agreements are highly favored in the law because they are a means of amicably resolving doubts and preventing lawsuits. Miller v. Republic National Life Insurance Company,
Proper regard for these principles compels a conclusion that a mere compromise and settlement of a claim asserting facts inconsistent to those asserted in a claim against a different defendant should not bar the latter claim. The contrary conclusion, in effect, compels a party to proceed to final judgment against two or more defendants instead of settling with a defendant who is desirous of settlement. This would not diminish assertion of inconsistent claims but would merely diminish settlements.
We should concede our error and expressly overrule Huckabee and hold there is no election until final judgment on the merits.
