Bocanegra v. Aetna Life Insurance Co.

Petitioner, BOCANEGRA, Janie P. LIFE

AETNA INSURANCE

COMPANY, Respondent. B-8077.

No.

Supreme Court of Texas.

July 1980.

Rehearing Sept. Denied appeals held settlement

court of civil the later suit. which barred her was an election judgment the court reversed the That for Aet- judgment court and rendered trial We hold that Mrs. na. an informed elec- Bocanegra not make did in this action. We that barred her tion the court of civil judgment of reverse the the the appeals and affirm trial court. working Clegg for Bocanegra began

Mrs. book Her 1965 as a binder. required her lift and handle books. work to got morning April As she out of bed one pain her experienced sharp she but did reported for work lower back. She pain. On employer tell about her not her bed, 3,1975, again arising from she June on did not pain, had another severe still injury. June 29 report job-related On any to that she went pain became so severe Hospi- Baptist room of the emergency Miller, pre- Her physician, Larry tal. Dr. including treatment scribed conservative Mrs. Boea- He told two weeks in traction. her back at negra might have hurt that she get any relief and after Failing work. tests, August on she under- extensive Dr. slipped for a disc. Wil- surgery went Mendelsohn, Mendelsohn, Branton & Les performed surgery. Mrs. liam Dossman Scott, Chrys L. Wayne A. Lambros and San employ- Bocanegra gave notice to her never Antonio, petitioner. for occupational er that she had sustained opera- August after her injury, but on Meador, Antonio, respondent. Joe for San tion, she with the Texas Industrial filed Injury or Notice of Accident Board her POPE, Justice. for and Claim Com- Occupational Disease wrote, “I was Plaintiff, she Bocanegra, pensation. Janie sued Aetna In notice in the course and group lifting telephone Life Insurance medi- books on injured my hospital policy judg- scope my employment cal and recovered accompa- In her finding body generally.” ment certain medi- back and upon jury swore, affidavit, “I she hospital nying hardship cal services needed resulted she while job on the above date non-occupational from a disease.1 Previ- hurt July employer.” On ously working the above had filed with group claim, the Aetna she filed a claim under Industrial Accident Board a settled, box which occupational policy on which she checked the she for an by, jury by using part or as a conse- caused or contributed 1. The court instructed of, arises, group policy: quence out of or disease which of the definition in the occupa- any employment or in the course are “NON- You instructed that the term compensation profit. tion a dis- OCCUPATIONAL DISEASE” means arise, not ease which and which is does asked if the claim was based on an accident. was not related to occupation. her He tes- She also wrote on that claim form that the tified: “About half prob- time in this accident occurred “At by lifting work lem there is no known injury or cause of the bending.” problem, July just happens. On she it filed a second About half of the claim with time there is a history specific Aetna on which of some she checked injury producing question problem.” “No” to the The whether her court claim was of civil appeals based concluded that Mrs. Bocane- on an accident. also filed a She gra’s was, occupational claim for an injury with Security American Life Insurance law, as a matter of inconsistent with the September 13 in which she state of upon facts which she later relied to stated that the accident occurred at work obtain a judgment in her suit on the health lifting while bending. September On policy that non-occupational inju- she had a 17, she filed a similar claim with Presiden- ry. The court rendered that she tial Life Insurance gave which take nothing. the same information. The although widely doctrine of On October Mrs. settled criticized,2 survives in wide-ranging branch- her compensation worker’s gen- claim for a es of the law that stretch from the widow’s $12,000 eral injury for which compensa- probate election in law to the choice in tion paid. carrier agree- settlement contract law between a suit for damages ment was “solely wages for lost and future and one for rescission. See 5 Williston on impaired earning capacity,” and expressly it (3d 1961). Contracts Jaeger 683-688 ed. §§ any payment excluded past or future Election, defense, an affirmative has been medical or hospital expenses, the items that remedies, held to rights, bar and inconsist- question. are here in positions ent arising out of the same state Bocanegra, Mrs. surgery after her of facts. 25 Am.Jur.2d Election of Reme- the settlement of her claim for occupa- an (1966); Annot., dies 7 116 A.L.R. 602 § tional injury, commenced these proceedings (1938). The situations in an election against Aetna to recover the amount of her might arise are so variable that an all-inclu- medical hospital asserted, bills. She elusive, sive definition has been and discus- found, jury and the that the medical and sions of the doctrine often borrow terms hospital services resulted from a non-occu- may that appropriately also relate to other pational supported She this claim reason, affirmative defenses. For that by her testimony own that she was not election is often confused with or likened to injured job on the but that she did not judicial estoppel, equitable estoppel, ratifi- know that fact operation. until after her cation, waiver or satisfaction. Those doc- Dossman, At that time Dr. surgeon, her told trines sometimes do not reach a situation her that her problem back was the result of equity good that conscience need to degenerative a disc pre-dated disease that reach through the doctrine of election. lingered but after the onset of the initial pain. back She any denied that she at time judicial A estoppel may arise ever told her doctors that she had sustained question when a necessary for the determi an injury on job. Dr. .the Dossman con- nation of prior adjudication a is decided. It firmed Bocanegra’s testimony and tes- constitutes a bar to a redetermination of that, tified opinion, his her disc trouble issue in a different cause. Benson v. anachronism, Fraser, It has been criticized because of its lack of Election Remedies: legal underpinnings Anachronism, (1976); fixed and called the An 29 Okla.L.Rev. 1 a following: legal judicial gardeners law, problem Merrem, a weed that child of the Election out, Hine, Remedies, should root (1954); remedy Election of Remedies: A 8 Sw.L.J. 109 and a Criticism, (1913); independent viability, 26 LaBay, Harv.L.Rev. 719 that has no Elec- delusion, Note, legal Basis, Election of Remedies: A tion of Remedies: The California 19 Has- (1938); tings (1968). Delusion? 38 Colum.L.Rev. 293 L.Rev. 1246

851 position not fit though the inconsistent 361 Wanda Petroleum principle, an better defined 1971); Knox, Tex. 291 mold Long v. 155 when the incon recovery Land will bar (1956); 292 Terminal election S.W.2d Houston remedy, right, sistency in the assertion of Westergreen, Tex. Co. unconscionable, so dis (1930). is Equitable estoppel differs or state so defenses, honest, dealing, or stulti contrary it re to fair each the above because justice or quires deception practiced upon legal is trifles process some fies the manifestly unjust. his party prejudice. who relies it to to be the courts as Barfield v. Howard Co. of Amaril M. Smith equi useful loosely A defined but similar lo, (Tex.1968); Oil S.W .2d 834 Concord It trust. doctrine is the constructive table Corp., Co. v. Oil and Aleo Gas trusts, it equity raised unlike other (Tex.1965); Penn, Gulbenkian conscience, fair good up in name 412, 252 (1952). Tex. S.W.2d 929 A ratifica good morals. Omo dealing, honesty, and rests of to upon tion manifestation assent Matthews, 367, Tex. 341 v. 161 hundro prior confirm or that of another. one’s act 401, (1960). “A constructive 405 S.W.2d may any prior litigation It occur without through which the con trust is the formula change posi in and the absence of of Beatty expression.” of finds equity science by prejudice party. tion or to other Co., Guggenheim Exploration 225 N.Y. v. Texas & & v. 288 Kirtley, Pac. Coal Oil Co. 378, 380, 386, (1919). Equity 122 380 N.E. 1926, (Tex.Civ.App. 619 S.W. —Eastland as a of trusts provides idea constructive Waiver, ref’d). writ relin voluntary 4 Pow skullduggery,” to R. tool “frustrate is quishment right, known sometimes though ell, (1949), 593 even Property Real § spoken of as intentional conduct inconsist grounded is that kind of a trust also right. ent with the a known assertion of purely Such a trust principles.3 elusive Co., v. Ford State Farm Mut. Auto. Ins. 550 practically creature of Its form is equity. 663, (Tex.1977). S.W.2d 667 Full satisfac limit, depends without and existence tion will a claim law will bar because the Wil v. upon the circumstances. Simmons permit double redress. James 847, son, (Tex.Civ.App.— 216 849 Company, Statham, Inc. v. 558 S.W.2d 865 1949, writ). Waco (Tex.1977); Klingensmith, McMillen v. 467 (Tex. 1971); Baylor S.W.2d 193 Bradshaw v. doctrine, therefore, may The election 99, University, 126 84 S.W.2d 703 Tex. (1) one suc constitute a bar to relief when (1935). (2) cessfully an informed choice exercises remedies, rights, or or more between two single underlying principle (3) which are so inconsistent states facts the election doctrine has not been found. (4) injustice. to constitute manifest See as Estoppel form, in some ratification and un & Leasing, Inc. Texas Bank Custom v. just suggested enrichment have been as the Dallas, (Tex. 869 Co. of Trust many basic for an in reasons 1973). they instances v. suffice. Schenck State posi seemingly A number of inconsistent 308, Line N.E. Telephone 238 N.Y. 144 an Shaffer, to the level of election Metroflight, 581 tions do not rise (1924): 592 Inc. v. 1979, recovery. may, for ex will One bar (Tex.Civ.App. S.W.2d 704 —Dallas and inconsistent e.). ap ample, plead alternative writ n. r. The court of civil ref’d has, being Rules 48 soundly, in facts without barred. peals perhaps this case more Procedure, 51, autho Texas of Civil held that will bar an action Rules inconsistency alter pleads One who injustice. procedures. Even such instances of manifest rize (1951). purpose plan thus constitutes a we richment 26 “It much or "Without conscious hazy shambling 4 R. with boundaries.” have this It is fenceless field created creature. Powell, 593, Dawson, (1949). Property Unjust En- 565 § time it in.” Real to fence J. 852

native or or remedies amount an election which will bar fur against two or parties more settle with ther action unless the choice is made with a remedy one them on the basis of one or prob full clear understanding of the state of facts and still recover lem, facts, and remedies to the essential pleaded others based on the an intelligent exercise of choice. Leonard alternative remedies or Hare, (1960): v. 161 Tex. 336 S.W.2d 619 By analogy, facts. voluntary insurer’s Trust, Slay Burnett v. 143 Tex. payment weekly compensa to a worker of (1945); Texas Loveless v. benefits tion will not bar defense that Ass’n, Employers Ins. Lopez there was no injury. accidental ref’d); Civ.App. writ 5 Willi- — Austin Go., Employers Associated Ins. S.W .2d (3d Jaeger ston on Contracts ed. § (Tex.Civ.App. Antonio writ —San Merrem, 1961); Election of Remedies ref’d). also See Southern Underwriters v. Texas, (1954); Am. 8 Sw.L.J. Schoolcraft, 138 Tex. 158 S.W.2d 991 Jur.2d, (1966). Election of Remedies 21§ (1942). The holding basis for the was to An exception to that rule exists when encourage prompt payments compensa action, course of though choice of a made following tion holding A facts, ignorance of the will cause harm payments were inconsistent a denial Trust, party. Slay an innocent v. Burnett an accidental injury or that constitut 394; supra Employers’ Indemnity at ed an admission of an would discour injury Felter, (Tex.Com.App.1925). 277 S.W. 376 age prompt payment weekly of benefits. Indemnity Hartford Accident and Co. v. present aptly This case illustrates Hale, (Tex.1966). 400 S.W.2d 312-13 the that bar a reason election should not previous a or a suit when course of action election, is, There that is no less than the claim was settlement choices, inconsistency in one un when first grounded uncertain and undetermined successfully pursues or right remedy occupational facts. The definition of an proves pursues which then unfounded and disease contained in section 20 of article one the that is allowed. Poe v. Continental complex 8306 is itself and difficult: Co., (Tex.Com. &Oil Cotton 231 S.W. 717 “Occupational Whenever the term Dis App.1921, holding approved); Schwartz v. Compen ease” is used in the Workmen’s Co., National Loan & Investment 133 State, shall sation Laws of this such term 133 (Tex.Civ.App. S.W.2d — Dallas any arising be to mean construed disease ref’d); Guaranty Building writ Breland v. employment out in the of and course of & Loan 119 (Tex.Civ.App.— S.W.2d 690 damage to the which causes or harm Am.Jur.2d, ref’d); Fort Worth writ such physical body structure of the and Election of Remedies 9. One assert § naturally or infections as other diseases concurrent but remedies or dis “Occupational An Dis result therefrom. per tinct causes of action different damage also include or harm ease” shall arising independent sons out of transac body oc physical to the structure of the Ward, tions. Shriro physi repetitious the result of curring as (Tex.1978); Savings American & Loan over a extending cal activities traumatic Musick, of Houston Ass’n period time in course of arising of and the (Tex.1975); Leasing, 588-89 Custom Inc. v. of employment; provided, that the date Dallas, Bank Texas & Trust Co. of date injury the be the cumulative shall (Tex.1973); Liberty Mutual Ordinary thereby. was caused disability Dallas, Ins. Co. v. First in National Bank pub the general diseases life to which (1951). 151 Tex. exposed employment lic outside of the except where compensable, shall be One’s choice between inconsistent not remedies, rights to an or states does not such follow as an incident of facts diseases had previ- the rentals “Injury” delay as that “Occupational Disease” or time, the suit ously By Guys’ that rejected. defined this section. to defeat accomplished purpose fully had definition, Bocanegra’s Under that Mrs. The court drilling operations. or other injury occupational may have been an one to shocking a sense held would be that “[i]t compensable, may it have been Guys could de- justice to hold that the not, which was “ordinary disease life” by the claim stroy value of the leasehold the it may or have been both. Tex.Rev.Civ. same time it exist and at the that did not diseases, Many Stat.Ann. art. § it upon the basis that delay collect rentals neatly do not fit within an either/or distri- though opinion, was a lease.” The valid bution, dispute the such a con- whether election, is an grounded upon an primarily compensable ongoing dition is or is an Guys the satisfaction which instance of full Uncertainty complex one. many areas through their lawsuit. already had achieved medicine and law is more the rule than the dismissed, the suit had though Even it was exception. be rule It would a harsh purpose that fully accomplished the same charges layman knowledge of medi- judgment would have achieved. favorable case, when, cal physicians causes as this Ruling Case Law quotes Seamans lawyers do not know Mrs. Boca- them. 703, 704: Miller, negra’s physician, first Dr. was of having right pursue If to one one opinion lifting bending the that the at makes his remedies several inconsistent work occupa- the bench was the cause of an suit, prosecutes it institutes tional Dr. advised to Dossman her anything of or receives final contrary surgery. after The settle- asserted, if value thus under agreement ment made affected ad- party other has been with her compensation showed that carrier constitutes an es- versely, such election disputed liability, period carrier toppel pursue thereafter another and time lost occupational for the claimed dis- remedy. And where ease, expenses and past right subsequent and future medical is inconsist- in the suit suit, nothing. up ent with that set in the former as paid which the carrier merely from Bocanegra distinguished lacked the requisite knowledge the remedy, party estopped though the is to bind her to an election. informed may proceeded to former suit not have of the Texas decisions inconsistency Some judgment. But where the harmonized, cannot they generally be need dis con- and is the remedies it is estoppel there where Guy, cussion. Oil v. 115 Tex. sidered that Seamans Co. without the former suit was dismissed (1925), reaching while S.W. judgment. trial before result, intermingles correct the doctrines of election, estoppel, and H. satisfaction. J. the quotation early The is an statement of wife, Guy and lessors of an oil and mineral An and contains errors. election doctrine against lease instituted suit Seamans Oil prosecution arise short of one’s may election Empire and Fuel Gas & judgment. may of a final One also claim to settlement, the During something by way cancellation of the lease. receive of them, value, an uncer- pendency against the of the even substantial under suit Sea- making an tain without election mans Empire and Gas could exercise none recovery person. which another lease, bars rights the but by they accorded the quotation some The be illustrative of kept tendering timely the alive by lease might to the level of situations which rise delay payments Guys rental the re it is an unreliable statement an but to accept. fused Just before the lease ex rule, general reject it. and we terms, pired by adopted Guys its own the Huckabee, posture, their dismissed suit for Lomas and Nettleton Co. Seamans, upon (Tex.1977) relied cancellation and drew a check on bank S.W.2d863 supra, holding there was an election. low. The Metroflight court assumed that The Huckabees first asserted in their law Metroflight had dismissed its federal court suit that two insurance companies in had claim asserting coverage insurance because sured the personal Huckabees’ real and pre-trial discovery had shown that claim to property that destroyed was in a fire. The groundless be and certain to fail. This as Huckabees, upon strength of that state sumption, stated, twice is wrong. The in facts, recovered in a settlement one hun surer’s eighty percent settlement for of the percent dred of their claim for the de very large coverage-based claim shows the stroyed realty eighty percent of their validity strength of the claim that in claim for the destroyed personalty. Their surance actually existed. lawsuit was then prejudice. dismissed with Seamans, Huckabee, In Metroflight, After succeeding with their claim that their respective plaintiffs realized most or all property insured, was they adopted the in what by asserting claimed position consistent it was not insured about which they By were certain. con- and sued their agent for neglect. his We trast, however, the fact which Mrs. held Huckabees, successfully after settling relied in with her com- asserting their claim on one state of facts pensation carrier, the nature her complex receiving almost the whole of their disease, highly uncertain which was claim, would permitted not be a second by evidenced the small settlement which recovery against another party by denying hospital included none of her and medical the truth of that state of facts. The case bills. decided, was correctly quotation judgment ap- of the court of civil Seamans, above, as discussed includes peals is reversed and the of the errors concerning the election doctrine. Cf. trial court is affirmed. Ward, Shriro 570 S.W.2d 395 1978). CAMPBELL, J., concurring.

The court of civil appeals in Metroflight, Shaffer, Inc. v. (Tex.Civ. GARWOOD, J., sitting. App. e.), writ ref’d n. r. fol — Dallas lowed but criticized Huckabee. As is char CAMPBELL, Justice, concurring. law, acteristic of this whole area of We attempt should not to draw an artifi- opinion equitable mixes estoppel, ratifica cial distinction between this case and the tion, satisfaction, judicial estoppel, unjust decisions Huckabee and Metroflight enrichment and other Perhaps matters. merely to avoid an admission that those underlying flaw in the analysis of the court decisions were erroneous. The claims in appeals civil Metroflight in is its basic those cases were as uncertain as the claims assumption. Metroflight had sued in feder in this case. Except uncertainty for there al claiming court that it had insurance cov obviously would have compromise been no erage arising for losses plane out of a crash. and settlement. This decision establishes a The defendant insurer coverage denied but rule of law that whether a settlement with paid later Metroflight eighty percent of the a defendant will be deemed an election bar- total Metroflight, claim. dismissing after defendant, ring suit against another its action in which it asserted insurance facts inconsistent with those asserted to coverage, proceeded against with a suit settlement, obtain the will be ultimately agent for damages the basis of the in by opinion determined this Court’s as to the consistent fact the plane was not in degree of uncertainty as to the facts incon- sured. The trial court held that Metrof- sistently asserted. light was by barred election. The court of civil appeals affirmed but criticized the v. Guy Seamans Oil Co. was not decided case, Huckabee which it felt bound to fol upon the law of elections but was decided equitable estoppel. This upon a clear-cut quo dictum Court in Huckabee followed a Jr., Petitioners, BALABAN, al., Mykro et Ruling in Case Law which is tation v.

compatible recognized principles procedure policy. party may A Texas COR- NEW TERMINAL WAREHOUSE prove totally claims plead and al., Respondents. PORATION et Madison, in Deal v. and defenses Texas. B-8861. No. 1978, (Tex.Civ.App. 576 S.W.2d 409 — Dallas e.); n. writ ref’d r. Rule T.R.C.P. Court of Texas. Supreme agreements highly fa Settlement are a means vored in law because are July prevent amicably resolving doubts and 12, 1980. Rehearing Sept. Denied ing Republic Miller National lawsuits. v. (5th Company, Life Insurance 559 F.2d 426 1977); Life Republic

Cir. National Insur Sussman, (5th

ance v. 564 F.2d 98 1977); Employers’

Cir. Alvarez v. Fire In (Tex.Civ. Company,

surance App. writ): no Coastal — Amarillo Producing Company Apollo States Gas v. Stone, Talbert, Alice Giessel Giessel & Inc., X-ray, Industrial 467 S.W.2d Watson, Giessel, Eastham, Henry P. writ): Civ.App. Corpus Christi — Jr., Forney, P. Ful- Forney, Dale & John Fidelity-Southern Fire Insurance Jones, Whitman, Jaworski, Jamail (Tex.Civ.App. bright 422 S.W.2d 552 Frank G. & r. Houston, —Houston writ ref’d n. Jamail, Kolius, Joseph for [14th D. Dist.] & Cook, e.); (Tex.Civ. State 407 S.W.2d petitioners. e.); App. n. writ ref’d r. — Waco Elkins, Nunnally D. Knox Vinson & Employers Pearce v. Texas Insurance Asso Houston, Lewis, respondents. Ann ciation, (Tex.Civ.App . —Dal e.) las writ ref’d n. r. motion for curiam, rehearing per overruled PER CURIAM. (Tex.1967). in this for writ of error applications Proper regard principles com- these with a granted were connection case pels compromise a conclusion that a mere case, Supply, B Sand companion B & Auto asserting settlement of Freight Pit, & Co. v. Central Trucking those in a claim asserted (Tex. 1980), Lines, Inc., 603 against a different defendant should not granted We day. this same handed down contrary bar the latter claim. The conclu- two cases to consider writs in these sion, effect, compels party proceed to light behind policies whether in final two more defend- art. enactment of Tex.Rev.Civ.Stat.Ann. ants defendant settling instead of with a (Vernon), right law common 2212a who is desirous of settlement. This would joint tortfeasors indemnity exists between claims not diminish assertion of inconsistent The Houston negligence cases. merely [14th settlements. would diminish Appeals present in the of Civil Court Dist.] express- We should concede our error not re that New Terminal case held is no ly overrule Huckabee and hold there co-tortfeasors, Gale indemnify quired to the merits. election until final Stevens, and Leon Trucking Park na Warehouse Myrko Balaban. New Terminal Wilson, Tex.Civ.App., supra, we held Supply, In B B Auto & indemnity is right law common

Case Details

Case Name: Bocanegra v. Aetna Life Insurance Co.

Court Name: Texas Supreme Court

Date Published: Jul 16, 1980

Citation: 605 S.W.2d 848

Docket Number: B-8077

Court Abbreviation: Tex.