Lead Opinion
This workers’ compensation suit poses the question of whether a self-insured municipality owes its employees the duty of good faith and fair dealing. The trial court held as a matter of law the doctrine of sovereign immunity shielded the city from an employee’s claim of bad faith in denying him compensation for an on-the-job injury. In eight points of error, the employee challenges the constitutionality of sovereign immunity and its applicability to this case. We affirm.
Robert Jackson, appellant, contends he injured his back while in the course and scope of his employment as a waste collector with the City of Galveston, appellee, a self-insured municipality. The City, unwilling to abide by a decision of the Industrial Accident Board awarding benefits to Jackson, filed suit to set aside the award. In his answer, Jackson contended that his injury prevented him from working for at least 210 days, and he sought compensation for medical expenses the City had not paid. Later, Jackson amended his response to allege the City had violated its duty to deal with him fairly and in good faith, and he sought exemplary damages for the City’s negligence and gross negligence in denying his claim for benefits. The trial court granted the City’s special exceptions, and Jackson chose to stand on his pleadings. By agreement of the parties, the bad faith claim was severed from Jackson’s claim for workers’ compensation benefits, and it was dismissed.
The controlling issue is whether Jackson’s bad faith cause of action against the City is barred as a matter of law. First, however, we address the procedural matter of whether the City’s special exceptions were defective.
A trial court is vested with broad-discretion in hearing, construing, and sustaining special exceptions to pleadings, and its ruling will not be disturbed on appeal unless an abuse of discretion has resulted in injury. Davis v. Quality Pest Control,
In its sworn denial to Jackson’s counterclaim, the City pleaded sovereign immunity under the Texas Tort Claims Act, Tex.Civ.PRAC. & Rem.Code Ann. § 101.001 et seq. (Vernon 1986 & Supp.1992) (“the Act”); as a self-insured municipality, the City denied it owed its employees the duty of good faith and fair dealing, and it denied being a compensation insurer. The City filed special exceptions, which were amended after Jackson filed a third amended counterclaim. Special Exception IV., which appellant terms the “meat” of this appeal, stated:
The City of Galveston specially excepts to paragraphs IX, X and XI as a whole and would show the court that those allegations are insufficient and improper in law and should be stricken because the City of Galveston was not a compensation insurer as alleged by Jackson, and because there is no duty of the City to deal with its employees fairly and in good faith recognized by the constitutional, statutory, or common law of the State of Texas, including the Insurance Code, Workers’ Compensation Act or the Deceptive Trade Practices Act.
The City’s amended special exceptions to Jackson’s third amended answer/counterclaim charge that Jackson failed to describe “any specific claims of Jackson for medical benefits and any specific denials of those claims by the City.” This Court, too, has difficulty ascertaining specifics of Jackson’s claims due to the absence of affidavits, medical records, or claim forms in the record. We decide the point, however, on whether the City’s special exceptions adequately raised the defense of governmental immunity. On this question, there is no doubt. Jackson countered the City’s special exceptions with a memorandum of law supporting his perspective that a self-insured political subdivision is an “insurance association,” thus owing a duty to deal fairly and in good faith when processing workers’ compensation claims. Aranda v. Ins. Co. of North America,
Next, we address the substantive question of whether the City owed Jackson a duty to deal fairly and in good faith concerning his claim for workers’ compensation benefits. The supreme court has held “there is a duty on the part of workers’ compensation carriers to deal fairly and in good faith with injured employees in the processing of compensation claims.” Id. at 212-13. The supreme court reasoned:
The duty of good faith and fair dealing is thus imposed on the insurer because of the disparity of bargaining power and the exclusive control that the insurer exercises over the processing of the claims....
.... there is a promise for a promise: the carrier agrees to compensate the employee for injuries sustained in the course of employment, and the employee agrees to relinquish his common law rights against his employer.
[The injured employee] is dependent on the carrier for protection from the economic calamity of disabling injuries. An arbitrary decision by the carrier to refuse to pay a valid claim or to delay payment leaves the injured employee with no immediate recourse.
Id. at 212. Jackson argues the reasoning in Aranda is no less compelling when the employer is a self-insured municipality.
The Legislature, however, has seen fit to shield a municipality from tort liability when the city is performing a “governmental” rather than a “proprietary” function. Abbott v. City of Kaufman,
When a municipality acts in a governmental function, it is liable only under a narrow set of circumstances, among them personal injury “caused by a condition or use of tangible personal or real property.” Section 101.021; Robinson v. Cent. Texas MHMR Ctr.,
Finally, Jackson attacks the constitutionality of the doctrine of sovereign immunity. First, he argues that language in Texas Local Government Code § 51.013, stating “the municipality may sue and be sued,” impliedly waives a city’s sovereign immunity and immunity from suit. Courts have “frequently denied” this proposition in similar cases involving hospital authorities and county hospital boards. Townsend v. Memorial Medical Ctr.,
The judgment of the trial court is affirmed.
Notes
. Tex.Rev.Civ.Stat.Ann. art. 962 (Vernon 1963) (citing Acts 1875).
. Bail v. Texarkana Water Corp.,
Dissenting Opinion
dissenting.
I respectfully dissent.
The Texas Supreme Court has imposed a duty on the part of workers’ compensation carriers to deal fairly and in good faith when processing claims brought by injured employees. Aranda v. Ins. Co. of North America,
In deciding that the doctrine of sovereign immunity excuses the City of Galveston from dealing fairly and in good faith with its injured employees, the majority explains that, for better or worse, the Legislature has seen fit to shield a municipality from tort liability when the city is performing a “governmental” function. Conversely, the doctrine of sovereign immunity would not protect the City from torts committed while performing a “proprietary,” or discretionary, function. In reality, both governmental and proprietary functions may be involved in fulfilling the requirement that cities “become either self-insurers, provide insurance under workmen’s compensation insurance contracts or policies, or enter into interlocal agreements with other political subdivisions providing for self-insurance, extending workmen’s compensation benefits to their employees.” Tex.Rev.Civ. StatAnn. art. 8309h § 2(a) (Vernon Supp. 1992). Although providing employees with workers’ compensation insurance is mandated by law, the State allows a city three options on how to fulfill the requirement. This discretionary aspect of the requirement is particularly significant, for if a city chooses to purchase coverage from an insurance company, its employees enjoy the protection afforded workers in the private sector, protection the supreme court imposes on the insurer “because of the disparity of bargaining power and the exclusive control that the insurer exercises over the processing of the claims[.]” Aranda,
