Texas Employers' Insurance Ass'n v. Chappell

Decision Date04 April 1973
Docket NumberNo. B--3772,B--3772
Citation494 S.W.2d 159
PartiesTEXAS EMPLOYERS' INSURANCE ASSOCIATION, Petitioner, v. Arthur R. CHAPPELL, Respondent.
CourtTexas Supreme Court

Dyer, Redford, Burnett, Wary, Woolsey & Dunham, James W. Wray, Jr. and B. Mills Latham, Corpus Christi, for petitioner.

Edwards & DeAnda, William R. Edwards and Philip Kent Maxwell, Corpus Christi, for respondent.

PER CURIAM.

Respondent's motion for rehearing is granted. Our former per curiam opinion in this cause, dated April 4, 1973, is withdrawn, our judgment of same date is set aside, and the following is substituted therefor.

The plaintiff, Arthur Chappell, has obtained a judgment against defendant, Texas Employers' Insurance Association (TEIA), for $3,726.75 which was stipulated to be the amount of medical expenses incurred by plaintiff following his injury in June 1969. That judgment also awarded plaintiff further relief in particulars not necessary to mention. The court of civil appeals affirmed. 486 S.W.2d 818.

A complete statement of the facts of this case may be found in the opinion of the court of civil appeals. The jury found that $3,726.75 was the cost of 'medical services reasonably required . . . for the cure or relief of the effects naturally resulting from (Chappell's) injury of November 29, 1962, and not heretofore paid by Texas Employers Insurance Company.'

TEIA contends that it is not liable for any part of those medical expenses because plaintiff has not proven, as he must under Vernon's Tex.Rev.Civ.Stat.Ann. art. 8306, § 7, that the carrier was given notice of the need for treatment and then refused to furnish it. There is conclusive proof that reasonable expenses were incurred as a result of necessary medical treatments, and there is conclusive proof that TEIA was notified and then refused to pay, but the proof fails to establish the amount incurred After TEIA was notified. Chappell was allowed to recover for all expenses, both before and after TEIA was notified on November 6, 1969. The court of civil appeals held, in effect, that notice of need for medical attention was unnecessary in view of the fact that TEIA had notice of the 1962 injury, which is all the statute requires. The court of civil appeals relied on three cases: Standard Fire Insurance Company v. Simon, 474 S.W.2d 530 (Tex.Civ.App.--Dallas 1971, no writ); Texas Employers' Insurance Ass'n v. Steadman, 415 S.W.2d 211 (Tex.Civ.App.--Amarillo 1967, writ ref'd n.r.e.); Trinity Universal Insurance Company v. Farley, 408 S.W.2d 776 (Tex.Civ.App.--Tyler 1966, no writ).

The rule of those cases is that when a claimant has notified the carrier of an injury, the carrier has the duty to move to furnish whatever aid is necessary as a consequence of that injury and the claimant need not make a special request for each item of expense. We regard those cases as sound on their facts, but the rule is not applicable when the injury and the need for treatment are...

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6 cases
  • Johnson v. Texas Emp. Ins. Ass'n, 8013
    • United States
    • Texas Court of Appeals
    • October 20, 1977
    ...818 (Tex.Civ.App. Corpus Christi 1972), reversed in part on other grounds but undisturbed as to the holding under consideration, 494 S.W.2d 159 (Tex.1973). The right of set off under the Texas Act is very doubtful. It was denied in Texas Indemnity Ins. Co. v. Arant, 171 S.W.2d 915, 920 (Tex......
  • Continental Ins. Co. v. Wolford
    • United States
    • Texas Court of Appeals
    • October 9, 1974
    ...Insurance Association v. Chappell, 486 S.W.2d 818 (Tex.Civ.App.-Corpus Christi 1972), affirmed in part and reversed in part 494 S.W.2d 159 (1973). Where the evidence is alleged to be factually insufficient, this Court is not authorized to substitute its own findings for those of the trial c......
  • Highlands Underwriters Ins. Co. v. Carabajal
    • United States
    • Texas Court of Appeals
    • November 30, 1973
    ...8306, Vernon's Ann.Civ.St.; Few v. Charter Oak Fire Insurance Company, 463 S.W.2d 424 (Tex.Sup. 1971); Texas Employers' Insurance Ass'n v. Chappell, 494 S.W.2d 159 (Tex.Sup. 1973). The only notice required by the statute to be given the carrier is notice of injury. It does not require speci......
  • Tex. Dep't of Ins.—Division of Workers' Comp. v. Mensch
    • United States
    • Texas Court of Appeals
    • January 14, 2015
    ...the reasonable cost of future hospital and medical services.” Id. at 701. Another case cited by Mensch, Texas Employers Insurance Association v. Chappell, 494 S.W.2d 159 (Tex.1973), dealt with notice, and the employee had already incurred the expenses. Finally, Pearce v. Texas Employers Ins......
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