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Saenz v. Fidelity & Guarantee Insurance Underwriters6/14/1996
Argued Nov. 15, 1994.
Rehearing Overruled Aug. 16, 1996.
HECHT, Justice, delivered the opinion of the Court in which GONZALEZ, ENOCH, BAKER and ABBOTT, Justices, joined.
Corina Saenz sued her employer's workers' compensation carrier and its adjuster for wrongfully inducing her to settle her claim and recovered actual damages for future medical costs and mental anguish, and punitive damages. We hold that Saenz' sole remedy for loss of medical benefits is rescission, that she did not adduce any evidence of mental anguish, and that because she is not entitled to actual damages, she is not entitled to punitive damages. Inasmuch as Saenz expressly disclaims rescission, we render judgment that she take nothing.
I.
Saenz had been working as a secretary for about two months when she fell over backward in a chair and hit her head on the floor. Saenz, then thirty-three years old, was hospitalized for several days. After being released, she continued to see numerous physicians for chronic headaches, drowsiness, seizures, and other ailments resulting from her accident. She has been diagnosed as having post-concussion syndrome, for which she may require medical treatment indefinitely.
The workers' compensation carrier for Saenz' employer, Fidelity & Guaranty Insurance Underwriters, promptly began paying her weekly wage benefits - as well as her medical bills. During the next year, Fidelity's adjuster, Gisela Armstrong, had many conversations with Saenz in an effort to settle her claim. Saenz repeatedly told Armstrong that her primary concern was that the medical expenses related to her injury be paid for the rest of her life. The Texas Workers' Compensation Act provides for this benefit. TEX. LAB.CODE § 408.021(a)(formerly TEX.REV.Civ. STAT. ANN. art. 8306, § 7 (Vernon Supp.1995)). Armstrong never told Saenz that she might be entitled to lifetime medical coverage for her injury. Saenz contends that Armstrong told her that workers' compensation would cover medical expenses for only five years. Armstrong denies that she ever said that.
Saenz did not have legal counsel. According to Saenz, Armstrong did not attempt to dissuade her from hiring a lawyer, but Armstrong did say that Saenz did not need a lawyer because she would not receive any more in settlement of her claim. Saenz had made two prior claims for workers' compensation . Each time she was represented by an attorney, and each time she settled for less than five years' medical benefits and a lump sum payment, of which her attorney was paid twenty-five percent. Saenz did not want to incur this legal expense again if it would make no difference in the size of e settlement, and she says Armstrong assured her it would not.
A lawyer for Fidelity wrote Armstrong that Saenz' claim was "a potentially dangerous case in the valley", where "juries tend to be very liberal". He believed Saenz' positive electroencephalogram indicated that her physical complaints were "legitimate", and he urged Armstrong to work out "a reasonable settlement ... without scaring the claimant off to an attorney." Armstrong, however, was unable to reach an agreement with Saenz.
Fidelity scheduled a prehearing conference before an Industrial Accident Board hearing examiner to attempt to resolve Saenz' claim. Present at the conference were Saenz and her husband, another lawyer for Fidelity, and the IAB hearing examiner. Fidelity's lawyer stated that he offered Saenz three alternative settlements: a lump sum payment of $45,000 and twenty years' medical coverage, $60,000 and ten years' coverage, or $65,000 and five years' coverage. Saenz recalls only the last offer, which she accepted. Fi
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