| |||||||||

A Promise Kept: Texas Firm Spends $25,000 to Recover $77.55
John Council
Texas Lawyer
March 20, 2006
In the age of tort reform, Texas plaintiffs attorneys are used to turning away clients whose suits cost more to litigate than can ever be recovered at trial. So why would a lawyer accept a case in which a client sought $77.55 -- an amount of money that might pay for 15 minutes of an attorney's time?
Partner James Holmes of Henderson, Texas' Wellborn Houston says he proudly accepted such a case in 1997. And years later, he and his East Texas firm ended up paying $25,000 in trial costs and legal fees out of their own pockets to recover that $77.55 for their client. The firm did not charge the client anything for the additional representation.
Holmes explains that, by representing Robbie L. Linton, he was making good on a promise his firm made nearly two decades earlier. On Jan. 29, Linton, a former oil field worker injured on the job 20 years earlier, won a verdict for $77.55 -- the cost of two prescriptions an insurance carrier refused to cover.
"This is the funniest tragic thing I've ever seen," Holmes says.
Holmes notes that Wellborn Houston founding partner Rex Houston represented Linton in a 1986 worker's compensation claim against his employer, after Linton injured his back while climbing a step onto an oil rig. At the time, the firm had six lawyers.
In 1987, Houston ultimately won an administrative award from the Industrial Accident Board in which Linton's employer's insurer was ordered to pay Linton $34,000 in lost earning capacity and cover his work-related injury medical costs for life. Houston, working on a 25 percent contingent fee, was paid $8,500 for his representation of Linton.
But in the late 1990s, Linton had trouble getting Traveler's Indemnity Co. to pay his medical claims, including a $3,000 chiropractor's bill and $77.55 for two pharmacy bills for pain medication. So in 1997, Linton called Holmes for help.
"Mr. Linton comes to see me, and he hands me a letter dated 1987. It is typed on carbon paper on a manual typewriter and it is signed by Rex Houston," says Holmes, a former insurance defense lawyer who joined Wellborn Houston in 1993. Houston is now retired from his 56-year-old plaintiffs firm. But the letter certified to doctors and pharmacists that Linton's work-related injury costs were covered by insurance.
"And it says if anybody needs any help, you call this law firm. And the client's recollection is that Rex issued a promise in 1987: if this ever became a problem, that we would stand behind it," Holmes says. "And at that point there was no way I was not going to take care of this man. So we began working."
Houston says it used to be common practice for his firm to write letters for its workers' compensation clients -- a practice the firm ceased years ago. Wellborn Houston had generated $1 million annually in fees from workers' comp cases, but after the Legislature altered the workers' compensation laws in 1991, the firm decided it would no longer represent worker's comp clients, Holmes says. Now Wellborn Houston represents plaintiffs in complex litigation.
Houston, 79, says he vaguely remembers Linton's case but is familiar with the contents of the letter. "The letter was so he'd have a record of what his rights were, even if I were dead and gone," Houston says. "It was just my job as a lawyer and taking care of them. That's all it was."
Linton says he kept the letter filed away for nearly 20 years.
"They always treated me fair. So it didn't surprise me a bit when they did what they did," Linton says of Holmes and his firm taking his case in 1997. "What surprised me is what Traveler's did."
Holmes says Traveler's eventually paid for the chiropractor bill, but steadfastly declined to cover the $77.55 in pharmacy bills.
Julie Tebbets, an associate with Colleyville's Ayers & Ayers who represents Traveler's, says the company believes Linton's current medical problems are not related to his 1986 injury.
"He would go for years without seeking any treatment. He didn't have any treatment from 1990 to 1997," Tebbets says. "And so the carrier had doctors review the records and concluded that his current condition was not related to the original injury."
Linton challenged the $77.55 dispute administratively, with Holmes' help. On June 17, 2004, the Texas Workers' Compensation Commission, formerly the Industrial Accident Board, awarded Linton the total cost of the pharmacy bills.
Traveler's appealed the administrative ruling by filing Traveler's Indemnity Co. v. Linton in the 4th District Court in Rusk County July 22, 2004. To deny the coverage of $77.55, Traveler's paid $195 to the Rusk County District Clerk's Office to file the suit.
"When you really look at it, it's not truly just over $77," Tebbets says. "This is a 19-year-old injury with significant gaps in medical treatment."
THE OLD SYSTEM
Preparing to litigate a 19-year-old worker's compensation suit is not an easy task for the modern-day Texas lawyer.
The Legislature changed the state workers' compensation laws significantly in 1991, altering the way administrative appeals were processed and setting specific amounts claimants could receive for certain injuries. The revisions resulted in smaller fees for plaintiffs lawyers handling workers' comp cases. Therefore, many Texas attorneys abandoned the workers' compensation practice, because it was no longer profitable.
Since Linton's claim was 19 years old, Traveler's Indemnity Co. v. Linton was tried under the old workers' comp laws, which many attorneys today are not familiar with, including Holmes.
"You're talking to a guy who never practiced in the old system. I had to pull old law books off the shelf that hadn't been used in 15 years," Holmes says. "I've got a book here that's so old the pages are yellow. The last supplement is 1986."
On Jan. 27, two days before the trial, Linton says Traveler's offered him a $5,000 settlement in exchange for dropping his lifetime medical coverage with them. He refused. The day before trial, the offer went up to $10,000, Linton says, but he still refused. He needs the medical coverage much more than the settlement money, Linton says.
"My spine is still screwed up in the same place from day one," says Linton, who hasn't worked since the 1986 injury and receives full Social Security disability benefits.
Tebbets declines to discuss the settlement offers but says that it was common under pre-1991 law for insurance company lawyers to offer workers a lump-sum payment in exchange for dropping their lifetime medical coverage with the carrier.
Holmes says his first question during voir dire was: "How many people believe that a promise made ought to be a promise kept?" All of the potential jurors raised their hands. During the trial, he argued to the jury that Traveler's had broken its promise to Linton.
Tebbets says she argued that the insurer denied the prescription claim "as not being necessary and related to the original injury."
After a three-hour trial involving only three witnesses, the jury ruled in Linton's favor, Holmes says.
Judge J. Clay Gossett has not yet signed a final judgment in the case, and Tebbets says she has not discussed a future course of action with Traveler's.
"The carrier stands behind its denial based on medical evidence," Tebbets says.
A spokeswoman for Hartford, Conn.-based Traveler's declines to comment about the suit.
Robert D. Allen, a partner in the Dallas office of Baker & McKenzie who represents insurance companies, says it's common for carriers to closely examine old workers' compensation claims to make sure they are still covered.
"They would certainly look at that very carefully, there's no question," Allen says. "But [to litigate] something over $77, that doesn't make sense.
"There's got to be more to the story than what's known at first blush," Allen adds.
Denied insurance claims are what plaintiffs attorney Mike Sawicki, a partner in Brown, Sawicki & Mitchell in Dallas, deals with every day.
"Insurance companies work on the power of saying 'no.' If they work on a viable claim, and it makes someone go away, they've just saved themselves some money and avoided paying a claim that they were legally required to," Sawicki says.
"And unfortunately a lot of people give up and don't get the benefit of the insurance they've been paying for," Sawicki says.
It took some fortitude for Holmes and his firm to handle Linton's case when it involved such a small claim, Sawicki says.
"I mean, a lot of other places might have found more profitable ways to spend their time," Sawicki says. "But it's a great feeling when you correct a wrong."
Holmes agrees. He's just as proud of the $77.55 verdict as he is of a $12.7 million settlement he obtained two years ago from a trucking company on behalf of a woman who was left paralyzed from a traffic accident.
"When I saw the letter from Rex, I didn't ask for permission, I did it. All of the partners agreed that it had to be done. I told them, 'Guys, I'm going to pay a doctor $1,000 to prove up $77 in medical bills.' They said, 'That's ridiculous, but it's got to be done.'"
Holmes says his firm -- which now has seven lawyers -- has filed a motion with the district court seeking to recover his attorney fees -- most of which he concedes he'll likely never see.
"You can't just select your cases based on money. You've got to take care of people," Holmes says. "And we've always believed if you take care of people, fees will take care of themselves. And this case is a good example."






