American Home Assurance Co. v. Rodriguez

OPINION

REEVES, Justice.

This is a suit to set aside a compromise settlement agreement between the appellant (American Home) and the appellee (Rodriguez) that resolved a worker’s compensation claim asserted by Rodriguez. In a prior unpublished opinion, this Court held that there was no evidence to support Rodriguez’ contention that agents of American Home made representations to her which induced her to enter into an unsatisfactory compromise settlement agreement. In Rodriguez v. American Home Assurance Co., 735 S.W.2d 241 (Tex.1987), the Supreme Court found that there was some evidence to support the trial court’s judgment setting aside the agreement. Consequently, the Supreme Court remanded the cause to this court to pass on the factual insufficiency points raised by American Home.

Rodriguez was injured in the course of her employment with the Del Monte Corporation in Crystal City. She hired an attorney, Sid Cowan, to pursue her workers’ compensation claim. He referred Rodriguez to Dr. Luis Gonzalez-Rios, an orthopedic surgeon. Rios’ original diagnosis was that Rodriguez suffered from a severe low back sprain. In the due course of settling the claim, Lynn Houston, American Home’s adjuster, referred Rodriguez to Dr. Coyle Williams for further examination. Dr. Williams concurred in Dr. Gonzalez-Rios’ diagnosis of a low back sprain. Dr. Williams’ diagnosis was reduced to writing and sent to American Home; a copy was sent to Dr. Gonzalez-Rios. In a follow-up examination, Dr. Williams again reported to Houston and Cowan that Rodriguez’ back would get better and that she could return to work.

Thereafter, Rodriguez, Cowan, and Katie Flahive, an attorney for American Home, met with a prehearing officer of the Industrial Accident Board (I.A.B.) and executed a compromise settlement agreement that settled Rodriguez’ compensation claim for $3,600 and two years of future medical expenses. Since Rodriguez had limited knowledge of the English language, Jesus Dovalina, a legal assistant employed by Cowan, attended the hearing to aid Rodriguez in understanding the proceedings.

Flahive testified that she did not specifically recall if all the doctors’ medical reports were in her file.1 But she did testify that the I.A.B. always requires an up-to-date medical evaluation, and that she had no reason to believe that her file did not contain all of those reports on Rodriguez. She further testified that in evaluating a case and reaching a settlement figure, it is her policy to look at and rely on, at least in part, all the medical records in her file. She was also of the opinion that Rodriguez’ attorney would not have settled the case without also having reviewed all those medical records.

Lynn Houston, American Home’s adjuster, did not personally talk with either Rodriguez or Cowan. She testified she determined that Rodriguez suffered a back sprain after reviewing Drs. Gonzalez-Rios’ and Williams’ medical reports. She sent those reports to Flahive. She further testified that compromise settlement agreements are based on medical reports and other information found in an adjuster’s case file.

Rodriguez’ pain persisted after the agreement was finalized. A myelogram was performed, and it was determined that she suffered from a herniated disc. Within six months from the date of the settlement, Rodriguez underwent surgery to remove the damaged disc. Suit was instituted to set aside the compromise agreement, and after a jury trial, a judgment was entered to that effect.

To set aside a compromise settlement agreement, a worker must show that *899misrepresentations concerning his or her injuries were made by the employer or compensation carrier, that the worker relied on these misrepresentations in making the settlement, and that there was a meritorious claim for more compensation than had been originally agreed to. Rodriguez, pp. 241-42; Brannon v. Pacific Employers Insurance Co., 148 Tex. 289, 224 S.W.2d 466, 468 (1949).

We are of the opinion that there was sufficient probative evidence for the jury to find that American Home relied on Rodriguez’ doctor’s medical records as well as Dr. Williams’ in entering the settlement agreement. When American Home’s agent used Rodriguez’ doctor’s reports in reaching the compromise settlement, it made the doctor its agent. Rodriguez, at p. 242; Mackintosh v. Texas Employers Insurance, 486 S.W.2d 148, 154 (Tex.Civ.App.— Dallas 1972, writ ref’d n.r.e.).

We are also of the opinion that there was sufficient evidence for the jury to have found that Rodriguez relied upon Dr. Williams’ representations. It was Dr. Williams’ opinion that Rodriguez suffered from a back sprain and she could return to work. A copy of this opinion was directed to Rodriguez’ attorney. The attorney-client relationship is one of principal and agent, and the acts of one ordinarily binds the other. Portnow v. Berg, 593 S.W.2d 843, 845 (Tex.Civ.App.—Houston [1st Dist.] 1980, no writ). It is reasonable that Dr. Gonzalez-Rios and Rodriguez’ attorney informed her of Dr. Williams’ diagnosis and prognosis.

Although Rodriguez had difficulty understanding the English language, she testified that Dr. Williams had communicated to her that she only had a sprained back and could, when he released her, return to work. She further testified that she made the decision to accept the compromise settlement agreement because she was told that “the doctors were of the opinion that there was nothing wrong with her back, save the back sprain.”

American Home also contends that the court erred in overruling its objection to Special Issue No. 5 because “it is improperly worded and insufficient to support a judgment that an agent of the appellant made a representation to appellee.” The issue asks:

Do you find from a preponderance of the evidence that the defendant, American Home Assurance Company, acting through its agents, servants or employees, used any of the representations found by you in Special Issue Nos. 1A, IB, 1C, or 3A, 3B or 3C (medical findings of the doctors) in making the agreement with Ana B. Rodriguez of February 3, 1983?

The jury answered the issue affirmatively.

We find that Special Issues Nos. 6 and 7 adequately addressed the question of whether American Homes’ agents made representations to Rodriguez. In Special Issue No. 6 the jury found that Rodriguez relied on medical advice of Drs. Williams and Gonzalez-Rios. In Special Issue No. 7 it found that the doctors’ representations materially induced Rodriguez into entering into the agreement with American Home. This point of error is overruled.

The remaining points of error all relate to the sufficiency of the evidence to establish the agency relationship between American Home and Drs. Gonzalez-Rios and Williams which have already been addressed by this opinion.

The judgment of the trial court is affirmed.

. She had destroyed the records in the normal course of business.