United States Court of Appeals
Fifth Circuit
F I L E D
UNITED STATES COURT OF APPEALS
July 8, 2003
FIFTH CIRCUIT
Charles R. Fulbruge III
____________ Clerk
No. 02-40698
____________
OZAN PATTERSON, Individually & as Rule 23 Class Representative
on behalf of all other similarly situated individuals; JOHN
BALLENGER, Individually & as Rule 23 Class Representatives on
behalf of all other similarly situated individuals,
Plaintiffs - Appellants,
versus
MOBIL OIL CORPORATION; FORUM INSURANCE COMPANY;
MOBIL CORPORATION; GLENDA MATOUSE, Individually & as
Agent for Mobil Oil Corporation; ROBERT GRONWALDT,
Individually & as agent for Mobil Oil Corporation; BEN STIFF,
Individually & as agent for Mobil Oil Corporation; CHARLES
TEEPLES, Individually & as Agent for Mobil Oil Corporation;
NATIONAL UNION FIRE INSURANCE COMPANY OF
PITTSBURGH, PA; AIG NATIONAL INSURANCE COMPANY;
AIG RISK MANAGEMENT INC; AIG INC; ENERGY PRINTING
INC; AMERICAN HOME ASSURANCE COMPANY;
INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA,
Defendants - Appellees.
______________________________________________________
THOMAS J BALLENGER,
Plaintiff,
ELLA RAY WHITEHEAD,
Appellant,
versus
MOBIL OIL CORPORATION,
Defendant - Appellee.
Appeal from the United States District Court
For the Eastern District of Texas
Before EMILIO M. GARZA and DeMOSS, Circuit Judges, and DUVAL,* District Judge.
EMILIO M. GARZA, Circuit Judge:
This case arises from a wave of state and federal litigation brought by employees and former
employees of Mobil, as well as their relatives. Generally, the employees assert that Mobil failed to
comply with Texas workers’ compensation law, such that Mobil was never a valid subscriber to the
workers’ compensation system. Under Texas’s scheme, employees covered by subscriber-purchased
policies receive compensation on a no-fault basis, and, in exchange, subscribing employers benefit
from an exclusive remedy provision. This provision prevents employees from suing subscribers for
negligence. Thus, the theory is that these employees were injured because Mobil’s allegedly
fraudulent representations that it was a subscriber caused them to forgo negligence lawsuits against
Mobil.
In the instant case, the plaintiffs, Ozan Patterson and John Ballenger, are using this theory to
allege a variety of civil violations under the Racket eer Influenced and Corrupt Organizations Act
*
District Judge of the Eastern District of Louisiana, sitting by designation.
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(“RICO”), 18 U.S.C. § 1861 et seq. Originally, Patterson and Ballenger brought this suit as a class
action under FED. R. CIV. P. 23, but we previously vacated the district court’s class certification. See
Patterson v. Mobil Oil Corp., 241 F.3d 417, 419 (5th Cir. 2001). Upon remand, the district court
granted summary judgment to the defendants. The plaintiffs timely appeal.
I
The issues presented by this case necessitate a detailed recitation of the facts and procedural
background, including a brief summary of the allegations in the pleadings and the roles of the parties.
In the primary cause of action, the plaintiffs allege that Mobil violated RICO by conspiring with
various insurers and claims adjusters over a thirty-year period (hereinafter “the RICO suit”).
Specifically, they allege that the defendants engaged in a long-term scheme to deprive the plaintiffs
of their common-law negligence causes of action against Mobil for workplace injuries. Mobil
allegedly used “fronting” insurance companies to obtain “sham” workers’ compensation policies in
order to hide the fact that it was self-insuring, which was not permitted by the Texas workers’
compensation scheme then in force. Further, the plaintiffs allege that the defendants used the
interstate mail and telephone wires to further this illegal enterprise.
During the relevant years, Mobil obtained its workers’ compensation insurance from several
different companies. Pre-1970 through 1981, Mobil’s insurer was Forum Insurance Company
(“Forum”); from 1982 through 1991, Mobil’s insurer was National Union Fire Insurance Company
of Pittsburgh, Pennsylvania; in 1992, Mobil’s insurer was American Home Assurance Company; and,
in 1993, Mobil was insured through the Insurance Company of the State of Pennsylvania. All are
named as defendants in the RICO suit. The latter three insurers are members of the American
International Group of Companies (“AIG”) and other various AIG companies have also been named
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as defendants (collectively, the “AIG Defendants”). In addition, the plaintiffs have sued Glenda
Matous and Robert Gronwaldt, representatives of AIG who adjusted Mobil workers’ compensation
claims, individually and as agents of Mobil.
Patterson was a Mobil employee from 1947 to 1982. In 1974, 1976, 1979, 1981, and 1982,
Patterson suffered on-the-job injuries. For each injury, Patterson sought and received workers’
compensation benefits from Mobil’s various insurers. Ballenger is the son of Thomas J. Ballenger,
who died in 1970 from burns sustained after an explosion at a Mobil plant. Ballenger’s mother, Ella
Ray Whitehead, sought and received workers’ compensation benefits from Forum, Mobil’s carrier
at that time. She also filed suit, on behalf of her and her surviving children, against Mobil, claiming
gross negligence and seeking punitive damages. See Ballenger v. Mobil Oil Corp., 488 F.2d 707,
708-09 (5th Cir. 1974). The jury found Mobil grossly negligent, but we reversed, concluding that
the evidence did not support that finding. Id. at 708, 713. During that suit, Mobil stated in its
pleadings that it had workers’ compensation insurance.
On March 23, 1999, the same day the plaintiffs filed the RICO suit, Whitehead filed a
“Request for Relief from Judgment” under FED. R. CIV. P. 60(b) (“the Rule 60(b) motion”). She
requested that the district court set aside the 1974 Ballenger judgment, arguing that Mobil had
perpetrated a fraud on the court by representing that it had workers’ compensation insurance.1
1
This case also has an extended and complex litigation history in state court. First, both
plaintiffs were members of a class action suit, filed in 1992, which involves similar theories and
defendants. McClelland v. Gronwaldt, No. A-144,481 (58th Di st. Ct., Jefferson County, Tex.).
Most recently, a Texas Court of Appeals reversed the class certification on procedural grounds. See
Gronwaldt v. McClelland, Nos. 09-99-125-CV, 09-99-591-CV, 2000 WL 800572, at *5 (Tex.
App.—Beaumont June 22, 2000, no pet. h.) (unpublished).
In addition, on October 5, 1998, Patterson and Ballenger filed separate suits based on various
state causes of action in the 60th Judicial District of Jefferson County, Texas. Patterson v. Mobil
Corp., No. B-159,657 (60th Dist. Ct., Jefferson County, Tex.); Whitehead v. Mobil Corp., No. B-
-4-
The RICO suit was originally assigned to Judge Fisher. Just after granting class certification,
Judge Fisher recused himself, sua sponte, without explanation. The case was reassigned to Judge
Cobb.2 The defendants immediately moved to have the certification order vacated, arguing that it was
inappropriate for Judge Fisher to have ruled on the issue since nobody knew why Judge Fisher
recused himself or when the conflict came to Judge Fisher’s attention.
The plaintiffs moved to have Judge Cobb recuse himself, citing 28 U.S.C. §§ 144 and 455 as
support. Specifically, they alleged that disqualification was mandatory because John Tucker, a
partner in Judge Cobb’s former law firm, Orgain, Bell & Tucker, L.L.P. (“OB&T”), represented
Mobil in the original Ballenger suit while Judge Cobb was still a partner at that firm. The plaintiffs
also argued that Judge Cobb’s impartiality might reasonably be questioned because of his relationship
with Tucker and OB&T. Finally, they contended that Judge Cobb was actually biased because he
might be required to consider the actions of his former law partner and law firm during the course
of the case. In particular, they noted that Tucker was one of the lawyers representing Mobil in the
159,657 (60th Dist. Ct., Jefferson County, Tex.). The Ballenger case is set for trial in September
2003.
Although not all of the above information on the state court proceedings is part of the record
on appeal, we may take notice of pending judicial proceedings. See, e.g., Lowrey v. Tex. A&M Univ.
Sys., 117 F.3d 242, 246 n.3 (5th Cir. 1997). In fact, Patterson and Ballenger have formally moved
us to take judicial notice of several documents. We grant the motion with respect to (1) the transfer
order from the 58th Judicial District Court of Jefferson County, and (2) the letter agreement setting
the Ballenger trial for September 23, 2003. We deny the motion with respect to Mobil’s state court
pleading (document 3). The AIG Defendants opposed this motion and conditionally requested that
we take judicial notice of an October 4, 2002 state court hearing transcript. That motion is denied.
2
Judge Cobb also ended up with the Rule 60(b) motion. Initially, the motion was assigned
to Judge Fisher, but it was reassigned to Judge Heartfield after Judge Fisher passed away. Upon
discovering that a family member was an attorney of record for Mobil, Judge Heartfield recused
himself, and the motion was reassigned to Judge Cobb.
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RICO suit.3 The plaintiffs also submitted an affidavit from John Ballenger in which he stated that he
believed Judge Cobb was biased against his case and would not be able to preside impartially over
the RICO suit.
At the hearing on the defendants’ motion to vacate, Judge Cobb asked the plaintiffs whether
Tucker or OB&T were mentioned in the complaint or whether the plaintiffs were seeking recovery
against Tucker or the firm. The plaintiffs answered no to both questions, and Judge Cobb denied the
motion to disqualify. Following this, the plaintiffs petitioned this court for a writ of mandamus,
seeking Judge Cobb’s disqualification, and we denied that petition. In re Patterson, No. 00-40001
(5th Cir. Jan. 10, 2000) (unpublished) (order denying mandamus).
After this court reversed the class certification, the defendants moved for summary judgment
and the plaintiffs made a supplemental motion for disqualification. The basis of the plaintiffs’ motion
was new evidence that Judge Cobb had represented Forum in a Mobil workers’ compensation case
in 1975. See Forum Ins. Co. v. Mitchell, No. A-98,195 (58th Dist. Ct., Jefferson County, Tex. Apr.
25, 1975) (unpublished). They contended that this gave Judge Cobb personal knowledge of relevant
facts, including whether Forum was a sham company that was actually controlled by Mobil at that
time and whether Mobil was a valid subscriber in the Texas workers’ compensation system. The
defendants opposed the motion. Judge Cobb noted i n a later order that he was asked to recuse
himself in an earlier stage of the McClelland litigation4 for similar reasons, but had refused to do so.
3
Tucker is not listed as an interested party or counsel at the beginning of Mobil’s appellate
brief, but he was list ed as Of Counsel for Mobil at least as late as December 16, 1999, when the
defendants filed their motion to vacate the class certification.
4
At one point, Mobil removed the McClelland litigation to federal court on grounds of federal
question jurisdiction. On interlocutory appeal, we held that federal question jurisdiction was lacking
and that an exercise of supplemental jurisdiction would be an abuse of discretion. McClelland v.
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In one of his final memorandum orders, Judge Cobb explicitly stated that his position as Forum’s
counsel of record twenty-seven years ago in a separate litigation did not warrant disqualification and
emphasized that the plaintiffs’ earlier attempt to secure disqualification from this court had been
unsuccessful. He then denied the motion to disqualify.
In a separate order, the district court granted the defendants’ motion for summary judgment
and denied the Rule 60(b) motion. Plaintiffs now appeal Judge Cobb’s refusal to stand recused and
the adverse summary judgment ruling.5
II
We first address the recusal issue. The denial of a motion to recuse is reviewed for abuse of
discretion. Matassarin v. Lynch, 174 F.3d 549, 571 (5th Cir. 1999) (citing In re Billedeaux, 972
F.2d 104, 106 (5th Cir. 1992)).
A
Under 28 U.S.C. § 144, a judge is to recuse himself if a party to the proceeding “makes and
files a timely and sufficient affidavit that the judge before whom the matter is pending has a personal
bias or prejudice either against him or in favor of any adverse party . . . .” A party may only file one
such affidavit for that case. Id. In addition, the affidavit must be filed “not less than ten days before
the beginning of the term at which the proceeding is to be heard” unless good cause is shown, and
the affidavit must state the facts and reasons for the party’s belief that bias or prejudice exists. Id.
Gronwaldt, 155 F.3d 507, 521 (5th Cir. 1998). Thus, we remanded the case to state court. Id.
5
Plaintiffs do not, however, brief the merits of the Rule 60(b) motion. Although they contend
the ruling should be vacated because Judge Cobb erred by failing to stand recused, they do not point
to any legal error in the Rule 60(b) ruling. Issues not briefed on appeal are waived. See United
States v. Thames, 214 F.3d 608, 611 n.3 (5th Cir. 2000). Thus, we consider the Rule 60(b) ruling
only as it relates to the recusal issue.
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This provision relates only to charges of actual bias. Henderson v. Dep’t of Pub. Safety &
Corr., 901 F.2d 1288, 1296 (5th Cir. 1990). When a party files a § 144 motion, the judge must pass
on the sufficiency of the affidavit, but may not pass on the truth of the affidavit’s allegations. Id. A
legally sufficient affidavit must: (1) state material facts with particularity; (2) state facts that, if true,
would convince a reasonable person that a bias exists; and (3) state facts that show the bias is
personal, as opposed to judicial, in nature. Id.
Admittedly, Judge Cobb did not specifically address the sufficiency of Ballenger’s § 144
affidavit during the hearing or in his written order. He did, however, refer to the recusal analysis he
published in the McClelland case. See McClelland v. Gronwaldt, 942 F. Supp. 297, 299-303 (E.D.
Tex. 1996). In that case, the plaintiffs filed a § 144 motion and accompanying affidavit, arguing that
Judge Cobb was biased because of his association with OB&T. Judge Co bb’s ruling on the issue
went into painstaking detail and concluded that McClelland’s affidavit failed the reasonable person
test. Id. at 301.
Although Ballenger’s affidavit is slightly more specific than the one at issue in McClelland,
we find that it suffers from the same overall defect. Judge Cobb’s relationship with Tucker and
OB&T is, by itself, insufficient to convince a reasonable person that Judge Cobb would be biased
against the plaintiffs or in favor of Mobil. Tucker’s representation of Mobil in the Ballenger suit is
also insufficient. That suit was litigated more than twenty-five years ago, and it has little bearing on
the merits of the present action. It was a workers’ compensation suit involving Mobil, and Mobil’s
participation in Texas’s workers’ compensation system had no direct bearing on whether it was
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grossly negligent with regard to the explosion that fatally injured Ballenger’s father.6 Finally, Judge
Cobb’s representation of Forum on a separate matter from long ago does not prevent him from ever
hearing cases in which Forum or Mobil are parties. See Chitimacha Tribe of La. v. Harry L. Laws
Co., 690 F.2d 1157, 1166 (5th Cir. 1982). Thus, we conclude that Judge Cobb did not abuse his
discretion when he denied the plaintiffs’ § 144 motion.
B
Recusal is also addressed in 28 U.S.C. § 455.7 The plaintiffs continue to argue that Judge
Cobb was required to recuse himself under § 455(a), § 455(b)(1), and § 455(b)(2). We consider each
in turn, again reviewing for abuse of discretion. United States v. Monroe, 178 F.3d 304, 309 (5th
Cir. 1999).
6
We recognize that the issue is tangentially related to the present suit. Obviously, if Mobil’s
subscriber status had been found invalid in 1971, then Whitehead and her children would have been
able to sue Mobil for simple negligence. Nonetheless, the possibility that another cause of action
against Mobil might have been available thirty years ago is remote and speculative. It is not as if
Whitehead attempted to bring a negligence suit at the time and failed. Accordingly, that possibility
has no bearing on whether a reasonable person would think Judge Cobb, a man with considerable
judicial experience, would actually be biased all these many years later.
7
In relevant part, 28 U.S.C. § 455 reads as follows:
(a) Any justice, judge, or magistrate judge of the United States shall
disqualify himself in any proceeding in which his impartiality might
reasonably be questioned.
(b) He shall also disqualify himself in the following circumstances:
(1) Where he has a personal bias or prejudice
concerning a party, or personal knowledge of disputed
evidentiary facts concerning the proceeding;
(2) Where in private practice he served as lawyer in
the matter in controversy, or a lawyer with whom he
previously practiced law served during such
association as a lawyer concerning the matter, or the
judge or such lawyer has been a material witness
concerning it . . . .
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When considering a claim under § 455(a), we must consider “whether a reasonable and
objective person, knowing all of the facts, would harbor doubts concerning the judge’s impartiality.”
In re Chevron U.S.A., Inc., 121 F.3d 163, 165 (5th Cir. 1997) (internal quotation marks omitted)
(emphasis added). This is because the go al of this provision is to “avoid even the appearance of
partiality.” Liljeberg v. Health Servs. Acquisition Corp., 486 U.S. 847, 860 (1988) (internal
quotation marks omitted). Thus, recusal may be required even though the judge is not actually
partial. In re Cont’l Airlines Corp., 901 F.2d 1259, 1262 (5th Cir. 1990).
The plaintiffs have a stronger argument under this provision than under § 144, although we
are not convinced that these facts would cast doubt in a reasonable person’s mind regarding Judge
Cobb’s impartiality. At first glance, a reasonable person might be inclined to think Judge Cobb could
be biased in favor of his former law partner and firm, especially given Judge Cobb’s participation in
at least one similar case. But a reasonable person would temper this inclination with the knowledge
that the event s in question occurred almost three decades ago. Thus, considering all the relevant
facts, one could conclude that Judge Cobb did not abuse his discretion with regard to § 455(a).
Nevertheless, we recognize that this is a close question. “‘[I]f the question of whether § 455(a)
requires disqualification is a close one, the balance tips in favor of recusal.’” In re Chevron, 121 F.3d
at 165 (quoting Nichols v. Alley, 71 F.3d 347, 352 (10th Cir. 1995)); see also In re Faulkner, 856
F.2d 716, 721 (5th Cir. 1998) (noting that “‘[p]eople who have not served on the bench are often all
too willing to indulge suspicions and doubts concerning the integrity of judges’” (quoting Liljeberg,
486 U.S. at 864-65)). We are bound to conclude that, given the specific facts alleged in the plaintiffs’
original and supplemental motions to disqualify, Judge Cobb should have recused himself under
§ 455(a). Thus, we need not address the other provisions of § 455.
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C
1
Although we conclude that Judge Cobb should have stood recused under § 455(a), we do not
automatically vacate the rulings issued after he should have recused himself. In our circuit, the
“harmless error” rule has long been applied in this context. Monroe, 178 F.3d at 309; United States
v. O’Keefe, 128 F.3d 885, 892 (5th Cir. 1997); Doddy v. Oxy USA, Inc., 101 F.3d 448, 458-59 (5th
Cir. 1996); In re Continental, 901 F.2d at 1263. We consider the following factors in determining
whether reversal or vacation is mandated: (1) the risk of injustice to the parties in this case; (2) the
risk that denial of relief will create injustice in other cases; and (3) “the risk o f undermining the
public’s confidence in the judicial process.” Liljeberg, 486 U.S. at 864; In re Continental, 901 F.2d
at 1263.
The plaintiffs dispute the applicability of the harmless error rule, arguing that when a judge
erroneously fails to stand recused, our precedent dictates that the judge’s post-recusal orders must
be automatically vacated. Tramonte v. Chrysler Corp., 136 F.3d 1025, 1028 (5th Cir. 1998); see also
Republic of Pan. v. Am. Tobacco Co., 217 F.3d 343, 347 (5th Cir. 2000) (citing Tramonte); Trevino
v. Johnson, 168 F.3d 173, 178 (5th Cir. 1999) (same). To the extent Tramonte and the cases that
cite it are inconsistent with In re Continental and its progeny, the older line controls. Diamond
Offshore Co. v. A&B Builders, Inc., 302 F.3d 531, 541 n.9 (5th Cir. 2002) (reiterating that one panel
of this court cannot overrule an earlier panel’s decision). This conclusion is bolstered by the fact that
the rule established in In re Continental is based on the clear wording of Liljeberg, wherein the
Supreme Court stated “relief is . . . neither categorically available nor categorically unavailable for
all § 455(a) violations.” 486 U.S. at 864. Liljeberg also announced the factors applied by this court
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in In re Continental. Id.
Finally, although the plaintiffs focus many of their recusal arguments on § 455(b)(2), we
reiterate that we need not consider Judge Cobb’s decision with respect to this provision. It could
only be relevant if the harmless error test appl ied to § 455(a), as we conclude above, but not to
§ 455(b). For the reasons given in Harris v. Champion, 15 F.3d 1538 (10th Cir. 1994), we are
confident that § 455(b) violations are also subject to the doctrine of harmless error. Id. at 1571.
2
We now apply the harmless error test of In re Continental to the district court’s subsequent
rulings; specifically, its summary judgment ruling in the RICO suit and its denial of the Rule 60(b)
motion. With regard to the first prong, we noted in In re Continental that the “risk of injustice to the
parties in allowing a summary judgment ruling to stand is usually slight.” 901 F.2d at 1263. Because
we review a summary judgment ruling de novo, using the same standards as the district court, the
parties are guaranteed a fair, impartial review of the merits of the ruling. As we stated in In re
Continental: “In cases where we would otherwise affirm such a ruling, little would be gained by
vacating and remanding with instructions that it be essentially reinstated.” Id.
The grant or denial of Rule 60(b) relief is reviewed for abuse of discretion, however. Flowers
v. S. Reg’l Physician Servs., Inc., 286 F.3d 798, 800 (5th Cir. 2002). Nonetheless, given the long
period of time between the original Ballenger judgment and the Rule 60(b) motion, as well as the
motion’s unique relationship to the RICO suit, we find that the possibility of injustice to the parties
is slight. The Rule 60(b) motion is premised on Mobil’s alleged fraud with respect to its subscriber
status. Accordingly, the merits of the motion will be determined by our de novo evaluation of the
district court’s summary judgment ruling, which was based on the fraud issue. Thus, we find the first
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prong of the harmless error test satisfied.
Next, we consider whether it is likely that our refusal to vacate the post-recusal orders would
create injustice in future cases. Again, we note that other cases appealed after a summary judgment
ruling will receive fair, impartial treatment from this court. Moreover, our holding that Judge Cobb
erred by failing to stand recused will serve as a cautionary note to future district courts considering
recusal motions in similar circumstances. Thus, we find the risk of injustice to other cases to be
slight, and so the second prong is met.
Finally, we do not believe the public’s confidence in the judicial process will be undermined
if we hold the violation of § 455(a) to be harmless error. The public will recognize that we have
clarified that, under these circumstances, a judge should recuse himself. In addition, reasonable
people will recognize that almost thirty years passed between the events in question and the district
court’s present rulings. The notion that all conflicts fade with time is a strong one, and we are
confident that this notion will moderate the public’s reaction. In fact, in light of the long passage of
time, the public may be more inclined to lose faith in the system if this court were to mindlessly vacate
Judge Cobb’s rulings. See In re Continental, 901 F.2d at 1263. Thus, we find that the § 455(a)
violation constituted harmless error.
III
A
Finding the recusal error to be harmless, we turn to the merits of the district court’s summary
judgment ruling. The district court held that the defendants were entitled to summary judgment
because the evidence showed that Mobil had workers’ compensation insurance from 1961 through
1995, and thus was a subscriber in Texas’s system. Further, it held that Ballenger and Patterson had
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not raised a genuine issue of material fact as to whether Mobil’s arrangements with its various
workers’ compensation insurers were fraudulent under Texas law.
Thus, the district court’s decision was based entirely on Texas law. For this reason, Mobil,
Forum, Matouse and Gronwaldt have asked this Court to certify the following question to the Texas
Supreme Court:8
Where an employer is the holder of a policy of workers’ compensation
insurance from an authorized insurer and gives notice of such to its
employees, is the employer’s right to the exclusive remedy provisions
available to a “subscriber” under the Texas Workers’ Compensation
Act conclusively established?
The plaintiffs oppose this motion, arguing that we should not ask the Texas Supreme Court to
consider this case because the record is too undeveloped. Alternatively, the plaintiffs ask that we
abate this appeal pending the outcome of Ballenger’s state court action.
The decision of whether to certify a question lies within our sound discretion. Nationwide
Mut. Ins. Co. v. Unauthorized Practice of Law Comm., 283 F.3d 650, 656 (5th Cir. 2002). As a
general rule, we do not use certification as a “panacea for resolution of those complex or difficult
state law questions which have not been answered by the highest court of the state.” Free v. Abbott
Labs., Inc., 164 F.3d 270, 274 (5th Cir. 1999) (internal quotation marks omitted). Although the state
law questions created by this case are important and complex, we feel, for the reasons given infra in
Part III.B, that Texas law is sufficiently clear. Accordingly, we deny the defendants’ motions to
certify and we deny the plaintiffs’ motion to abate the appeal.
B
8
The AIG Defendants do not oppose this motion. Instead, they ask that, should we grant
certification, we also certify several sub-issues. We treat this as a second motion for certification.
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As noted above, we review a grant or denial of summary judgment de novo, using the same
criteria employed by the district court. Mongrue v. Monsanto Co., 249 F.3d 422, 428 (5th Cir.
2001). Summary judgment is proper if, drawing all inferences in favor of the non-moving party, there
is no genuine issue of material fact and the moving party is entitled to judgment as a matter of law.
Id.; FED. R. CIV. P. 56(c). Generally, the plaintiffs must establish a genuine issue of material fact
regarding Mobil’s status as a workers’ compensation subscriber.9 We consider each of the plaintiffs’
contentions in turn.10 At the outset, however, it should be emphasized that although we conclude that
many of Mobil’s actions were improper or illegal, these actions did not affect its status, under Texas
law, as a workers’ compensation subscriber and thus did not affect its entitlement to the exclusive
remedy protection of the workers’ compensation system.
1
9
The plaintiffs argue that Mobil bears the burden of establishing its status as a workers’
compensation subscriber. We disagree. In a common-law negligence suit, Mobil would be required
to prove its subscriber status as part of its affirmative defense that it was enti tled to the exclusive
remedy protections of the workers’ compensation system. This is not a common-law negligence suit,
however. It is a RICO action. To maint ain a civil RICO action using mail and wire fraud as the
predicate acts, the plaintiff must show that the defendant engaged in a scheme to defraud and used
the mail or wires to execute that scheme. See 18 U.S.C. §§ 1341, 1343, 1961(1)(B). In the present
case, the plaintiffs argue that the scheme to defraud was Mobil’s false representations to its
employees that it was a subscriber. Thus, it is the plaintiffs’ burden to show that a scheme to defraud
existed by showing that Mobil was not a subscriber. Of course, if a party bears the burden of proof
at trial, it also bears that burden at the summary judgment stage. Celotex Corp. v. Catrett, 477 U.S.
317, 324-26 (1986).
10
At the outset, we note that the period of time covered by the RICO suit spans two different
workers’ compensation systems in Texas. The “old” system, adopted in 1914 and repealed in 1991,
was codified at TEX. REV. CIV. STAT. ANN. arts. 8306 et seq. The current scheme is codified at TEX.
LAB. CODE ANN. § 401 et seq. We have considered both and find them to be substantively identical
for the purposes of our analysis. In addition, none of the parties suggest that the outcome of this suit
depends on differences between the two schemes. Thus, for clarity and brevity, we refer only to the
“old” scheme because that scheme was in effect during most of the twenty-odd years at issue,
although our legal conclusions hold for both.
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First, the plaintiffs argue that Mobil was not a subscriber during the years that Forum was its
insurer because Mobil and Forum have not proven that Mobil actually purchased policies from Forum
during the relevant years. Moreover, the plaintiffs emphasize that Forum was a subsidiary of Mobil
and that Forum was completely controlled by Mobil. According to the plaintiffs, Forum was nothing
more than a “front for self-insurance” and so Mobil was not a valid subscriber.
Under the relevant statutory scheme, a workers’ compensation subscriber is defined as “any
employer who has become a member of the association by paying the required premium; provided
that the association holds a license issued by” the Texas Commissioner of Insurance. TEX. REV. CIV.
STAT. ANN. art. 8309, § 1 (Vernon 1967) (emphasis added). “Association” is defined as the state-
created workers’ compensation carrier “or other insurance company authorized” to write workers’
compensation policies. Id. Thus, the plaintiffs are correct that, in order to achieve subscriber status,
Mobil was required to obtain a workers’ compensation policy by paying a premium to an authorized
insurer.11
In response to this allegation, the defendants produced the following proof: (1) Certificates
of Authority for Forum issued by the State of Texas, which indicate that Forum was authorized to
write workers’ compensat ion insurance during the relevant period; (2) declaration pages from the
workers’ compensation policies issued by Forum from 1970 to 1981, accompanied by the sworn
affidavit of an authorized agent for Forum stating that the declaration pages were true and correct
11
Mobil was also required to provide notice to its employees that it was a participant in the
workers’ compensation system, either by filing constructive notice with the Industrial Accident Board
or by providing actual notice. TEX. REV. CIV. STAT. ANN. art. 8306, § 3c, art. 8308, §§ 18a–20
(Vernon 1967). Mobil submitted summary judgment evidence that it provided both kinds of notice
during the entire time period in question, and plaintiffs do not dispute this. For the purposes of this
case, we consider the notice requirement to be met.
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copies; and (3) copies of notices of coverage from the Industrial Accident Board, indicating that
Mobil was a subscriber in the system during each of the eleven years. Despite this overwhelming
proof, the plaintiffs persist in their argument that there is a genuine issue of material fact because
(1) the defendants have not produced the policies themselves, but only the declaration pages, and (2)
Mobil and Forum have not shown that the premium funds actually exchanged hands. We find these
arguments to be meritless. Martinez v. H.B. Zachry Co., 976 S.W.2d 746, 748 (Tex. App.—Houston
[1st Dist.] 1998, pet. denied) (finding a copy of the information page of a workers’ compensation
policy, accompanied by a sworn affidavit from an agent stating that the copy was true and correct,
to be sufficient to establish the employer was a subscriber at the summary judgment stage); see also
Dealers Nat’l Ins. Co. v. Simmons, 421 S.W.2d 669, 672 (Tex. Civ. App.—Houston [14th Dist.]
1967, writ ref’d n.r.e.) (accepting copy of voluntary endorsement and testimony of employer that
policy had been issued but destroyed after it expired as evidence that the policy was issued). The
plaintiffs cannot suggest that there is a genuine issue of material fact on this point simply by listing
the other possible evidence of coverage that Mobil and Forum could have produced.
Likewise, we reject the plaintiffs’ self-insurance argument.12 The workers’ compensation
scheme does not forbid an employer and an insurer from being one and the same. Otis Elevator Co.
12
In fact, we find the plaintiffs’ argument on this point to be smoke and mirrors. Generally,
“self insurance” means that one has established reserves for future losses instead of purchasing
insurance. Such action would certainly fall outside the bounds of Texas’s “old” workers’
compensation system. But Mobil and Forum have essentially uncontroverted evidence of insurance
policies and repeated contractual relationships. Under Texas law, if a Mobil worker was injured
during the term of one such policy, Forum would be liable for any workers’ compensation benefits
awarded, not Mobil. See, e.g., Aranda v. Ins. Co. of N. Am., 748 S.W.2d 810, 812 (Tex. 1988). In
addition, because Forum was an authorized workers’ compensation insurer, the State of Texas was
able to monitor the financial stability of Forum during the policy periods. Thus, this arrangement is
materially different from “self insurance.”
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v. Allen, 185 S.W.2d 117, 120 (Tex. Civ. App.—Forth Worth 1944) (explicitly allowing an
authorized insurer to carry workers’ compensation insurance on its own employees), aff’d in relevant
part and rev’d on other grounds, 187 S.W.2d 657, 658-59 (Tex. 1945). Even assuming the plaintiffs
are correct that Forum was under Mobil’s complete control during some or all of the relevant years,
this is immaterial. Forum was authorized by the State of Texas to write workers’ compensation
policies, and Mobil obtained just such a policy. Thus, the requirements of the statutory scheme were
met, and, as a matter of law, Mobil was a subscriber.
2
Second, the plaintiffs contend that Mobil was not a subscriber during the years it was insured
by the AIG Defendants, 1982 through 1993, because the AIG Defendants only fronted coverage for
Mobil and thus Mobil was actually self-insured. This self-insurance argument is similar to the one
mentioned above, see supra Part III.B.1, but the alleged scheme is slightly more complex. During
this period, Mobil supposedly engaged in a cash-flow retrospective plan. Under this plan, Mobil had
the insurer file a conventional retrospective rated insurance policy with the state, but did not actually
pay the premium indicated by that policy. Instead, Mobil paid only a fraction of that premium to
cover the insurer’s expected losses paid, expenses, insurance risk premium and premium taxes. In
addition, Mobil issued letters of credit to the insurer for the difference between the conventional
premium and the amount actually paid. Mobil also reinsured the insurer’s risk through an off-shore
subsidiary. Through this complex arrangement, Mobil and its reinsurance subsidiary became the true
insurers of the risk associated with Mobil’s workers’ compensation program.
Mobil does not dispute that it used this “cash-flow retro” plan. Instead, it argues that such
an arrangement does not invalidate its subscriber status because its side agreements with the insurer
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and reinsurer are immaterial. Our review of the summary judgment evidence leads us to believe that
Mobil’s cash-flow retro plan was, at the very least, highly improper. Mobil was aware that such a
plan had been formally forbidden by the Texas State Board of Insurance,13 but chose to use a cash-
flow retro plan anyway because it was significantly cheaper. Moreover, Mobil designed the
arrangement with a number of safeguards to avoid detection. Nonetheless, Mobil is correct that,
under Texas law, its status as a subscriber was not invalidated by its use of this arrangement.
The wording of the Texas Insurance Code is clear:
The Board [of Insurance] shall prescribe a uniform policy for
workmen’s compensation insurance . . . and any contract or
agreement not written into the application and policy shall be void
and of no effect and in violation of the provisions of this subchapter,
and shall be sufficient cause for revocation of license to write
workmen’s compensation insurance within this State.
TEX. INS. CODE ANN. art. 5.57 (emphasis added). Further, the Texas courts have repeatedly held that
a “side agreement to a valid and enforceable workers’ compensation policy which violates a statutory
or regulatory requirement is invalid and ineffective.” Brookshire Grocery Co. v. Bomer, 959 S.W.2d
673, 676 (Tex. App.—Austin 1997, pet. denied) (listing cases); Associated Employer Lloyds v.
Dillingham, 262 S.W.2d 544, 546 (Tex. Civ. App.—Forth Worth 1953, writ ref’d) (holding that a
contract to rebate part of the premium in the policy, directly or indirectly, is illegal and void and
cannot be a defense to a suit for the full premium brought by the insurer’s receiver); Glenn H.
13
In 1980, the State Board of Insurance issued Workers’ Compensation Bulletin No. 511,
which clearly stated that “paid loss retrospective” or “cash flow” plans were of great concern to the
department because they fell outside the uniform policy approved by the board and referred to in TEX.
INS. CODE art. 5.57. The bulletin concluded that insurers “that write such plans are subjecting
themselves to possible disciplinary action by this Department.” It did not, however, indicate that use
of such a plan would invalidate an employer’s subscriber status. Thus, this bulletin is not probative
of the legal issue before us.
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McCarthy, Inc. v. Knox, 186 S.W.2d 832, 836-38 (Tex. Civ. App.—Galveston 1945, writ ref’d
w.o.m.) (same).
Thus, the cash-flow retro agreements between Mobil and the AIG Defendants were illegal and
void. The conventional policies executed by the parties and filed with the state remained in full force
and effect during the years in question. If the AIG Defendants had become bankrupt and their
trustees had chosen to sue Mobil for the premiums it did not pay, Mobil might well have been liable.
In addition, if the scheme had been discovered by the appropriate state agencies, Mobil and the AIG
Defendants would undoubtedly have been fined, and the AIG Defendants might have lost their
workers’ compensat ion insurance licenses. See TEX. INS. CODE ANN. art. 5.57. But nothing in
Texas’s statutory law or case law suggests that these illegal cash-flow retro arrangements would have
affected Mobil’s subscriber status.14
The defendants have provided copies of the entire policies issued by the AIG Defendants to
Mobil for the relevant policy years, as well as authenticating affidavits. We have examined the
policies and find no mention of a rebate system or cash-flow arrangement in any of them. We
conclude that these policies remained valid during their terms and satisfied the necessary conditions
for Mobil to achieve subscriber status. See Tankersley v. Durish, 855 S.W.2d 241, 248 (Tex.
App.—Austin 1993, writ denied) (“Where the illegal agreement is not incorporated in the policy, but
is apart from it, the policies themselves are valid.”); see also TEX. INS. CODE ANN. art. 5.57; TEX.
14
Presumably, this reflects a conscious choice by the state legislature and judiciary. It is not
our task to say what sanctions are appropriate in this context. In fact, a bias against depriving
employers of their subscriber status for this type of violation may be wise. It creates a level of
certainty in the workers’ compensation system and ensures that workers will not be deprived on the
benefits of the system every time an employer or insurer violates the state’s various administrative
rules and regulations. See, e.g., Larchmont Farms, Inc. v. Parra, 941 S.W.2d 93, 95 (Tex. 1997)
(concluding that “Texas [has] an interest in maintaining a stable workers’ compensation system”).
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REV. CIV. STAT. ANN. art. 8309, § 2 (Vernon 1967) (stating that when an authorized insurer “issues
a policy conditioned to pay [workers’] compensation, the holder of such policy shall be regarded as
a subscriber so far as applicable under this law”).
3
Third, the plaintiffs contend that Mobil’s own employees adjusted Mobil’s workers’
compensation claims from 1965 to 1994, in violation of Texas law. They argue that this precludes
summary judgment on the issue of whether Mobil qualified as a workers’ compensation subscriber.
After considering the arguments of the parties and the applicable state law, we again conclude that
Mobil’s actions were probably illegal. Again, however, we cannot conclude that these actions
deprived Mobil of its subscriber status under state law.
The plaintiffs first cite to TEX. INS. CODE ANN art. 1.14-1, which was repealed in 1999.
Although it existed in various forms over the thirty-year period at issue, article 1.14-1 generally
addressed unauthorized insurance. It included the act of adjusting claims or losses in the definition
of “insurance business” and prohibited unauthorized persons or insurers from directly or indirectly
doing the acts of an insurance business. See, e.g., id. § 2–3 (Vernon 1990). A violation of article
1.14-1 subjected the offending person or entity to administrative and civil penalties. Id. § 3. But the
statute does not contain any language that could be interpreted to affect an employer’s subscriber
status. Id.; see also 28 TEX. ADMIN CODE §§ 65.5, 65.10 (suggesting that it is unethical and
fraudulent for an insurer to allow an employer to adjust claims and that the remedy for such conduct
is to ban the person from appearing before the workers’ compensation board).
The plaintiffs attempt to buttress their argument by citing to Aranda v. Insurance Co. of
North America, 748 S.W.2d 210 (Tex. 1988), and Natividad v. Alexsis, Inc., 875 S.W.2d 695 (Tex.
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1994), for the proposition that Texas law requires “the insurer or someone acting under the insurer’s
direct control to adjust claims, because of the insurers’ duty of good faith and fair dealing” to the
insured. This is undoubtedly an accurate reflection of Texas law. Neither Aranda nor Natividad,
however, address the issue at hand: whether improper claims adjustment behavior by an employer
prevents that employer from attaining subscriber status in Texas’s workers’ compensation system.
Instead, Aranda and Natividad address the circumstances under which an employee may bring a tort
action against a workers’ compensation insurer for breach of the duty of good faith and fair dealing.
Natividad, 875 S.W.2d at 697-98; Aranda, 748 S.W.2d at 211-14. Thus, they are almost entirely
irrelevant.
Aranda and Natividad do offer one valuable insight into Texas workers’ compensation law:
together they indicate that the duty of good faith and fair dealing owed by an insurer to an employee
is separate from the compensation claim and non-delegable. Natividad, 875 S.W.2d at 698; Aranda,
748 S.W.2d at 214. In Natividad, the workers’ compensation insurer had contracted with an outside
adjusting firm for the performance of claims handling services. 875 S.W.2d at 696. The Texas
Supreme Court held that an employee’s suit for breach of good faith and fair dealing was not viable
against the adjusting firm because the insurer remained liable for “actions by those agents or
contractors that breach the duty of good faith and fair dealing owed to the insured by the carrier.”
Id. at 698. If anything, Natividad indicates that Mobil’s insurers would be liable to Mobil’s
employees for any improper claims handling under a tort theory of recovery, assuming that those
employees could show the misdeeds amounted to a breach of the duty of good faith and fair dealing.
In addition, the employees would almost certainly have to show that their tort claims were separate
from their compensation claims and produced an independent injury. See Aranda, 748 S.W.2d at
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214.
Mobil may have risked administrative and civil penalties when it adjusted the workers’
compensation claims of its own employees, in violation of article 1.14-1. Likewise, Forum and the
AIG Defendants may have risked tort liability or various civil sanctions by improperly allowing Mobil
to adjust claims. But, even under this worst case scenario, Mobil’s subscriber status was not
invalidated.
Thus, despite the plaintiffs’ vigorous arguments to the contrary, we conclude that there is no
genuine issue of material fact with regard to Mobil’s subscriber status.15 And, in turn, there is no
genuine issue of material fact that Mobil was engaged in a scheme to defraud its employees by lying
about its subscriber status during the years in question. In light of the foregoing, we find that the
district court correctly awarded summary judgment to the defendants with regard to the RICO suit.16
15
The plaintiffs also argue that the district court abused its discretion by refusing to allow them
the opportunity to conduct any discovery. They argue that, had discovery been permitted, they could
have created a genuine issue of material fact sufficient to survive summary judgment.
We review a district court’s discovery decisions for abuse of discretion and affirm such
decisions unless they are clearly unreasonable or arbitrary. Moore v. Willis Indep. Sch. Dist., 233
F.3d 871, 876 (5th Cir. 2000). We have reviewed the plaintiffs’ various discovery motions and we
find that the district court did not abuse its discretion. Although the plaintiffs probably could have
discovered more factual information to support their arguments, the legal merits of those arguments
would not have improved. In other words, any genuine issues of fact produced by the plaint iffs’
discovery would not have been material. Thus, the district court properly concluded that the
requested discovery was not likely to change the outcome of the summary judgment motion. See,
e.g., Resolution Trust Corp. v. Sharif-Munir-Davidson Dev. Corp., 992 F.2d 1398, 1401 (5th Cir.
1993) (holding that it is not an abuse of discretion to preclude further discovery and enter summary
judgment if it reasonably appears that further discovery would not create a genuine issue of material
fact).
16
The plaintiffs’ RICO claims are predicated on Mobil’s allegedly fraudulent representations
regarding its subscriber status. See note 10 supra. Because we conclude there is no genuine issue
of material fact on this issue, the plaintiffs’ RICO claims must fail. Thus, it is not necessary to discuss
all the possible RICO issues in detail. We suspect, however, that the plaintiffs’ complaint does not
state a valid RICO claim for other reasons.
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IV
For these reasons, we find that the district court properly awarded summary judgment to the
defendants and we AFFIRM.
AFFIRMED; DEFENDANTS’ MOTIONS TO CERTIFY IS DENIED; PLAINTIFFS’
MOTION FOR ABATEMENT OF THE APPEAL IS DENIED; PLAINTIFFS’ MOTION FOR
JUDICIAL NOTICE IS GRANTED IN PART AND DENIED IN PART; AIG DEFENDANTS’
Even if we assume both that the plaintiffs had a valid property interest in their causes of action
under Texas law and that Mobil deprived them of this property by fraudulently representing that it
was a subscriber, we doubt the plaintiffs have satisfied the RICO standing requirement. A plaintiff
may not sue under RICO unless he can show concrete financial loss. In re Taxable Mun. Bond Sec.
Litig., 51 F.3d 518, 523 (5th Cir. 1995); accord Imagineering, Inc. v. Kiewit Pac. Co., 976 F.2d
1303, 1310 (9th Cir. 1992). It is undisputed that the plaintiffs received workers’ compensation
benefits from Mobil’s insurers for each and every work-related injury at issue. Because it is unclear
whether Mobil was negligent with regard to these injuries, it is possible that the plaintiffs ended up
better o ff—that is, the plaintiffs may have recovered more by collecting workers’ compensation
benefits over the years than if they had exercised their right to sue. If this is in fact the case, then the
plaintiffs have failed to show that they were injured at all, much less that they suffered the concrete
injury required for RICO standing.
In addition, at the time of the injuries, the plaintiffs were notified by Mobil that it was a
subscriber to Texas’s workers’ compensation system, chose not to opt-out, and recovered from Mobil
on a no-fault basis for their various injuries. Thus, despite the plaintiffs’ boilerplate damages
allegations, it is hard to see how they received less than they were entitled to. Cf. Price v. Pinnacle
Brands, Inc., 138 F.3d 602, 607 (5th Cir. 1998) (dismissing plaintiffs’ RICO claims based on fraud
because plaintiffs’ conclusional allegations of injury failed to show that the plaintiffs received less than
what they bargained for).
Moreover, this cause of action seems to stretch the bounds of RICO far beyond its intended
purpose. See, e.g., Cedric Kushner Promotions, Ltd. v. King, 533 U.S. 158, 165 (2001) (reiterating
that RICO is targeted primarily at organized crime). It may be that RICO’s standing requirement that
a plaintiff be “injured in his business or property” does not extend this far. 18 U.S.C.§ 1964(c). At
least one court has suggested that federal law should determine whether a given property interest,
recognized by state law, rises to the level of RICO “business or property.” DeMauro v. DeMauro,
115 F.3d 94, 96 (1st Cir. 1997); see also Price, 138 F.3d at 607 (“And even though courts may look
to state law to determine, for RICO purposes, whether a property interest exists, it does not follow
that any injury for which a plaintiff might assert a state law claim is necessarily sufficient to establish
a claim under RICO.” (citations omitted)). If the federal threshold for “business or property” depends
on the statutory purpo se, t hen it seems clear that the instant RICO claims are meritless. See
DeMauro, 115 F.3d at 96 (suggesting that the threshold does depend on RICO’s purpose).
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MOTION FOR JUDICIAL NOTICE IS DENIED.
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