Texas Civil Practice and Remedies Code Section 41.0105 limits recoveries of medical care expenses by an injured claimant to those expenses actually paid or incurred by or on behalf of the claimant. A number of appellate decisions have addressed what this paid-or-incurred language means in different contexts. The opinion in Katy Springs Manufacturing, Inc.
In Port Elevator-Brownsville, L.L.C. v. Casados, the Texas Supreme Court reaffirmed this State’s prohibition on split workforces (i.e., Texas employers are not permitted to cover some but not all employees with worker’s compensation insurance if the employer is a subscriber), and confirmed that a temporary employee is covered by the employer’s comp policy (and subject to the comp bar) even if the employer took steps to intentionally exclude the temporary employee from coverage (such as not paying premiums for such employees or not including a classification for temporary employees under the policy).
Practitioners on both sides of the bar that deal with personal injury and wrongful death claims should take note of this opinion because it confirms what many in the defense bar have been arguing for a number of years. But coverage attorneys should also take note because one key point in the Court’s analysis was its acceptance of a rule set out by the Amarillo Court of Appeals in 1940 — that "premiums are an issue between the employer and the insurer; they do not affect the employee’s coverage." (Slip op. at 9) (citing Tex. Employers’ Ins. Ass’n v. Stanton, 140 S.W.2d 337, 339-40 (Tex. Civ. App.–Amarillo 1940, writ ref’d).