Some cases hold that when the record shows that the insurer possessed evidence reasonably showing that the insured's claim might not be valid, the bad faith action is not viable as a matter of law. See St. Paul Lloyd's Ins. Co. v. Fong Chun Huang, 808 S.W.2d 524, 526 (Tex.App. — Houston [14th Dist.] 1991, writ denied); St. Paul Guardian Life Ins. Co. v. Luker, 801 S.W.2d 614, 618 (Tex.App. — Texarkana 1990, no writ); Millers Cas. Ins. Co. v. Lyons, 798 S.W.2d 339, 343-44 (Tex.App. — Eastland 1990, writ granted); National Union Fire Ins. Co. v. Hudson Energy Co., 780 S.W.2d 417, 426-27 (Tex.App. — Texarkana 1989), aff'd, 811 S.W.2d 552 (Tex. 1991); Fuentes v. Texas Employers' Ins. Ass'n, 757 S.W.2d 31, 33-34 (Tex.App. — San Antonio 1988, no writ). Under these authorities, it is not enough for the insured to show that the insurer should have known to pay the claim, or that there were other facts suggesting the claim was valid.
That states a claim for constructive discharge. Appellees rely on Fuentes v. Texas Employers' Ins. Ass'n, 757 S.W.2d 31 (Tex.App.-San Antonio 1988, no writ), and Long v. Tascosa Nat'l Bank of Amarillo, 678 S.W.2d 699 (Tex.App. — Amarillo 1984, no writ), for the proposition that appellants waived their constructive discharge claim. In Fuentes and Long, however, the amended petitions deleted all reference to the claims attacked by special exceptions.
We note that other courts have utilized the same approach to evidentiary points in bad faith cases. See St. Paul Lloyd's Ins. Co. v. Fong Chung Huang, 808 S.W.2d 524 (Tex.App. — Houston [14th Dist.] 1991, writ denied) (where record established that insurer had reasonable basis to deny claim, court reversed bad faith judgment for insured and rendered judgment for insurer); St. Paul Guardian Ins. Co. v. Luker, 801 S.W.2d 614 (Tex.App. — Texarkana 1990, no writ) (same); Millers Casualty Ins. Co. v. Lyons, 798 S.W.2d 339 (Tex.App. — Eastland 1990), aff'd, 866 S.W.2d 597 (Tex. 1993) (same); National Union Fire Ins. Co. v. Hudson Energy Co., 780 S.W.2d 417 (Tex.App. — Texarkana 1989), aff'd, 811 S.W.2d 552 (Tex. 1991) (where record showed "just cause" for insurer to deny claim, award of exemplary damages for bad faith deleted from judgment for insured); Fuentes v. Texas Employers' Ins. Ass'n, 757 S.W.2d 31 (Tex.App. — San Antonio 1988, no writ) (where insurer showed reasonable basis for denying claim, summary judgment for insurer affirmed). In Polasek, evidence showed that the insurer had a reasonable basis for denying the insured's claim; thus, the court reversed the insured's judgment in the bad faith case and rendered judgment that he take nothing.
In the present case, Liberty Mutual states that it denied workers' compensation benefits to Mr. Guajardo based on Dr. Isensee's report which said that he was able to return to work. Liberty Mutual asserts that a carrier will not be held liable for breach of the common-law duty of good faith and fair dealing if its denial of workers' compensation benefits was based on the carrier's reliance on a medical opinion from which the carrier could have reasonably determined that the claim was invalid or questionable. Fuentes v. Texas Employers Ins. Ass'n, 757 S.W.2d 31, 33 (Tex.App. — San Antonio 1988, no writ). In Fuentes, a workers' compensation carrier stopped paying a worker's benefits pending his appeal of an Industrial Accident Board (IAB) award.
If, however, Jackson National were found to owe such a duty to the plaintiffs, Jerry and Brian have adduced no evidence that the company breached that duty. Under Texas law, if a reasonable basis exists for questioning the claim, an insurer may deny it and litigate the matter without also facing a bad faith claim, even if that denial later proves to be in error. See Aranda, 748 S.W.2d at 212; Fuentes v. Texas Employers' Ins. Ass'n, 757 S.W.2d 31. 33-34 (Tex.App.-San Antonio 1988, no writ). The denial may be erroneous and still be in good faith if it was fairly based upon the information available to the insurer at the time of denial. See St. Paul Guardian Ins. Co. v. Luker, 801 S.W.2d 614, 621 (Tex.App.-Texarkana 1990, no writ).
On this record, we determine there is nothing for us to review as to the quantum meruit claim because it is clear from the record that Blue Oak abandoned its quantum meruit claim and that the trial court's order denying the plea to the jurisdiction does not address the claim. See Fuentes v. Tex. Employers' Ins. Ass'n, 757 S.W.2d 31, 32 (Tex. App.—San Antonio 1988, no writ) (not reaching an issue regarding whether a party could bring a cause of action because the party abandoned the claim in the trial court). STANDARD OF REVIEW
To corroborate its contention, St. Paul first proposes that the evidence developed at trial was not before it at the time of the denial; however, much of the evidence presented came from St. Paul's files and the testimony of its employees. Next, St. Paul points to its reliance upon the opinion letter provided by counsel as the reasonable basis for its denial of coverage. Fuentes v. Texas Employers' Ins. Ass'n, 757 S.W.2d 31, 33 (Tex.App. — San Antonio 1988, no writ). Further, St. Paul views its denial to be reasonable as a matter of law, National Union Fire Ins. v. Hudson Energy, 780 S.W.2d 417 (Tex.App. — Texarkana 1989), aff'd, 811 S.W.2d 552 (Tex. 1991), because it had information that the notice of suit was late.
See W.C. Banks, Inc. v. Team, Inc., 783 S.W.2d 783, 785 (Tex.App. — Houston [1st Dist.] 1990, no writ) (an unsigned docket sheet entry reading "Judgment for Plaintiff rendered this day. Orders to follow" was not sufficient to constitute a rendition of judgment because parties agreed the judge never made an oral announcement in court and there was no evidence the unsigned docket notation was made by the trial judge or at his direction.) Appellee argues that the facts in Fuentes v. Texas Employers' Insurance Association, 757 S.W.2d 31 (Tex.App. — San Antonio 1988, no writ) are analogous to those now before us and contends that we should follow the court's holding in that case. Fuentes filed suit against his workers' compensation insurance carrier alleging violations of the Texas Insurance Code as well as unfair/bad faith settlement practices.
The carrier, on the other hand, argues that it may rely upon a medical opinion, which need not necessarily amount to a formal release by the treating physician, and which may be an IME, as a reasonable basis for stopping weekly benefits. Fuentes v. T.E.I.A., 757 S.W.2d 31, 33 (Tex.App. — San Antonio 1988, no writ). Under the circumstances of this case, we agree with the carrier that Dr. Capen's opinion, although not a release from a treating physician, did constitute a reasonable basis as a matter of law. Puckett upheld a sizeable bad faith judgment against a worker's compensation carrier, where the carrier directly violated a number of the compensation laws, acts which its own expert admitted were unreasonable. Puckett is distinguishable, as there the carrier unilaterally terminated weekly benefits when the worker was still unable to work, without the benefit of any medical release from any source. Puckett does not control here.
Point of error number 11 is overruled. Points of error six, seven, and eight challenge the trial court's refusal to submit certain instructions to the jury in connection with question number one. Relying on Aranda and Fuentes v. TEIA, 757 S.W.2d 31 (Tex.App. — San Antonio 1988, no writ), TEIA specifically requested the following instructions: Texas Employers Insurance Association may deny invalid or questionable claims without breaching its duty of good faith and fair dealing, even if such denial is erroneous.