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Tuesday, May 26, 2026

Insurer, not employer, to pay workers' comp benefits - HRD America

Worker alleges negligence and failure to provide safe workplace or tools

An employee filing a personal injury claim can seek his exclusive remedy of recovery of workers’ compensation benefits from the insurance carrier, not the employer, the Texas Court of Appeals said in a recent case.

The plaintiff in the case was working when he fell from a ladder, fractured his left heel bone, and injured his left knee and ankle. He filed a lawsuit seeking damages from the defendant, which was doing business as Lopez Carpets, based on negligence and gross negligence.

The suit alleged that the plaintiff was an “on-duty employee” of the defendant, that he suffered injuries within the business premises, and that the defendant failed to provide a safe workplace or safe tools for employees.

The defendant argued that the trial court would not have jurisdiction over the case until the completion of the plaintiff’s administrative proceeding before the Texas Division of Workers’ Compensation, which had exclusive jurisdiction to determine the plaintiff’s employment status at the time of the injury.

Read more: The difference between a specific injury and cumulative injury

The trial court decided to hold off from dealing with the case until the workers’ compensation division determined the plaintiff’s employment status.

The hearing between the plaintiff and the defendant’s workers’ compensation insurer, Texas Mutual Insurance Company, took place. An administrative law judge found that the...



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