Glenn et al v. L. Ray Calhoun & Co. et al

Filing 84

ORDER GRANTING 56 Motion for Summary Judgment by OneBeacon America Insurance Company; GRANTING 68 Motion for Summary Judgment by Texas Business Purchasing Alliance, Inc. and Assurance Resources, Inc.; GRANTING 74 Motion for Summary Judgment by Ty Templeton; DENYING 78 Motion for Summary Judgment by Third Party Plaintiff, L. Ray Calhoun & Co., d/b/a Calhoun and Company, et al. The only remaining claims in this case are OneBeacon's counterclaims for costs and attorney's fees against Calhoun. Signed by Judge Sam Sparks. (kkc)

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IN THE UNITED STATES DISTRICT
FOR THE WESTERN DISTRICT OF TE
AUSTIN DIVISION

AM

I

j:

I7

bs

WILLIAM GLENN and CHERYL GLENN,
Plaintiffs,
Case No. A-13-CA-701-SS

-vs-

L. RAY CALHOUN & CO. d/b/a Calhoun and
Company, et al.; L. RAY CALHOUN AND
COMPANY d/b/a Calhoun and Company, et al.;
CALHOUN & COMPANY, INC. d/b/a Calhoun
and Company, et al.; LINDON RAY CALHOUN
a/k/a L. Ray Calhoun a/k/a L. Ray Calhoun,

Individually;

ONEBEACON AMERICA
INSURANCE COMPANY; ASSURANCE
RESOURCES, INC.; TEXAS BUSINESS
PURCHASING ALLIANCE, INC.; and TY
TEMPLETON,
Defendants.

ORDER
BE IT REMEMBERED on the 8th day of January 2015, the Court held a hearing in the

above-styled cause, and the parties appeared by and through counsel. Before the Court are
OneBeacon America Insurance Company's Motion for Summary Judgment [#56], Third Party
Plaintiff, L. Ray Calhoun & Co., d/b/a Calhoun and Company, et al.'s Responses [##63, 69], and
OneBeacon America Insurance Company's Reply [#70]; Defendants Texas Business Purchasing
Alliance, Inc. and Assurance Resources, Inc.'s Motion for Final Summary Judgment [#68], and
Third Party Plaintiff L. Ray Calhoun & Co., d/b/a Calhoun and Company, et al.'s Response [#71];

Third-Party Defendant Ty Templeton's Motion for Summary Judgment [#74], Third Party Plaintiff
L. Ray Calhoun & Co., d/b/a Calhoun and Company, et al. 'S Response [#80], and Templeton's Reply

/

[#81]; Third Party Plaintiff, L. Ray Calhoun & Co., d/b/a Calhoun and Company, et al. 's Motion for

Summary Judgment, or in the Alternative, Partial Summary Judgment [#7 8], and OneBeacon

America Insurance Company's Response [#79].

Having considered the motions, responsive

pleadings, the case file as a whole and the applicable law, the Court enters the following opinion and
orders.

Background
Plaintiffs William Glenn (Glenn) and his wife Cheryl Glenn filed suit in Texas state court
in September 2012. Plaintiffs originally filed the suit against Glenn's former employer, L. Ray

Calhoun & Co., d/b/a Calhoun and Company (Calhoun), for negligence after Glenn was injured in
a workplace accident. Plaintiffs later added claims against OneBeacon America Insurance Company

(OneBeacon) for benefits under an insurance policy (the Policy) which funds an employee welfare
benefit plan Calhoun put in place for its employees (the Plan). Calhoun, in turn, asserted a claim

against OneBeacon for any amounts owed under the Policy. Plaintiffs and Calhoun also asserted
claims against Texas Business Purchasing Alliance (TBPA), Assurance Resources, Inc. (ART), and
Ty Templeton (Templeton) (collectively, the Agent Defendants), the agencies and agent which

helped Calhoun purchase the Policy and, in so doing, allegedly made false statements and
misrepresentations to Calhoun regarding the Policy in failing to explain the differences between a

worker's compensation policy and an occupational accident policy. OneBeacon removed the action
to this Court on August 14, 2013.

By order dated January 3, 2014, the Court remanded Plaintiffs' claims against Calhoun.

Following agreed dismissal of other portions of this action, the parties agree the claims remaining

in this action are: (1) Calhoun's insurance coverage claims against OneBeacon; (2) Calhoun's fraud
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and negligent misrepresentation claims against the Agent Defendants; and (3) OneBeacon's

counterclaim for costs and attorney's fees against Calhoun.'
Each of the parties has filed a motion for summary judgment. Specifically, OneBeacon
argues: (1) the claims are barred due to Calhoun's failure to exhaust administrative remedies as

required by the Employee Retirement Income Security Act of 1974 (ERISA); (2) OneBeacon
properly denied any claim for benefits for Glenn because Glenn was not covered under the Policy;
and (3) Calhoun's fraud and negligent misrepresentation claims fail because: (a) Calhoun cannot

establish one or more elements of the claims, (b) the alleged misrepresentations were not made by
an agent

of OneBeacon, (c) virtually all of the claims are barred by the statute of limitations, and

(d) the claims are preempted by ERISA.

TBPA and ART maintain: (1) Calhoun's fraud and misrepresentation claims fail because:
(a) they do not owe a duty to Calhoun, (b) they are not liable as a result

of any statements made by

Templeton, (c) Calhoun has not shown any actionable reliance, and (d) the majority of the claims
are barred by the statute of limitations; and (2) Calhoun's insurance coverage claims fail because:
(a) Glenn was not covered under the Policy, and (b) they did not have a contract with Calhoun.

Templeton contends Calhoun's claims against him fail because: (1) they are barred by the

statute of limitations; (2) he did not owe a duty of care to Calhoun; (3) there is no evidence to
support Calhoun's fraud claims; (4) Calhoun has not identified any misrepresentations made by

Templeton; (5) claims of insufficient insurance coverage are not covered under the Deceptive Trade
Practices Act (DTPA); and (6) Calhoun's damages are not the result of Templeton's conduct.

Following voluntary dismissal of certain claims by the parties, on April24, 2014, the Court entered an order
setting forth the claims remaining in this action and granting the parties ten days to file any clarification. No party filed
any clarification.

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Finally, Calhoun asserts it is entitled to summary judgment on its claims against OneBeacon

for failure to pay under the Policy because Glenn was covered under the Policy. The parties have
filed responsive pleadings, and the matters are now ripe for determination.

Analysis
I.

Legal StandardSummary Judgment
Summaryjudgment is appropriate under Rule 56 ofthe Federal Rules of Civil Procedure only

"if the movant shows there is no genuine dispute as to any material fact and that the movant is
entitled to judgment as a matter of law."

FED. R.

Civ. P. 56(a). A dispute is genuine only if the

evidence is such that a reasonable jury could return a verdict for the nonmoving party. Anderson

v.

Liberty Lobby, Inc., 477 U.S. 242, 254 (1986).
The party moving for summary judgment bears the initial burden of "informing the district

court of the basis for its motion, and identifying those portions of [the record] which it believes

demonstrates the absence of a genuine issue of material fact." Celotex Corp.

v.

Catrett, 477 U.s.

317, 323 (1986). The burden then shifts to the nonmoving party to establish the existence of a

genuine issue for trial. Matsushita Elec. Indus. Co., Ltd.

585-87 (1986); Wise

v.

v.

Zenith Radio Corp., 475 U.S. 574,

E.I. Dupont de Nemours & Co., 58 F.3d 193, 195 (5th Cir. 1995). The

parties may satisfy their respective burdens by tendering depositions, affidavits, and other competent
evidence. Topalian

v.

E/irman, 954 F.2d 1125, 1131(5th Cir. 1992).

The Court will view the summary judgment evidence in the light most favorable to the nonmovant. Rosado

v.

Deters,

5

F.3d 119, 122 (5th Cir. 1993). The non-movant must respond to the

motion by setting forth particular facts indicating there is a genuine issue for trial. Miss. River Basin
Alliance v. Westphal, 230 F.3d 170, 174 (5th Cir. 2000). "After the non-movant has been given the

opportunity to raise a genuine factual issue, if no reasonable juror could find for the non-movant,
summary judgment will be granted." Id.

Summary Judgment Evidence

II.

Templeton is an independent retail insurance agent who offers clients insurance options from
a number of different insurers. He first contacted Calhoun in 2006 seeking to act as Calhoun's

insurance agent. OneBeacon Mot. Summ. J. [#56-4] Ex. C (Beaty Depo.) at 38; Id. [#56-5] Ex. D
(Calhoun Depo.) at 60;

Id.

[#56-7] Ex. I (Cernera Aff.) ¶ 4; Id. Ex. L (Templeton Aff. I) ¶J 2-3.

Templeton originally facilitated the sale of an Occupational Accident, or "0cc Acc," insurance
policy issued by BCS Insurance Company (BCS) to Calhoun in August 2006. Templeton Aff. I

¶J 2-3.
TBPA is a wholesale insurance agency, acting as an intermediary between insurance agents
and insurance companies. ART provides third-party administration of 0cc Acc programs on behalf

of insurance companies. TBPA & ART's Mot. Summ. J. [#68-2] Ex. B (Templeton Aff.

TI)

¶ 2.

OneBeacon began selling insurance policies in Texas in January 2008. Cemera Aff. ¶ 12.
The coverage originally issued by BCS was assumed by an insurance policy issued by

OneBeacon (the Policy) with an original effective date of August 1, 2008. OneBeacon Mot. Summ.
J. [#56-2] Ex. A (the Policy).2 The Policy covers certain workplace injuries suffered by an "Eligible

Person." The Policy provides for an "Eligible Person" to be covered, "the Policyholder must.

pay the premium to Us on or before the Premium Due Date." Id.

§

V. The Policy further requires

the Policyholder to "report the actual number of Eligible Persons on a monthly basis" and provides

2

plan.

See

The Court's prior order granting Calhoun's motion to remand in part concluded the Policy is part of an ERISA
Order of Jan. 3, 2014 [#33] at 8-10.

-5-

that the premium rate varies based on the number of Eligible Persons. Id. at 4 & § VI. The Premium
Due Date under the Policy is the first of each month. Id. at

1

&

§ I.

In an email sent October 6, 2009, Calhoun's office manager asked Templeton "I need to

know what our exposure is on 0cc Acc vs if we had Workers Comp ins. If you confirm what I have
been told, we may want a quote on workers comp instead." Calhoun's Resp. to TBPA & ARI Mot.
Summ. J. [#71-2] Ex. 1-C. Templeton replied:

The main difference is you get unlimited medical with work comp, while 0cc/ace you
get between $300,000 and 1 million depending on what coverage you buy. Also
employers liability come with work comp and is an option with occ/acc. I can quote
both if you like, but work comp is more expensive.
Id. Calhoun did not obtain a worker's compensation policy until May 19, 2011. Calhoun Depo. at

111-12,325-26.
Glenn was employed by Calhoun beginning April 13, 2010. OneBeacon Mot. Summ. J.
[#56-3] Ex. B at 3. Glenn was injured in the workplace on May 19, 2011. Beaty Depo. at 46; Resp.
to OneBeacon Mot. Summ. J. [#69-2] Ex. 1 (Calhoun Aff.) at 3. Calhoun reported the injury on May

25,2011. Id. [#69-6], Ex. 1 -D. OneBeacon notified Calhoun by letter dated July29, 2011 addressed
to counsel for Calhoun (the Denial Letter) it was denying coverage under the Policy. In pertinent

part, the Denial Letter explained the claim was denied because:
(2) it has not been established that Mr. Glenn was an Eligible Person as defined by
the Policy; (3) even assuming Mr. Glenn was an Eligible Person as defined by the
Policy, Calhoun was obligated to include him in its reporting of Eligible Persons for
April and for May 2011, but did not do sorather, Calhoun waited until he had been
injured in the reported Accident to report him and request coverage; (4) even if Mr.
Glenn was an Eligible Person as defined by the Policy, under Section VI of the Policy
Calhoun was obligated to pay a premium for him on or before the Premium Due Date
of May 1, 2011, which Calhoun failed to do; (5) Mr. Glenn was not a covered
employee at the time of the reported Accident; (6) Sections II and IV of the Policy
require that coverage for an injured employee must already be in place at the time of

an Accident, but no coverage was in place as to Mr. Glenn at the time of the reported
Accident; (7) Section XI of the Policy excludes coverage for benefits attributable to
injuries occurring or conditions existing prior to the Effective Date of coverage; (8)
Section XI of the Policy excludes coverage for a Pre-Existing Condition or Injury;
and (9) it is contrary to public policy to insure against a known loss or a loss in
progress, and the reported Accident and Mr. Glenn's injuries occurred prior to
Calhoun's request for coverage as to Mr. Glenn.

OneBeacon Mot. Summ. J. [#56-7] Ex. H (Denial Letter) at 1-2. The Denial Letter also set forth
the procedure for appealing the denial of coverage, and explained the appeal must be in writing and
received by OneBeacon within 180 days. Id. at 6-7. Neither Glenn nor Calhoun submitted an
appeal. Cernera Aff. ¶ 9.

III.

Application
As noted above, the claims remaining in this action fall into three categories. Specifically,

(1) Calhoun's claim of coverage under the Policy; (2) Calhoun's state law claims for fraud and

misrepresentation; and (3) OneBeacon' s counterclaim for costs and attorney's fees. The parties have

moved for summary judgment as to the claims in the first two categories. The Court will address
them in turn.
A. Insurance Coverage Claims

OneBeacon has moved for summaryjudgment as to Calhoun's claims based on OneBeacon' s
denial of coverage under the Policy, arguing: (1) the claims are barred due to Calhoun's failure to

exhaust administrative remedies as required by ERISA; and (2) Calhoun is not entitled to seek

benefits under the Policy as OneBeacon properly denied any claim for benefits for Glenn because
Glenn was not covered under the Policy. Calhoun has also moved for summary judgment against

OneBeacon, arguing Glenn is covered under the Policy. TBPA and ART have also moved for
summary judgment, arguing Calhoun's insurance coverage claims fail because: (1) Glenn was not
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covered under the Policy; and (2) they did not have a contract with Calhoun. Templeton also
contends the insurance coverage claims fail because Calhoun has not established any liability on his
part. The Court will address the arguments of OneBeacon and Calhoun first.
1.

Exhaustion

OneBeacon first argues any claims by Calhoun for coverage under the Policy are barred due
to a failure to exhaust administrative remedies. The Fifth Circuit requires claimants seeking benefits

from an ERISA plan to first exhaust all administrative remedies available under the plan before

bringing suit to recover benefits. Coop. Benefit Adm 'rs, Inc.
2004); Bourgeois

v.

v.

Ogden, 367 F.3d 323, 336 (5th Cir.

Pension Plan for Emps. of Santa Fe Int'l Corps., 215 F.3d 475, 479 (5th Cir.

2000). The Fifth Circuit, however, has also made clear ERISA exhaustion is not a prerequisite to
federal court jurisdiction. See Hager v. NationsBankN.A., 167 F.3d 245, 248 n.3 (5th Cir. 1999)

(noting failure to exhaust administrative remedies does not deprive court of subject matter

jurisdiction); Chailland v. Brown &Root, Inc.,45 F.3d 947, 950n.6(5thCir. 1995) (notingbecause
exhaustion is not required by ERISA, it is not prerequisite to jurisdiction). Accordingly, a plaintiff's
failure to exhaust available administrative remedies maybe excused on equitable grounds. See, e.g.,
McGowin

v.

ManPower Int'l, Inc., 363 F.3d 556, 559 (5th Cir. 2004) (considering whether failure

to exhaust should be excused because administrative review would be futile and because plaintiff

was denied "meaningful access" to review process); Hall v. Nat'l Gypsum Co., 105 F.3d 225, 233
(5th Cir. 1997) (holding plan administrator could not raise failure to exhaust administrative remedies

because mechanism for appeal was not in place at time plaintiffs claim was denied and plaintiff

made efforts to have his claim denial reviewed); Denton v. First Nat '1 Bank of Waco, 765 F.2d 1295,

1302-03 (5th Cir. 1985) (addressing plaintiff's assertion of futility exception to ERISA exhaustion
requirement).
Although not precisely clear, as an initial matter, Calhoun suggests the Policy is not governed

by ERISA. As noted above, the Court addressed, and rejected, that argument in an order dated

January 3, 2014, granting in part Calhoun's motion to remand. Calhoun also asserts exhaustion is
not mandated because the terms of the Policy do not explicitly require exhaustion. The origins of
the exhaustion requirement, however, are based on judicial interpretations of the ERISA statutory
scheme and Congressional intent. See Denton, 765 F.2d at 1301 (discussing history and concluding

"Congress' ERISA fiduciary framework mandates the exhaustion requirement").
Calhoun further argues exhaustion is not required because the claim for coverage falls
outside the exhaustion requirement. See Harrow v. Prudential Ins. Co., 279 F.3d 244, 252 (3rd Cir.
2002) (indicating ERISA exhaustion requirement does not apply to claims arising from violations

of substantive statutory provisions); see also Chailland, 45 F.3d at 950 (discussing exceptions to
ERISA exhaustion requirement and finding requirement did not apply where claim did not involve
any action of a plan covered by ERISA). Calhoun's argument is misplaced. The issue before the

Court is clearly an attack on a denial of benefits under an ERISA plan. As such, it falls squarely

within the ERISA exhaustion requirement. Bourgeois, 215 F.3d at 479 ("[C]laimants seeking
benefits from an ERISA plan must first exhaust available administrative remedies under the plan
before bringing suit to recover benefits."). Indeed, even the case Calhoun itself relies on views the
exhaustion requirement as applicable to such claims. See Harrow, 279 F.3d at 253 ("Plaintiffs

cannot circumvent the exhaustion requirement by artfully pleading benefit claims as breach of
fiduciary duty claims."); see also Drinkwater v. Metro. Life Ins. Co., 846 F.2d 821, 826 (1st Cir.

1988) (noting exhaustion doctrine would be "rendered meaningless"

if plaintiffs were allowed to

bypass exhaustion by artfully dressing contract claims in statutory clothing).
The summary judgment evidence establishes Calhoun was advised of the requirement to

exhaust administrative remedies, the manner in which to do so, and the deadline for doing so in the
Denial Letter sent to Calhoun's counsel dated July 29, 2011. Calhoun maintains the exchange of

correspondence between its counsel and counsel for OneBeacon, "beginning on July 19, 2011 and
continuing thereafter" was "in response to the initial denial by One Beacon [sic] of the Glenn claim"
and thus constitutes an appeal of the decision. Resp. to OneBeacon Mot. Summ. J. [#69] at 12.

Calhoun's argument is flawed for at least two reasons. First, although Calhoun refers to
correspondence exchanged between counsel following the denial of benefits, it has not presented
copies of the correspondence as part of its summary judgment evidence. Moreover, Calhoun has
pointed to no evidence it complied with the instructions provided as to filing an appeal. Specifically,
the Denial Letter states the appeal must be sent to Robert E. Pierce, a claims examiner for

OneBeacon. Denial Letter at 7. Accordingly, the Court concludes Calhoun has failed to comply
with the ERISA exhaustion requirement. See Swanson v. Hearst Corp. Long Term Disability Plan,
586 F.3d 1016, 1018-19 (5th Cir. 2009) (rejecting argument that letter sent to insurer satisfied

exhaustion requirement where letter merely expressed an "intention to appeal"); Holmes
& Gamble Disability Benefit Plan, 228 F.

v.

Proctor

App'x 377, 379 (5th Cir. 2007) (unpublished) (holding

plaintiff "did not substantially comply with the Plan's appeal procedures [because he] stated only
his intent to appeal the Plan's decision at some time in the future"). OneBeacon is entitled to

summary judgment on Calhoun's claim of entitlement to benefits under the Policy for this reason
alone.

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2. Coverage for Glenn

OneBeacon also contends Calhoun cannot recover on any claim based on a right to benefits

under the Policy due to the "fortuity doctrine" because Glenn was not covered under the Policy at
the time of his injury. The "fortuity doctrine" bars coverage for a loss the insured already knows to
have occurred or which is in progress at the inception of the carrier's initial policy. Dali. Nat'l Ins.
Co. v. SabicAms., Inc., 355 S.W.3d 111, 119 (Tex.

App.Hous.

[1st Dist.] 2011, pet. denied);

Certain Underwriters at Lloyd Subscribing to Policy No. WDO-10000 v. KK]VI Inc., 215 S.W.3d
486, 495 (Tex.

App.Corpus Christi 2006, pet. denied); Warrantech

Corp. v. Steadfast Ins. Co.,

210 S.W.3d 760, 767 (Tex. App.Fort Worth 2006, pet. denied). "The doctrine has its roots in the

prevention of fraud; because insurance policies are designed to insure against fortuities, fraud occurs

when a policy is misused to insure a certainty." Scottsdale Ins. Co.

v.

Travis, 68 S.W.3d 72, 75 (Tex.

App.Dallas 2001, pet. denied).
As set forth above, the summary judgment evidence establishes the Policy required Calhoun
as the Policyholder "to report the actual number of Eligible Persons on a monthly basis" and to "pay

the premium to [OneBeacon] on or before the Premium Due Date." The Policy

§

V & VI.

According to OneBeacon's view of the evidence, Calhoun never reported Glenn to OneBeacon or
paid premiums for Glenn under the Policy. Calhoun disagrees on both points.
In support, OneBeacon largely relies on the testimony of Becky Beaty (Beaty), the office

manager for Calhoun. Beaty Depo. at 14; Calhoun Depo. at 11. L. Ray Calhoun (L. Ray), the

president of Calhoun, testified Beaty was responsible for reporting employees to OneBeacon.
Calhoun Depo. at 195-96. Beaty testified she forwarded the information regarding new employees
to ARI or her contact at Templeton's office. Beaty Depo. at 86-87, 110-12. ARI used the list of

-1 1..

names to calculate the proper amount of premium to charge for the Policy, send invoices, and collect
the premiums due. Id. at 114-15, 122-24. Beaty testified, in order to save money, L. Ray decided

not to cover all his company's employees under the Policy. Id. at 123.
Calhoun maintained company records listing each of its employees.

See

OneBeacon Mot.

Summ. J. [#56-6] Ex. F. ART sent Calhoun monthly invoices for the premiums due under the Policy.

The invoices contain a "Current Employee Census," listing the names and dates-of-hire of employees
as well as the amount of premiums charged for each individual employee next to the name of the

employee. Id. Ex. E. A comparison of Calhoun's records of its employees and the monthly invoices
sent to Calhoun for premiums owed under the Policy establishes Calhoun employed a number of

people who were not listed in the monthly invoices. Id. Exs.

EF.

Calhoun's records list Glenn as an employee starting with the month of April 2010. Id. Ex.
F. The first monthly ARI invoice listing Glenn as an employee was the invoice for the billing month

of July 2011, which shows a billing date of June 5,2011, and a payment due date of July 1,2011.
Id. Ex. E.

Beaty testified that immediately after Glenn was injured in the workplace on May 19, 2011,
she was concerned she had not reported Glenn to ART or Templeton. At L. Ray's urging, she

checked and discovered she had not. Beaty Depo. at 46-47. Beaty agreed "Mr. Calhoun's response

was to make sure that [Glenn] was covered and reported immediately." Id. at 47-48. Thus, Beaty
sent an email to Templeton's office at 12:23 p.m. on May 19,2011, asking that Glenn and three other

individuals be added to the

Policy.3

Id. at 48, 53; OneBeacon Mot. Summ. J. [#56-7] Ex. G. Beaty

Notably, the email lists a date-of-hire for Glenn of April 18, 2011. Beaty admitted she knew that was a lie.
Beaty Depo. at 53-54. Apparently as a result, the invoice for the billing month of July 2011 identifies Glenn's date-ofhire as April 18,2011. OneBeacon Mot. Summ. J. [#56-6] Ex. E. Documentation submitted by Beaty on May 25, 2011,

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admitted her email was an attempt to correct the problem presented by her failure to report Glenn
as an employee earlier. She stated she and L. Ray had conversations about the issue on May 19 and

agreed L. Ray "understood that [she was] attempting to get Mr. Glenn covered even though he may

have said to take the risk of not covering him." Beaty Depo. at 57-5 8. Beaty testified:
Q: You were trying to make sure that Mr. Glenn was covered even though you

were reporting him to the insurance company after he had been in an accident.
That's true, isn't it?
A: Yes.

***

Q: [Y]ou understood when you reported Mr. Glenn immediately after his injury
that it was not proper to seek coverage for a risk that already turned into a loss,
but you were trying to do that anyway and that's true, isn't it?.

A: Yes.

Id. at 54, 135-36.

OneBeacon maintains this evidence establishes Glenn was not covered under the Policy at
the time of his injury because he had never been reported as an employee by Calhoun, nor had

Calhoun paid a premium for him.
Calhoun disagrees and first argues Glenn was properly reported because the Policy only
requires the Policyholder to report an "Eligible Person" to the Texas Workforce Commission (TWC)
quarterly, and Calhoun complied with this requirement.

See

Resp. to OneBeacon Mot. Summ. J.

[#69-4] Ex. 1-B.

Calhoun is correct the definition section of the Policy states an "Eligible Person" must "be

identified by the Policyholder" on the quarterly report filed with the TWC. The Policy

§ I.

But the

in support of Glenn's claim following his injury also identifies Glenn's start date as April 18, 2011. Resp. to OneBeacon
Mot. for Summ. J. [#69-6] Ex. 1-D.

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Policy also requires the Policyholder to "report the actual number of Eligible Persons on a monthly

basis" and "remit the premium due" based on that infonnation. Id.

§

VI. Calhoun's reliance on

submitting a quarterly report to the TWC as satisf,'ing the reporting requirement of the Policy is not

well-founded in light of the monthly nature of the premium calculation and billing under the Policy.
Calhoun also argues the premium payment requirement was satisfied for two reasons. First,
Calhoun reasons because it made at least a partial payment for May2011, the Court should allocate
a portion of the payment to cover

Glenn.4

Second, Calhoun asserts the Policy permitted a grace

period for timely making payments, and the payment tendered on June 14,2011, for the April, May,
and June 2011 premiums was sufficient to provide coverage to Glenn at the time of his injury on

May 19, 2011.

Calhoun's arguments fall short of the mark on several bases. First, the Premium Due Date
under the Policy is the first of each month. The Policy also contains a thirty-one day Grace Period
permitting coverage to continue if payment is made within that time. The Policy at

§

VI. Calhoun

admits he did not submit a payment for the time period in which Glenn was injured until June 14,
2011, which is outside the thirty-one day Grace Period. Moreover, the Grace Period provision states,

"[a]fter the first premium, any premium not paid by its due date is in default," and only concerning
those premiums in default does the Grace Period apply. Id. Calhoun's "first premium" paid for
Glenn, however, was the June 14, 2011 payment. As such, the Grace Period is inapplicable.

Second, Calhoun points to nothing in the Policy which contemplates partial payments or

permits allocation of partial payments so as to cover employees not identified on a billing invoice.

Calhoun suggests OneBeacon had a history of difficulty in calculating the premium payments and accepting
partial payments from Calhoun. Resp. to OneBeacon Mot. Summ. J. [#69] ¶J 12-13. No evidence, however, is cited
in support of this assertion.

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Moreover, Calhoun's argument would require a retroactive withdrawal of coverage for employees
who were identified, presumably employees who did not suffer a workplace injury.
Finally, as OneBeacon points out, Calhoun's argument flouts the reality that the invoices

submitted to Calhoun charged premiums for specifically named individual employees. Simply put,

Calhoun asks this Court to permit it to buy insurance after the fact to cover a known loss. This
request clearly violates the "fortuity doctrine" and is therefore barred by Texas law.
Inc.

v.

Gulf Ins. Co., 901

S.W.2d 495, 501 (Tex.

App.Hous. [14th Dist.]

See

Two Pesos,

1995, no writ)

(identifying basic concept of insurance as wager against the occurrence or non-occurrence of a
specified event in which "the carrier insures against a risk, not a certainty"). Accordingly,
OneBeacon is entitled to summary judgment on Calhoun's insurance coverage claims.
3.

Insurance Claims Against Other Defendants

TBPA and ART have also moved for summaryjudgment as to Calhoun's insurance coverage
claims. They first maintain the claims fail because Glenn was not covered under the Policy. TBPA
and ARI also contend the claims fail because they are not parties to the Policy contract. Templeton

similarly contends he is not liable to Calhoun for any claims based on coverage.
As an initial matter, the Court notes it is not at all clear Calhoun is still asserting any

insurance coverage based claims against any party other than OneBeacon. As set forth above, in an

order dated April 24, 2014, the Court set forth the remaining claims as including, in pertinent part,

"Calhoun's insurance coverage claims against OneBeacon" and directed the parties to file any
clarification to the contrary. No party filed any clarification. As a result, it appears Calhoun is no
longer pursuing any claims based on insurance coverage against any party other than OneBeacon.

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Moreover, the Court agrees with TBPA and ART that Calhoun has no contractual relationship
with them under the Policy and therefore has no basis to impose liability against them for any failure
to provide insurance coverage under the Policy. Finally, as OneBeacon has demonstrated, Calhoun's

insurance coverage claims fail on the merits, and any claims based on insurance coverage against
TBPA, ART, and Templeton fail for the same reasons.
B. State Law Claims

OneBeacon, TBPA, ART, and Templeton (Third-Party Defendants) have all also moved for

summary judgment as to Calhoun's state law claims based on fraud and misrepresentation on a

number of bases.
Before addressing the arguments presented by Third-Party Defendants, a brief discussion of

the factual basis of these claims is appropriate. Calhoun's petition asserting these claims cites as the
sole basis of the misrepresentations the October 6, 2009 email exchange between Beaty and

Templeton set forth above.

See Notice Removal [#1-3], Ex. C

(Def. 's 2d Am. Third-Party Pet.) ¶ 11.

In responding to discovery, Calhoun additionally identified an oral representation made to L. Ray

in August 2006 by Templeton who allegedly stated an 0cc Acc policy "would do everything

workers' compensation would do, but for less money." OneBeacon Mot. Summ. J. [#56-3] Ex. B
at 45 In responding to the motions for summary judgment, Calhoun asserts for the first time alleged

misrepresentations made by Carolyn S. Duane (Duane), the president of ART, in letters dated June

13,2008, and April 20, 2011, in which Duane supposedly extolled the benefits of the Policy without
In responding to discovery, Calhoun also identified as "misrepresentations" various portions of the Policy.
Both Beaty and Calhoun, however, testified they had not read the Policy prior to the filing of this lawsuit. Beaty Depo.
at 109; Calhoun Depo. at 62. Calhoun cannot rest a claim of misrepresentation on language which it was not aware of,
nor can Calhoun assert reliance on the language of the Policy it did not read. See Dolenz v. A. B., 742 S.W.2d 82, 85
(Tex. App.Dallas 1987, writ denied) (finding because plaintiff lender delivered loan proceeds to borrower prior to any
representations by borrower's attorney to plaintiff, plaintiff could not have detrimentally relied on those representations).

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disclosing the legal limitations of an 0cc Acc policy in comparison with a worker's compensation
policy. Resp. to TBPA & ART Mot. Summ. J. [#71-2] Exs. 1-D & 1-E.
1. Defenses

Unique to OneBeacon

As an initial matter, as discussed above, the parties did not contest this Court's Order ofApril
24, 2014 [#53] when the Court laid out the remaining claims in this lawsuit to include only: (1)

Calhoun's insurance coverage claims against OneBeacon; (2) Calhoun's fraud and negligent
misrepresentation claims against the Agent Defendants; and (3) OneBeacon's counterclaims for costs
and attorney's fees against Calhoun. As a result, it appears Calhoun is no longer pursuing the fraud

and negligent misrepresentation claims against OneBeacon, and OneBeacon' s motion for summary

judgment could be granted on this basis alone.6
OneBeacon also contends Calhoun's state law claims against it are preempted by ERISA.
Because the Court has determined the Policy is governed by ERISA, the remaining step in

determining whether Calhoun's state law claims are preempted by ERISA requires the Court to

determine whether Calhoun's state law claims "relate to" the ERISA plan. 29 U.S.C.

§

1144(a)

(providing ERISA "shall supersede any and all State laws insofar as they may now or hereafter relate
to any employer benefit plan"). State law claims addressing an area of exclusive federal concern,

such as the right to receive benefits under an ERISA plan, and directly affecting the relationship

between traditional ERISA entities "relate to" the ERISA plan. Access Mediquip L.L.C.

v.

UnitedHealthcare Ins. Co., 662 F.3d 376, 382 (5th Cir. 2011); E.I. DuPont de Nemours & Co.

v.

Srniyer, 517 F.3d 785, 800 (5th Cir. 2008); see also Aetna Health Inc.

6

v.

Davila, 542 U.S. 200, 209

Moreover, as OneBeacon points out, Calhoun's response to its motion for summary judgment wholly fails
to address these claims.

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(2004) ("[A]ny state-law cause of action that duplicates, supplements, or supplants the ERISA civil

enforcement remed[ies] conflicts with the clear congressional intent to make the ERISA remed[ies]
exclusive and is therefore preempted.").
OneBeacon argues Calhoun's state law claims against it are preempted because the only
damages Calhoun claims to have suffered are the benefits bargained for in purchasing the Policy, i.e.

the payments provided for under the Policy. Although Calhoun's petition is less than precisely clear

regarding damages, the Court agrees Calhoun does not appear to be seeking any other damages
against OneBeacon. Nor does Calhoun suggest otherwise in responding to the motion for summary
judgment.

The Court therefore concludes any state law claims Calhoun is asserting against

OneBeacon are preempted. See Hansen

v.

Cont'l Ins. Co., 940 F.2d 971, 979 (5th Cir. 1991)

(finding determination plan is governed by ERISA tantamount to determination plaintiff's state law
causes of action are barred); see also Metro. Lfe Ins. Co. v. Taylor, 481 U.S. 58, 62-63 (1987)

(determining common law contract and tort claims seeking to recover benefits preempted by
ERISA); Bank ofLa.

v.

Aetna US. Healthcare Inc., 468 F.3d 237, 242-44 (5th Cir. 2006) (holding

breach of contract claim preempted by ERISA); Peace v. Am. Gen. Life Ins. Co., 462 F.3d 437, 450
(5th Cir. 2006) (finding state law breach-of-contract claim to recover difference between what

annuity will pay and what plaintiffalleges he was promised annuity would pay is claim that "relate[s]

to" an "employee benefit plan" and is preempted by ERISA); Ellis v. Liberty Life Assurance Co., 394
F.3d 262, 276-78 (5th Cir. 2004) (holding claims under Texas Insurance Code and for breach of
duties of good faith and fair dealing preempted by ERISA); McNeil v. Time Ins. Co., 205 F.3d 179,

191(5th Cir. 2000) (deciding state law claims for breach of contract, breach of duty of good faith
and fair dealing, negligent misrepresentation, common law discrimination, waiver, estoppel,

ratification, and under Texas Insurance Code preempted by ERISA); Hogan v. Kraft Foods, 969 F.2d
142, 144-45 (5th Cir. 1992) (finding ERISA preempts plaintiffs state law claims for breach of

contract, violations of insurance code, deceptive trade practices, breach of duty of good faith and fair
dealing, negligence, and intentional infliction of emotional distress). Accordingly, OneBeacon is

entitled to summary judgment as to Calhoun's state law claims.
2. Statute of Limitations

The Third-Party Defendants contend virtually all of Calhoun's state law claims are barred

by the applicable statutes of limitations. Calhoun has specifically asserted claims under the DTPA,
for fraud, under the Texas Insurance Code, for negligence, and for negligent misrepresentation.
Claims based on a violation of the Texas Insurance Code must be brought "before the second

anniversary" of the date the improper practice occurred or the date the plaintiff discovered or, by the

exercise of reasonable diligence, should have discovered the improper practice. TEx.

Aim.

§

INS.

CODE

541.162. Claims under the DTPA similarly must be commenced within two years after the

date on which the false, misleading, or deceptive act or practice occurred or within two years after
the consumer discovered or, in the exercise of reasonable diligence, should have discovered the
occurrence of the false, misleading, or deceptive act or practice. TEX. Bus. & COM. CODE ANN.
§

17.565; Haidar v. Nortex Found. Designs, Inc., 239 S.W.3d 924, 926 (Tex.

App.Dallas 2007,

no pet.). Claims for common law fraud are governed by a four year limitations period. TEX.
PRAC. & REM. CODE ANN.

§

1

Civ.

6.004(a)(4); Newby v. Enron Corp., 542 F.3d 463,468 (5th Cir. 2008).

Claim for negligence and negligent misrepresentation are governed by a two year statute of

limitations. TEx. Civ. PRAC. & REM. CODE ANN.

§

351, 354-55 (5th Cir. 2008).

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16.003; T1G ins. Co.

v.

AonRe, Inc., 521 F.3d

While the parties agree on the length of the applicable limitations periods, they disagree as
to when limitations began to run. In this case, the analysis is clouded by Calhoun's rather vague

assertion of its claims.

Although not precisely clear, it appears Calhoun alleges various

misrepresentations were made to it by the Agent Defendants concerning the scope of coverage
afforded by the Policy. More specifically, Calhoun is apparently contending the Agent Defendants

failed to adequately explain the difference between an 0cc Acc policy and a worker's compensation

policy. Calhoun maintains, as a result, it chose an 0cc Acc policy, resulting in exposure to far
greater legal liability to Glenn for his workplace injury.

Under Texas law, "a cause of action accrues when a wrongful act causes some legal injury,
even if the fact of injury is not discovered until later, and even if all resulting damages have not yet

occurred." S.V.

v.

R.V., 933 S.W.2d

1,4 (Tex. 1996). The Supreme Court of Texas has also said

"[a] cause of action generally accrues, and the statute of limitations begins to run, when facts come
into existence that authorize a claimant to seek a judicial remedy." Johnson & Higgins of Tex., Inc.
v.

Kenneco Energy, Inc., 962 S.W.2d 507, 514 (Tex. 1998).
Calhoun first suggests its state law claims accrued on the date OneBeacon denied coverage

July 29, 2011. Calhoun correctly points out that when insurance benefits are at issue, the statute of
limitations begins to run when the insurer denies the claim for those benefits. Citigroup Inc.

v. Fed.

Ins. Co., 649 F.3d 367, 373 (5th Cir. 2011); ProvidentLfe &Acc. Ins. Co. v. Knott, 128 S.W.3d 211,
221 (Tex. 2003). Calhoun's state law claims against the Agent Defendants, however, do not seek

benefits under the Policy, but rather assert the Agent Defendants misled Calhoun. This legal concept
is therefore inapplicable.

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Calhoun next suggests its state law claims did not accrue until Glenn filed suit against
Calhoun in September 2012. According to Calhoun, it was not until then it suffered any damages
as a result

of the misrepresentations by the Agent Defendants because the damages suffered are

Calhoun's inability to assert the legal defenses available under the worker's compensation scheme
in Texas.
Third-Party Defendants, in turn, contend Calhoun's cause of action accrued at the time the
Policy was issued on August 1, 2008. They correctly point out Texas courts have held "an insured

has a duty to read the policy and, failing to do so, is charged with knowledge of the policy terms and
conditions." Ruiz v. Gov'tEmp. Ins. Co., 4 S.W.3d 838, 841 (Tex.
Amarco Petroleum, Inc.

v. Tex.

App.El Paso

Pac. Indem. Co., 889 S.W.2d 695, 699 (Tex.

1999, no pet.);

App.Hous. [14th

Dist.] 1994, writ denied). Third-Party Defendants therefore maintain Calhoun should have known

of the facts underlying the state law claimsthe fact the Policy did not provide the legal benefits a
worker's compensation policy would

provideby reading the Policy

at the time it was issued.

Specifically, Third-Party Defendants point to the language on the cover page of the Policy stating

in all capital letters:

"THIS IS

NOT A POLICY OF WORKERS' COMPENSATION

INSURANCE," and "THE POLICYHOLDER LOSES THOSE BENEFITS WHICH WOULD
OTHERWISE ACCRUE UNDER THE WORKERS' COMPENSATION LAWS." The Policy at
1.

Several Texas courts have agreed with Third-Party Defendants' view of the law. See Khoei
v.

Stonebridge Lfe Ins. Co., No. H-13-2181, 2014 WL 585399, at *7 (S.D. Tex. Feb. 14, 2014)

(finding claims insurer misrepresented policy coverage in selling policy accrue when policy is
issued); Steadfast Ins. Co. v. SMX98, Inc., No. H-06-2736, 2009 WL 890398, at * 16 (S.D. Tex. Mar.
-21-

30, 2009) (stating cause of action based on insurer's misrepresentation or failure to disclose in

connection with sale of insurance policy accrues when policy is issued); Range! v. Progressive Cnty.
Mut. Ins. Co., 333 S.W.3d 265, 269 (Tex.

App.El Paso 2010, pet. denied) (deciding claims based

on alleged misrepresentations concerning extent of insurance coverage accrued when plaintiffs
purchased the policy); Mauskar v. Hardgrove, No. 1 4-02-00756-cv, 2003 WL 21403464, at * 3 (Tex.

App.Hous. [14th Dist.] June 19, 2003, no pet.) (same, stating "[h]ad

[plaintiff] read the policies

at the time he purchased them, he would have known that the policies were not going to meet his

alleged pay-out expectations"). Notably, Calhoun cites no legal authority to the contrary.
Moreover, the facts of this case render Calhoun's argument inapposite. Calhoun was sued
in August 2010 by another employee who was injured at work. OneBeacon Mot. Summ. J. [#56-7]
Ex. M; Calhoun Depo. at 42-43, 274. After that lawsuit, L. Ray became aware of some of the

limitations of the Policy and began inquiring about different options. Calhoun Depo. at 275-76. He
told Beaty to "Check into this. Find some insurance that does cover that, and also look into

Workers' Comp." Id. at 44. Beaty did so and was provided an excerpt of an article discussing the
discussing the differences between worker's compensation policies and occupational accident

policies by another insurance agent. OneBeacon Mot. Summ. J. [#56-7] Ex. 0. Calhoun was
therefore clearly aware of the extent of coverage afforded by the Policy well before the filing of

Glenn's lawsuit, the date Calhoun maintains the state law causes of action accrued.
Calhoun first asserted claims against the Third-Party Defendants in a third-partypetition filed

in state court on July 8, 2013. As set forth above, the original purchase date for the Policy was
August 2008. The Policy was thereafter renewed yearly. The Court thus concludes Calhoun's state
law claims based on representations made in August 2006 and June 2008 accrued at the latest on the

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original purchase date for the Policy and are barred by limitations. Calhoun's state law claims based

on Templeton's email in 2009 accrued at the latest on the subsequent renewal of the Policy in August
2010. Thus, the only claim based on that representation which is not barred by limitations is the
claim for fraud. Similarly, Calhoun's state law claims based on the April 2011 email accrued at the

latest on the subsequent renewal of the Policy in August 2011. Therefore, no claim based on that

representation is barred by limitations. Accordingly, Third-Party Defendants are entitled to summary

judgment as to all of Calhoun's state law claims except for fraud based on Templeton's 2009 email
and Calhoun's claims based on Duane's 2011 letter. The Court will, therefore, restrict the following

discussion solely to those claims.
3. No Actionable Misrepresentations

Third-Party Defendants contend Templeton's 2009 email does not provide a basis for legal
liability for several reasons. First, OneBeacon, TBPA, and ARI all contend Templeton was not

acting as their agent and did not have authority to render them vicariously liable. In support,
OneBeacon provides the affidavit of the employee in charge of the occupational accident insurance
program. She states Templeton was not an employee, agent, or other representative of OneBeacon

and had no affiliation with OneBeacon. Cernera Aff. ¶ 4. Templeton also states in affidavit
testimony he was not acting on behalf of, or as agent for, OneBeacon. Templeton Aff. I ¶J 4-7.
Calhoun presents no evidence to the contrary. Accordingly, OneBeacon is entitled to summary

judgment as to Calhoun's state law claims based on any statement by Templeton.

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Templeton also states in affidavit testimony he was not acting on behalf of, or as agent for,
TBPA or ART. Templeton Aff II ¶ 4,7 In response, Calhoun points to documents "that Templeton
signed as an agent" that are "styled with TBPA headings or contain directions to return the

documents to TBPA." Resp. to TBPA & ART Mot. Summ. J. [#71] at 14. Calhoun contends
because "[t]here is no showing in said documents that Templeton was not the agent of ARI!TBPA,"
neither TBPA nor ARI should be granted summary judgment on this basis. Id.

A review of the documents rebuts Calhoun's argument. The two documents are a request
for a quote for insurance and an application for insurance. Each is, indeed, signed by Templeton.

However, it is clear Templeton signed as an insurance agent for Calhoun, respectively seeking a

quote and applying for insurance from TBPA. Id. [#71-2] Exs. 1-A & 1-B. Rather than support

Calhoun's assertion, the two documents support the position of TBPA and ART that Templeton was
not acting on their behalf Accordingly, TBPA and ART are entitled to summary judgment as to

Calhoun's state law claims based on any statement by Templeton.
Templeton contends Calhoun cannot impose liability on him for alleged misrepresentations

concerning the differences between 0cc Acc and worker's compensation for several reasons. First,
Calhoun points to no evidence it ever communicated to Templeton a desire to obtain worker's
compensation insurance. Texas courts have declined to impose on an insurance agent a duty to
explain policy terms to an insured. Ruiz, 4 S.W.3d at 841; Garrison Contractors, Inc.

v.

Liberty

Mut. Ins. Co., 927 S.W.2d 296, 300 (Tex. App.El Paso 1996), aff'd, 966 S.W.2d 482 (Tex. 1998).

Therefore, absent some affirmative misrepresentation of the terms of coverage by an insurer, an

Both Beaty and L. Ray admitted in their depositions they had never spoken directly with anyone from ARI
or TBPA regarding the scope of coverage under the Policy or the differences between 0cc Acc and worker's
compensation insurance. See TBPA & ART's Mot. Summ. J. [#68-1], Ex. A at 100-03; id. [#68-3], Ex. C at 303.

-24-

insured's mistaken belief concerning the extent of coverage is not grounds for a misrepresentation
claim. Burton

v.

State Farm Mut. Auto. Ins. Co., 869 F. Supp. 480, 486 (S.D. Tex. 1994) (common

law claim); State Farm Cnty. Mut. Ins. Co.

v.

Moran, 809 S.W.2d 613, 620-2 1 (Tex. App.Corpus

Christi 1991, writ denied) (DTPA claim). Nor is an agent negligent for failing to obtain insurance

coverage of a type that was not requested. See Sonic Sys. Int'l., Inc.

v.

Croix, 278 S.W.3d 377,

393-94 (Tex. App.Hous. [14th Dist.] 2008, pet. denied) (finding no legal duty arises on part of
insurance agent owed to client merely because agent has knowledge of need for additional
insurance); Moore v. WhitneyVaky Ins. Agency, 966 S.W.2d 690, 692 (Tex.

App.San Antonio

1998, no pet.) (deciding agent did not breach any duty where insured admitted he never requested

a specific type of coverage and agent provided policy of insurance in accordance with understanding

of insured's expectations); see also West Hous. Airport, Inc. v. Millennium Ins. Agency, Inc., 349
S.W.3d 748, 754 (Tex. App.Hous. [14th Dist.] 2011, pet. denied) (finding insurance broker does
not have duty to disclose coverage limitations under comprehensive general liability policy unless

inclusion of limitation renders policy non-compliant with coverage requested by client).
Second, Calhoun's own summary judgment evidence demonstrates it was well aware it was

not purchasing worker's compensation insurance. The application referenced above was signed by

Beaty on behalf of Calhoun on August 1, 2006. In pertinent part, the application states "WE
ACKNOWLEDGE AND FULLY UNDERSTAND:"
THIS IS NOT A PROGRAM OF WORKERS' COMPENSATION INSURANCE,
WE DO NOT BECOME A SUBSCRIBER TO THE WORKERS'
COMPENSATION SYSTEM BY PURCHASING THIS COVERAGE AND IF WE
ARE A NON-SUBSCRIBER, WE LOSE CERTAIN COMMON LAW DEFENSES
TO SUIT AS WELL AS CERTAIN LIMITATIONS ON LIABILITY THAT
WOULD OTHERWISE ACCRUE UNDER THE WORKERS' COMPENSATION
LAWS. WE MUST COMPLY WITH THE WORKERS' COMPENSATION LAW
-25-

AS IT PERTAINS TO NON-SUBSCRIBERS AND THE REQUIRED
NOTIFICATIONS THAT MUST BE FILED AND POSTED.

Resp. to TBPA & ARI Mot. Summ. J. [#71-2] Ex. 1-A.
In addition, as set forth above, in 2010 Beaty and L. Ray began separately investigating the

differences between worker's compensation policies and occupational accident policies, and sought
the advice of an insurance agent other than Templeton in so doing. OneBeacon Mot. Summ. J. [#5 67] Ex.

0. Accordingly, the Court concludes Calhoun has not pointed to evidence showing the

requisite elements to establish a claim of fraud based on Templeton's email. See TIG Ins. Co.
Sedgwick James

v.

of Wash., 276 F.3d 754, 762-63 (5th Cir. 2002) (finding elements of common law

fraud including material misrepresentation, intent by defendant for plaintiffto rely on statement, and
actual reliance not satisfied by evidence insurance agent misunderstood general liability policy to

include additional insured clause).
Finally, as to Duane's 2011 letter, as noted above, Calhoun did not point to the letter as a

basis for any claim until responding to the motions for summary judgment. For this reason alone,
the letter cannot support a claim for relief by Calhoun. Moreover, the body of the letter refutes

Calhoun's contention Duane was assuring the renewed 0cc Ace coverage was comparable to

worker's compensation coverage. In the letter Duane states she is "excited to announce our new
program which will replace your current Occupational Accident product." Resp. to TBPA & ARI
Mot. Summ. J. [#71-2] Ex. 1 -D. Duane details several new features, none of which address coverage
differences between 0cc Ace and worker's compensation insurance. Duane then specifically states

"[ajil of your benefits have either remained the same or increased (as reflected above)." Id. Absent

-26-

from the letter is any affirmative misrepresentation concerning the scope of coverage afforded by the

Policy to Calhoun. Accordingly, the letter is insufficient to support a claim for relief by Calhoun.

Conclusion
Based on the foregoing, the Court GRANTS summary judgment in favor of OneBeacon,
TBPA, ARI, and Templeton, and DENIES Calhoun's motion for summary judgment. The only

remaining claims in this case are OneBeacon' s counterclaims for costs and attorney's fees against
Calhoun.

Accordingly,
IT IS ORDERED that OneBeacon America Insurance Company's Motion for

Summary Judgment [#56]; is GRANTED;
IT IS FURTHER ORDERED that Defendants Texas Business Purchasing Alliance,
Inc. and Assurance Resources, Inc.'s Motion for Final Summary Judgment [#68]; is

GRANTED;
IT IS FURTHER ORDERED that Third-Party Defendant Ty Templeton's Motion for

Summary Judgment [#74]; is GRANTED;
IT IS FiNALLY ORDERED that Third Party Plaintiff, L. Ray Calhoun & Co., d/b/a

Calhoun and Company, et al. 's Motion for Summary Judgment, or in the Alternative, Partial
Summary Judgment [#7 8] is DENIED.
SIGNED this the

27

day of January 2015.

SAM SPAR'?1
UNITED STATES DISTRICT JUDGE

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