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Steele v. Murphy & Beane, Inc.

Court of Appeals of Texas, Sixth District, Texarkana

July 10, 2019


          Submitted: July 2, 2019

          On Appeal from the 250th District Court Travis County, Texas Trial Court No. D-1-GN-18-005640

          Before Morriss, C.J., Burgess and Stevens, JJ.



         Viacom, Inc., hired Melanie Steele as an independent makeup artist to work on an Austin, Texas, set for a television series produced by Viacom in 2006 called Meet the Bulldogs.[1] When the Viacom production team "cut the lights for filming purposes," Steele fell down two flights of stairs and suffered severe injuries, including broken and cracked teeth, lacerations to the face and body, broken bones, a bruised back, a strained neck, head trauma, and a torn meniscus in each knee, ultimately leading to double knee replacement surgery.

         After the accident, Steele received correspondence from Murphy & Beane, Inc., a third-party administrator from California, informing her of treatment plans and benefits. Their handling of Steele's claim, including a dispute over the need for total knee replacement surgery, led to a lawsuit filed by Steele against both Murphy & Beane and Viacom for fraud, fraudulent inducement, gross negligence, and violations of the Texas Deceptive Trade Practices Act and Texas Insurance Code. Murphy & Beane and Viacom filed a plea to the jurisdiction which argued that the Texas Department of Insurance, Division of Workers' Compensation (Division), had exclusive jurisdiction over Steele's claims and that Steele failed to exhaust administrative remedies.

         The trial court granted the plea to the jurisdiction and dismissed Steele's claims, without prejudice, to allow her to exhaust administrative remedies. Steele appeals. Because we agree with the trial court's conclusion that Steele did not exhaust administrative remedies with the Division, we affirm the trial court's judgment.

         I. Factual and Procedural Background

         After the accident, Steele said a Viacom employee took her to the hospital so she could receive medical care under Viacom's Self Insurance Group as a result of the injury she suffered while working in Texas in the course and scope of her employment with Viacom. Steele countersigned a Texas Workers Compensation Work Status Report.

         According to Steele's petition, Murphy & Beane's agent informed her that she had a "complicated case because the injury happened in Texas but the company handling the claim was from California." Steele asserted that the agent never told her that Murphy & Beane was seeking to transfer the claim from Texas to California, but that they did so by filing an Employer's Report of Occupational Injury or Illness in California with the Department of Industrial Relations two months after her injury. Steele also complained that Murphy & Beane failed to inform her that the case should be handled under the Texas Workers' Compensation System, failed to file the claim in Texas, and

misrepresented to [Steele] that (a) [Steele's] accident occurred in California, that (b) [Steele] was an employee located primarily in California, that the claim was a California claim, and not a Texas claim, that (c) she could not seek treatment from doctors of her choosing, that (d) she would have to travel to California to receive a [panel qualified medical examination (QME)], and that (e) Murphy & Beane could close her case for non-compliance.

Steele claimed that when she travelled to California for the QME, following a threat to terminate coverage by Murphy & Beane, she was informed that no doctor was available to see her. Because she returned to Texas without receiving a QME, Steele complained that it was "difficult to receive medically necessary treatments without either having to undertake unnecessarily difficult and repeated negotiations with Murphy & Beane, or just having the requested treatments flat out denied."

         Steele also asserted that, acting on behalf of Viacom, Murphy & Beane continuously injured her by misrepresenting workers' compensation coverage available to her, by applying the improper medical-treatment guidelines of California rather than Texas, not timely filing the injury notice in Texas, misrepresenting that the injury occurred in California, not properly registering the self-insured group or third-party administrator in Texas, claiming that Steele was a regular employee domiciled in California, not timely filing a notice of injury claim in California, actively obstructing Steele's ability to receive medically necessary treatment in her home state, and misrepresenting to Steele that her coverage could be canceled by Murphy & Beane for not complying with requests to cease seeking treatment or for refusing to fly to California to receive a QME.

         As a result of these actions, Steele sued in Travis County in 2016, but the Austin Court of Appeals issued a writ of mandamus compelling the trial court to dismiss Steele's claims for lack of subject-matter jurisdiction because (1) the Division had exclusive jurisdiction over Steele's claims and (2) she had not exhausted administrative remedies. In re Murphy & Beane, ...

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