In a disappointing decision, the Fifth Court of Appeals in Dallas let Texas Mutual off the hook for altering a medical record. The decision is Texas Mutual Insurance Company v. Juan Narvaez.
After a reported work injury, an emergency room doctor at Parkland hospital recorded on a progress note that Mr. Narvaez described lower back pain. A Texas Mutual adjuster took that hospital record and wrote in “x 3 mos” meaning “times three months.” Then, Texas Mutual used the document at depositions. Then, Texas Mutual used the document at trial purporting it to be evidence in front of a Dallas jury. Texas Mutual’s lawyer even submitted the document to the Court under a business record affidavit, claiming it to be a true and correct record from the hospital. And, the Fifth Court of Appeals, in an opinion written by Chief Justice Carolyn Wright, said this was ok.
When it became clear during the trial that the document had been altered, the trial court judge, Martin Hoffman, declared a mistrial and sanctioned Texas Mutual for litigation fraud. He conducted a hearing to determine what occurred, then issued an order finding that the state’s largest workers compensation insurer knowingly and fraudulently altered the medical record. As a sanction, the judge ordered Texas Mutual to post his ruling on its website under the section labeled “fighting fraud.” He also granted summary judgment favor of Mr. Narvaez.
Not surprisingly, Texas Mutual issued a press release boasting their “delight” with the ruling, as if to say “look at us, we faked a document and got away with it.” Texas Mutual’s litigation conduct, and the appeals court’s apparent approval of it, demonstrate the need for real and substantial legislative insurance reform in the Texas workers’ compensation system.