Bestor v. Service Lloyds Ins. Co
In Bestor v. Service Lloyds Ins. Co., 276 S.W.3d 549 (Tex. App.--Waco 2008, no pet.), the claimant alleged that the insurer's refusal to pay compensation benefits was tantamount to a breach of contract.
Therefore, he sued Service Lloyds under that common law theory to recover the administrative attorneys fees incurred while prosecuting his claim before the Texas Workers' Compensation Commission (TWCC).
Despite finding logical basis to Bestor's legal theory, the appellate panel nonetheless concluded that logic had to "yield to the requirement that he have exhausted his claim administratively." Id. at 552.
In other words, the question of whether he could recover his attorney's fees fell within the Commission's exclusive jurisdiction.
This was so because the demand for attorney's fees was "based on Service Lloyd's dispute of Bestor's entitlement to worker's compensation benefits." Id. at 553.
It did not matter if the claim implicated contract or tort principles causes of action; whether the Commission had exclusive jurisdiction over it depended upon whether the claim was "based on" an alleged delay or denial of worker's compensation benefits. Id.