Workers in Grand Prairie, Arlington, Irving, Fort Worth, Dallas, Mesquite, Garland, Richardson, Carrollton, Hurst, Euless, Bedford, or anywhere else in Texas may wonder about this situation. What if you are hurt at work while driving a company vehicle, your employer has workers compensation benefits you seek and obtain, and the vehicle has underinsured / uninsured (UM) benefits purchased by your employer? Can you obtain the UM benefits?
The Amarillo Court of Appeals had this issue come up in a case they issued an opinion in on September 26, 2011. The style of the case is, Robert Smith v. City of Lubbock and St. Paul Fire and Marine Insurance Company.
This case was an appeal from a summary judgment in favor of Lubbock and St. Paul. This court reversed as it relates to St. Paul but affirmed the decision as it relates to the employer, City of Lubbock.
The issue was whether or not the Texas workers compensation laws bar an employee from suing his employer upon an UM injury suffered by the employee while working. The damages at issue arose when Smith was struck by an intoxicated driver while Smith was working for Lubbock. The intoxicated driver was not an employee of Lubbock nor was he sufficiently insured. So, Smith made a claim for UM benefits under the policy purchased by Lubbock for its employees, even though he already received workers’ compensation benefits. The claim was denied and this lawsuit resulted.
Lubbock argued that the state workers’ compensation laws barred Smith from additional recovery. Smith claimed those statutes only precluded recovery for work-related injuries arising from common law torts as opposed to a contract and his claim arises from an insurance contract.
Here are some undisputed facts:
First, Lubbock acquired the policy from St. Paul on behalf of its employees.
Second, Smith was an employee of Lubbock at all times relevant.
Third, Smith suffered injuries at the hands of a drunk driver while Smith was within the course and scope of his employment.
Fourth, Lubbock paid for Smiths injuries through its workers compensation plan / insurance.
Pursuant to Texas Labor Code, Section 408.001(a), “Recovery of workers’ compensation benefits is the exclusive remedy of an employee covered by workers’ compensation insurance coverage or a legal beneficiary against the employer or an agent or employee of the employer for the death of or a work-related injury sustained by the employee.”
Smith is asking the court to interpret the statute as simply referring to tort claims, not those arising from contract.
In discussing this case the court pointed out that the statute does not contain the words “tort” or “negligence.” It does not mention a particular chose-in-action. Given that the common law choses-in-action of tort and contract have existed for more than a century, it is safe to presume that the legislators knew of them when enacting Section 408.001(a). Yet, they opted not to express them in the statute. Instead, they incorporated terms focusing upon a remedy for particular injuries, not a cause of action through which remedies are generally sought. Those terms were “workers’ compensation benefits” being the “exclusive remedy” for “work-related injuries” encountered by employees “covered by workers’ compensation insurance.”
It cannot be doubted that breach of contract is a common law claim. So, it would seem that Smith’s effort to categorize his claim upon the policy as one for breached contract to trump the exclusivity provision is of little value to him.
Simply put, if an employee suffers work-related injuries and seeks their redress from an employer that subscribes to a workers’ compensation program, there is only one way to obtain them. It is through that compensation program. It does not matter if the employer provides those benefits from its own pocket or via a contract with a third party insurer; once it provides them, statute bars the employee from forcing the employer to redress the injuries through other means. For the court to rule otherwise would provide the employee a backdoor way of recovering more from his employer than the exclusive workers’ compensation remedy.
This case was an attempt by Smiths’ attorney to maximize a recovery for Smith that did not work out.