ISIA Spring Meeting

ISIA Spring Meeting June 11, 2010

Case Law Update

Robert Fanning

Indiana Supreme Court

Smith v. Champion Trucking - Smith was employed by Champion and was injured at work. Champion paid $4,342.42 in medical expenses. The injury was caused by a third party and Smith settled with the third party for $10,342. A few weeks later, Smith was assigned a PPI rating worth $26,500 in additional compensation and demanded that from Champion. Champion claimed that the third party settlement was a complete bar to an additional worker's compensation recovery. The Board agreed with Champion, the Court of Appeals reversed, holding that the termination provision of the Act did not apply to cases pending at the Board, and the Supreme Court reversed the Court of Appeals, holding that the third party settlement released the third party and the Workers' Compensation Act clearly provides that a settlement with a third party without the employer's consent bars the workers' compensation claim.

Washington Township v. Beltway - Washington Township underpaid Beltway's medical billing based on a review by a billing review service. Beltway filed an Application with the Board claiming that the payment was not consistent with Indiana law. The Board held that Washington Township had the burden of proving that the amount It paid was consistent with Indiana law; that is, at the 80th percentile of all charges for like service in the same community. The Court of Appeals agreed with the Board and the Supreme Court affirmed that decision.

Indiana Court of Appeals

Tony v. Elkhart County - Tony was injured while working for Elkhart County. He returned to work with restrictions, but claimed that his restrictions were being ignored and that his complaints about that resulted in his being told not to complain anymore and his co-workers being told that he was a "faker". Tony quit his job and filed a civil suit against Elkhart County, claiming that its actions amounted to a constructive discharge in retaliation for his making a workers' compensation claim. The Trial Court dismissed his case, but the Court of Appeals reversed that decision and held that in Frampton v. Central Indiana Gas Co., a discharge from employment in retaliation for the exercise of a statutory right was held to be an exception to the employment at will doctrine, and Elkhart County's actions could be held to have been so intolerable that Tony had no other option but to resign, therefore creating constructive retaliatory discharge.

Barrett v. City of Brazil - Barrett was killed by a third party in a work related accident. The third party was ordered to pay $4,350 in restitution to Barrett's widow. The insurance company for the third party vehicle tendered its $50,000 policy limits, and Barrett's insurance company tendered its $50,000 underinsured motorist policy limits. Barrett's widow filed a workers' compensation case, and City of Brazil asked the Board to dismiss the the claim based on the fact that $104,350 had been paid on behalf of the third party, and the Board dismissed the case. The Court of Appeals reversed, holding that the payments were other than by agreement. They were judgments for a lesser sum than the amount of the workers' compensation payable, and therefore, Barrett's widow could pursue the workers' compensation case by assigning the rights under the judgments to City of Brazil.

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