No Duty to Defend Intentional Tort Claim

In a per curiam opinion, the NJ Appellate Division affirmed that a workers’ compensation insurance company is not required to defend an intentional tort claim following a Section 20 resolution.

Intentional Tort v Negligence

A New Jersey appellate court found that an employee could not proceed with an intentional tort claim against an employer because the evidence needed to meet the two-prong standard was lacking.

Workers' Compensation Insurance: Intentional Wrong?

Employers' liability insurance policies generally exclude coverage for "intentional wrongs" committed against employees, even if those employees also pursue workers' compensation claims.

Navigating the Complexities of Workers' Compensation Exclusivity in New Jersey

The recent decision in Lopez v. Corozal Auto Repair Inc., a case heard in the United States District Court for the District of New Jersey, provides valuable insights into the intricate legal landscape of workers' compensation law. Specifically, the court delved into the critical issue of the exclusivity rule and its narrow exceptions, particularly focusing on intentional wrong claims under NJSA 34:15-8.

Intentional Tort Claim Barred by the Exclusivity Rule

The New Jersey Workers Compensation Act (WCA), N.J.S.A. 34:15-1 to -146, generally prohibits employees from suing their employers for injuries sustained in workplace accidents. In a recent case the Court probed the boundaries of the "intentional wrong" exception to that general rule.

NJ Supreme Court to Review Workplace Insurance Exclusion

The NJ Supreme Court will review whether a workers’ compensation insurance company has a duty to defend an employer against personal injury claims brought by the employer’s employee under an employer's liability insurance policy.

Workplace Injury: No Civil Recourse

A recent decision by the New Jersey Superior Court, Appellate Division, highlighted the application of the Workers' Compensation Act's exclusivity bar in a case involving a fatal parking lot accident on employer property. The court in Faisal Jameel v. HMH Hospitals Corporation affirmed the dismissal of a civil lawsuit against the employer, finding that workers' compensation covered the tragic incident and did not meet the high standard for the "intentional wrong" exception.

Workers' Compensation Bar Prevails

The New Jersey Appellate Division affirms the exclusivity of workers' compensation in a workplace-fall case.

NJ Supreme Court Limits Employer Insurance Coverage for Worker Injuries

In a recent decision, the New Jersey Supreme Court clarified the scope of insurance coverage for employers facing lawsuits from injured workers. The case Dionicio Rodriguez v. Shelbourne Spring LLA addresses whether an employer's liability insurance policy covers claims of gross negligence, recklessness, and intentional misconduct brought by an employee who has already received workers' compensation benefits.

Trench Injury Not an Intentional Wrong

A Federal Court held that injuries sustained while cleaning a trench conveyor trim removal system at a paper manufacturing facility did not meet the threshold test for an intentional tort.

Failure to Assist Not Actionable

 For a workplace injury claim to bypass the exclusive New Jersey Workers' Compensation Act, the employer's conduct must be an "intentional wrong" – meaning they knew injury or death was virtually certain, and the injury is beyond the scope of typical industrial employment. Simply entrusting an injured employee to a friend for transport to medical care generally doesn't meet this high bar.

Podcast: A Federal Court Analyzes an Intentional Wrong Claim

The recent US District Court decision in Lopez v. Corozal Auto Repair Inc. delves into the critical issue of the exclusivity rule and its narrow exceptions, focusing on intentional wrong claims under NJSA 34:15-8. To expand the discussion among all workers' compensation community stakeholders, we have generated a free podcast on this topic.

Horseplay Is Not an Intentional Tort

Pranks at work may be considered “arising out of the course of employment” and compensable events. Those same injuries are not considered intentional events and would not give rise to cause a civil action against an employer for damages for pain and suffering. 

Not A Violation of Public Policy

In rejecting an employee’s attempt to go forward with a lawsuit directly against an employer, the NJ Appellate Division ruled, in an unreported case*, that an employee, in a novel argument,  may assert the “violation of public policy” as an allegation.

NJ Supreme Court Bars Expansion of Injured Workers Remedies

Additional tort claim disallowed against insurance companies for intentional failure to comply with court of compensation's, an administrative agency, order to provide provide benefits.

Wade Stancil v. ACE USA (067640)
Argued 3/26/12 Decided 8/1/12 see http://tinyurl.com/d4pycqw

SYLLABUS 

(This syllabus is not part of the opinion of the Court.  It has been prepared by the Office of the Clerk for the 

convenience of the reader.  It has been neither reviewed nor approved by the Supreme Court.  Please note that, in the 

interests of brevity, portions of any opinion may not have been summarized.) 

Wade Stancil v. ACE USA (A-112-10) (067640) 

Argued March 26, 2012 -- Decided August 1, 2012

HOENS, J., writing for a majority of the Court.

The Court considers whether an injured employee may sue his employer’s compensation carrier for pain and suffering caused by the carrier’s delay in paying for medical treatment, prescriptions, and other services. Plaintiff Wade Stancil was injured in 1995 while employed by Orient Originals.  He received workers’ compensation benefits from his employer’s compensation carrier, defendant ACE USA (ACE).  In 2006, following a  trial, the court of compensation determined that Stancil was totally disabled.  In 2007, Stancil filed a motion in the compensation court seeking an order compelling ACE to pay outstanding medical bills.  

During a hearing on the motion, the compensation judge commented that ACE had a history of failing to make payments when ordered to do so.  On September 12, 2007, the compensation judge granted Stancil’s motion, warned ACE against any further violation of the order to pay, and awarded Stancil counsel fees.  On October 29, 2007, the parties returned to the compensation court for a further proceeding relating to the disputed bills.  After finding that the bills identified in the September 12 order remained unpaid and that ACE’s failure to make payment was a willful and intentional violation of the order, the court issued another order compelling ACE to make immediate payment and again awarding counsel fees.  

The court commented on its limited ability to ensure that carriers would comply with orders, noted that it lacked the authority to enforce orders through contempt proceedings, found that Stancil had exhausted his administrative remedies, and suggested that he seek further relief in the Superior Court.  In 2008, Stancil underwent additional surgery and psychiatric treatment.  Stancil’s physician attributed the need for additional treatment to an earlier treatment delay caused by the carrier’s delay in paying medical providers.  

On April 15, 2009, Stancil filed this lawsuit in the Superior Court.  In his complaint, Stancil claimed that ACE required him to undergo medical examinations by physicians of its own choosing and then rejected the recommendations of those physicians and refused to authorize the recommended medical care.  The complaint stated further that Stancil obtained orders from the compensation court, but ACE failed to comply.  Stancil contended that ACE’s failure to authorize needed treatment caused him unnecessary pain and suffering, a worsening of his medical condition, and expenses that should have been paid by ACE.  ACE responded by filing a motion to dismiss the complaint.  ACE argued that the Workers’ Compensation Act, N.J.S.A. 34:15-1 to -142 (the Act), is the exclusive remedy for the claims pled in the complaint and therefore no damages could be awarded.  The trial court granted ACE’s motion.  The court analyzed the impact of then-recently adopted amendments to the Act and found that the Legislature had foreclosed resort to the Superior Court for the kind of tort-based relief demanded by Stancil.

The Appellate Division affirmed.  418 N.J. Super. 79 (App. Div. 2011).  The panel agreed with the trial court that The Legislature’s amendments to the Act foreclosed Stancil’s claims.  The panel also rejected Stancil’s argument that ACE’s willful disregard of compensation court orders met the Act’s intentional wrong exception to the litigation bar. The Supreme Court granted certification limited to determining whether an employee who suffered a work-related injury has a common-law cause of action for damages against a workers’ compensation carrier for its willful failure to comply with court orders compelling it to provide medical treatment when the delay or denial of treatment causes a worsening of the employee’s medical condition and/or pain and suffering.  207 N.J. 66 (2011).  

HELD:  An injured employee does not have a common law right of action against a workers’ compensation carrier for pain and suffering caused by the carrier’s delay in paying for or authorizing treatment because 1) the workers’ compensation system was designed to provide injured workers with a remedy outside of the ordinary tort or contract remedies cognizable in the Superior Court; 2) in amending the Workers’ Compensation Act in 2008, the Legislature rejected a provision that would have given the compensation courts broader permission to authorize a resort to the Superior Court and adopted a remedy that permits compensation courts to act through a contempt power; and 3) 2allowing a direct common-law cause of action against a carrier would undermine the workers’ compensation system by substituting a cause of action that would become the preferred manner of securing relief.

CHIEF JUSTICE RABNER, JUSTICE LaVECCHIA, and JUDGE WEFING (temporarily assigned) join  in JUSTICE HOENS’s opinion. JUSTICE ALBIN filed a separate, dissenting opinion. JUSTICE  PATTERSON did not participate.

Related Blog Articles

Workers' Compensation: Bad Faith Claims Maybe Going to the Jury

Aug 05, 2011

The lower court had rejected the case and dismissed it holding that the jurisdiction for bad faith is exclusively within the purview of the Division of Workers' Compensation. Stancil v. ACE USA, 418 N.J. Super. 79, 12 A. 3rd 223...

http://workers-compensation.blogspot.com/

NJ Supreme Court To Rule on Several Critical Issues

Apr 23, 2012

A-112-10 Wade Stancil v. ACE USA (067640). 3. The Exclusivity Rule: Under the circumstances of this case, which include a finding by the federal Occupational Safety and Health Administration that the accident was the result ...

http://workers-compensation.blogspot.com/

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Willful OSHA Violation Alone Not Enough Alone to Circumvent the Exclusivity Doctrine

"New Jersey’s Workers’ Compensation Act (the Act), N.J.S.A. 34:15-1 to -128.5, provides a prompt and efficient remedy for an employee’s claim against an employer for a workplace injury. The Legislature made the statutory workers’ compensation remedy  its preferred mechanism for providing compensation to injured  workers......Based on the strong legislative preference for the workers’ compensation remedy and an intentional-wrong standard that even an employer’s recklessness and gross negligence fails  to satisfy, we hold that this matter falls short of demonstrating that an intentional wrong creating substantial certainty of bodily injury or death occurred. " Justice LaVecchia

A finding of a willful OSHA violation is not conclusive in determining whether the employer committed an intentional wrong for the purposes of the Workers' Compensation Act. Instead, it is one factor among the totality of circumstances to be considered. The issuance of a willful OSHA violation against employer (trench collapse injury) was insufficient to defeat a motion for summary judgment, so the Court examined the totality of the circumstances of the accident and applies the conduct and context prongs of the substantial-certainty standard.

In reviewing the substantial certainty of injury prong of the dual test to determine employer liability beyond workers' compensation, the court distinguished this case from all prior decisions by relying upon the fact that the employer did not intentionally remove a safety device. Noting that the employer's actions in this circumstance, failure to have a proper trench preventing collapse system in place, where the soil was poor in violation of OSHA provisions, did not eliminate the exclusivity of remedy. The court specifically indicated that an employer should not be mearly penalized for actions taken for economic business motivation.

Furthermore, the high threshold of the content prong of the test was not satisfied the court enunciate. "...The type of mistake in judgment by the employer and ensuing employee accident that occurred on this construction site was so far outside the bounds of industrial life has never to become contemplated for inclusion in the Act's exclusively bar," ie. mere violation of an OSHA safety requirements.

Van Dunk v. Reckson Associates Realty Corporation, 2012 WL 2377854 (2012).
 

Related articles

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Dual Employment Status Bars Double Recovery

An employee may have dual employers but ultimately can only receive a single recovery from only one employer for work-related injuries. The “exclusivity doctrine,” permitting a complete recovery of damages against an employer, limits an injured worker’s benefit recovery to the compensation system, barring an intentional tort.

Insurance Coverage Denied in Employee Suit

A recent case, Rice Enterprises, LLC v. RSUI Indemnity Co., highlights the complexities of insurance coverage for employers facing lawsuits from employees. The case involved a former employee who sued Rice Enterprises for negligence related to alleged sexual harassment and assault by a manager. Rice Enterprises sought coverage under its insurance policies, specifically a Workers' Compensation and Employers' Liability policy from Zenith Insurance Company and a Commercial Umbrella liability policy from RSUI Indemnity Company.  

The Exclusivity Rule Is Not A Bar to a Discrimination Action

The New Jersey Supreme Court ruled that an employer could be liable under both the Law Against Discrimination Act [LAD] and the Worker's Compensation Act (WCA). Court reasoned that the dual remedies can work in harmony as they are both statutory claims. The Court noted that the common law remedies of the LADs are not prohibited by the WCA since they are statutory in nature. By allowing both claims to go forward, a worker is not limited to the statutory caps for recovery under the Worker's Compensation Act.

Workers' Compensation News - July 10, 2007, Vol. 5 Issue 107

Workers' Compensation News - July 10, 2007, Vol. 5 Issue 107

FLORIDA EXPANDS INTENTIONAL TORT EXCEPTION Employee's injury was substantial certainty from employer's failure to respond to requests for new ladder did not require proof that employer concealed danger. "Even though case law on the intentional tort exception to workers' compensation immunity is devoid of any defined test that will establish substantial certainty as a matter of law, it is evident that concealment of the dangerous condition is only one of several factors in a nonexclusive list. " Bakerman v The Bombay Company, ___So. 2d____, 2007 WL 1774420 (Fla.), decided June 21, 1007

OSHA ORDERED TO RELEASE TOXIC EXPOSURE DATABASE — More than 25 Years of Workplace Sampling Yields Public Health Research Bonanza Washington, DC — The U.S. Occupational Safety & Health Administration (OSHA) has wrongfully withheld data documenting years of toxic exposures to workers and its own inspectors, according to a federal court ruling posted today by Public Employees for Environmental Responsibility (PEER). As a result, the world’s largest compendium of measurements of occupational exposures to toxic substances - more than 2 million analyses conducted during some 75,000 OSHA workplace inspections since 1979 - should now be available to researchers and policymakers. Each year, an estimated 40,000 U.S. workers die prematurely because of exposures to toxic substances on the job. Press Release: http://www.peer.org/news/news_id.php?row_id=882 Decision: http://www.peer.org/docs/dol/07_02_07_finkel_foia_ruling.pdf


ASBESTOS: Travelers Settles AC&S Claims The Travelers Cos. Inc. said today it has settled litigation with ACandS Inc., a former distributor and installer of asbestos products, for $449 million.http://www.courant.com/business/hc-trav-litig,0,1651056.story

ASBESTOS: NO SAFE LEVEL OF EXPOSURE Cong. Jerrold Nadler (D-NY) held a hearing on June 25 on the federal government’s response to the hazardous air contaminants that polluted lower Manhattan after the 9/11 attacks. The featured witness was former EPA administrator Christine Todd Whitman, who was in the hot seat for her claims that the air in NYC was safe to breathe. Much less attention was paid to former OSHA assistant secretary John Henshaw, who sat next to Whitman, but was left largely unscathed by the questioning. At least one Henshaw exchange deserves attention. The former OSHA chief insisted there are “safe levels of exposure to asbestos.” FYI: The WHO’s policy statement on the elimination of asbestos-related disease is here and the Institute of Medicine’s report on Asbestos: Selected Cancers (2007) is here. http://thepumphandle.wordpress.com/2007/07/06/safe-levels-of-asbestos-by-john-henshaw/

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