Aetna Life Insurance v. Industrial Accident Commission

241 P.2d 530, 38 Cal. 2d 599, 1952 Cal. LEXIS 207
CourtCalifornia Supreme Court
DecidedMarch 18, 1952
DocketL. A. 22103
StatusPublished
Cited by33 cases

This text of 241 P.2d 530 (Aetna Life Insurance v. Industrial Accident Commission) is published on Counsel Stack Legal Research, covering California Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Aetna Life Insurance v. Industrial Accident Commission, 241 P.2d 530, 38 Cal. 2d 599, 1952 Cal. LEXIS 207 (Cal. 1952).

Opinions

SCHAUER, J.

Aetna Life Insurance Company seeks review of an order of the Industrial Accident Commission which denies Aetna’s claim of lien against $2,400 payable to Leo Y. Nowak, an employe of Consolidated Yultee Aircraft Corporation, under a compromise agreement between the employe and American Motorists Insurance Company, the workmen’s compensation insurance carrier of Yultee.

Petitioner contends, in effect, that the Industrial Accident Commission has failed in this ease to give effect to the legislative intention, declared in the Workmen’s Compensation Act (Lab. Code, § 4903, par. (f)) and the Unemployment Insurance Act (3 Deering’s Gen. Laws, Act 8780d, § 207) and emphasized by this court in Bryant v. Industrial Acc. Com. (1951), 37 Cal.2d 215 [231 P.2d 32], that a disabled workman is not entitled to unemployment compensation disability benefits for a period of unemployment caused by a disability for which he is entitled to workmen’s compensation. The record sustains this contention and the order of the commission must be annulled.

It was held in the Bryant case that, to make the declared intent effective, the Industrial Accident Commission, pursuant to paragraph (f) of section 4903 of the Labor Code, must allow a lien “against any amount to be paid as [workmen’s] compensation” for the “amount of unemployment compensation disability benefits which have been paid under or pursuant to the Unemployment Insurance Act in those cases where, pending a determination under [the workmen’s compensation law] . . ., there was uncertainty whether such benefits were payable under that act or payable [under the workmen’s compensation law].”

In the present case the Industrial Accident Commission contends that the lien cannot or should not attach to the amount payable under the compromise because that sum is not an “amount to be paid as [workmen’s] compensation.” This contention is untenable. The compromise payment comes [601]*601within the definitions of “compensation” as enunciated in sections 3207 and 5001 of the Labor Code. (See footnotes 2 and 3, infra, p. 604.) To sustain the contention would not only derogate the statute but would permit the Industrial Accident Commission to adopt and effectuate a policy sharply contrary to that which has been clearly declared by the Legislature and which has been expressly upheld by this court. (Bryant v. Industrial Acc. Com. (1951), supra, 37 Cal.2d 215.)

The history of this proceeding is as follows: Nowak, the employe, was unable to work for several months because of a disabled back. He claimed that his disability was the result of an industrial injury and filed his application for adjustment of claim with the Industrial Accident Commission. American Motorists Insurance Company, the workmen’s compensation insurance carrier, denied liability.

Aetna, during the period in question, was the insurer of Vultee, the employer, under a voluntary plan for the payment of unemployment compensation disability benefits and other benefits, including medical expenses, where an employe became unable to work because of a nonindustrial injury. This plan was adopted pursuant to the Unemployment Insurance Act (3 Deering’s Gen. Laws, Act 8780d, art. 10, pt. 6). Aetna paid $1,256.05 unemployment disability benefits, other benefits which were used for living expenses, and medical expenses. It filed its claim of lien for the amount of these payments with the Industrial Accident Commission in the proceeding brought by Nowak against American Motorists Insurance Company. On this claim Nowak endorsed the following: “I consent to the requested allowance of a lien against my compensation.”

Nowak and American Motorists negotiated a compromise of their controversy as to whether Nowak was entitled to workmen’s compensation. Their agreement recites, as the reason for compromise, that “grave dispute exists as to whether there was an injury arising out of and in course of the employment, and if so, whether said injury resulted in the condition of which applicant complains. There is also dispute as to whether there is resultant permanent disability. The parties seek to avoid the hazards of further litigation.” They “agree to settle any and all claims on account of said injury by the payment of . . . $2,400.00 ... in one lump sum, less attorney’s fees as set by the Commission.” The compromise agreement does not mention Aetna’s claim of lien.

[602]*602Shortly after the compromise was presented to the Industrial Accident Commission for approval, the employe’s attorney wrote to the Industrial Accident Commission stating that the employe and the workmen’s compensation insurance carrier 1 ‘ contemplated that the lien of Aetna Life Ins. Co. would not be observed. For that reason, the reason for the Compromise and Release was specifically framed so that it went only to resolvement of the issue of injury and to the issue of permanent disability”; that “Aetna has merely paid what is its true share considering the fact that applicant’s condition may have been wholly or partially non-industrial.” A copy of this letter was sent to Aetna. Aetna then wrote to the Industrial Accident Commission stating, “We believe that the only reason for the proposed compromise is an effort on the part of the applicant to retain the $1,200 admittedly paid to him by the Aetna Life Insurance Company and an effort on the defendant’s part to help him retain it, thereby saving them the payment of an equal amount in order to effect compromise. The issue of the Aetna Life Insurance Company’s lien is before the commission and we do not believe the applicant and the defendant have a legal right to in effect destroy our statutory lien by agreement simply by stating that the compromise does not intend to dispose of certain issues.” Aetna’s letter requested a further hearing. Such hearing was had. Aetna established that it had paid $1,256.05 in medical expenses and weekly payments which the employe used for living expenses and that its policy did not cover industrial injuries.

At that hearing (and in its petition for rehearing) Aetna directed the referee’s attention to the opinion of the District Court of Appeal in Bryant v. Industrial Acc. Com. (1950), reported at (Cal.App.) 224 P.2d 444. This is the Bryant case in which we granted a hearing and the final opinion in which is reported at 37 Cal.2d 215 [231 P.2d 32]. While the Bryant case was pending in this court the Industrial Accident Commission made the order here attacked; it approved the compromise and ordered that Aetna’s claimed lien be denied and that Aetna be dismissed from the proceeding.

The Industrial Accident Commission takes the position that an essential basis for application of paragraph (f) of section 4903 of the Labor Code and the principles enunciated in the Bryant case is the determination by that commission that the disabling injury was sustained in circumstances which entitle the disabled employe to workmen’s compensation dur[603]*603ing a period for which he has received unemployment compensation disability benefits, and that, for the benefit of the injured workman, it can leave open the question whether his injury was industrial, and that a person in the position of Aetna, who has advanced disability payments prior to determination of the issue, has no right to have the issue determined.

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Bluebook (online)
241 P.2d 530, 38 Cal. 2d 599, 1952 Cal. LEXIS 207, Counsel Stack Legal Research, https://law.counselstack.com/opinion/aetna-life-insurance-v-industrial-accident-commission-cal-1952.