AIG/AIU Insurance Co. v. South Akers Mining Co.

192 S.W.3d 687, 2006 WL 140571
CourtKentucky Supreme Court
DecidedJune 15, 2006
Docket2005-SC-0178-WC
StatusPublished
Cited by12 cases

This text of 192 S.W.3d 687 (AIG/AIU Insurance Co. v. South Akers Mining Co.) is published on Counsel Stack Legal Research, covering Kentucky Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
AIG/AIU Insurance Co. v. South Akers Mining Co., 192 S.W.3d 687, 2006 WL 140571 (Ky. 2006).

Opinion

OPINION OF THE COURT

On September 16, 1999, Ronnie Charles was killed in a roof fall accident while working for the defendant-employer as an underground coal miner. It was later found that the accident resulted from the employer’s intentional violation of several mine safety statutes and regulations and that his surviving spouse and minor child were entitled to increased benefits under KRS 342.165(1). Affirming decisions by an Administrative Law Judge and the Workers’ Compensation Board, the Court of Appeals determined that the employer’s workers’ compensation insurance carrier was hable for the increased benefits that KRS 342.165(1) authorized although a term in the insurance contract excluded such coverage. We affirm.

*688 Appealing, the insurance carrier relies upon the terms of its contract with the defendant-employer. It argues that the parties had the right to contract freely and that there is no conflict between the terms of their agreement and the public policy embodied in KRS 342.165(1). The carrier maintains that the purpose of the statute is to promote workplace safety by penalizing employers for safety violations. Therefore, sums paid under the statute are properly viewed as being a penalty for which the employer is liable rather than compensation to the injured worker or his surviving dependents.

The contract of insurance provided, in pertinent part, as follows:

F. Payments You Must Make
You are responsible for any payment in excess of the benefits regularly provided by the workers!’] compensation law including those required because:
1. of your serious and willful misconduct;
2. you knowingly employ an employee in violation of law;
3. you fail to comply with a health or safety law or regulation; or
4. you discharge, coerce or otherwise discriminate against any employee in violation of the workers!’] compensation law.
If we make any payments in excess of the benefits regularly provided by the workers!’] compensation law on your behalf, you will reimburse us promptly-

Workers’ compensation is statutory. Among the purposes of Chapter 342 is to assure that the costs of production include compensation to the victims of work-related accidents, thereby enabling them to meet their ongoing needs for the essentials of life and preventing them from becoming dependent on public assistance. Consistent with this purpose, KRS 342.340(1) requires every employer that is subject to Chapter 342 to insure its “liability for compensation” with an authorized carrier or to furnish proof of its financial ability to self-insure. KRS 342.365 requires that a carrier issuing a policy against liability under Chapter 342 must agree to pay promptly “all benefits conferred by this chapter and all installments of the compensation that may be awarded or agreed upon” and that the carrier’s agreement “shall be construed to be a direct promise by the insurer to the person entitled to compensation, enforceable in his name.” KRS 342.375 provides that every policy or contract of insurance “shall cover the entire liability of the employer for compensation to each employee subject to this chapter.” 1 It permits employers to have separate policies for specific locations, provided that the liability to each employee is secured and no employee loses any benefit rights.

Although freedom of contract is a basic right, the legislature has determined that an employer’s entire liability for workers’ compensation benefits must be secured as a matter of public policy. KRS 342.340(1); KRS 342.365; and KRS 342.375. Therefore, workers’ compensation insurance policies must comply with Chapter 342 by covering the employer’s entire liability, including the liability imposed by KRS 342.165(1). See Beacon Insurance Company of America v. State Farm Mutual Insurance Company, 795 S.W.2d 62 (Ky.1990). This assures that injured workers or their surviving dependents will receive all of the benefits to which they are entitled.

By their very nature, workers’ compensation acts involve trade-offs by employers and workers. By securing the *689 payment of compensation and operating under Chapter 342, employers avoid common law liability for the effects of their tortious conduct unless it involves “willful and unprovoked physical aggression” by an employee, officer, or director. KRS 342.690(1); Shamrock Coal Co. v. Maride, 5 S.W.3d 130 (Ky.1999). Chapter 342 holds an employer liable for medical benefits and limited amounts of income benefits but relieves the employer of liability for pain and suffering and for punitive damages even in instances where the accident causing an injury results from the employer’s intentional safety violation. An injured worker foregoes the right to damages in exchange for the right to receive statutorily-determined compensation without regard to fault.

As defined in KRS 342.0011(14) “compensation” consists of income benefits and medical and related benefits. Chapter 342 provides for income benefits in amounts that do not replace all of the injured worker’s lost wages. 2 In instances where the accident resulting in an injury is due to an employer’s intentional safety violation, the 1999 version of KRS 342.165(1) provides for a 15% increase in “the compensation for which the employer would otherwise have been liable under this chapter.” If a safety violation by the worker contributed to causing the accident, compensation is decreased by 15%.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

D.W. Wilburn, Inc. v. Wade Massengill
Court of Appeals of Kentucky, 2021
Judy Construction v. Shawn Smith
Kentucky Supreme Court, 2019
McCoy Elkhorn Coal Corp. v. Sargent
553 S.W.3d 802 (Missouri Court of Appeals, 2018)
Blackstone Mining Co. v. Travelers Insurance Co.
351 S.W.3d 193 (Kentucky Supreme Court, 2011)
Kentucky Employers' Mutual Insurance v. J & R Mining, Inc.
279 S.W.3d 513 (Kentucky Supreme Court, 2009)
Chaney v. Dags Branch Coal Co.
244 S.W.3d 95 (Kentucky Supreme Court, 2008)
Vogler v. Branch Erections Co., Inc.
640 S.E.2d 419 (Court of Appeals of North Carolina, 2007)
Realty Improvement Co., Inc. v. Raley
194 S.W.3d 818 (Kentucky Supreme Court, 2006)

Cite This Page — Counsel Stack

Bluebook (online)
192 S.W.3d 687, 2006 WL 140571, Counsel Stack Legal Research, https://law.counselstack.com/opinion/aigaiu-insurance-co-v-south-akers-mining-co-ky-2006.