Birkenbuel v. Montana State Compensation Insurance Fund

687 P.2d 700, 212 Mont. 139, 1984 Mont. LEXIS 1026
CourtMontana Supreme Court
DecidedAugust 28, 1984
Docket83-525
StatusPublished
Cited by20 cases

This text of 687 P.2d 700 (Birkenbuel v. Montana State Compensation Insurance Fund) is published on Counsel Stack Legal Research, covering Montana Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Birkenbuel v. Montana State Compensation Insurance Fund, 687 P.2d 700, 212 Mont. 139, 1984 Mont. LEXIS 1026 (Mo. 1984).

Opinions

MR. CHIEF JUSTICE HASWELL

delivered the Opinion of the Court.

James G. Birkenbuel appeals the decision of the Cascade County District Court granting defendant’s motion for summary judgment. Birkenbuel’s tort action against the State Compensation Insurance Fund (State Fund) was dismissed pursuant to the exclusive remedy clause of the Worker’s Compensation Act, Section 39-71-411, MCA. We reverse.

Plaintiff Birkenbuel suffered a compensable injury in 1980. Birkenbuel’s employer was insured by the State Fund in accordance with compensation Plan III. Section 39-71-[141]*1412301 et seq., MCA. The State Fund paid Birkenbuel biweekly temporary total disability payments during his healing period.

In early 1983, the State Fund determined that Birkenbuel had achieved maximum healing. Settlement negotiations were initiated with the plaintiff. Birkenbuel retained John Hoyt to represent him in these proceedings.

Initially the State Fund proposed that $6,000 be paid Birkenbuel in periodic payments. This figure was based on a 20 percent impairment rating of the knee. Birkenbuel responded through his attorney with a $35,000 lump sum proposal. This offer was designed to allow the claimant to start his own business.

The $35,000 offer was deemed excessive by the State Fund in light of the impairment rating and other considerations. A counter-offer of $17,325 was made to Birkenbuel.

This counter-offer was reduced to writing, and a formal petition for full and final compromise settlement was submitted to Birkenbuel for his signature on May 19, 1983. Birkenbuel’s attorney initially rejected the counter-offer, negotiating for a full and final settlement that could be reopened within four years. After no success, the attorney for the claimant waived his fees, and drafted a cover letter to the State Fund accepting the terms of the petition. Accompanied by this letter and the petition, Birkenbuel traveled to the Helena State Fund office to accept the $17,325 offer.

The petition was not honored by the State Fund. In rejecting its previous offer, the State Fund took exception to the strongly worded cover letter drafted by claimant’s counsel.

Suit was filed June 7, 1983, alleging tortious acts on the part of the State Fund. Specifically, Birkenbuel alleged the State Fund breached both a common-law and a statutory duty under the Unfair Trade Practices Act, Section 33-18-101 et seq., MCA, to negotiate in good faith. Alternately, the plaintiff alleged the State Fund acted fraudulently and intentionally inflicted emotional distress. Actual and puni[142]*142tive damages were requested.

The State Fund filed a motion to dismiss arguing the District Court action was barred by the exclusive remedy provision of the Workers’ Compensation Act. It was also argued that the State Fund was a state agency and punitive damages were not recoverable.

The motion to dismiss was converted to a motion for summary judgment by the District Court. Plaintiff took the depositions of Robert F. Owens, the claims examiner for the State Fund who handled plaintiff’s workers’ compensation claim, Peter J. Strizich, supervisor of the State Fund claims department, and A. G. Pillen, a former bureau chief of the State Fund.

The court granted summary judgment for the State Fund and dismissed Birkenbuel’s complaint. Birkenbuel appeals this judgment raising the following issues:

(1) Is a tort action against the State Fund for bad faith in settling a compensation claim barred by the exclusive remedy provision of the Workers’ Compensation Act?

(2) Are punitive damages recoverable against the State Fund?

In essence, the exclusive remedy clause of the Workers’ Compensation Act, Section 39-71-411, MCA, immunizes the employer from common-law actions for work-related injuries. Elimination of common-law actions was the quid pro quo surrendered by workers in return for the benefits of a statutory system of more certain compensation for work-related injuries regardless of fault.

Certain exceptions have been recognized to the exclusive remedy clause and a related provision in the Act, Section 39-71-2905, MCA. The latter section provides that the penalties and assessments of Chapter 71 are the only assessments that can be made against an insurer for compensation disputes.

The District Court failed to acknowledge two prior decisions of this Court construing exclusive remedy exceptions. In Hayes v. Aetna Fire Underwriters (1980), 187 Mont. [143]*143148, 609 P.2d 257, we held an injured worker could assert a separate claim in District Court alleging a private insurer committed intentional torts and acted in bad faith in adjusting and processing a compensation claim. The defendant in Hayes was a Plan II private insurer of the plaintiffs employer. Section 39-71-2201 et seq., MCA. In Vigue v. Evans Products Co. (1980), 187 Mont. 1, 608 P.2d 488, we applied a similar ruling to a Plan I self-insurer. Section 39-71-2101 et seq., MCA. The current case presents the third situation — a tort action against the State Fund, the Plan III insurer.

The reasoning of our decisions in Hayes and Vigue is equally applicable to the present case. The alleged tortious conduct did not arise within the employment relationship of Birkenbuel and his employer. The emotional injury described in the complaint occurred subsequent in time to his employment and is not work-related.

Our statutory system of workers’ compensation does not provide workers with benefits for injury sustained from settlement negotiations with an insurance carrier. As such, the exclusivity provisions of the Workers’ Compensation Act do not bar independent actions for tortious conduct arising from such interactions. Any contrary interpretation would result in the inequity whereby workers surrendered more protection than they received when our statutory system of compensation was adopted.

Birkenbuel pled a breach of common-law and statutory duties of good faith in insurance settlement negotiations. The State Fund argued that it is not a private insurance company and not subject to the provisions of the insurance code.

Bad faith in claim settlement is an actionable tort independent of the insurance code; we need not reach the question of the applicability of the code to the State Fund. In Lipinski v. Title Ins. Co. (Mont. 1982), [202 Mont. 1,] 655 P.2d 970, 977, 39 St.Rep. 2283, 2291, we held “. . . insurance companies have a duty to act in good faith with [144]*144their insureds, and that this duty exists independent of the insurance contract and independent of the statute.”

The State Fund may not be a private insurance company that actively pursues the sale of insurance policies. However, it is a publicly administered body that indemnifies employers for work-related injuries. Insurance contracts are executed with employers who choose Plan III coverage. These employers pay premiums for the coverage and at the end of the year the State Fund returns excess funds to its insured in the form of dividends.

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Birkenbuel v. Montana State Compensation Insurance Fund
687 P.2d 700 (Montana Supreme Court, 1984)

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Bluebook (online)
687 P.2d 700, 212 Mont. 139, 1984 Mont. LEXIS 1026, Counsel Stack Legal Research, https://law.counselstack.com/opinion/birkenbuel-v-montana-state-compensation-insurance-fund-mont-1984.