Charlton, M. v. PMA Insurance Group

CourtSuperior Court of Pennsylvania
DecidedNovember 6, 2015
Docket618 EDA 2015
StatusUnpublished

This text of Charlton, M. v. PMA Insurance Group (Charlton, M. v. PMA Insurance Group) is published on Counsel Stack Legal Research, covering Superior Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Charlton, M. v. PMA Insurance Group, (Pa. Ct. App. 2015).

Opinion

J-A24002-15

NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT I.O.P. 65.37

MATTHEW CHARLTON IN THE SUPERIOR COURT OF PENNSYLVANIA Appellant

v.

PMA INSURANCE GROUP AND MYLENE ZIMMERMAN

No. 618 EDA 2015

Appeal from the Order January 21, 2015 In the Court of Common Pleas of Philadelphia County Civil Division at No(s): December Term, 2013 No. 000914

BEFORE: PANELLA, J., WECHT, J., and STRASSBURGER, J.*

MEMORANDUM BY PANELLA, J. FILED NOVEMBER 06, 2015

Appellant, Matthew Charlton, appeals from the order that granted

judgment on the pleadings to Appellees, PMA Insurance Group and Mylene

Zimmerman, in Charlton’s action alleging that the Appellees had

intentionally inflicted emotional distress upon him. Charlton contends that

the trial court erred in concluding that emotional distress suffered as the

result of threats of disclosure childhood sexual abuse made by a workers’

compensation insurer is an “injury arising in the course of employment,”

therefore restricting Charlton’s remedies to those provided under the

____________________________________________

* Retired Senior Judge assigned to the Superior Court. J-A24002-15

Workers’ Compensation statute. We agree with Charlton, and therefore

reverse and remand.

When reviewing a challenge to an order granting judgment on the

pleadings, we must accept all well-pleaded allegations in the complaint as

true. See Guerra v. Redevelopment Authority of City of Philadelphia,

27 A.3d 1284, 1288-1289 (Pa. Super. 2011). We therefore set forth the

factual basis for this matter as alleged in Charlton’s complaint.

In 1986, Charlton was injured in a workplace accident that left him

physically and emotionally injured. From that time to the present, PMA has

provided Charlton with benefits pursuant to the Workers’ Compensation Act.

One of these benefits is psychiatric treatment by Timothy Michals, M.D.

During the course of Dr. Michals’s treatment, Charlton disclosed that he had

been sexually abused as a child. Dr. Michals never treated Charlton for the

childhood sexual abuse, and instead referred Charlton to another mental

healthcare professional. However, Dr. Michals’s treatment notes recorded

Charlton’s disclosure and the subsequent referral.

Several years later, Zimmerman, a senior account claims

representative employed by PMA, requested Dr. Michals’s treatment notes

for Charlton, in order to review Charlton’s continuing eligibility for benefits.

Dr. Michal complied with the request, and Zimmerman subsequently

contacted Charlton. During the course of their conversation, Zimmerman

stated, “we are tired of paying for something that happened to you as a

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child.” Charlton immediately recognized this as a reference to his childhood

sexual abuse and became agitated and anxious, as he believed this to be a

threat to shame him with his childhood sexual abuse if he did not settle his

workers’ compensation claim. In fact, Zimmerman concluded the

conversation with a demand that Charlton settle his claim.

Shortly thereafter, Zimmerman left a voice mail message for Charlton,

which contained the following.

Matthew, this is Mylene calling from PMA. When you get a minute and you can talk please give me a call back at []. The only thing that is in question is the recent request for your surgery that we don’t feel is related to the original injury back several … back in 1986 because of current things that have gone on with your current work[,] your repetitive motion, you lifting, that sort of thing.

What we talked about the other day actually is done and over. That will never ever be discussed again and that was something that was brought up to me, I brought up to you[.] And that is the only group of people who will be discussing that. So if you want to give me a call back I’d appreciate it. Bye.

Charlton suffered debilitating anxiety, humiliation, fear, and feelings of

betrayal from Zimmerman’s reference to his childhood sexual abuse.

Charlton subsequently filed a complaint asserting that Zimmerman, as

an agent for PMA, had intentionally inflicted emotional distress on him.

Appellees filed preliminary objections, which the trial court overruled.

Appellees filed an answer with new matter, asserting that Charlton’s claim

was subject to the exclusivity provisions of the Workers’ Compensation Act.

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Appellees then filed a motion for judgment on the pleadings, which the trial

court granted. This timely appeal followed.

On appeal, Charlton argues that the trial court erred in concluding that

the exclusivity provisions of the Workers’ Compensation Act (“the Act”)

applied to his claims. The exclusivity provision of the Act states that

[t]he liability of an employer under this act shall be exclusive and in place of any and all other liability to such employe, his legal representative, husband or wife, parents, dependents, next of kin or anyone otherwise entitled to damages in any action at law or otherwise on account of any injury or death as defined in § 301(c)(1) and (2) or occupational disease as defined in § 108.

77 P.S. § 481(a). Thus, the Act bars any tort action “flowing from any work-

related injury.” Taras v. Wausau Ins. Companies, 602 A.2d 882, 884

(Pa. Super. 1992) (citation omitted). The exclusivity provision is a

fundamental part of the statutory scheme whereby employers assume

liability without fault for work-related injuries, but are relieved of the risk of

the possibly larger verdicts that might result from tort litigation. See Lewis

v. School District of Philadelphia, 538 A.2d 862, 867 (Pa. 1988).

Furthermore, it is well established that “insurance carriers are entitled

to the same immunity [from tort claims] in processing a compensation claim

as the employer.” Taras, 602 A.2d at 885; see also 77 P.S. 501(a)(1). In

return, the Act provides specific remedies to claimants against insurers who

improperly handle a compensation claim. See 77 P.S. §§ 701-797. Thus, a

claimant whose work-related injuries are exacerbated by an insurer’s

improper conduct in handling the claim is restricted to the remedies provided

-4- J-A24002-15

in the Act. See Santiago v. Pennsylvania Nat. Mut. Cas. Ins. Co., 613

A.2d 1235 (Pa. Super. 1992). “[A]s the appellee’s claim is ultimately based

upon an injury compensable under [the Act], he is limited to the remedies

provided within the framework of the [A]ct.” Kuney v. PMA Insurance

Companies, 578 A.2d 1285, 1288 (Pa. 1990).

In contrast, a claim that an insurer’s conduct in handling a claim

exacerbated a non-work-related injury is not subject to the exclusivity

provisions of the Act. See Tropiano v. Travelers Ins. Co., 319 A.2d 426

(Pa. 1974); Taras, 602 A.2d at 886. The boundaries of the exclusivity

provisions of the Act “are determined by the nature of the injury alleged and

the role of the carrier with respect to that injury.” Taras, 602 A.2d at 887.

In Taras, the plaintiff, Taras, claimed that the insurance company and

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Related

Lewis v. School Dist. of Philadelphia
538 A.2d 862 (Supreme Court of Pennsylvania, 1988)
Kuney v. PMA Insurance
578 A.2d 1285 (Supreme Court of Pennsylvania, 1990)
Taras v. Wausau Ins. Companies
602 A.2d 882 (Superior Court of Pennsylvania, 1992)
Guerra v. REDEVELOPMENT AUTHORITY OF PHILA.
27 A.3d 1284 (Superior Court of Pennsylvania, 2011)
Santiago v. Pennsylvania National Mutual Casualty Insurance
613 A.2d 1235 (Superior Court of Pennsylvania, 1992)
Tropiano v. Travelers Insurance
319 A.2d 426 (Supreme Court of Pennsylvania, 1974)

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Charlton, M. v. PMA Insurance Group, Counsel Stack Legal Research, https://law.counselstack.com/opinion/charlton-m-v-pma-insurance-group-pasuperct-2015.