Dworkin, Chambers & Williams, P.C. v. Provo

81 P.3d 1053, 2003 Colo. LEXIS 940, 2003 WL 22832550
CourtSupreme Court of Colorado
DecidedDecember 1, 2003
Docket02SC792
StatusPublished
Cited by326 cases

This text of 81 P.3d 1053 (Dworkin, Chambers & Williams, P.C. v. Provo) is published on Counsel Stack Legal Research, covering Supreme Court of Colorado primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Dworkin, Chambers & Williams, P.C. v. Provo, 81 P.3d 1053, 2003 Colo. LEXIS 940, 2003 WL 22832550 (Colo. 2003).

Opinion

Justice BENDER

delivered the Opinion of the Court.

INTRODUCTION

In this case, we hold that an attorney does not violate a specific workers' compensation penalty statute by advising an insurer to violate a lawful order, even if the attorney acts with fraud or malice. To reach this holding, we address two related issues: first, whether an attorney fails, neglects, or refuses to obey a lawful order in a workers' compensation setting by advising an insurer not to comply with the order; and second, whether the workers' compensation penalty statute extends to a claim against an attorney for fraudulently or maliciously advising an insurer to violate a lawful order.

Section 8-48-304(1) of the Workers' Compensation Act of Colorado allows fines to be imposed against "[alny employer or insurer, or any officer or agent of either, or any employee, or any other person who ... fails, neglects, or refuses to obey any lawful order...."

Interpreting this statute, the court of appeals held that the insurer's attorneys could not fail, neglect, or refuse to obey an order not directed at them. Provo v. Indus. Claim Appeals Office, 66 P.3d 138, 145 (Colo.App.2002). However, the court of appeals concluded that as "agents" of the insurer, the attorneys could be liable under the statute if they acted with fraud or malice. Id.

We hold that, in a workers' compensation setting, an attorney who lacks the authority to bind an insurer does not violate a lawful order by advising the insurer to violate the order, even if the attorney acts with fraud or malice. We construe the relevant provision of $ 8-48-804(1) as penalizing only those persons with the authority to bind the insurer with respect to actions required by a lawful order and whose actions violate the order. 1 In the absence of evidence to the contrary, an attorney does not bind an insurer in such actions. Thus, an attorney typically is not an "agent"-one with the authority to bind a principal-within the meaning of the statute. The plain language of this statute omits any mention of attorneys acting in an advisory capacity, instead penalizing only those who fail, neglect, or refuse to obey a lawful order. We also hold that the statute by its express terms does not extend to a claim against an attorney who allegedly acts with fraud or malice in advising an insurer to violate a lawful order because the statute does not expressly provide for such a claim.

Thus, we affirm the court of appeals in part and reverse it in part. We affirm the court of appeals' holding that the attorneys did not fail, neglect, or refuse to obey a lawful order under the terms of the statute. *1055 However, we reverse the court of appeals holding that the statute may apply to an attorney who acts with fraud or malice. Accordingly, we remand this case to the court of appeals with instructions to return it to the Industrial Claim Appeals Office to dismiss the claim against the attorneys.

I. FACTS AND PROCEEDINGS BELOW

Claimant Susan J. Provo was seriously injured on the job at Atmel Corporation. At-mel's workers' compensation insurer was Industrial Indemnity Company. Attorney Gregory K. Chambers and his firm Dworkin, Chambers and Williams, P.C. (collectively, the "attorneys") initially represented the insurer regarding Provo's workers' compensation claim.

As a preliminary matter, we note that our review of the record does not reveal any evidence that the attorneys had the authority to bind the insurer with respect to the payment of Provo's benefits. The attorneys did not act on behalf of the insurer, which ultimately decided whether to pay for Provo's treatment. At all times, the attorneys acted in an advisory capacity to the insurer regarding Provo's benefits.

At the center of this dispute is a 1998 order by an administrative law judge (ALJ) requiring the insurer to pay for Provo's chiropractic treatment. The order required the insurer to cover "all [of Provo's] reasonable and necessary medical expenses" for a particular chiropractor, then specifically found that "/o/ecasional chiropractic treatment ... is especially reasonable and appropriate ... for a claimant with such severe injuries and permanent consequences" (emphasis added). The order, which was not appealed, left no doubt that the insurer was obligated to pay for Provo's chiropractic treatment.

Chambers advised the insurer that the 1998 order did not require it to cover Provo's chiropractic treatment. He also informed the insurer that if it denied coverage, Provo would be compelled to return to court, which could force a final settlement of her claim. A letter from Chambers to the insurance ad-Jjuster reveals his extreme misinterpretation of the order as well as his stonewalling tacties:

[The ALJ] leaves open the issue as to whether any of the [chiropractic] treatment ... would be considered reasonable and necessary. Given the fact that [the insurer's doctor] has already indicated it would not be reasonable and necessary, we have a basis for denying any treatment in the future from [the chiropractor].
In denying treatment, this would obviously result in [Provo] filing another Application for Hearing for payment of this medical treatment. At that time, I would recommend that we add the issue of permanent partial disability so that we can close this claim out. Hopefully, at that time, opposing counsel will be more interested in settling the claim.

In the letter, Chambers appeared to be aware that his interpretation of the order was strained, since he thought that denying coverage would "obviously" force Provo to return to court. Chambers' letter exposes his strategy of engaging in hardball legal maneuvering with a worker who suffered from serious and permanent injuries.

Although the insurance adjuster interpreted the order as obligating the insurer to cover chiropractic treatment, the insurer followed Chambers' advice and refused to pay Provo's chiropractic bills for a period of about six months.

Provo then moved for sanctions against the insurer under a different section of the Workers' Compensation Act, § 8-48-401(2)(a), 8 C.R.S. (2003), 2 which allows a claimant to seek penalties against an insurer who willfully denies payment of benefits. 3 *1056 Under this provision, the Division of Workers' Compensation receives eight percent of the amount of benefits wrongfully denied. 4 After a hearing, an ALJ found that the 1998 order clearly required the insured to cover Provo's chiropractic treatment and that the insurer's refusal to pay was "wrongful, deliberate, and intentional," and "willful, unreasonable, and legally unsupportable." Accordingly, the ALJ awarded to the Division the statutory eight percent penalty, amounting to less than $100.

In her brief to this Court, Provo explains that she did not pursue a claim against the insurer under § 8-48-304(1), 3 C.R.S.

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Cite This Page — Counsel Stack

Bluebook (online)
81 P.3d 1053, 2003 Colo. LEXIS 940, 2003 WL 22832550, Counsel Stack Legal Research, https://law.counselstack.com/opinion/dworkin-chambers-williams-pc-v-provo-colo-2003.