Sprayberry v. Commercial Union Insurance

232 S.E.2d 111, 140 Ga. App. 758, 1976 Ga. App. LEXIS 1624
CourtCourt of Appeals of Georgia
DecidedNovember 22, 1976
Docket52529
StatusPublished
Cited by7 cases

This text of 232 S.E.2d 111 (Sprayberry v. Commercial Union Insurance) is published on Counsel Stack Legal Research, covering Court of Appeals of Georgia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Sprayberry v. Commercial Union Insurance, 232 S.E.2d 111, 140 Ga. App. 758, 1976 Ga. App. LEXIS 1624 (Ga. Ct. App. 1976).

Opinions

Marshall, Judge.

The question presented in this workmen’s compensation case is whether an insurer may receive credit for payments made to an injured employee pursuant to the laws of another state which state did not have jurisdiction to authorize such payments.

Claimant was injured while working as an employee of Steadman Heating & Air Conditioning Company. Steadman’s place of business is in Georgia and it does most of its work in Georgia, but it has a Tennessee mailing address and does work in Tennessee. The claimant is a [759]*759Georgia resident and the injury occurred in Chickamauga, Georgia, near the Tennessee state line. Claimant had worked for Steadman in Tennessee. Following his injury claimant was treated hy physicians in Tennessee. Claimant began receiving weekly checks in the amount of $70 from Steadman’s workmen’s compensation insurer. The checks were sent pursuant to Tennessee’s workmen’s compensation laws (which benefits were less than claimant could have received under Georgia law). Claimant received and cashed these checks for nearly a year before he began to question the amount he was receiving. Just before the running of the one year limitation for filing a claim in Georgia, he retained counsel and made demand against the insurer, and, upon its being denied, filed ,a^ workmen’s compensation claim under Georgia law. Claimant had received $3,570 in benefits up to that time.

The administrative law judge awarded the claimant full benefits under Georgia’s workmen’s compensation laws and denied the insurer’s request for credit for the payments it had already made under Tennessee law. On appeal to the full board, the insurer was awarded credit for such payments. The board found that the payments were made in accordance with Tennessee law, were not gratuities, and were made in good faith; that the absence of jurisdiction in Tennessee was not known until the administrative law judge adjudicated that fact; that insurer was entitled to credit for monies already paid; and that insurer should not be assessed attorney fees for the reasons aforesaid. The superior court affirmed, and claimant appeals to this court.

Claimant contends that the board erred in finding that the insurer’s payments were made "in accordance with Tennessee law” and in finding they were made in "good faith since it was not known that Tennessee did not have jurisdiction until the administrative law judge adjudicated that fact.” Claimant further contends that the payments made were gratuities because made without any agreement or approved award, and that claimant was entitled to attorney fees because of the bad faith shown by the insurer. Held:

1. The board’s finding that the claimant received [760]*760payments "in accordance with Tennessee law” is supported by evidence in the record in the form of a stipulation made by claimant’s counsel that claimant had been receiving payments of $70 per week under the provisions of Tennessee law. Such evidence is competent and is sufficient to support the board’s finding. Code § 114-710. See Fox v. Hartford Acc. &c. Co., 130 Ga. App. 104 (1) (202 SE2d 568).

2. The finding of the board that the payments were made "in good faith” was made relative to the board’s determination that claimant’s attorney fees should not be assessed against the insurer. This finding is also supported by the record, for it is reasonable or at least arguable that Tennessee had jurisdiction over the claim. See Tenn. Code Ann. § 50-917 (which provides extraterritorial jurisdiction as to injuries occurring outside the state under certain circumstances). There is no evidence that the payments were made by the insurer to avoid paying the higher Georgia benefits, or to "lull” claimant into letting the one year statute run. An award of attorney fees may not rest upon pure speculation and conjecture. Frith v. Liberty Mut. Ins. Co., 107 Ga. App. 285, 289 (129 SE2d 812). The issue contested by the insurer is not whether claimant is entitled to payments under Georgia law, but whether it is entitled to a credit for previous payments made. This issue is by no means a settled one. See Division 3, infra. "Attorney fees may not be awarded where the matter was closely contested on reasonable grounds. Gulf Life Ins. Co. v. Moore, 90 Ga. App. 791, 798 (84 SE2d 696).” Pacific Employers Ins. Co. v. Peck, 129 Ga. App. 439, 442 (200 SE2d 151). Attorney fees were properly denied in this case.

3. The critical issue in this case is whether the claimant is entitled to keep those benefits paid him by the insurer under Tennessee law as gratuities, or whether the insurer is entitled to a credit for them. Claimant cites several cases which propound the general principle that payments made to an employee in the absence of an approved agreement or award are mere gratuities. Reliance Ins. Cos. v. Richardson, 137 Ga. App. 678 (1) (224 SE2d 812); Mason v. City of Atlanta, 124 Ga. App. 849 (1)(186 SE2d 285). These cases, and others (See, e.g., [761]*761Hartford Acc. &c. Co. v. Snyder, 126 Ga. App. 31 (9) (189 SE2d 919); Thomas v. Lumbermens Mut. Cas. Co., 57 Ga. App. 434 (195 SE 894); Attaway v. First Nat. Bank, 49 Ga. App. 270 (175 SE 258).) hold that payments made without an agreement or approved award do not toll the running of the one year statutory period within which a claim must be filed in Georgia. It is conceded that the payments made under the Tennessee statute in this case did not toll the running of the one-year filing period in Georgia, and had claimant not filed within that one-year period, the claim would have been barred. Code § 114-305. However, the question here is not whether the claim is barred by the statute, but whether the insurer in entitled to credit for payments made, where a claim is timely made. We believe that Code § 114-415 is authority for the board to allow such credit. It provides: "Any payments made by the employer to the injured employee during the period of his disability, or to his dependents, which by the terms of this Title were not due and payable when made, may, subject to the approval of the State Board of Workmen’s Compensation, be deducted from the amount to be paid as compensation: Provided, that in the case of disability such deductions shall be made by shortening the period during which compensation must be paid and not by reducing the amount of the weekly payments.” The allowance for such credit to the insurer is discretionary with the board. See Davis v. Cobb County, 106 Ga. App. 336 (2) (126 SE2d 710); Dodgen v. St. Paul Fire &c. Ins. Co., 138 Ga. App. 499 (227 SE2d 64); Harrison Co. v. Norton, 244 Miss. 752 (146 S2d 327). This Code section does not limit the credit allowable to payments made to an employee only after an award has been made. See, e.g., Davis v. Cobb County, supra. The statute clearly allows credit for payments made to an employee "during the period of his disability,” whether made before or after an award. To disallow such credit would permit double recovery and would be an injustice to the insurer and the premium-paying public. We do not foresee a danger of "lulling” claimants beyond the one-year period for filing, for such attempts by an insurer/employer would constitute fraud, and would toll the running of the statute. See Indemnity Ins. Co. v. O’Neal, 104 Ga. App. 305 (2) (121 SE2d 689); Whelchel v. [762]*762American &c. Ins. Co., 54 Ga. App.

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Sprayberry v. Commercial Union Insurance
232 S.E.2d 111 (Court of Appeals of Georgia, 1976)

Cite This Page — Counsel Stack

Bluebook (online)
232 S.E.2d 111, 140 Ga. App. 758, 1976 Ga. App. LEXIS 1624, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sprayberry-v-commercial-union-insurance-gactapp-1976.