Travelers Insurance v. Henry

2005 VT 68, 882 A.2d 1133, 178 Vt. 287, 2005 Vt. LEXIS 151
CourtSupreme Court of Vermont
DecidedJune 24, 2005
Docket04-174
StatusPublished
Cited by16 cases

This text of 2005 VT 68 (Travelers Insurance v. Henry) is published on Counsel Stack Legal Research, covering Supreme Court of Vermont primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Travelers Insurance v. Henry, 2005 VT 68, 882 A.2d 1133, 178 Vt. 287, 2005 Vt. LEXIS 151 (Vt. 2005).

Opinion

Reiber, C J.

¶ 1. In this appeal, we are asked by the United States Court of Appeals for the Second Circuit to answer the following certified question: under 21 V.S.A § 624(e), does a workers’ compensation carrier have a right to reimbursement from, or a future credit against, underinsured/uninsured (UIM) benefits recovered by an injured employee under an automobile liability policy that was purchased by his employer? 1 As discussed below, we conclude that under the plain language of 21 V.S.A. § 624(e) a workers’ compensation carrier does not have a right to be reimbursed out of such proceeds, nor to have the balance of the proceeds treated as a credit against future payment of benefits, except to prevent a double recovery. The question of whether an employee has received a double recovery can be answered only after the nature and extent of the injured employee’s damages has been determined. When this determination has been made, the extent of a workers’ compensation carrier’s right to reimbursement or to a credit against future payments can be ascertained.

*290 ¶ 2. The underlying facts are undisputed. In December 1999, defendant John Henry was seriously injured in a two-car automobile accident that occurred during the course of his employment. The driver of the second car, Kristy Herrick, was solely responsible for the accident. Henry received workers’ compensation benefits from plaintiff Travelers Insurance Company, his employer’s workers’ compensation carrier. He also recovered $100,000 in damages from Herrick’s personal liability insurer, the limit of the policy. After deducting the costs of recovery (including attorney’s fees), $66,060.75 of this money was paid to Travelers ($56,004.42 for a lien and $10,108.83 as an advance payment of permanency benefits not yet paid). Henry also sought to recover under the UIM provisions of two automobile liability policies: one that he had purchased himself, which had a policy limit of $100,000, and one that had been purchased by his employer, and issued by Travelers, with a policy limit of $400,000.

¶ 3. In August 2001, Travelers filed a declaratory judgment action in the United States District Court for the District of Vermont seeking a declaration that pursuant to 21 V.S.A. § 624(e) it was entitled to reimbursement from all of the UIM proceeds that Henry recovered. According to Travelers, Henry’s recovery of UIM proceeds in addition to his receipt of workers’ compensation benefits constituted a “double recovery” within the meaning of 21 V.S.A. § 624(e). Thus, Travelers sought reimbursement out of the UIM proceeds for the workers’ compensation benefits that it had paid up to the date of recovery, as well as a credit toward any future benefits that it would be obligated to pay. 2

¶ 4. In an April 2002 entry order, the district court granted partial summary judgment to Henry, concluding that under 21 V.S.A. § 624(e) Travelers had a right to reimbursement out of the UIM proceeds only to the extent that Henry had received a double recovery. The court explained that the question of whether Henry had received a double recovery could not be decided until all potential coverage had been determined and the nature and extent of Henry’s damages had been considered. In its order, the court also granted Henry’s request to join his personal automobile liability insurer as a party and add a counterclaim against both UIM carriers for the benefits allegedly due under the policies. The parties then stipulated, solely for the purpose of *291 determining their respective rights with respect to the UIM proceeds, that Henry’s “total damages” were the sum of the available UIM coverage ($500,000) and the total amount of workers’ compensation benefits paid through the date of the court’s final judgment order. 3

¶ 5. In late 2003, the court granted judgment in Henry’s favor, dismissing Travelers’ complaint and awarding Henry $500,000 in UIM proceeds. The court found that the plain language of 21 V.S.A. § 624(e) protected two types of recoveries from the reimbursement rights of workers’ compensation insurers: (1) payments from privately purchased plans (including UIM coverage) and (2) payments from any other first party plan. Because the UIM policy purchased on Henry’s behalf by his employer was a first party insurance policy, the court concluded that Henry was not obligated to reimburse Travelers out of the UIM proceeds. Travelers appealed to the Second Circuit, which certified the questions at issue in this appeal.

¶ 6. We begin with an overview of the reimbursement statute. Generally speaking, 21 V.S.A. § 624 allows an injured employee to pursue a cause of action against a third party where the injury for which workers’ compensation is payable “was caused under circumstances creating a legal liability to pay the resulting damages in some person other than the employer____” Id. § 624(a). If an injured employee recovers damages from a liable third party, the employer or workers’ compensation carrier is generally entitled to reimbursement for the workers’ compensation benefits that it has paid. Id. § 624(e). Ideally, the statute operates to provide a fair result for all parties:

[T]he insurance carrier, representing the employer, comes out even, being without fault or injury; the third party wrongdoer pays exactly the damages he would have paid without any workers’ compensation law; the attorney is reimbursed for services rendered, and the employee — in addition to what he has already received in compensation benefits — is entitled to the remainder.

*292 St. Paul Fire & Marine Ins. Co. v. Surdam, 156 Vt. 585, 590, 595 A.2d 264, 266 (1991) (quotation omitted); see also 6 A. Larson, Larson’s Workers’ Compensation Law § 110.02 (2004).

¶ 7. Prior to its amendment in 1999,21 V.S.A. § 624(e) provided:

In an action to enforce the liability of a third party, the injured employee may recover any amount which the employee or the employee’s personal representative would be entitled to recover in a civil action. Any recovery against the third party for damages resulting from personal injuries or death only, after deducting expenses of recovery, shall first reimburse the employer or its workers’ compensation insurance carrier for any amounts paid or payable under this chapter to date of recovery, and the balance shall forthwith be paid to the employee or the employee’s dependents or personal representative and shall be treated as an advance payment by the employer on account of any future payment of compensation benefits.

In Travelers Cos. v. Liberty Mutual Insurance Co., 164 Vt. 368, 372-73, 670 A.2d 827, 829-30 (1995), we interpreted this provision to allow a workers’ compensation insurer to be reimbursed out of UM/UIM payments made to an employee by his employer’s liability carrier after concluding that the employer’s liability carrier was a “third party” within the meaning of 21 V.S.A.

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Bluebook (online)
2005 VT 68, 882 A.2d 1133, 178 Vt. 287, 2005 Vt. LEXIS 151, Counsel Stack Legal Research, https://law.counselstack.com/opinion/travelers-insurance-v-henry-vt-2005.