Upchurch v. UNIVERSAL UNDERWRITERS INS.

610 So. 2d 1163, 1992 WL 86050
CourtCourt of Civil Appeals of Alabama
DecidedDecember 11, 1992
Docket2910076
StatusPublished
Cited by7 cases

This text of 610 So. 2d 1163 (Upchurch v. UNIVERSAL UNDERWRITERS INS.) is published on Counsel Stack Legal Research, covering Court of Civil Appeals of Alabama primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Upchurch v. UNIVERSAL UNDERWRITERS INS., 610 So. 2d 1163, 1992 WL 86050 (Ala. Ct. App. 1992).

Opinion

Sarah Jean Upchurch brought an action against the defendants, Universal Underwriters Insurance Company (Universal) and Glenda Gail Hodnett Jones, alleging intentional fraud and seeking compensatory and punitive damages. Specifically, Upchurch contends that the defendants misrepresented or suppressed facts relating to her purported entitlement to have the value of certain employer-paid insurance premiums included in the calculation of her average weekly wages for purposes of determining her temporary disability benefits. The defendants denied the allegations and moved for summary judgment. A hearing was held, and the trial court granted the defendants' motion. Upchurch appeals; we affirm.

The relevant facts are as follows: In July 1988 Upchurch sustained a back injury *Page 1165 while working within the line and scope of her employment with Hoyle Chevrolet, Inc. (Hoyle). Universal is the workers' compensation carrier for Hoyle. Relying on information provided by Hoyle, Jones, the claims adjuster for Universal, calculated Upchurch's average weekly wages, and based upon Jones's calculations, Universal began paying Upchurch benefits for a temporary total disability on August 23, 1988. These payments continued for approximately fifty weeks and ceased on July 30, 1989.

At all times relevant to this action, Hoyle paid the premiums for health and life insurance for its employees. For several months following Upchurch's injury, Hoyle continued to pay premiums for Upchurch that totalled $167.80 per month. However, on May 8, 1989, Hoyle stopped making these payments. The record indicates that at no time before or after this date did Jones and Universal factor the monetary equivalent of the premiums into Upchurch's average weekly wages or into the calculation of her disability benefits. Upchurch attained legal counsel and sought to have the value of the premiums included in her wages and in the disability payments made after Hoyle discontinued paying the premiums. Ultimately, Upchurch brought this action for intentional fraud against the defendants.

Sections 25-5-11, 25-5-51 to -53, and 25-5-59, Ala. Code 1975, set out the exclusivity provisions in our workers' compensation act and provide that no employee subject to the act may seek damages for an injury occasioned by a work-related accident "other than as provided in this article." See § 25-5-52.

However, our supreme court has held that the exclusivity provisions of the act do not bar claims for intentional tortious conduct, i.e., intentional fraud. Lowman v. PiedmontExecutive Shirt Manufacturing Co., 547 So.2d 90 (Ala. 1989). The act "should not be an impervious barrier, insulating a wrongdoer from the payment of just and fair damages for intentional tortious acts only very tenuously related to workplace accidents." Id. at 94 (citing Carpentino v. TransportIns. Co., 609 F. Supp. 556 (D.C.Conn. 1985)).

Nevertheless, in accommodation to the exclusivity provisions of the act and in order to ensure against borderline or frivolous claims, it is necessary that Upchurch meet a higher burden or make a stronger showing than that required by the "substantial evidence rule" as it applies to issues in regard to tort claims generally. Tittle v. Custard Ins. Adjusters,590 So.2d 880 (Ala. 1991); Lowman, 547 So.2d 90. In order to present her claim to a jury, Upchurch must present evidence that, if accepted and believed by a jury, would qualify asclear and convincing proof of fraud. Lowman, 547 So.2d 90.

In its order granting summary judgment, the trial court found that the question of whether fringe benefits, such as employer-paid insurance premiums, should be included in an employee's average weekly wages has not been settled legislatively or judicially in this state. Consequently, the court held, Universal could not as a matter of law be deemed to have defrauded Upchurch. Upchurch, however, maintains that statutory and case law in this state clearly establish that fringe benefits may be treated as part of an employee's weekly wages and that, therefore, the defendants were on notice that the value of the insurance premiums paid by Hoyle should have been included in her computed earnings. She asserts that she has presented evidence putting squarely at issue whether the fringe benefits she received from Hoyle satisfied the legal criteria for inclusion as part of her wages and asks this court to reverse the trial court's summary judgment, thereby allowing a jury to decide the factual questions raised in her fraud claim.

We have examined the relevant statutory and case law regarding wage allowances for compensation purposes and disagree with the trial court's finding that the law is unsettled in this area. Section 25-5-57(b), Ala. Code 1975, provides in pertinent part as follows:

"Whatever allowances of any character made to an employee in lieu of wages are *Page 1166 specified as part of the wage contract shall be deemed a part of his earnings."

In Ex parte Murray, 490 So.2d 1238, 1240 (Ala. 1986), our supreme court stated as follows regarding the above-mentioned portion of the statute:

"[U]nder Section 25-5-57(b), the term 'earnings' is comprised of three elements: (1) allowances of any character; (2) made to the employee in lieu of wages; and (3) specified as part of the wage contract."

The court in Murray held that employer-paid medical, hospitalization, and life-insurance premiums are fringe benefits constituting "allowances of any character" and are therefore includable in the computation of an employee's average weekly wage to determine benefits. In the subsequent case of Goodyear Tire Rubber Co. v. Gilbert, 521 So.2d 991 (Ala.Civ.App. 1987), this court found Murray to be dispositive of the question of whether employee-paid fringe benefits are includable in wage computation.

In the case at bar, the trial court reasoned that becauseMurray and Gilbert do not clearly stand for the proposition that employer-paid insurance premiums are always "made to the employee in lieu of wages" or that they are always "specified as part of the wage contract" (the second and third elements of "earnings" under § 25-5-57(b)), then, as a matter of law, Upchurch could not prevail under her theories of fraud. However, we find the questions of whether these fringe benefits were provided in lieu of wages and whether they were provided as part of the wage contract to be issues more properly determinable by the trier of fact. It is not, as the trial court apparently concludes, necessary that such fringe benefits are, in all cases, legally determined to be provided in lieu of wages and as part of the wage contract before plaintiffs may avoid summary judgment in actions for fraud.

Accordingly, we do not agree with the trial court's stated rationale for granting the defendants' motion for summary judgment. Rather, we find that the dispositive question before us is whether Upchurch met her burden of proof in order to overcome the defendants' motion. In other words, did Upchurch present clear and convincing evidence of the alleged claims against the defendants?

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Cite This Page — Counsel Stack

Bluebook (online)
610 So. 2d 1163, 1992 WL 86050, Counsel Stack Legal Research, https://law.counselstack.com/opinion/upchurch-v-universal-underwriters-ins-alacivapp-1992.