*2 NIX, C.J., LARSEN, Bеfore FLAHERTY, and jj. McDERMOTT, ZAPPALA, CAPPY, PAPADAKOS and OPINION ZAPPALA, Justice. presented issue in this appeal is whether an employee
who sustains an covered the Pennsylvania Work- men’s Compensation § may P.S. et seq., assert a separate injuries tort action for allegedly out arising of mali- cious and fraudulent conduct and abuse of the legal process to terminate workmen’s by agents benefits employer’s insurance carrier. Based our upon decision PMA Insurance Company, 578 A.2d we conclude that the exclusivity provisions of the Act prohibit a tort action against the agents of the insurance injuries carrier allegedly caused their actions in handling the employee’s compensa- tion claim. from an order appeal
This is County Court Common affirming the order the Delaware in favor Paul Insur- judgment of St. granting summary Pleas Services, Inc., Companies, ance Vocational Rehabilitation Williams, granted M.D. allocatur limited John T. We acting it to individuals or entities stated above as relates issue carrier. of an or the insurance behalf fell work- On Calvin Alston while April Appellant wrists, spine, neсk injuries sustained ing on a ladder and (St. Paul), the Companies Paul Insurance back. St. carrier, Alston’s assigned Dunham, began Alston file Robert a claims examiner. receiving disability total contracted with Vocational Rehabili- Appellee
St. Paul later Services) (Vocational Services, to obtain Alston’s tation Inc. records, report recovery, to mоnitor his St. medical *3 M.D., 7, 1982, Resnick, an ortho- January Paul. On Edward requested by Alston Vocational pedist, examined Services. any Dr. reported Resnick that examination did reveal symp- to significant findings causally that could be related 24, of, He or to the 1981. complained April toms strong pain that was a of chronic possibility stated there X-rays final could be syndrome, оpinion but reserved his until had examined. Alston refused to allow Dr. Resnick to take any X-rays. 1982, assigned Vocational Alston’s file February, Services Rohrer, Appellee Janet a “rehabilitation employee, an in February, was treated
nurse”. Alston evaluated and March, Dr. Wynne, J. Brendon D.O. April, that was unable to calculate a Wynne indicated to Rohrer he After Rohrer firm on which Alston could return work. date Paul, findings Dr. a decision was reported Wynne’s to St. approach toward aggressive made to institute a more allegedly Alston. May to meet with Alston and his wife on arranged
Rohrer At prognosis. his medical discuss treatment time, indicated that would like schedule Rohrer she Williams, M.D., for Alston with John T. whom appointment she allegеdly agreed described as a “miracle worker”. Alston to be examined. 31, 1982,
On Alston August was examined Dr. Williams. alleged Alston that he was not informed that an independent occur, medical examination would or that Dr. Williams had the ability sign physician’s affidavit of or that he recovery, him physician accompany entitled to have his own examination. Dr. conducted а brief examination. Williams records, review of prior X-rays, Without Alston’s medical contact treating physician, with the Dr. Williams told Alston he was able to return to work.
Dr. Williams executed a affidavit of physician’s recovery. Subsequently, approached Robert Dunham Alston to negotiate lump sum settlement of his workmen’s compensation bene- fits. Alston rejectеd the offer as insufficient. St. Paul then petition filed a to terminate Alston’s benefits. months,
Alston’s benefits were discontinued for nineteen petition until St. Paul’s to terminate was denied. The benefits attorney’s were reinstated and fees were awarded to Alston. St. Paul appealed the referee’s decision to the Workmen’s Compensation Appeal Boаrd. The decision was underlying affirmed, of attorney’s award fees was reversed on the Board’s finding of a reasonable contest. No was taken appeal from the Board’s order. 6,1984, July
On the Alstons initiated the trespass action for Paul, compensatory and punitive damages St. Vocational Services, and Dr. joined Williams. Ms. Rohrer was as an additional dеfendant Vocational Services. The essence of the Alstons’ claim is the allegation that the defendants con- *4 to and made spired misrepresentations to the Alstons to them of workmen’s compensation defraud A summary judgment motion for was filed on behalf of the motion, In Appellees. their the Appellees upon relied Ward, decision in Rоsipal Montgomery Superior Court’s (1987), 521 Pa.Super. granted, A.2d 49 alloc. 516 Pa. (1987), dismissed, appeal A.2d 93 A.2d 495 that an tort holding against action employer her was barred exclusivity provision of the granted the Act. The trial court Compensation Workmen’s summary judgment motion. Superior The affirmed. Superior Court appeal,
On employ- is afforded to immunity legal Court held that еxclusivity under the insurers compensation and their ers Compensation Act extends provisions inten- also to claims based negligence, acts of only to its decision tional, Citing and willful misconduct. wanton immuni- that the Court concluded Rosipal, supra, Superior han- from the arising civil actions ty extended cover a claim. dling of workmen’s her performing while Rosipal, In plaintiff filed a notice of guard. employer as The security duties a indemnity wage payments. and initiated compensation payable a termination that was later filed petition The recovery. plain- a affidavit of The physician’s supported a following hearing were a before tiff’s benefits reinstated referee. her action plaintiff brought
The civil duress, infliction of economic emotional alleging distress, false and breach procuring recovery, affidavit agreement. preliminary The filed it from the action under that was immune objections, asserting Act. The trial court dismissed Compensation the Workmen’s objections, granted the Superior but the preliminary for review and reversed. employer’s petition Compensa- that the Workmen’s Superior Court stated flowing work-related tion Act barred all civil actions that the did not injuries. rejecting argument accident, the Court rea- Superior from a work-related arise accident, would have that without a work-related there soned out of which the compensation proceedings nо workmen’s been civil arose. The Court concluded action of action as all of the plaintiff had failed to state a cause had complaint in her ultimate basis allegations under the Workmen’s injury compensable within its framework. her claims must be considered *5 The Superior expanded analysis Court on its Rosipal the instant case. The court hеld that when sustain injuries during employment, course of their because of an intentional wrongdoing by their itself, exclusive for the or for the handling claim, lies within the framework of the Workmen’s Com- pensation Act. The Superior Court concluded that the admin- istrative remedies established therein are the exclusive reme- dies for claimants who believe that their benefits have been wrongfully suspended or terminated com- pensation insurer. The applied analysis as well to those or entities employed by individuals the insurer case, to review the such as Vocational Services and Dr. Williams.
Subsequent to the
Superior Court’s decision
the instant
case, we addressed the issue of whether an
immu-
nity from tort actions under the Workmen’s
if
protects its insurance carrier
the insurer is alleged to have
in fraud
engaged
deprive
injured
and deceit to
an
employee
his worker’s
In
v. PMA Insur-
Co.,
ance
sustained
PMA were sustained
objections
filed
Preliminary
claim.
*6
sole
employee’s
that the
the trial court on the basis
by
Act.
Compensation
provided
was
the Workmen’s
PMA,
Pa.Super.
379
Kuney
reversed.1
Superior Court
(1988).
the
allocatur and reversed
granted
We
We stated that
the
481(a),
Act,
quid
§
the historical
Compensation
reflects
P.S.
the
whereby
and
quo
pro
between an
fault for a work-related
liability without
employer assumes
damage
of
larger
of the
injury,
possibility
but is relieved
benefits from
in a
law action. The
verdict
common
forgoes recov-
compensation,
of
payment
the expеditious
damages.
employer’s liability
of
An
ery of
elements
some
gov-
compensation
exclusively
its
carrier are
liability
the
of
Act.
Compensation
erned
the Workmen’s
out of the
arising
claim
analyzing
employee’s
whether the
was
of his
benefits
allegedly
handling
fraudulent
Compen-
remedies of the Workmen’s
subject to the exclusive
established
provisions
the penalty
we examined
sation
system of
comprehensive
that “...
the
therein. We concluded
substantive,
comprising
and remedial
laws
procedural,
fo-
be the exclusive
compensation system should
work
injuries
any way
of
in
related to the
rum for redress
175-176,
1287, citing
578 A.2d at
Kuney, 525
at
place.”
168, 172, 74
Kligerman,
Co. v.
Casualty
American
(1950).
claim that
held that an
We
of benefits
delayed payment
wrongfully
insurance carrier
the framework
the statute.
must
considered within
be
Kuney
dispositive
We find that our decision
attempts Appellant
instant case. The
issue raised
that the defen-
Kuney
the basis
distinguish
case
service,
or vocational rehabilitation
physician
not a
dant was
explicitly
overruled
its
1. The
Court’s decision
See,
Paul,
аl.,
et
case.
Alston v. St.
later decision in the instant
(1989).
Pa.Super.
As in crux lawsuit Alstons’ is that agents insurance carrier and its wrongfully delayed receipt of compensation benefits. The Workmen’s establishes forum resolving disputes the exclusive regard- ing right the employee’s and the or delay compensation sys- discontinuance of The workmen’s tem all encompasses disputes coverage over payment benefits, they whether arise from aсtions taken carrier, or the insurance agents. carrier’s Only employer or *7 employer’s insurance carrier may seek terminate an em- Therefore, ployee’s it no significance is of that no penalties prescribed are for the the agents of carrier, for insurance such the penalties against are available employer or its insurance carrier.
The order of the is affirmed. CAPPY, J., a concurring opinion. files LARSEN, J., files a in dissenting which opinion PAPADAKOS, J., joins.
CAPPY, Justice, concurring.
I concur in the result offered in
I
majority opinion.
the
write separately
express my
with
majori-
dissatisfaction
v.
Poyser
Company,
Newman &
Inc. 514 Pa.
ty
decision
PMA Insurance
522 A.2d
548
which
Co.,
(1990)
now,
In Poyser,
Court,
majority
clear
this
interpreting
language of the Workmen’s Compensation
determined
that an
employee
suing
employer
barred from
whose
intentional
conduct
employee.
tortious
had harmed the
majority opined
that
exclusive remedy was
hand,
Act itself
other
On the
compensation.
for an
employee
may sue a fellow
employee
that an
provides
to the
exception
animus”
“personal
tort under the
intentional
Lunch, Act. Dolan v. Linton’s
provision of the
exclusivity
411(1)1
(1959);
§
Thus the
114,
I believe that this an instance where thе logical extension of a well may intentioned interpretation only lead not absurdity injustice. Nevertheless, but also correc- absent now, Poyser legislation, tive for the law Pennsylva- remains and, case, nia in the judice the case sub as falls squarely alone, within its ambit. For that reason I am join constrained to in result offered majority. LARSEN, Justice, dissenting. majority hоlds that an employer’s immunity
tort actions of workers under the Compen- Workmen’s sation not only extends the employer’s compensation carrier also to “those or individuals entities who or perform performing assist the functions of the insurance in handling carrier compensation workmen’s as agents claims employees carrier,” intentional, or of the who commit active upon fraud deceit order to them deprive fact, these alleged “agents employees” independent are I contractors. believe that the Act should not provide and, therefore, such far reaching immunity should bar action. I Accordingly, dissent. Inc.,
In Poyser v. Neuman Company, & 32, 40, the majority held that the Workmen’s Compensation Act does not preserve right “the of an employee to sue his injury where the employer’s caused intentional wrongdoing is no such provision [in t]here Zappala categorizes 2. I note Mr. Justice the Vocational Rehabilita- "agents” tion Service and Dr. Williams as insur- carrier, However, generalized using concept agree ance agency. I designation аppellees with Mr. Justice indepen- Larsen’s of these two dent contractors. *9 at Poyser Act.” Compensation Pennsylvania The Workmen’s However, Poyser 38, my dissent at 551. 514 Pa. A.2d “ of J.), purpose I ‘the out (joined by Papadakos, pointed Act] Compensation legislation [the this kind of the against to an employee the available remedy to restrict the employee, to close to compensation, in tort against the any recourse parties, to third Co., 251, 254- H. v. Arden Verner negligence.’ Kline added).” (1983) (emphasis Subse- 159-160 Co., 525 Pa. PMA Insurance quently, Kuney v. Poyser so majority expanded
A.2d 1285 the wrongdoing for the intentional right to sue preclude carrier, which of employer’s of carrier’s includes the insurance necеssity J.), I (joined Papadakos, my agents. dissent the Work- stated that an should be barred an action tres- maintaining men’s from at hands of separate he has incurred pass for the insurance carrier. employer’s compensation Now, majority extending bar insurance carriers’ tort actions in Pennsylvania: This is first independent contractors. having of contraсtors independent independent contractors of the Act immunity underlying purpose principal. immunity to such attenuated by extending is not served course, majority present If remains on its extremes. immune everyone will be and the em- liability, inten- have matter how ployee will no whatsoever —no despicable injury. tional or the act that caused the Accordingly, I would reverse order Court, affirming grant appellees’ summary motion for proceedings. for further judgment and remand PAPADAKOS, J., joins dissenting opinion. in this