*1 air. ongoing Because the condition present leak case
сarbon monoxide isolated, sudden, temporary, In- coverage Air not exclude Exclusion
door does resulting injuries. Because the Indoor coverage,
Air exclusion did we exclude its whether enforcement
need address prohibited by strong public
would
policy of the state.
Conclusion question posed by 24 The the Unit- initial District for the States Western
ed public
District addressed whether Oklahoma prevent In-
policy would enforcement question Air Exclusion. Before
door answered, necessary it was
could be deter- Air Exclusion
mine what the Indoor exclud- Air The reach the Indoor Exclusion is
ed.
subject multiple interpreta- reasonable
tions; arguably apply only it could to either air,
permanent conditions or both tem-
porary permanent conditions of the air. provision subject multiple is
Because the consequently ambiguous,
interpretations and
it construed properly the insurer.
Accordingly, the Air Indoor Exclusion does coverage bodily injury
not exclude result- sudden,
ing from accidental leaks of carbon
monoxide.
Tracy MEEKS, Appellant,
GUARANTEE INSURANCE
COMPANY, Appellee. 113,752
No.
Supreme Court Oklahoma.
FILED: 02/28/2017 *3 Bisher,
Rick RYAN BISHER' RYAN SIMONS, City, PHILLIPS & Oklahoma *4 Oklahoma, for Appellant. Latham, Carter,
Bob Lindsey Brian Eliza- Albers, beth LATHAM STEELE WAGNER. LEHMAN, Tulsa, & for Appellee. Oklahoma ’Colbert, J.
¶ 1 appeal retained to reiterate proper application this Court’s decision Ins. Summers v. Zurich Am. 33, 565, monetary awards—al- though paid—not provided as ordered. Tо- day, reemphasizes that an order of (WCC) Workers’ clearly previously that ordered identifies finds insurer benefits and failed dem- that in, delay onstrate its or non- cause for with, compliance providing court ordered require- benefits satisfies the certification ments delineated Summers. Because the here, requirements were met employee may proceed on court his against bad-faith claim insurer for insurer’s alleged provide tempo- refusal to rary disability by total as ordered benefits the WCC.
FACTS AND PROCEDURAL HISTORY 2014, September 10, appellant, 2 On Tracy (Meeks), petition Meeks filed dis- appellee, alleging court trict Southside Recycling through (Employer), LLC its in- carrier, surance Insurance Co. Guarantee (Insurer), engaged in had in bad faith systematic pattern refusing practice temporary disability court ordered total (TTD) separate twenty-six occa- 2013, 17, sions, just support, In Meeks DECEMBER cause. TTD previously on various entered 24,
relied DECEMBER particular, Meeks orders WCC. 31, 2013, JANUARY DECEMBER proffered a Order that June WCC stated: JANUARY JANUARY determined, previously The Court 28, 2014, JANUARY was, ordered, claimant entitled 4, 2014 FEBRUARY temporary disability payments. total twenty-six separate for a total of occa- respondent such Court ordered sions. repeatedly respondent benefits and had penalties on Insur- The WCC assessed based comply Court’s failed with the orders. payment prior late TTD How- er’s awards. given respondent the op- The Court has ever, denied certification under portunity to its just respondent’s “due to carrier refusal or with the failure claimant, penalty requested paying said matter, respon- in this Court’s orders today.” healing to the satisfy its in that dent failed burden ¶ 3 Insurer its motion to filed dismiss regard resulting ordering contending lieu answer that Meeks failed respondent pay penalties and interest procedural requirements to follow the under 18, 2010, its APRIL AUGUST Act, the Oklahoma JANUARY SEPTEMBER commencing prerequisite to ac- AND JUNE OCTOBER Relying tion in district court. Insurer 2012 orders. *5 Sizemore, alleged that a on Insurer Respondent comply to fail to continued premised only upon action a can be carrier’s payment order for with the Court’s tem outright refusal porary total benefits to claimant disability acknowledged that award. Insurer Meeks 2014, day and now on this 19th of JUNE sought pursuant certification WCC consideration, this for cause and af came 42(A), request to section but that was denied. counsel, hearing arguments of ter Summers, ¶ Relying 4 on the district court FOL Court and ORDERS AS FINDS finding Insurer’s motion to dismiss sustained LOWS: possess that Meeks a certification or did again, respondent THAT has 42(A) complying other order with section cause, just comply claimant failed Athough the Rule 58. district court acknowl- temporary disability payments total since 26, edged that the June 2014 Order WCC 12, the last 2012 on order OCTOBER findings made detailed of fact Insurer’s about following specific occasions: twenty-six separate failing occasions 24, 2012, DECEMBER good orders absent WCC 2012, DECEMBER 31 shown, court based its de- 2013, 7, 2013, 14, JANUARY JANUARY express nial on for denial certifi- WCC’s 21, 2013, JANUARY prior cation that all awards were satisfied hearing. appealed. to the WCC Meeks 28, 2013, 4,
JANUARY
FEBRUARY
2013,
again,
presented
5 Once
this Court is
2,
5, 2013,
2013,
MARCH
APRIL
surrounding
with the
certification
confusion
procedures
requirements pursuant
15, 2013,
OCTOBER
section
the Workers’
22, 2013,
29,
OCTOBER
OCTOBER
Summers,
еxplained
Act
58
and Rule
as
2013,
33,
565,
213
and set forth
P.3d
12,
NOVEMBER
NOVEMBER
36, 142
v.
Cas.
2006
Sizemore Cont’l
OK
19,
2013,
2013
NOVEMBER
confusion, here,
compound
P.3d 47. The
was
NOVEMBER
by the fact that Meeks’
ed
bad-faith claim
DECEMBER
alleged
premised on Insurer’s
failure to
ordered,
not on a claim of
DECEMBER
as
benefits
pro
Thus,
(2)
unpaid
unpaid
benefits.
retained
or
benefits have
been
reemphasize
appeal
vided as
the two alter-
ordered” without
cause.
Summers,
33, ¶
categories
for
native
certification articulated
213 P.3d at
Summers,
Silljer
added).
(emphasis
and reaffirmed
v.
or
certification
Mega
der is
jurisdiction
Life and Health Ins.
the vehicle that confers
v, Mercy
are: “that a final
the' district
court.
Stewart
Center,
Inc.,
(1)
¶ 3,
unpaid
or Health
award
remains
provided
(2)
(where
have not
or-
reemphasized
been
as
Summers, ¶
(em-
procedural
dered.”
faith action for As STANDARD OF Summers, REVIEW delineated certification (1) procedures remaining differ awards appeal 6 The of this essence turns (2) unpaid provided benefits not or upon propriety of the district court’s dered. jurisdiction—purely question law. issues of Court reviews de novo without law Unpaid, Payment, Outright 1. The Late or legal rulings. to the lower deference court’s Pay Monetary Refusal tо Award Serv., Tcina, Inc., K H Inc. & Well 1219, 1223. 62, 9, 51 procedures unpaid, payment of, late insurer’s out
ANALYSIS
right
monetary
refusal
a final
benefit
¶7
outset,
At
owing
a district court
employee
award still
are two fold:
(1)
may only
jurisdiction
exercise
in an em must
provided
first utilize the mechanism
42(A)1
ployee’s
bad-faith action
or her
Compensa
his
of the Workers’
(2)
employer/insurer
employee
when that
tion Act
have the
award certified
Compen
judgment
an order of the
obtained
enforcement as a
of the district
certifying
pursuant
sation Court
“that
final
work
to Rule 58 of the Workers’
Summers,
ers’
award
remains
either
Court rules.
42(A),
1. Under section
November
shall beаr interest at the
*6
percentage
applicable
judgments
rate
to
in civ-
compensation
payment
A. If
of
or an install-
pursuant
il cases
to Section
Title 12
727 of
of
payment
compensation
ment
due
the
under
Upon
filing
the Oklahoma Statutes.
the
of the
award, except
of an
terms
in the case of an
copy
certified
of the Court's award a writ of
appeal of an award or an
from the
award
process
execution shall issue and
shall be exe-
Fund,
Multiple Injury
is
Trust
not made within
taxed,
cuted
the cost thereof
as in the case
and
(10) days
ten
after the same is due
the
execution,
judgments
of writs of
оn
of courts of
employer
therefor,
or insurance carrier liable
record,
provided by
as
Title 12 of the Okla-
may
the Workers'
Court
order a
Statutes;
however,
provided,
provi-
homa
the
copy
certified
of the
be filed in the
award to
relating
section
sions
execution and
any county,
office of the Court clerk of
which
process for the enforcement of awards shall be
lump
award whether accumulative or
sum
provisions
are cumulative to other
now
and
existing
subject
shall have the same force and be
the
may
adopted
or which
hereafter be
judgments
same law
of the district Court.
as
relating to liens or enforcement of awards or
Any compensation
payments
awarded and all
compensation.
claims for
thereof directed to be made
order of the
added).
(emphasis
Okla.
tit.
Stat.
Court, except
appeal
in the case of an
of an
award or an award of
from the
2. Rule 58 of Rules of the Oklahoma Workers’
Fund,
Injuty
Multiple
Trust
shall bear interest
provides:
(18%)
eighteen percent
per year
rate of
at the
application
directing
paid by
An
for an order
certifica-
from the date ordered
the Court until
any
compen-
the date of satisfaction. On or
November
tion to district court of
workers'
after
may
paid
be
after
to the
ordered
from
sation award
heard
notice
to be
giv-
Multiple Injury
respondent and insurance carrier has been
the
Trust
shall bear sim-
Fund
(10)
ple
only
days
percentage
applica-
en
the scheduled
interest
at the
at least ten
before
rate
respondent
judgments
pursuant
such trial the
and
ble
in civil
trial thereon. At
cases
opportu-
be afforded an
insurance carrier shall
Section 727 Title 12
the Oklahoma Stat-
good
why
application
Any
nity
from
date of
to show
cause
the
utes
the
the award.
award
granted.
Multiple Injury
prior
should not be
Trust Fund
42(A)
¶¶
9-10,
inquiry
an
pensation
discourage
non-com-
mere
identifying
“certification order will issue
pliance,
provide a
for en-
mechanism
provided
not
benefits which have
been
as
judgment in district court.
forcement of the
The certification
make
ordered.
order will
Sizemore,
¶ 25,
at
2006 OK
53-
P.3d
specific findings [of facts]
to the basis for
But,
an
insurer’s bad
refusal
that
the court’s determination”
the insurer
beyond
incentive. Id. Nota-
award is
good
why
failed
demonstrate
cause
42(A)
contemplates
bly,
only
section
dollar
Summers,
award should not be
certified.
owing
monetary
on
amount still
award.
¶ 11,
at
OK 33
213 P.3d
owing, by
no
is
Consequently,
amount
where
42(A)
terms,
apply.
not
its
section
does
See
reemphasizes
11 This Court
Summers,
¶33, 13,
569;
2009 OK
at
P.3d
employee
complied
where
42(A).
85, §
see also
Stat.
Okla.
tit.
42(A)
Rule
and obtains
certifying
9 In
an award аs un
finding that an
WCC order
award mone
paid
employer
pursuant
42(A),
to section
tary
unpaid
good
benefits remains
(10)
given
and its insurer must be
at
ten
least
may
cause,
employee
days
notice
the trial
certification.
(1)
copy
file
the certification
certified
2008).
(Supp.
Okla.
ch. Rule 58
Stat. tit
attached,
order,
with the award
time,
At that
the insurer
judgment
proceed
as a
court
opportunity
shall be afforded an
to show
pursuant
execution
to section
good
why
application for
an order
may
the claimant
a claim tort for the
file
directing certification
the district
Sizemore,
insurer's
faith.
granted.
not
the insur
should
Id. Beсause
¶ 26,
option,
142 P.3d
54. In the latter
at
duty
er owes a
to act in
faith and deal
unpaid
the amount
benefits listed
fairly
injured employee,
towards the
the in
an element of
order becomes
why
surer
the burden to
bears
demonstrate
damages
the claimant’s
in the bad faith
provided
as ordered. See
were
claim.
Co.,
Christian Am.
Home Assurance
904;3
Summers,
¶¶
25-26,
¶ 12,
parties: intention- the Workers’ such that Guarantee Insurance ally just “invites, to make encourages gives refused and and viabili- refusal payments to of Mi-. required the detriment ty by injured to a bаd faith claim the and paid Although Insurance Meeks. Guarantee Sizemore, 36, 142 unpaid worker.” 2006 OK arrearages penalty purge the and as a ¶ 1). J., (Taylor, concurring 47 P.3d being contempt to held in of amount avoid may payment in its de- court and use such WINCHESTER, J., dissenting:' claim, payment of the bad the fense prevent bringing cannot Meeks from his Mr. ¶ judge 1 The law used the administrative in court. bad faith claim the district statutory power to appropriate assure the ¶ of tort of essence the “[T]he intentional insurer/employer paid or- the what regard to insurance indus bad faith with the question insurer/employ- Without the dered. unreasonable, try is the insurer’s required pay that in amount. As er conduct, including unjustified withholding the ease, judge penalty the and the assessed policy....” payment of due under a McCor paid, including pen- ordered was the amount Co., kle Atlantic Ins. 1981 OK v. Great alty. principle I would reinforce the the faith, 21,637 In P.2d 587. breach bad judge contempt power has the to insure com- case, delay of contract insurance the refers judge’s depart pliance with the I orders. diligent duty act in a manner an insurer’s majority expanding faith” to in “bad negotiation, investigation, in relation de compensation proceedings. workers’ fense, being of and settlement claims made against a, In faith claim the insured.8 ¶2 my I continue to hold as ex view insurer, compensation a workers’ pressed in the dissent attached to Sizemore unjustifiable prove delay in claimant must Co., 36, 142 Casualty v. Continental consequences payment of of an award. In that I that I P.3d 47. ease stated would of the actual delay the the basis dama form consistently principal to the hold ges.9 correct Court was Kuykendall Aerospace v. both Gulfstream recognized a it first common Goodwin when Technologies, 2002 OK 66 P.3d and tort insurance law action for an earner’s bad Insurance, v. AIU Deanda compensa refusing faith in G.S.2001, provided § 1080. Title 85 P.3d tion award. Sizemore remedy the for failure under the by correctly overruling reaffirmed the law of to the terms the award claimant. Kuykendall contrary decisions to the and wrongful delay pay remedies for exclusive Today’s squarely Deanda. fits within decision by pay, provided ment or refusal to which is of the Goodwin Sizemore line cases. the exclude statutes compensation insurer When a workers’ re common-law fuses to and ordered remedies. awarded Century payments 8. awarded and all thereof Badillo v. Mid Ins. Court, by except to be of directed made order appeal in the case of аn of an award.... shall delay precipitates precise 9. “Unwarranted eighteen percent of bear interest at the rate sought hardship economic the insured to avoid (18%) per year paid from the date ordered by purchase policy.” die of Christian Am. Upon of Court until the date satisfaction ... Home Assurance filing copy of the certified of the Court's award a process of shall be writ execution shall issue and taxed, in the executed the cost thereof as 42(A), provided perti- 1. Title 85 O.S. execution, judgments of of of case writs part: payment nent "If of or an record, provided by of 12 of the payment courts Title installment due under Statutes; however, provided, pro- the terms of an award ... is not within ten Oklahoma made (10) days relating after the same is due visions of this section execution therefor, or insurance carrier liable process shall be for the enforcement awards may order a to be copy certified provisions aw.ard now exist- and are to other cumulative any county, in the court clerk of filed office relating ing may adopted or hereafter be which lump which or sum award whether accumulative liens or enforcement of awards claims subject shall have force to the the same compensation. judgments Any same law as court. majority opinion toppling 3 The continues allow the essence the tradeoff.” providers ben- [Footnotes omitted.] Workers efits be sued bad faith. Deanda, 54, ¶ 5, at (Opala, concurring). J. concurring opinions In one the two *11 ¶ Deanda, Justice Boudreau wrote: Opala Justice in a continued footnote with this observation: Legislature designed “The Oklahoma “Exposing compensation workers’ carri- compensation system as a our workers’ liability ers to for delictual bad faith would fast, way employ to compensate efficient lawyers forcе to hire insurers to defend job injuries. ees for accidental on the The litigation. a new class Carriers compensation system is a com also would have to the risk of assume prehensive statutory to fix scheme com losing satisfying potentially eases and pensation for, to, medical care large uncontemplated verdicts. This liabili- employees. Soloray, Caffey covered ty passed employers be on to in would the pro quid It is a OK 874. premiums. form of insurance increased quo employer/carrier between the and the employers costs to added would employee. employeе gives up right disrupt equilibrium turn costs and tort, gaining remedy to sue in a certain benefits that the Workers irrespective exchange, of fault. Id. In promised Act to maintain.” high litigation cost of avoids the Deanda, 54, n.11, possible judgments. Upton v. 98 P.3d at n. excessive J, Corrections, Dept. (Opala, concurring). State ex. rel. 46, 9 P.3d judge law 6 The administrative has been given citing power carrier con- implement bargain, Legisla- “To tempt noncompliance judg- with final compensation ture the workers’ established Commission ment when the carrier remedy system as the em- exclusive an uncontroverted refuses medical or job suffer on the ployees who accidental expense. The related Administrative Work- injuries. remedy Under the exclusive doc- Act, provides ers’ Section 732 trine, compensation replace em- part: pertinent ployers/carriers’ liability tort for work-re- any person attending any pro- party “If or injuries.” accidental lated ceeding ... before the Commission refuses ¶¶ Deanda, 2-3, at 1090 any judgment of an final (Boudreau, concurring). J. judge administrative or the Commis- law concurring opinion 4 In the other found willfully sion or refuses an uncon- Deanda, Opala opined: Justice expense or with- troverted medical related forty-five days respondent after the very employer’s “The reason an and an statement, person received the insurer’s status-based and contract-based party, at of the the discretion administra- immunity liability from tort are cotermi- Commission, judge may tive law or the be stems, part, equity’s prin- nous in contempt found to be of the Commission Insurers, ciple subrogation. who are may subject to a not to fine exceed by agreement that calls for bound 10,000.00).” ($ Ten Dollars Thousand insured, agree of the indemnification encourage shoes and I administra- stand the insured’s assume While would compensation judges pow- contempt the sum total of the tive to use their latter’s law statute, responsibility. To that a workers’ ers I would hold consistent with this immunity from in the insurer’s tort find that the district court cause now granting in- liability is not before this erred coterminous with immunity “crafty employer’s insured own surer’s motion to But would dismiss. willfully refusing abrogate protection by gamesmanship” the latter’s indeed by the removing bargain’s very pedestal as ordered administra- Okla.Sess.Laws, ary 2. c. eff. Febru- remedied, only judge can be
five law penalty in the workers’ interest statutes, a fine for but also 10,000.00.
contempt up to $ respectfully Accordingly, I dissent. *12 and Cheri
Susan SPENCER Petitioners,
Chandler, WYRICK, Respondent.
Justice Patrick 115,765 No.
Case
Supreme Court Oklahoma.
FILED MARCH 2017
Ryan Kiesel, Brady Henderson, D. R. Oklahoma, City, ACLU of Oklahoma Okla- homa, Attorneys for Petitioners Leader, Special Attorney Neal Assistant General, General, Attorney Office of the Oklahoma, City, Attorney for Oklahoma Re- spondent
