The appellee, a member of the Arkansas National Guard, brought this action against Northwestern National Life Insurance Company (Northwestern), the appellant, to recovеr disability insurance benefits for a back injury. Northwestern issued a group disability policy to the National Guard Association of the United States Insurance Trust (NGAUS). The group disability policy provided bеnefits if the insured became totally disabled as a result of a nonoccupational accidental injury. However, the policy excluded from coverage any injury or sickness arising out of the insured’s occupation or employment for which the insured was eligible for worker’s compensation benefits or similar coverage.
The appellee incurred a series of back injuries. The first on March 15, 1985, while he was pushing a vehicle at his home. He suffered another on May 17,1985, at guard drill. The final injury occurred on July 17, 1985, when the appellee was working as а mechanic for the Arkansas National Guard. Appellee received disability benefits for the May 17th injury and received worker’s compensation benefits from the United States Depаrtment of Labor for the July 17th injury.
Northwestern denied liability based on a policy provision excluding any disability for which the insured is eligible for worker’s compensation or similar benefits. Northwestern also denied coverage alleging that the Employee Retirеment Income Security Act of 1974 (ERISA) preempted the appellant’s state law cause of action.
The jury returned a verdict of $19,800 for the appellee. The trial court awarded a 12% statutory penalty and attorneys’ fees of $10,000. The appellant appeals from the trial court’s denial of its post trial motions for a new trial or in the alternative for judgment notwithstanding the verdict. The appellee cross appeals, alleging the $10,000 attorneys fee awarded by the trial court is inadequate.
The appellant contends the trial сourt erred in refusing to give the jury an estoppel instruction. Our case law is quite clear that estoppel in pais or equitable estoppel may be pled in both courts of equity аnd courts of law. Aclin v. Caplener,
In Atkins the claimant signed a joint petition that his lung and brain abscess problems were work related and collected $15,000 in worker’s compensation benefits as a result of a settlement with his employer and the Workers’ Compensation Commission. Subsequently, the claimant attеmpted to collect under a health care policy claiming the illness to be non-work related. The Court of Appeals held that the claimant signed a sworn joint petition maintaining that his lung and brain abscess problems were work related, and therefore, the claimant was estopped from asserting either illness to be non-work related. The Court of Appeаls quoted from a Texas Court of Appeals case citing the controlling rule:
If one having a right to pursue one of several inconsistent remedies makes his election, institutes suit, and prosecutes it to final judgment, or receives anything of value under the claim thus asserted, or if the other party has been affected adversely, such election constitutes an estoрpel thereafter to pursue another and inconsistent remedy.
Aetna Life Insurance Company v. Bocanegra,
Here, the appellee signed a statement certifying that his July 17, 1985, injury was sustained in the performance of his duty as an Arkansas National Guard mechanic. Subsequently, the appellee instituted suit to collect disability benefits from the appellant alleging that the March 15, 1985, back injury was the permanently disabling injury. On onе hand the appellee claimed that the July 17th injury was work related, on the other he claims that the July 17th injury was not work related but merely an aggravation of his earlier non-occupational injury.
The appellant’s theory of the case is that the benefits for which the appellee now seeks recovery relate to the same back injury, the July 17th episode, for which he recovered worker’s compensation benefits. Relying on Atkins the appellant requested an estoppel instruction because the election by the appellee to collect worker’s compensation benefits for the July 17th injury precludes collection of disability payments for the same injury. Despite the trial judge’s remark that estopрel was not familiar to the jury and not generally understood by laypersons, our law requires that a trial court instruct the jury on all material issues presented by the pleadings and the evidencе. Daniel v. Quick,
The appellee argues that an estoppel instruction was not appropriate because the appellant failed to prove the four central elements of estoppel.
While the principle of requiring сonsistency is customarily considered a form of equitable estoppel, although lacking the elements of reliance and injury, it is more a matter in the nature of a positive rule оf procedure based on manifest justice.
We find that the trial judge’s failure to give the appellant’s estoppel instruction constituted error, and accordingly we reverse.
Although wе reverse upon the finding the trial judge erred in failing to give an estoppel instruction, we comment on appellant’s additional points for reversal for purposes of retrial. The appellant contends it was error to hold that the appellee’s state law causes of action were not preempted by the Employee Retirement Income Security Act of 1974 (ERISA).
The appellаnt also alleged that the trial court erred in admitting plaintifPs/appellee’s exhibit #13, a document addressed to the appellee from the Civil Service Retirement System. Appellee introduced this document in part to prove that the funds from the Department of Labor were charged against his retirement benefits and therefore did not constitute worker’s comрensation or similar benefits. The appellant argued that this document was the only basis upon which the jury might have determined that the appellee was not attempting to recover disability benefits from the same injury for which he received worker’s compensation benefits.
The trial court exercises discretion in the admission of evidence. Missouri Pac. R.R. v. Mackey,
Reversed and remanded.
Notes
Appellee received benefits of $21.67 for the May 17th injury under the rehabilitation clause of the policy.
The four elements of estoppel are: (1) the party to be estopped must know the facts; (2) one must intend that his conduct shall be acted on or must so act that the party asserting the estoppel has the right to believe the other party sо intended; (3) the party asserting the estoppel must be ignorant of the true facts; and (4) the party asserting the estoppel must rely on the other party’s conduct. Linda Elenia Askew Trust v. Hopkins,
The appellee’s complaint alleged breach of contract and also asked for a 12% statutory penalty and attorneys’ fees pursuant to Ark. Code Ann. § 23-79-208 (1987).
