The intersection of workers’ compensation laws and automobile insurance can lead to difficult situations in which a plaintiff may not know who is responsible for the bills in his or her accident. An experienced Maryland attorney familiar both with personal injury law and workers’ compensation law can help ensure that the right party is held responsible.
In a recent case, a Maryland appellate court considered a motor vehicle accident in which the defendant, who was driving for his employer, rear-ended the plaintiff. The plaintiff’s car was insured by Progressive; the policy included uninsured/underinsured motorist coverage. The defendant’s car was insured by State Farm and the State Farm policy included third-party liability coverage.
Because of the accident, the plaintiff suffered injuries to his knee and lower back. These injuries were covered by his employer’s workers’ compensation insurance. The plaintiff filed not only a workers’ compensation claim, but also a third-party claim against the defendant and his insurer Progressive for denying him underinsured motorist benefits.
Before trial, the defendant offered the plaintiff his $25,000 (State Farm) policy limits. Progressive would neither accept the offer, nor waive subrogation. It tendered the State Farm check to the plaintiff and the plaintiff amended his complaint to sue Progressive for breach of contract.
The jury found for the plaintiff, awarding him $91,583.90. The $25,000 payment was deducted and the balance was left owing. The workers’ compensation claim was closed.
The plaintiff demanded that Progressive pay part of the judgment under its underinsured motorist coverage, but Progressive refused. The plaintiff filed a motion with the court to enforce the judgment and order Progressive to pay the balance. The trial court denied the motion and the plaintiff appealed.
The Court of Special Appeals reasoned that the parties agreed about the balance due, the amount of the workers’ compensation lien for benefits paid, and that Progressive could reduce benefits payable to the plaintiff by the amount of workers’ compensation benefits that were unreimbursed.
The plaintiff, however, argued that the amount of the lien was not applicable. He argued that instead the amount of the reimbursement should be reduced by the proportional amount of attorneys’ fees and costs. He also argued that the court first had to calculate the amount Progressive owed to him, and then determine the workers’ compensation benefits that Progressive could deduct from what it owed. Through a set of complicated calculations that took out attorneys’ fees, the plaintiff claimed that $39,708.32 was the amount of unreimbursed workers’ compensation benefits. He argued that the insurer could subtract this sum of unreimbursed benefits from the judgment balance of $66,583.90, and pay him $26,875.58.
The insurer argued that the statute didn’t allow the workers’ compensation lien to be reduced by costs or attorneys’ fees. Rather, the lien held by the workers’ comp insurer simply represented the benefits recovered by the plaintiff. It argued that because the workers’ comp lien of $84,446.21 was more than the $66,583 of the judgment, Progressive did not owe anything to the plaintiff.
The Court of Special Appeals explained that the plain meaning of reimbursement is a repayment or restoration. In this case, the statute was not ambiguous. The amount of reimbursement available by statute was determined by the amount of benefits received. There was no statutory authority for the plaintiff’s claim that the reimbursement amount should be the workers’ compensation lien minus attorneys’ fees. Therefore, the court found that the insurer owed the plaintiff nothing.
If you are hurt while driving for your employer, you should consult with an experienced Maryland personal injury and workers’ compensation benefits attorney as soon as possible. Contact the attorneys of Steinhardt, Siskind and Associates at (866) 902-4111 or via our online form. We can assess what the best course of action will be to obtain the maximum recovery for your injuries.
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