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Workers compensation is the exclusive remedy for a permanently disabled worker and his wife who allege that an insurer and its claims administrator delayed, discouraged and denied benefits for 10 years, the Texas Supreme Court has ruled.
Glenn Johnson worked for Tucson, Arizona-based Asarco L.L.C., a mining, smelting, and refining company, as a rotary furnace operator in Amarillo, Texas. Mr. Johnson was involved in an accident in 1998 that resulted in third-degree burns on more than half his body, and “subsequent treatment has required the amputation of his left arm below the elbow, multiple skin grafts and the loss of full use of his right hand,” according to an Amarillo Globe-News report from Feb. 18, 1999.
There is no dispute that Mr. Johnson is entitled to lifetime workers comp benefits, however, there are disputes over the “details and amounts” of those benefits, court records show.
According to records, Mr. Johnson and his wife Natalie Johnson filed a lawsuit against Asarco's workers comp insurer, Greensburg, Pennsylvania-based Old Republic Insurance Co., and its claims administrator, Atlanta-based Crawford & Co. Mr. and Mrs. Johnson allege that, for 10 years, there has been “a battle plan to delay, discourage and deny” benefits “to wreak havoc on Glenn's and Natalie's lives,” records show.
While they agreed they must pursue claims for workers comp through the administrative process, they said they intended to pursue claims for “unrelated” damages in the courts, according to records.
Crawford filed a motion for summary judgment, but the state's 7th District Court of Appeals in Amarillo denied its petition in March 2014, records show.
The Texas Supreme Court on Friday ruled that “the Division of Workers' Compensation has exclusive jurisdiction over the Johnsons' claims and the Workers' Compensation Act provides their exclusive remedies.”
“The Act bars the Johnsons' claims for negligence, gross negligence, breach of contract, quantum meruit, breach of the duty of good faith and fair dealing, and statutory violations,” the ruling states.
The Johnsons argued that Mrs. Johnson isn't seeking relief as an Asarco employee, so her claims are independent of the Workers' Compensation Act, records show. However, according to the ruling, “Natalie's claims, like Glenn's, arise out of Crawford's conduct in investigating, handling, and settling Glenn's claim for workers compensation benefits. … We have held that an employee's spouse cannot bring a separate action alleging claims under the Act.”
Ruling that the state's Division of Workers' Compensation has exclusive jurisdiction over Mr. and Mrs. Johnsons' claims, the Texas Supreme Court concluded that Crawford is entitled to mandamus relief.
The 11th U.S. Circuit Court of Appeals on Thursday found that Florida's workers compensation exclusive remedy provision prevents a $9.5 million liability judgment from being paid by an insurer to the estate of a Florida worker killed on the job.