Greene v. Transport Ins. Co.

• Decision Date: 13 January 1984
• Docket Number: No. 67165,67165
• Citation: 169 Ga.App. 504,313 S.E.2d 761
• Parties: GREENE v. TRANSPORT INSURANCE COMPANY.
• Court: Georgia Court of Appeals

Page 761

313 S.E.2d 761

169 Ga.App. 504

GREENE v. TRANSPORT INSURANCE COMPANY.

No. 67165.

Court of Appeals of Georgia.

Jan. 13, 1984.

Robert H. McDonnell, Atlanta, for appellant.

Michael T. Thornton, Atlanta, for appellee.

SHULMAN, Presiding Judge.

Appellant, an employee of Motor Convoy, Inc., filed suit against appellee, which is Motor Convoy's insurer for both workers' compensation coverage and motor vehicle coverage. In his complaint, appellant alleged that he had suffered a ruptured disc while using a motor vehicle owned by his employer and insured by appellee, and that appellee had refused to pay the personal injury protection benefits he sought. In its defense, appellee raised the doctrine of collateral estoppel and, subsequently, summary judgment based on this doctrine was granted to appellee. Appellant now argues that application of that doctrine was improper and untimely.

Appellee attached to its motion for summary judgment certified copies of the awards of the administrative law judge and the State Board of Workers' Compensation in the workers' compensation claim appellant filed based on the incident which allegedly resulted in appellant's ruptured disc. In an award affirmed by the full board, the ALJ denied appellant's claim for benefits, finding that "[t]he evidence shows as a matter of fact that the claimant had a cervical disc disease and the claimant has not carried the burden of proof to show that he had an accident and injury which arose in and out of the course of his employment..." The ALJ continued, stating that "the claimant's overweight and day-to-day activities contributed to his ultimate necessity to have an operation just as much or more than his work activities..." After perusing the findings and conclusions of the ALJ and the full board, the trial court granted summary judgment to appellee after it had determined that "the issues raised in the case at bar are the exact issues plaintiff raised in the workers' compensation case ... [and] the parties to the instant case were also parties to the workers' compensation proceedings."

1. Under a plea of estoppel by judgment, sometimes referred to as "collateral estoppel" or as "estoppel by verdict," "the former adjudication is a bar if the same issues were litigated by the parties or their privies in the previous action, though it is not essential that it be upon the same cause of action. [Cits.]" Smith v. Wood, 115 Ga.App. 265(1), 154 S.E.2d 646. "[T]he doctrines of res judicata and estoppel by judgment are applicable to awards of the State Board of [Workers'] Compensation on all questions of fact in matters in which it has jurisdiction." Woods v. Delta Air Lines, 237 Ga. 332, 227 S.E.2d 376.

Appellant does not take issue with the identity of the parties. In his first enumerated error, appellant contends that the trial court erred when it applied the estoppel defense because the workers' compensation proceedings did not conclude with a finding that appellant's disc condition existed prior to the alleged injury. However, that is not the real question; rather, it must be determined that the issue litigated in the workers' compensation proceeding was identical to that in the insurance case. Otherwise, collateral estoppel is inappropriate. Smith v. Wood, supra. After a review of the record, we agree with the trial court's assessment: the issue before the court in the insurance case was previously decided against appellant in the workers' compensation case.

Under the workers' compensation statute, the ALJ must determine whether the employee suffered a compensable injury, an injury "by accident arising out of and in the course of the employment..." OCGA § 34-9-1(4)(Code Ann. § 114-101). If one suffers "bodily injury ... arising out of the operation, maintenance or use of a motor vehicle which is accidental ...," he is entitled to basic no-fault benefits under the Georgia Motor Vehicle Accident Reparations Act. OCGA § 33-34-2(1)(Code Ann. § 56-342b). "It is interesting to note that the words 'arising out of' which have so often been construed in workers' compensation cases are the touchstone of liability under no-fault. They are commonly considered as meaning that the designated cause is a contributing proximate cause of the injury ... or where there is apparent to the rational mind, upon consideration of all the circumstances, a causal connection between the predicate and its subject ... The threshold question is whether the operating force bears such a...