Ihm v. Crawford & Co.
| Citation | 254 Neb. 818,580 N.W.2d 115 |
| Decision Date | 26 June 1998 |
| Docket Number | No. S-96-237,S-96-237 |
| Parties | Bruce A. IHM, Appellant, v. CRAWFORD & COMPANY and Zurich Insurance Company, Appellees. |
| Court | Nebraska Supreme Court |
Syllabus by the Court
1. Demurrer: Pleadings: Appeal and Error. In an appellate court's review of a ruling on a general demurrer, the court is required to accept as true all the facts which are well pled and the proper and reasonable inferences of law and fact which may be drawn therefrom, but not the conclusions of the pleader.
2. Jurisdiction: Judgments: Appeal and Error. When a jurisdictional question does not involve a factual dispute, its determination is a matter of law, which requires an appellate court to reach a conclusion independent from the decisions made by the lower courts.
3. Workers' Compensation: Torts: Liability. The Nebraska Workers' Compensation Act is an employee's exclusive remedy against an employer for an injury arising out of and in the course of employment, and as such, payment of workers' compensation benefits relieves the employer of tort liability in connection with an accident.
4. Workers' Compensation. When an employee sustains an injury that arises out of and in the course of his or her employment and such injury is covered by the Nebraska Workers' Compensation Act, then the employee surrenders his or her right to any other method, form or amount of compensation or determination thereof for that injury against his or her employer or the workers' compensation insurer.
5. Workers' Compensation: Penalties and Forfeitures. The penalty provisions contained in Neb.Rev.Stat. § 48-125(1) (Reissue 1993) exclude the possibility of a common-law bad faith tort claim for damages resulting from delay in either authorization for or payment of medical expenses.
Steven H. Howard, of Law Offices of Ronald J. Palagi, P.C., Omaha, for appellant.
Thomas M. Locher and Paul A. Mihulka, of Hansen, Engles & Locher, P.C., Omaha, for appellee Crawford & Co.
Thomas J. Culhane and Kevin R. McManaman, of Erickson & Sederstrom, P.C., Omaha, for appellee Zurich Insurance Co.
The appellant, Bruce A. Ihm, was injured while working for Millar Elevator Service Company (Millar Elevator). Appellee Zurich Insurance Company (Zurich) is Millar Elevator's workers' compensation insurance carrier, and appellee Crawford & Company is Zurich's agent for processing and administering workers' compensation claims. Ihm received treatment and underwent various surgeries as a result of his compensable injuries. During the course of his treatment, Ihm developed reflex sympathetic dystrophy. Unable to obtain adequate medical treatment in Nebraska for the condition, Ihm sought treatment in Colorado. Ihm claims that he suffered additional personal injuries and damages because his treatment for reflex sympathetic dystrophy was delayed as a result of the appellees' refusal to provide authorization for the treatment. Ihm's petition in the district court claimed that the delay violated the appellees' duty of good faith in processing and administering Ihm's workers' compensation claim. The district court sustained appellees' demurrers, finding that the Nebraska Workers' Compensation Act provided the exclusive remedy for Ihm's injuries and that therefore the court lacked subject matter jurisdiction over the cause. For the reasons that follow, we affirm.
Ihm filed a petition in the district court for Douglas County on August 1, 1995, alleging that the appellees had failed to act in good faith in administering his workers' compensation claim. Specifically, Ihm alleged that on February 8, 1990, he suffered severe and debilitating injuries as a result of an on-the-job accident while he was employed by Millar Elevator. The petition states that the injuries On December 5, 1995, the appellees each filed a demurrer to Ihm's petition. Zurich's demurrer asserted that Ihm's petition failed to state facts sufficient to constitute a cause of action. Crawford & Company's demurrer asserted that the district court lacked subject matter jurisdiction over the case, that there was an action pending between the parties for the same cause in the Nebraska Workers' Compensation Court, and that the petition did not state a cause of action.
Ihm received as a result of the accident were compensable under the Nebraska Workers' Compensation Act. Ihm claims that while undergoing treatment for his compensable injuries, he developed a condition known as reflex sympathetic dystrophy.
On February 5, 1996, the district court sustained the appellees' demurrers. The court determined that the Workers' Compensation Court was the sole source of remedy over the issues of the case and that Ihm had failed to state sufficient facts to constitute a cause of action for the tort alleged under Nebraska law. The court then dismissed the case for lack of subject matter jurisdiction. Ihm timely appealed.
On appeal, Ihm asserts that the trial court erred (1) in sustaining the demurrers and finding the petition did not and could not state a cause of action, (2) in determining that the Nebraska Workers' Compensation Act provides the exclusive remedy for intentional bad faith tort claims and that the act bars any such action, and (3) in dismissing the action and not allowing Ihm an opportunity to amend his petition.
In an appellate court's review of a ruling on a general demurrer, the court is required to accept as true all the facts which are well pled and the proper and reasonable inferences of law and fact which may be drawn therefrom, but not the conclusions of the pleader. Coburn v. Reiser, 254 Neb. 495, 577 N.W.2d 289 (1998); Syracuse Rur. Fire Dist. v. Pletan, 254 Neb. 393, 577 N.W.2d 527 (1998).
When a jurisdictional question does not involve a factual dispute, its determination is a matter of law, which requires an appellate court to reach a conclusion independent from the decisions made by the lower courts. Big John's Billiards v. Balka, 254 Neb. 528, 577 N.W.2d 294 (1998); In re Interest of Floyd B., 254 Neb. 443, 577 N.W.2d 535 (1998).
The Nebraska Workers' Compensation Act is an employee's exclusive remedy against an employer for an injury arising out of and in the course of employment, and as such, payment of workers' compensation benefits relieves the employer of tort liability in connection with an accident. Brown v. American Tel. & Tel. Co., 252 Neb. 95, 560 N.W.2d 482 (1997). The Nebraska Workers' Compensation Act extends a degree of immunity to workers' compensation insurers as well. Neb.Rev.Stat. § 48-110 (Reissue 1993) provides in part:
When employer and employee shall by agreement, express or implied, or otherwise as provided in section 48-112 accept the provisions of the Nebraska Workers' Compensation Act, compensation shall be made for personal injuries to or for the death of such employee by accident arising out of and in the course of his or her employment, without regard to the negligence of the employer, according to the schedule provided in such act, in all cases except when the injury or death is caused by willful negligence on the part of the employee.
Neb.Rev.Stat. § 48-111 (Reissue 1993) further provides:
Such agreement or the election provided for in section 48-112 shall be a surrender by the parties thereto of their rights to any other method, form, or amount of compensation or determination thereof than as provided in the Nebraska Workers' Compensation Act, and an acceptance of all the provisions of such act, and shall bind the employee ... as well as the employer.... For the purpose of this section, if the employer carries a policy of workers' compensation insurance, the term employer Read together, these two statutes provide that when an employee sustains an injury that arises out of and in the course of his or her employment and such injury is covered by the Nebraska Workers' Compensation Act, then the employee surrenders his or her right to any other method, form, or amount of compensation or determination thereof for that injury against his or her employer or the workers' compensation insurer.
shall also include the insurer. The exemption from liability given an employer and insurer by this section shall also extend to all employees, officers, or directors of such employer or insurer....
Ihm's action against the appellees is an action for the intentional tort of bad faith. The primary question presented by this case is whether Ihm can maintain such an action given the foregoing exclusivity provisions of the Nebraska Workers' Compensation Act. If the exclusivity provisions bar an action for bad faith against a workers' compensation insurer, then the district court lacked subject matter jurisdiction over the action and correctly sustained the appellees' demurrers.
Ihm's petition states that the original accident arose out of and in the course of his employment and that the injuries he sustained as a result of the accident are compensable under the Nebraska Workers' Compensation Act. Ihm further pled that he has performed "all the terms, covenants and conditions to be performed on his part under the Nebraska Workers' Compensation Act." However, it is Ihm's position that the action against the appellees is not an action for compensation for his work-related injuries. Rather, Ihm claims, and we must assume for the purposes of this appeal, that the appellees breached their duty of good faith in the administration of his workers' compensation claim by refusing to authorize reasonable medical treatment for his compensable injuries. Ihm asserts that this refusal and the resultant delay in treatment caused him to suffer greater permanent impairment, extended pain and suffering, lost wages and loss of earning power because of the greater permanent impairment, future medical expenses,...
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