The Indiana Court of Appeals reversed a finding that a company had acted in bad faith in denying workers' compensation benefits because there was a dispute over who should pay the benefits. The appellate court also encouraged employers to come to an early agreement to share treatment costs pending a liability determination to avoid a situation similar to the one in the instant case.
In Ag-One Co-Op and Trane v. James Andrew Scott, No. 93A02-0904-EX-298, James Andrew Scott, a former Trane employee who went to work for Ag-One, went without medical care or compensation from June 2004 until September 2006 because Trane and Ag-One Co-Op disputed who was responsible for his medical expenses. Scott hurt his shoulder in September 2002 while working for Trane and received workers' compensation benefits. He worked for Ag-One from March to May in 2004 and re-aggravated his shoulder injury. Scott filed an application for adjustment of claim against Trane; Trane asked that Ag-One be brought on as a party because it believed the company was liable for part of Scott's injuries.
In early 2006, a single hearing member of the Indiana Worker's Compensation Board and the full board found Trane, not Ag-One, to be responsible for Scott's medical care and expenses. The full board also allowed Scott 45 days to file a claim against Ag-One, which he did, alleging bad faith. The full board affirmed the single hearing member's decision that Ag-One acted in bad faith and should pay half the $5,000 in damages and $1,600 in attorney's fees.
The Court of Appeals found Borgman v. Sugar Creek Animal Hospital, 782 N.E.2d 993 (Ind. Ct. App. 2002), to be instructive in its finding that that there can be no bad faith in denying benefits if the employer didn't act improperly in denying benefits, wrote Judge Paul Mathias.
"While we share the Board's concern that Scott went without medical care while Trane and Ag-One disputed who was liable for Scott's worker's compensation benefits, we fail to see how Ag-One can be said to have acted in bad faith in denying Scott's claim for benefits when Ag-One was ultimately found not to be liable for such benefits," he wrote.
The appellate court cautioned that its decision shouldn't be interpreted as encouragement for multiple employers in disputes over liability to refuse payment while awaiting the Indiana Worker's Compensation Board's decision. It understood the board's frustration with Trane and Ag-One in refusing to cover Scott's benefits while awaiting the board's decision, and noted that if they had both paid something during the dispute, the company found not liable could be reimbursed from the other employer. The appellate court ordered the decision reversed and vacated.
"We encourage employers in like situations in the future to come to an early agreement to share treatment costs pending determination of which employer is fully or partially liable. Doing so could go far in facilitating settlement of the claim and will avoid liability for the type of bad faith determined by the Board in this case, a determination that will usually be upheld under our deferential standard of review," Judge Mathias wrote.
Judge Margret Robb concurred and wrote in a separate opinion in addition to vacating the order Ag-One pay damages to Scott, the board should enter an order determining Trane's responsibility for the entire $5,000 as bad faith damages.