Insurance Carrier Accountable for Worker's Compensation Claim
In Sibley v. Adjustco, Inc., 596 So. 2d 1048 (Fla. 1992), the insurance carrier's intentional tortious actions actually occurred during the claims process and did not involve acts or conduct totally separate and independent of the workers' compensation claim process.
Specifically, the insurance carrier there edited material aspects of the employee's statements obtained during the processing and handling of the workers' compensation claim, and based in part on the insurance carrier's fraudulent acts, the carrier had refused to timely pay the employee workers' compensation benefits. See 596 So. 2d at 1050.
At that time the applicable workers' compensation statute provided the identical immunity and exclusivity as contained in the statute applicable here.
This Court specifically held that the employee in that instance, notwithstanding his right to process a statutory claim under the Workers' Compensation Law with the insurance carrier, could also file and maintain an independent common law action in tort against the insurance carrier based on the intentional fraudulent acts committed during the claims process itself. See id. at 1050-51.
In Inservices, Inc. v. Aguilera, 837 So. 2d 464 (Fla. 3d DCA 2002), the Third District is in conflict with and misapplied this Court's holding in Sibley v. Adjustco, Inc., 596 So. 2d 1048 (Fla. 1992) by incorrectly concluding that the workers' compensation scheme does immunize a compensation carrier from wrongdoing which occurs during its claim process.
Sibley in fact stands for the proposition that the workers' compensation system does not immunize a workers' compensation carrier from any intentional acts of wrongdoing and does not limit a carrier's accountability for their intentional misconduct exclusively to intentional acts occurring independently of the claims handling process.
The Court has clearly concluded that the workers' compensation system does not immunize an insurance carrier's intentional fraudulent actions while processing a claim, and this holding has clear application where an insurance carrier allegedly intentionally causes additional injuries to workers while administering the worker's workplace injury claim. See Sibley, 596 So. 2d at 1050.
Thus, contrary to the dissenting view, this Court must address this direct conflict created by the Third District's opinion and its misapplication of our holding in Sibley. See Robertson v. State, 829 So. 2d 901, 904 (Fla. 2002) (stating that misapplication of decisional law creates conflict jurisdiction).