LUMBERMENS MUTUAL CASUALTY COMPANY, WORKMEN'S COMPENSATION CARRIER FOR LIFE INSURANCE COMPANY OF VIRGINIA, APPELLANT,
v.
PHILIP SIMON, LOUIS COLLINS, ET AL., APPELLEES
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A workers' compensation insurance carrier appealed an equitable distribution award under Florida's Workmen's Compensation Act. The carrier sought reimbursement from the injured employee's third-party settlement, but the appellate court reversed the trial court's finding of comparative negligence and remanded for recalculation because the employee carried his burden of proof that the settlement was reduced due to proof of damages issues, not comparative negligence.
The court reversed the trial court's finding of comparative negligence because the employee presented overwhelming evidence negating any negligence on his part, and the actual reason for the reduced settlement was concern about proving damages (specifically lost income claims), not comparative negligence. The carrier was entitled to 50% recovery unless the employee demonstrated lack of full value recovery due to comparative negligence, insurance limits, or collectibility issues.
[1] A workers' compensation carrier is entitled to recover fifty percent (50%) of its payments to an injured employee from the employee's recovery against a third-party tortf…
[2] The burden of proof rests upon the employee to demonstrate that their recovery from a third-party tortfeasor was less than the full value of damages sustained due to comp…
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Join FLexlaw to unlock all legal intelligence“The employer or carrier shall recover fifty per cent (50%) of what it has paid and future benefits to be paid unless the employee or dependent can demonstrate to the court he did not recover the full value of damages sustained because of comparative negligence or because of limits of insurance coverage and collectibility.”
States the statutory standard for equitable distribution and allocates burden of proof to the employee to show less than full value recovery.
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Join FLexlaw to unlock all legal intelligenceAn injured employee received $12,154.58 in workers' compensation benefits from the carrier. The employee settled a third-party claim against the tortf…
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BERANEK, Judge.
This is an appeal from an order of equitable distribution under Section 440.39(3)(a) of the Florida Workmen’s Compensation Act. Appellant is an insurance carrier which paid workers’ compensation benefits in the amount of $12,154.58 to an injured employee. The employee, appellee herein, sued a third party tortfeasor for the injuries arising from a work related injury and settled for $15,150.00. The trial court awarded the compensation carrier $1,000.00 as its equitable share of the recovery. Section 440.39(3)(a), Florida Statutes (Supp. 1974), provides for equitable distribution to a compensation carrier as follows:
The employer or carrier shall recover fifty per cent (50%) of what it has paid and future benefits to be paid unless the employee or dependent can demonstrate to the court he did not recover the full value of damages sustained because of comparative negligence or because of limits of insurance coverage and collectibility. The burden of proof will be upon the employee .
The trial court applied this statute and found that the employee had demonstrated he had not received full value in his third party action by virtue of his own comparative negligence.
Section 440.39(3)(a), Florida Statutes (Supp.1974), makes the questions of “comparative negligence” and less than “full value” recovery factual determinations for the trial court. The evidence presented by counsel for the injured employee was minimal to say the least. The testimony of the employee was presented on the issue of his own comparative negligence. This testimony totally negated any negligence on his part. In addition, an accident report was stipulated into evidence which also negated a finding of comparative negligence. The only support for comparative negligence was an answer by the defendant to an interrogatory. This answer was totally negated by the clear physical facts shown in the stipulated accident report and the appellee’s unrebutted testimony. Since the appellee’s own evidence was overwhelmingly against a finding of comparative negligence and since the burden of proof under the statute belongs to appellee, we conclude that the trial court erred in this regard.
In addition, a review of the evidence and arguments before the trial court indicates the real reason for the settlement of the third party claim was not because of comparative negligence but because of problems with proof of damages on the plaintiff’s case. Both counsel and his client were worried that the extensive alleged losses in income resulting from the accident would not believed by a jury. The plaintiff asserted he was making about $100.00 per week less selling insurance than he had made before the accident and that he was entitled to $57,000.00 in lost earnings.
We conclude that the trial court erred in awarding the carrier the sum of $1,000.00. The finding of comparative negligence and the award of $1,000.00 are reversed and the matter remanded for further proceedings. As stated in National Ben Franklin Insurance Company v. Hall, 340 So. 2d 1269 (Fla.4th DCA 1976), at 1270:
It is clear from the terms of this statute that unless appellee demonstrates that he did not recover the full value of the damages sustained by him because of comparative negligence or because of limits of insurance coverage and collectibility, appellant would be entitled to recover 50% of what it paid.
REVERSED AND REMANDED.
LETTS, J., concurs.
DAUKSCH, JAMES C., Jr., Associate Judge, dissents without opinion.
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Safeco Ins. Co. v. Sarkisian, 389 So. 2d 1088 (Fla. 4th DCA 1980)…e and collectibility. Thus, the legislature has now cast the burden on the employee if he is to succeed in reducing the employer’s carrier’s recovery from the 50% statutory entitlement. Id. at 548. See also, Lumbermens Mutual Casualty Co. v. Simon, 375 So. 2d 894 (Fla. 4th DCA 1979), and Maryland Casualty Co. v. Whitley, 375 So. 2d 18, 19 (Fla. 1st DCA 1979) where the court held: • Inadequate insurance, however, is only one prong of the statutory test. The employee must demonstrate that he got less than the…
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Md. Cas. Ins. Co. v. Reeves, 418 So. 2d 1257 (Fla. 4th DCA 1982)…lf of the full value of the damages he sustained. Under both the statute and case law, the burden of proof is on the employee to demonstrate that his recovery did not represent the full value of his damages. Lumbermens Mutual Casualty Co. v. Simon, 375 So. 2d 894 (Fla. 4th DCA 1979). The issue on appeal is whether employee — insured—appellee carried that burden, i.e., whether there is substantial competent evidence in the record to support the trial court’s conclusion that the amount recovered from the tort…
Authorities Cited
- Nat'l BEN Franklin Ins. Co. v. Grover Hall, 340 So. 2d 1269 (Fla. 4th DCA 1976)