SAFECO INSURANCE COMPANY, APPELLANT,
v.
BARBARA LYLES SARKISIAN, LOUIS SCHULTZ AND GOVERNMENT EMPLOYEES INSURANCE COMPANY, APPELLEES

Fla. 4th DCA | 1980-11-05
No. 79-797
ANSTEAD, J., concurs., LETTS, C. J., dissents with opinion.
389 So. 2d 1088 Florida District Court of Appeal, Fourth District (1980) Caution
Cited by 8 cases

AI-generated. These summaries, headnotes, and key points are machine-generated and may contain errors or omissions. Always verify against the full opinion text below. Not legal advice.

Synopsis

Safeco Insurance Company appealed a trial court's decision to award it only $8,000 from a $75,000 third-party settlement rather than the statutory 50% ($37,500). The court reversed, holding that under Florida's workers' compensation statute, the carrier is entitled to 50% of the settlement unless the injured employee demonstrates she failed to recover full damages due to comparative negligence or insurance limits.


Holding

The carrier is entitled to 50% of the third-party settlement. Once the carrier establishes the benefits paid, the burden shifts to the employee to prove she did not recover full value because of comparative negligence or insurance limitations. The employee's failure to present evidence at the hearing means the carrier satisfied its burden.


Headnotes

[1] Under Florida Statute § 440.39(3)(a), an employer or carrier is entitled to recover 50% of compensation benefits paid to an injured employee from a third-party settlement…

[2] The burden of proof rests on the employee to demonstrate that a third-party settlement recovery was less than the full value of damages sustained due to comparative negli…

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Key Quotes

“The employer or carrier shall recover 50 percent of what it has paid and future benefits to be paid unless the employee or dependent can demonstrate to the court that he did not recover the full value of damages sustained because of comparative negligence or because of limits of insurance coverage and collectibility.”

The operative statute establishing the default 50% recovery right for workers' compensation carriers from third-party settlements.

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Facts & Procedural History

Barbara Lyles Sarkisian was injured in an automobile accident during employment and received $85,275 in workers' compensation benefits from Safeco Ins…

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Opinion of the Court
HURLEY, Judge.

HURLEY, Judge.

On this appeal an employer’s compensation carrier questions the trial court’s refusal to award it 50% of the settlement received by an injured employee. We reverse.

Barbara Lyles Sarkisian was injured in an automobile accident during the course of her employment. As a result, her employer’s compensation carrier, Safeco Insurance Co., paid her benefits of $85,275.00. When Ms. Sarkisian filed suit against the third-party tortfeasor, Safeco filed a notice of payment of compensation and medical benefits. The suit was settled for $75,000.00. On motion, however, the trial court declined to award Safeco 50% of the settlement and instead, entered an order of equitable distribution, awarding Safeco $8,000.00.

The operative statute is Section 440.-39(3)(a), Florida Statutes (1975).1 It provides in part:

The employer or carrier shall recover 50 percent of what it has paid and future benefits to be paid unless the employee or dependent can demonstrate to the court that 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.

In Ramar-Dooley Construction Co. v. Norris, 341 So. 2d 546 (Fla. 2d DCA 1977), the court recognized that the above statute constituted a departure from past practice and said:

The legislature has acted. We must give effect to the statutory criteria they have imposed. Under the revised statute, once the carrier establishes the expenditures it has made and the future benefits it is to pay, the employer Or carrier has the right to receive its 50% of any recovery against a third party tortfeasor, unless the employee demonstrates to the court that he did not recover full value of the damages he sustained because of (a) comparative negligence, or (b) limits of insurance coverage 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 full value of his claim “because of limits of insurance coverage and collectibility.” (Emphasis supplied.) The burden of proof is on the employee.

In the case at bar, the trial court conducted an evidentiary hearing on Ms. Sarkisian’s motion to determine equitable lien. Though she was present, she did not testify. Indeed, the only evidence received at the hearing was an injury progress report showing compensation benefits of $85,-275.00 paid because of the automobile accident, and an affidavit executed by counsel for the third-party tortfeasor. Nonetheless, the trial court denied Safeco’s claim for 50% of the $75,000 settlement. The court explained its rationale in its order denying Safeco’s petition for rehearing:

There is evidence that a second incident or occurrence involved the Plaintiff, as an employee. The nature of that incident or occurrence is referred to simply as a “robbery” which involved the Plaintiff and which occurred within a couple of weeks that followed the accident which gave rise to the present lawsuit. It appears that a part of the workmen’s compensation payments made by Safeco Insurance Company on behalf of BARBARA LYLES SARKISIAN could well have been attributed to or allocated to that accident, the subject matter of this suit, and the robbery which was a subsequent incident or occurrence.

We believe that Safeco satisfied its burden of going forward with the evidence by showing that $85,275.00 in benefits were paid on account of the automobile accident of January 14, 1975. The burden then shifted to Ms. Sarkisian to present evidence disputing the amount of the benefits, or the purpose for which they were paid. This she failed to do. Thus, the trial court’s order is not grounded on evidence in the record and must be reversed. We also note that there is a void of testimonial or documentary evidence on the issues of comparative negligence and collectibility. Accordingly, the order on petition for equitable distribution is reversed and the cause is remanded with directions to conduct a new hearing on the plaintiff’s motion. In order to permit effective appellate review, the trial court is requested to make findings of fact.

REVERSED and REMANDED.

ANSTEAD, J., concurs.

LETTS, C. J., dissents with opinion.

. Effective July 1, 1977, the statute’s recovery figure of 50% was amended to 100%.

Dissent
LETTS, Chief Judge,

LETTS, Chief Judge,

dissenting:

I dissent.

In my view the record supports a demonstration of damages in the sum of $300,000 which the plaintiff settled for $75,000 which was $25,000 less than the policy limit.


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Cited By

  • Am. States Ins. Co. v. Rozier, 450 So. 2d 547 (Fla. 4th DCA 1984)
    …s to be carried by “demonstrat[ion] to the court.” From this we conclude that the court must weigh the evidence, just like a jury would, and evaluate the case if he has evidence before him which will permit it. See Safeco Insurance Co. v. Sarkisian, 389 So. 2d 1088 (Fla. 4th DCA 1980). We know of no absolute law mandating the use of an expert witness and in the light of the evidence presented, we do not think one was required in the case now before us. We are not unaware that the actual order appealed from is…
  • Travelers Indem. Co. v. Jacobs, 402 So. 2d 1261 (Fla. 3d DCA 1981)
    …s under equitable distribution is required to prove that “he did not recover the full value of damages sustained because of comparative negligence or because of limits in insurance coverage and collectibility.” See Safeco Insurance Co. v. Sarkisian, 389 So. 2d 1088 (Fla. 4th DCA 1980); Maryland Casualty Co. v. Whitley, 375 So. 2d 18 (Fla. 1st DCA 1979), cert. denied, 383 So. 2d 1205 (Fla.1980). Although comparative negligence is no longer an issue because the court entered a summary judgment in favor of the Ja…
  • Peninsular Life Ins. Co. v. Picklesimer, 402 So. 2d 1326 (Fla. 4th DCA 1981)
    …ase, the Plaintiff presented no evidence whatever to demonstrate that he was unable to collect any part of his damages from the individual assets of the tort-feasor. Therefore, the trial judge was in error. See Safeco Insurance Company v. Sarkisian, 389 So. 2d 1088 (Fla. 4th DCA 1980); Maryland Casualty Co. v. Whitley, 375 So. 2d 18 (Fla. 1st DCA 1979); Edmondson v. Swope, 395 So. 2d 553 (Fla. 5th DCA 1981); Ramar-Dooley Construction Company v. Norris, 341 So. 2d 546 (Fla. 2d DCA 1977). There is another facet…

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