NATIONAL BEN FRANKLIN INSURANCE COMPANY, APPELLANT,
v.
GROVER HALL ET AL., APPELLEES

Fla. 4th DCA | 1976-12-24
No. 76-685
MAGER, C. J., and CROSS, and ALDERMAN, JJ., concur.
340 So. 2d 1269 Florida District Court of Appeal, Fourth District (1976) Negative Treatment
Cited by 47 cases

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Synopsis

The court affirmed the trial court's equitable distribution of a worker's compensation lien, awarding the carrier a small fraction of its claimed amount after considering the employee's comparative negligence and the settlement amount.


Holding

The court affirmed the trial court's equitable distribution, awarding American States Insurance $380.00 in satisfaction of its worker's compensation lien, based on the employee's significant comparative negligence.


Headnotes

[1] When an employee demonstrates that their recovery from a third-party action is less than the full value of damages sustained due to comparative negligence or insurance li…

[2] The pro rata share of an employer or insurance carrier in a third-party recovery, when the employee's recovery is less than full value, is calculated by multiplying the p…

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Facts & Procedural History

An employee injured on the job received worker's compensation benefits from American States Insurance. The employee later settled a third-party neglig…

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Opinion of the Court
ALDERMAN, Judge.

ALDERMAN, Judge.

This is an appeal from a final order granting equitable distribution on a Workmen’s Compensation lien. Appellee, Grover Hall, was injured when a tire exploded while he was inflating it. He filed suit against a third party. Appellant, National Ben Franklin Insurance Company, filed a notice of lien for payments made by it to appellee under the Workmen’s Compensation law for injuries arising out of the same incident. Appellee’s claim against the third party was settled for $45,000. Appellee filed a motion for equitable distribution of the settlement proceeds between himself and appellant. The trial court entered the order which is the subject of this appeal awarding to appellant $1,891.89.

At the hearing on the motion for equitable distribution it was established that appellee received, or was entitled to receive, Workmen’s Compensation payments totaling $28,600. The full value of the damages sustained by appellee was at least $200,000. Appellee did not recover the full value of the damages sustained by him because of his comparative negligence and because of limits of insurance coverage and collectibility. It was established that appellee was 50% negligent and that there was a liability insurance limit of $50,000. The net amount received by appellee, after payment of his attorney’s fees and other costs, was $26,481, which equalled 58.8% of the settlement. The trial court used the following formula to determine the amount of equitable distribution: 58.8% X 1/2 X 45/200 X $28,600 = $1,891.89 The controlling statute is Section 440.39(3)(a), Florida Statutes (1975), the relevant portion of which provides:

“ . . . Upon suit being filed the employer or the insurance carrier, as the case may be, may file in the suit a notice of payment of compensation and medical benefits to the employee or his dependents, which said notice shall be recorded and the same shall constitute a lien upon any judgment recovered to the extent that the court may determine to be their pro rata share for compensation benefits paid or to be paid under the provisions of this law. The employer or carrier shall recover fifty percent (50%) 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. Such proration shall be made by the judge of the trial court upon application therefor and notice to the adverse party. . . . ”

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. That would be 50% of $28,-600, or $14,300. However, the record in this case establishes that appellee did not recover the full value of his damages. The provision of the statute allowing appellant to recover 50% of what it has or will pay is therefore not applicable in this case. The only issue is whether the trial court applied the correct factors to determine the amount of equitable distribution.

The formula used by the trial court in this case was incorrect in one respect. As previously stated the provision of § 440.-39(3)(a), allowing the employer or carrier to recover 50% of what it has paid or will pay, is not applicable to the facts of this case. Therefore the trial court should not have included this factor in its formula. The effect of this error was to reduce the base amount of compensation subject to proration from $28,600 (the amount the carrier actually paid or will pay) to $14,300 (50% of the amount the carrier actually paid or will pay).

When an employee, in accordance with § 440.39(3)(a), establishes that his recovery is for less than the full value of his damages, the 50% of benefits factors is inapplicable.1 The pro rata share of the employer or insurance carrier may then be properly calculated by the following formula: (percentage of recovery actually received by employee) X (actual recovery as reduced from full value of damages sustained because of comparative negligence or because of limits on insurance coverage and eollecti-bility/full value of damages sustained) X (amount paid and future benefits to be paid by employer or carrier) = equitable distribution due to employer or carrier. Applying this formula in the present case the correct calculation is as follows: 58.8% X 45/200 X $28,600 = $3,782.78.

We have considered the other issues raised by appellant, and except as stated above, we find that the trial court did not abuse its discretion.

REVERSED and REMANDED with instructions that appellant be allowed equitable distribution in the amount of $3,783.78.

MAGER, C. J., and CROSS, and ALDERMAN, JJ., concur. . Except that the employer or carrier would not be entitled to receive more than 50% of what it has paid and future benefits to be paid.


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Citator

Cited By (23 total)

  • LEE v. Risk Mgmt., Inc., 409 So. 2d 1163 (Fla. 3d DCA 1982)
    …nd the court may then make an “equitable distribution” of the proceeds. The fact that the latter was the rule under the “50% statute,” Fireman’s Ins. Co. of Newark v. Phillips, 368 So. 2d 98 (Fla.3d DCA 1979); National Ben Franklin Ins. Co. v. Hall, 340 So. 2d 1269 (Fla.4th DCA 1976), may not be determinative since the present provision is significantly different both in letter and spirit.…
  • Sentry Ins. Co. v. Keefe, 427 So. 2d 236 (Fla. 3d DCA 1983)
    …d for the entry of an order in accordance with this opinion.4 Reversed and remanded with directions. . It appears that this figure resulted from applying (with an arithmetical mistake) the formula adopted in National Ben Franklin Ins. Co. v. Hall, 340 So. 2d 1269 (Fla. 4th DCA 1976). Because, however, it requires that the carrier share an “equitable” portion of the plaintiffs attorneys’ fees and costs, National Ben Franklin cannot be employed under the new statute, which forbids that result. Lee v. Risk Mana…
  • Ramar-Dooley Constr. Co. v. Norris, 341 So. 2d 546 (Fla. 2d DCA 1977)
    …f 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. Cf., National Ben Franklin Ins. Co. v. Hall, 340 So. 2d 1269 (Fla.4th DCA 1976) (1976). In this case, the employee’s counsel informed the court of the $30,000 settlement and his one-third contingency fee and suggested a 25% pay back as being fair and equitable. The amended statute was then brought to the cou…

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