Compliance

Workers Comp Claimant Cannot Sue Third Party and Administrator

By Staff Report

Jun. 29, 2010

The workers’ compensation exclusive remedy doctrine bars an injured correctional officer from suing an “independent third party” and the party’s third-party administrator, a Connecticut appellate court has ruled.


The ruling in Daniel D’Amico v. ACE Financial Solutions Inc. et al., to be published Tuesday, June 29, stems from injuries D’Amico suffered while restraining an inmate in a youth correctional facility in 1992, court records state.


He suffered neck, back, shoulder, arm and hand injuries and later was diagnosed as suffering from post-traumatic stress disorder, depression, fibromyalgia, hypertension and other problems.


The state provided D’Amico benefits for many of the claimed injuries, but in 2001 it transferred its responsibility for claims to ACE, which the Connecticut Appellate Court opinion described as a “corporation involved in the business of financial derivatives.”


ACE engaged Berkley Administrators of Connecticut Inc. to administer state claims including the one filed by D’Amico, court records state. Then in 2003, Berkley said it no longer would pay for D’Amico’s psychiatric medication and treatment “because it was considered palliative and no longer necessary.”


In 2005, D’Amico sued ACE and Berkley, alleging breach of contract and breach of the implied covenant of good faith and fair dealing. A trial court in 2008 granted the defendants summary judgment based on the workers’ comp exclusive remedy doctrine.


The correctional officer appealed, arguing that ACE is an “independent third party” and not an insurer, so the exclusive remedy doctrine does not apply. But the state appellate court disagreed.


It upheld the lower court’s dismissal of the suit and said the exclusive remedy provision bars D’Amico’s action, even if ACE is an independent third party as D’Amico asserted. 


Filed by Roberto Ceniceros of Business Insurance, a sister publication of Workforce Management. To comment, e-mail editors@workforce.com.


 


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