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  • Florida Supreme Court Answers Three Important Questions Regarding the Scope of Benefits and Remedies Available to Injured Workers

Florida Supreme Court Answers Three Important Questions Regarding the Scope of Benefits and Remedies Available to Injured Workers

In the recent case of Moralez v. Zenith Insurance Company, SC13-696, the Florida Supreme Court considered several important questions regarding the ability of a decedent’s estate to bring a negligence claim against an employer following a work-related accident or injury that led to the decedent’s death and the exclusive nature of the workers’ compensation system. The central issue in this case was the “exclusive remedy” doctrine of workers’ compensation law. In general, this doctrine provides that employers are liable for the injuries that their employees sustain through the course and scope of their employment, and that an injured employee’s sole remedy for seeking compensation is through the workers’ compensation system–not a civil action.

In Moralez, the plaintiff brought a wrongful death action on behalf of her deceased spouse’s estate against his employer. The decedent “was crushed to death by a palm tree while working for [the defendant employer].” The plaintiff entered into a settlement agreement with the employer’s workers’ compensation insurance carrier and executed a release stating that the settlement constituted the “sole remedy with respect to the insurance coverage” that the insurance carrier provided to the employer. The employer’s workers’ compensation liability policy also contained a provision indicating that workers’ compensation constitutes an injured employee’s sole remedy. 

While the settlement was being negotiated, the plaintiff filed a wrongful death lawsuit alleging that the employer’s negligence caused her spouse’s death. The plaintiff obtained a default judgment against the employer for $9.5 million. When a party fails to respond to a lawsuit that has been filed against them, the court may enter a default judgment against that party after a specified waiting period. The employer refused to pay the judgment, and the plaintiff filed another lawsuit alleging that the employer’s insurance carrier breached its insurance policy contract.

The insurance carrier removed the case to federal court, and the Eleventh Circuit held that “it is unclear under Florida law ‘whether a workers’ compensation exclusion in an employer liability policy . . . bars coverage of an employee’s tort judgment obtained in a separate negligence suit against the employer.” The appellate court also determined that (1) “Florida law is unsettled as to whether the [decedent’s] estate has standing to sue [the insurance carrier] under [the employer’s] liability policy,” and (2) “whether, if the workers’ compensation exclusion does not bar the estate’s claim, the release in the workers’ compensation settlement agreement prevents the estate from collecting the tort judgment from [the insurance carrier].” The Eleventh Circuit certified these questions for the Florida Supreme Court to consider.

In its opinion, the Florida Supreme Court determined that the estate had standing to bring a breach of contract claim by virtue of the tort judgment it had obtained against the insurance carrier. Florida law clearly provides that “a judgment creditor has standing to bring a suit against a liability insurer that may have coverage for the judgment.”

Next, the Florida Supreme Court turned to whether the workers’ compensation exclusion precluded the insurance carrier from covering the plaintiff’s judgment against the employer. Based on the plain language of the terms used in the insurance policy, the court determined that “the workers’ compensation exclusion bars coverage of claims arising from bodily injuries for which [the employer] is required to pay benefits under workers’ compensation law.” The insurance policy constitutes gap coverage, which protects the employer from the limited circumstances in which an employee can sue the employer despite the availability of workers’ compensation benefits.

As a result of this finding, the court next held that workers’ compensation laws prohibited the plaintiff from pursuing additional benefits and damages through a civil case against the employer. “Rather, because the estate allied that [the employer’s] negligence caused [the spouse’s] death, its exclusive remedy was under Florida’s Workers’ Compensation Law.” The court also considered the plain language of the settlement agreement and its release provision, and it concluded that the agreement also barred the plaintiff from bringing a civil case against the employer. The settlement complied with workers’ compensation laws, which allow parties to settle their claims, and constituted the plaintiff’s sole remedy against the employer for her spouse’s death.

If you or someone you know has been injured on the job, The Hoffman Firm can help. Our attorney has several years of experience and expertise in the field of workers’ compensation claims and can help you obtain the recovery you deserve for your injuries. Whether you have been hurt on the job, forced to return to work too soon, or simply need help figuring out what steps to take next, we will guide you through the workers’ compensation system and zealously advocate for your rights. Call us now for a free consultation at (800) 223-1866.

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Evan A. Hoffman

Evan A. Hoffman

Mr. Hoffman’s philosophy is "our knowledge and experience is your best defense." He has been a featured author on criminal law issues such as driving under the influence, domestic violence and illegal searches.

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