Gibson v. Southern Guar. Ins. Co.
Gibson v. Southern Guar. Ins. Co.
Opinion of the Court
Jalone Gibson appeals from a summary judgment entered for the defendants, Southern Guaranty Insurance Company, Inc. ("SGI"), Med-Manage, Inc., and Roberta Shaw. We affirm.
Mr. Gibson was injured on the job while working for American Sign Company on May 11, 1989, when a falling ladder struck his head. SGI, the workers' compensation carrier for American Sign, hired Med-Manage to manage the medical aspects of Gibson's workers' compensation claim. Med-Manage assigned Roberta Shaw as Gibson's medical case coordinator. Gibson visited a series of physicians during his evaluation, treatment, and rehabilitation following his injury.1
Gibson sued on July 30, 1991, alleging the tort of outrageous conduct, bad faith, fraud, conspiracy, and negligence and wantonness in the manner in which the defendants had handled his need for psychological testing and treatment that arose out of his workplace injury. The trial court granted SGI's Rule 12(b)(6), A.R.Civ.P., motion to dismiss as to the bad faith and conspiracy claims, on September 20, 1991. SGI, Med-Manage, and Shaw each moved for a summary judgment. The trial court entered a summary judgment in favor of all defendants as to all remaining claims on September 14, 1992. Gibson appeals from that judgment.
The exclusivity provisions of the Alabama Workers' Compensation Act limit the liability of the workers' compensation insurer to those claims prescribed under the statute for job-related injuries. Lowman v. Piedmont ExecutiveShirt Mfg. Co.,
Did the trial court err in entering the summary judgment on the outrageous conduct claim? The type of conduct that could give rise to liability for outrageous conduct is outlined in the seminal case of American Road Serv. Co. v. Inmon,
"The emotional distress . . . must be so severe that no reasonable person could be expected to endure it. Any recovery must be reasonable and justified under the circumstances, liability ensuing only when the conduct is extreme. By extreme we refer to conduct so outrageous in character and so extreme in degree as to go beyond all possible bounds of decency, and to be regarded as atrocious and utterly intolerable in a civilized society."Id. (citations omitted).
Gibson contends that the defendants' course of conduct in handling his medical treatment constitutes outrageous conduct. *Page 1067
We disagree. The trial court must determine, in the first instance, whether recovery for outrageous conduct is warranted.Continental Casualty Ins. Co. v. McDonald,
The record reveals that, in the course of evaluation and treatment for his injury, Gibson was referred to a multitude of physicians. Dr. Charles E. Herlihy, a psychiatrist, examined Gibson and, in February 1990, recommended that SGI approve neuropsychological evaluation and support therapy to assist in the treatment of depression and anxiety apparently caused by Gibson's injury. Due to a series of misunderstandings, delays, and breakdowns in communication, Gibson did not receive the neuropsychological evaluation until October 1990.
Shaw informed SGI that Gibson had told her on April 2, 1990, that he was no longer depressed and did not need to return to see Dr. Herlihy. Gibson later denied having told Shaw that he did not desire psychotherapy. Gibson was examined by a psychiatrist, Dr. Claude L. Brown, in October 1990. After a neuropsychological evaluation, Dr. Brown diagnosed Gibson as having mild somatization disorder and recommended that he return to light work and undergo supportive psychotherapy.2 SGI's claims adjuster, Virginia Farrior, informed Gibson's attorney in December 1990 that Gibson's future medical treatment would remain open, that psychotherapy was not pursued because Gibson had earlier stated he was not depressed and did not want to continue seeing Dr. Herlihy, and that SGI would provide psychotherapy treatment if Gibson so desired.
Gibson was not allowed to see the doctor of his choice, because SGI would pay only for his visits to those physicians approved by SGI. A workers' compensation insurer has a statutory right to select which physicians a claimant will receive coverage for, §
Did the trial court err in entering the summary judgment on the claim of intentional fraud? In order to overcome the defendants' prima facie showing that there was no genuine issue of material fact in regard to this claim and thereby send this claim to the jury, Gibson must present not just "substantial evidence," §
We further note that the alleged fraud concerned future acts, i.e., the intent of SGI to refuse future psychological treatment, and, thus, that Gibson must prove the elements of promissory fraud to withstand a motion for summary judgment. We do not find sufficient evidence that, at the time it made any alleged misrepresentations, SGI intended not to do the acts promised, and that the misrepresentations were made with the intent to deceive Gibson. See Vance v. Huff,
We must conclude also, then, that the court properly entered the summary judgment as to the fraud claim. The summary judgment is affirmed.
AFFIRMED.
HORNSBY, C.J., and MADDOX, ALMON, ADAMS, HOUSTON and STEAGALL, JJ., concur.
KENNEDY, J., concurs in part and dissents in part.
Dissenting Opinion
I agree with the majority that the plaintiff presented inadequate evidence of "outrageous conduct." Accordingly, I concur with the majority as to that claim. I respectfully dissent, however, as to the majority's handling of Gibson's claim of intentional fraud. It appears to me that the majority does not view the evidence here "in a light most favorable to the nonmovant," Gibson. Assessing the evidence in a light most favorable to Gibson, I believe he did produce evidence legally sufficient to create a genuine issue of material fact. I would hold that a jury must decide this claim.
Reference
- Full Case Name
- Jalone Gibson v. Southern Guaranty Insurance Company
- Cited By
- 10 cases
- Status
- Published