Fireman's Fund Insurance v. Crowder
Fireman's Fund Insurance v. Crowder
Concurring Opinion
concurring specially. I concur in the result reached by the writer of the majority opinion but feel that the proper judgment to be entered up would be "Judgment affirmed on main appeal; affirmed in part and reversed in part on cross appeal.”
I am authorized to state that Judges Pannell and Whitman, concur herewith.
Dissenting Opinion
dissenting. I concur in the holding that the board has no jurisdiction over medical coverage in excess of the statutory $5,000 and therefore cannot adjudicate subrogation rights in excess of this limit.
While the majority opinion states the judgment is affirmed, the language of Divisions 2, 4 and 5 appears to reverse that part of the court’s judgment which affirmed the board’s directive that the claimant refund to the insurer the sums previously received in compensation and medical expenses. It is to this language that I dissent.
The opinion says the board is without authority to alter the finality of its previous judgment that compensation was payable. The action of the board did not revoke its previous decision. It merely exercised its authority to enforce subrogation rights which are clearly provided in Code Ann. § 114-403. The board has the authority to decide and enforce subrogation issues arising under the Act. See Travelers Ins. Co. v. Houck, 118 Ga. App. 154, 156 (162 SE2d 781), cert. den. 118 Ga. App. 867. The majority opinion seems to hold that the board has no jurisdiction over Code Ann. § 114-403. This is difficult to understand when Code § 114-715 provides: "All questions arising under this Title, if not settled by agreements of the parties interested therein, with the approval of the State Board of Workmen’s Compensation, ^shall be determined by the members, except as otherwise herein provided.”
To hold that the claimant cannot be ordered to refund amounts already received from the insurer even though he has also recovered from the tortfeasor is to nullify the real purpose of Code Ann. § 114-403 as defined by Georgia court decisions. The Supreme Court has held: "The real purpose of the provisions in the workmen’s compensation law for giving to the employer the right of subrogation has been described as a means for recouping the
Further, to hold that there can be no refund for amounts already received will induce workmen’s compensation insurers to delay as long as possible, by means of any and every technicality, the payment of benefits when they know they have, in effect, no subrogation. The result will be the negation of a process which was designed to afford speedy relief to an injured worker.
In my opinion, neither the board nor the superior court is in error.
I am authorized to state that Judge Eberhardt concurs in this dissent.
Opinion of the Court
This is a workmen’s compensation case. The right of an insurer to subrogation is one of the principal questions herein; and the jurisdiction of the State Board of Workmen’s Compensation to administer funds from an insurance policy for
2. The Workmen’s Compensation Board is without authority of law to revoke, modify or change an award or agreement, duly approved, for compensation and medical expenses retroactively. The attempt by the board to order the employer-claimant to repay certain payments received is beyond the authority of the board to change the finality of the judgment previously made by ordering repayment. It is an absolute nullity, and is surplus-age to the award here made. Code §§ 114-111, 114-403, 114-415, 114-705, 114-711, as amended by Ga. L. 1963, pp. 141, 145; Bishop v. Bussey, 164 Ga. 642, 647 (139 SE 212); Sutton v. Macon Gas Co., 46 Ga. App. 299 (2) (167 SE 543); Jones v. American Mut. Liab. Ins. Co., 48 Ga. App. 351 (172 SE 600); Hartford Acc. &c. Co. v. Tolison, 118 Ga. App. 660, 662 (165 SE2d 192); Gravitt v. Ga. Cas. Co., 158 Ga. 613 (123 SE 897); Aetna Life Ins. Co. v. Davis, 172 Ga. 258 (157 SE 449); Knight v. Shelby Mut. Ins. Co., 110 Ga. App. 149 (1) (137 SE2d 925).
3. The State Board of Workmen’s Compensation having determined that all parties received notice of the subrogation rights of the insurer and employer as required in accordance with the workmen’s compensation subrogation statute (Ga. L. 1922, pp. 185, 186, as amended; 1937, pp. 528, 530; Ga. L. 1963, pp. 141, 145; Code Ann. § 114-403), the insurer and employer are entitled to subrogation rights under this law. However, the board had no authority over additional medical benefits provided by the additional medical coverage endorsement for $10,000 over
4. The board did not err in holding that the award of medical payments was "extinguished to the extent of the compensation payments for which Fireman’s Fund Insurance Company is liable and the medical payments up to the statutory amount” of $5,000. However, the board erred in directing Crowder to refund any sums either for medical payments or for weekly compensation payments heretofore awarded to him. While the cross appellant claims that the court erred in extinguishing the claim of the employee for compensation payments or medical payments which were past due and unpaid at the date of the award, this was not the effect of the award.
5. Since as ruled above, the board could not order the employee-claimant to refund any payments heretofore made to him under an award, and that the same was surplusage, but that the findings of the board were otherwise correct, the judgment of the lower court must be affirmed. However, no ruling is here made as to the right of the subrogee to file any civil action against either the claimant or the insurer of the third-party tortfeasor. See Branch & Howard v. Ga. Cas. Co., 39 Ga. App. 319 (147 SE 144); Knight v. Shelby Mut. Ins. Co., supra.
Judgment affirmed on the main appeal and on the cross appeal.
070rehearing
On Motion for Rehearing.
On December 18, 1970, Judge Hall, the writer of the dissent in this case, dissented, requiring, under our rules, that these cases be considered by the entire court. The vote now stands in case #45559 with seven Judges for affirmance, and two for dissent. As to case #45560, three of the majority of seven are of the opinion
The movant here professes still not to understand the decision rendered, professing that the decision implies that any attempt by the insurer to recover these amounts which it had paid, would not lie in any court. This court rendered no such decision since that question must be decided by a court having jurisdiction of the parties and of the subject matter. However, this court did hold that the board was correct in determining that all parties received notice of the subrogation rights of the insurer and employer as required by the statute, and the board properly stopped all future payments of workmen’s compensation.
But the main thrust of the motion is that the court erred in holding that the board had no authority over additional medical benefits provided by the additional medical coverage endorsement for $10,000 over and above that authorized by the statute. Even the dissenting judges here are in agreement that the board has no such jurisdiction. Hence, this portion of our judgment is, in effect, affirmed by all nine of our judges. The dissent simply seeks to require the board, in a subrogation case, to declare the rights of all the parties and render a judgment accordingly. Seven of the judges of the majority do not agree.
Because of the history of these cases, and to avoid any future misunderstanding, the above is added to this opinion. We thus repeat: "No ruling is here made as to the right of the subrogee to file any civil action against either the claimant or the insurer of
Reference
- Full Case Name
- FIREMAN'S FUND INSURANCE COMPANY Et Al. v. CROWDER; And Vice Versa
- Cited By
- 19 cases
- Status
- Published