Thomas V. Flaherty
Edward P. Tiffey
Flaherty, Sensabaugh & Bonasso
Charleston, West Virginia
Attorney for the Defendant,
Continental Insurance Company
CHIEF JUSTICE BROTHERTON delivered the Opinion of the Court.
1. "W.Va. Code, 23-2-6a [1949] extends the employer's
immunity from liability set forth in W.Va. Code, 23-2-6 [1991] to
the employer's officer, manager, agent, representative or employee
when he is acting in furtherance of the employer's business and
does not inflict an injury with deliberate intention." Syllabus
point 4, Henderson v. Meredith Lumber Co., Inc., 190 W.Va. 292, 438
S.E.2d 324 (1993).
2. An employee who receives workers' compensation
benefits for injuries that result from a motor vehicle collision
with a coemployee which occurs within the course and scope of
employment is not entitled to assert a claim for uninsured or
underinsured motorist benefits. Because of the provisions for
employer and coemployee immunity contained in W.Va. Code §§ 23-2-6
and 6a (1994), workers' compensation is the exclusive remedy
available to an injured employee, and an uninsured or underinsured
motorist carrier has no liability.
Brotherton, Chief Justice:
This case is before the Court upon a certified question
from the Circuit Court of Mason County, West Virginia. The issue
is whether the plaintiff, an accident victim who has received
workers' compensation benefits, can also obtain uninsured motorist
benefits even though the defendants are shielded from liability by
grants of immunity contained in the Workers' Compensation Act, West
Virginia Code §§ 23-2-6 and 6a.
The facts surrounding the accident are not in dispute.
The plaintiff, Shelby Wisman, alleges that on July 5, 1990, the
defendant, William J. Rhodes, negligently crossed the center of the
highway and drove his truck into the truck that the plaintiff was
operating, causing him serious, permanent injuries. The plaintiff
and the defendant were both employees of the defendant, Shamblin
Stone, Inc. The lower court concluded that both men were acting
within the course and scope of their employment, operating trucks
owned by Shamblin Stone.
Shamblin Stone is a participant in the West Virginia
Workers' Compensation Fund, and the plaintiff received workers'
compensation benefits for his injuries. Shamblin Stone maintained
a liability insurance policy on the truck driven by the defendant,
William J. Rhodes. However, that insurer denied coverage to the
plaintiff on the grounds that the plaintiff was acting within the scope of his employment at the time of the injury and was covered
by workers' compensation.
At the time of the accident, Shamblin Stone also had an
insurance policy with the defendant, Continental Insurance Company,
which insured the vehicle driven by the plaintiff. The policy
language which addresses uninsured and underinsured motorist
coverage provides, in part, that:
We will pay all sums the "insured" is legally
entitled to recover as damages from the owner
or driver of an "uninsured" or "underinsured"
motor vehicle. The damages must result from
"bodily injury" sustained by the "insured", or
"property damage" caused by an "accident".
The owner's or driver's liability for these
damages must result from the ownership,
maintenance or use of the "uninsured" or
"underinsured motor vehicle".
Continental maintains that the plaintiff is barred from
recovering uninsured motorist benefits because he is not "legally
entitled to recover" from defendants Rhodes and Shamblin Stone
because the accident occurred while both were acting within the
scope of their employment, and Shamblin Stone is a participant in
the West Virginia Workers' Compensation Fund.
However, the plaintiff insists that Continental must pay
him uninsured motorist benefits that he is "legally entitled to
recover" within the meaning of the policy, and Continental may not
raise the workers' compensation bar as a defense to the policy's
contractual obligations.
By order entered December 30, 1992, the Circuit Court of
Mason County certified the following question to this Court:
May the plaintiff, who is precluded by grants
of immunity contained in the Workers'
Compensation Act, W.Va. Code 23-2-6 and 6a
from securing a judgment against defendants
Shamblin Stone or Rhodes, nonetheless assert a
claim under the uninsured or underinsured
motorist provisions contained in the insurance
policy issued by defendant Continental,
pursuant to W.Va. Code 33-6-31, covering the
vehicle plaintiff was driving at the time of
the accident?
The circuit court answered the question in the affirmative.
"The Workmen's [Workers'] Compensation Act was designed
to remove negligently caused industrial accidents from the common
law tort system." Mandolidis v. Elkins Industries, Inc., 161 W.Va.
695, 700, 246 S.E.2d 907, 911 (1978) (emphasis in original). West
Virginia Code § 23-2-6 provides, in pertinent part, that an
employer who subscribes and pays premiums into the Workers'
Compensation Fund "shall not be liable to respond in damages at
common law or by statute for the injury or death of any employee,
however occurring . . . ." "W.Va. Code, 23-2-6a [1949] extends the
employer's immunity from liability set forth in W.Va. Code, 23-2-6
[1991] to the employer's officer, manager, agent, representative or
employee when he is acting in furtherance of the employer's
business and does not inflict an injury with deliberate intention."
Syl. pt. 4, Henderson v. Meredith Lumber Co., Inc., 190 W.Va. 292, 438 S.E.2d 324 (1993).See footnote 1 "This statutory immunity of a coemployee
is not violative of the due process provisions of the State and
Federal Constitutions because, like the employer, a coemployee is
involved in a compromise of rights; among employees, the quid pro
quo is that each employee surrenders his common law right to bring
tort actions against other employees in return for immunity to
their tort suits." Deller v. Naymick, 176 W.Va. 108, 342 S.E.2d
73, 76 (1985).
In Deller, this Court was asked whether the immunity from
tort liability found in W.Va. Code § 23-2-6a is inapplicable to the
extent that a doctor employed by a subscriber to the Workers'
Compensation Fund or by a self-insured employer is covered by
liability insurance. In holding that immunity from tort liability
is not waived to the extent that liability insurance coverage is
available, we discussed the purposes behind employee and coemployee
immunity:
[T]he purpose of coemployee (and employer)
immunity under the Workers' Compensation Act
is to replace the common-law tort claims and
defenses between or among employers and
employees with the no-fault, exclusive remedy
of workers' compensation. Liability insurance
coverage does not remove this reason for the
rule, and allowing suits would emasculate the
workers compensation system greatly. For
example, by the same theory, any employee
covered by automobile liability insurance,
which coverage is usually required by W.Va.
Code, 17D-2A-3 [1982], would be subject to
suit for an injury sustained by a coemployee
in a motor vehicle accident in the course of
and resulting from employment. Also, unlike
governmental immunity (in the context of
liability insurance coverage), coemployee (and
employer) immunity under the Workers'
Compensation Act does not result in a total
denial of the right to apply for redress of
grievances. Instead, the alternative workers'
compensation remedies are available in lieu of
the common-law remedies.
Id. at 80-81 (footnotes omitted) (emphasis added).
The fact that workers' compensation benefits are an
exclusive remedy in Virginia was critical to the Supreme Court of
Virginia's decision in Aetna Casualty & Surety Co. v. Dodson, 235
Va. 346, 367 S.E.2d 505 (1988), which presented an issue similar to the one that is now before us. In Dodson, the United States Court
of Appeals for the Fourth Circuit asked the Supreme Court of
Virginia to answer the following certified question:
Does Virginia law permit recovery by an
insured's estate under the UM provision of the
insured's policy (paid for by the insured),
where the insured was killed in a work-related
motor vehicle accident and where the
employer/vehicle owner and co-employee/vehicle
operator both had insurance, but where the
exclusive remedy clause of the Virginia
Workmen's Compensation Act bars recovery under
those other policies?
In response to the question posed by the Fourth Circuit
Court of Appeals, the Supreme Court of Virginia reasoned that a
condition precedent to the insurance company's liability under its
uninsured endorsement was not met because "[t]he phrase 'legally
entitled to recover as damages' interposes, as a condition
precedent to the UM insurer's obligation, the requirement that the
insured have a legally enforceable right to recover damages from an
owner or operator of an uninsured motor vehicle." Id. at 508. The
court concluded that "[b]ecause workers' compensation afforded the
exclusive remedy against the decedent's employer and fellow
employees for his accidental death, his statutory beneficiaries are
not 'legally entitled to recover' damages against them." Id.
(emphasis added).See footnote 2
In its discussion, the Supreme Court of Virginia alluded
to the fact that "[t]he parties have cited a number of cases in
which other jurisdictions have considered similar questions, but
most are inapposite because workers' compensation is not an
exclusive remedy in those jurisdictions." Id. One noted exception
was Perkins v. Insurance Co. of North America, 799 F.2d 955 (5th
Cir. 1986), a case governed by Mississippi law, which provided that
workers' compensation was an injured employee's exclusive remedy
for work-related injuries against his employer and his fellow
employees. The Supreme Court of Virginia observed that
Mississippi's uninsured or underinsured motorist law, virtually
identical to Virginia's, was incorporated into the language of the
subject insurance policy, and that in the absence of a ruling by
the Mississippi courts, the federal court in Perkins turned to
Professor Larson's treatise on workers' compensation:
"Ordinarily, for the uninsured motorist clause
to operate in the first place, the uninsured
third person must be legally subject to
liability. Thus, if the third person is
specifically made immune to tort suit by the
compensation act's exclusive remedy clause,
the uninsured motorist provision does not come
into play. In the familiar example of
coemployee immunity, the issue thus becomes
whether the accident was in the course of
employment; if it was, the uninsured motorist
carrier has no liability." 799 F.2d at 959
(emphasis deleted)(quoting A. Larson, 2A
Workmen's Compensation Law § 71.23(i) at 14-37
(1983) (1987 Supp. at 14-44).
Dodson, 367 S.E.2d at 508.
Like the Supreme Court of Virginia in Dodson, we agree
with this analysis. We conclude that an employee who receives
workers' compensation benefits for an injury that occurs within the
course and scope of employment is not entitled to assert a claim
for uninsured or underinsured motorist benefits. Because of the
provisions for employer and coemployee immunity contained in W.Va.
Code §§ 23-2-6 and 6a (1994), workers' compensation is the
exclusive remedy available to an injured employee, and an uninsured
or underinsured motorist carrier has no liability.See footnote 3
Thus, in the case now before us, the plaintiff may not
assert a claim under the uninsured or underinsured motorist
provisions of the policy issued by the defendant, Continental. Our
answer to the certified question is no.
Any employer subject to this chapter who
shall subscribe and pay into the workmen's
compensation fund the premiums provided by
this chapter or who shall elect to make direct
payments of compensation as herein provided
shall not be liable to respond in damages at
common law or by statute for the injury or
death of any employee, however occurring,
after so subscribing or electing, and during
any period in which such employer shall not be
in default in the payment of such premiums or
direct payments and shall have complied fully
with all other provisions of this chapter.
The continuation in the service of such
employer shall be considered a waiver by the
employee and by the parents of any minor
employee of the right of action as aforesaid,
which the employee or his or her parents would
otherwise have: Provided, That in case of
employers not required by this chapter to
subscribe and pay premiums into the workers'
compensation fund, the injured employee has
remained in such employer's service with
notice that his employer has elected to pay
into the workers' compensation fund the
premiums provided by this chapter, or has
elected to make direct payments as aforesaid.
West Virginia Code § 23-2-6a (1985) then provides that
the immunity from liability set out in § 23-2-6 "shall extend to
every officer, manager, agent, representative or employee of such
employer when he is acting in furtherance of the employer's
business and does not inflict an injury with deliberate intention."
Footnote: 2 After the Supreme Court of Virginia answered the
certified question, the Fourth Circuit reversed the United States
District Court decision (649 F.Supp. 1455 (E.D.Va. 1986)), stating
that "under Virginia law, the exclusive remedy clause of the
Virginia Workmen's Compensation Act barred recovery under the
decedent's uninsured motorist insurance policy." Dodson v. Aetna
Casualty & Surety Co., 851 F.2d 736, 738 (4th Cir. 1988).
See generally John P. Ludington, L.L.B., Annotation, Automobile Uninsured Motorist Coverage: "Legally Entitled to Recover" Clause as Barring Claim Compensable Under Workers' Compensation Statute, 82 A.L.R.4th 1096 (1990), in which the author addresses an issue similar to that which is now before this Court: "Does the tort immunity of an employer or coemployee mean that an injured employee is not 'legally entitled to recover' from the employer or coemployee, and therefore cannot receive uninsured motorist benefits for vehicular injuries received in an accident arising out of, and in the course of, employment?" Id. at 1099. The author states that "[i]nsofar as the uninsured motorist coverage has been bought and paid for by someone other than the injured employee, the results have been uniform. The injured employee cannot recover uninsured motorist benefits under the uninsured motorist coverage in policies obtained by his or her employer, partner or the negligent coemployee." Id.
Footnote: 3 See also State Farm Mutual Automobile Insurance Company v. Webb, 562 N.E.2d 132, 135 (Ohio 1990), in which the Supreme Court of Ohio reviewed the proper construction to be given to the phrase "legally entitled to recover" and concluded that "[a]n insurer is not liable to its insured on an uninsured motorist claim where the claim arises from an accident in which the tortfeasor- motorist causing the insured's injuries has liability insurance but is immune pursuant to the statutory fellow-employee doctrine, because the insured is not legally entitled to a recovery from the tortfeasor." Id. at syllabus.