Car Crash During Employment – Who Pays the Medical Bills?
Submitted by New Jersey Workers Compensation Lawyer, Jeffrey Hark.
If you’re in a car crash during the course of employment who pays your medical bills? Also, if you recover from a third-party, do you have to pay back the Worker’s Compensation carrier for the medical temporary disability and permanency award you obtain?
This issue comes up again and again for lots of my clients are involved in car crashes while they are in the course of their employment. I represent many landscapers, trash truck operators, and other commercial truck driver/employees operating company vehicles on behalf of their employer who are struck by other cars.
In this case Tina Talmage was seriously injured while in the course of her employment when she was operating a company vehicle. She settled the third-party case against the Burns family the amount of their insurance$250,000.00 yet this was not a great deal of money given her injuries. The bigger problem Tina had was that she was working at the time of the crash and obtained $127,000.00 of Worker’s Compensation benefits through her employer who was insured with The Hartford. This court affirmed her long standing statutory obligation to pay that $127,000 back to the Worker’s Compensation carrier.
Specifically, this case lays out the statutory primacy of New Jersey Worker’s Compensation benefits system over personal automobile protection first party medical insurance benefits that come with every auto policy. As a result, Tina had to pay back the statutory amount to the Worker’s Compensation carrier from the funds she received from the tortfeasor in her crash. Tina Talmage fought this all the way up to the Appellate Division because the net proceeds to her from the 3rd party insurance settlement with the defendant Connie Burns with not enough to cover all of her pain and suffering.
The court examined the New Jersey PIP statute and the New Jersey Worker’s Compensation statute. The court recognized the Section 40 lien rights the Worker’s Compensation carrier is allowed to assert against any third-party recovery. This is a statutory entitlement on behalf of the Worker’s Compensation carrier in order to avoid double recovery. Employees are not allowed to use Worker’s Compensation medical and TDB benefits, recover against the tortfeasor from a motor vehicle crash, without reimbursing the Worker’s Compensation carrier for the compensation benefit expenses they received. Technically this is called the “collateral source” rule which relieves the PIP carrier from making payments for the same medical treatment and expenses which are covered by the Worker’s Compensation statute. In addition the court recognized the statutorily acceptable and anticipated primary burden placed upon the Worker’s Compensation system as a matter of legislative policy. The New Jersey Supreme Court addressed this issue in the matter of Frasier v NJM, 142 N.J. 590 (1995). This court went on to recognize the intention of the Section 40 lien statute to “prevent an injured employee from recovering from a third-party am retaining the Worker’s Compensation payments while at the same time recovering and retaining the full damages resulting from the third-party tort action.” Greene v. AIG Cas. Co. 433 N.J. Super. 59, 68 (App. Div. 2013).
What is the practical effect in this case? Plaintiff was able to settle with the $250,000 policy limits from the Burns family. Lets presume, after attorneys fees and costs, there was only $150,000.00 left for the plaintiff. This court ordered plaintiff to pay back $127,000 worth of benefits paid by the Worker’s Compensation carrier. As a result there was only $23,000.00 left to distribute to the plaintiff, for what appears to be substantially catastrophic injuries.
Jeffrey S. Hark, Esq.