Kuney v. PMA Insurance

LARSEN, Justice,

dissenting.

I dissent.

Today, the majority holds that where a claim has as its “ultimate basis” an injury compensable under the Workmen’s Compensation Act, 77 P.S. §§ 1-1601.1 (Act), the claimant is “limited to the remedies provided within the framework of the act.” Maj. op. at 1288. Not only does this holding have no basis in the law, but, taken to its logical conclusion, the majority’s holding will preclude a workmen’s compensation claimant from bringing a malpractice action against the physician who negligently treats his or her work related injury.

Nowhere has the legislature stated that claims which are “ultimately based” upon a compensable injury must be raised in a workmen’s compensation proceeding. The Act quite simply and specifically applies to injuries “arising in the course of ... employment and related thereto.” 77 P.S. § 411(1). In Krawchuk v. Philadelphia Electric Co., 497 Pa. 115, 439 A.2d 627 (1981), this Court determined that there are two requirements for compensability of an injury under the Act: (1) the injury must arise in the course of employment, and (2) the injury must be related to the employment. The Act does not, therefore, apply to the economic and emotional harm suffered by a claimant due to the intentionally wrongful, obdurate, and fraudulent behavior of a workmen’s compensation carrier occurring after the employee has been separated from his place of employment.1

*179The legislature, in providing various remedies for “unreasonable” delays in the payment of compensation and “unreasonable contests” of compensation claims, was not addressing the kinds of conduct alleged by appellee, George C. Kuney, herein.2 “Unreasonable” conduct is conduct that is not rational, “not guided by reason or sound judgment.” The Random House Dictionary of the English Language 2084 (2d ed. 1987) Appellee has not alleged that appellant, PMA Insurance Company, acted unreasonably or without sound judgment. Rather, appellee has alleged bad faith, misrepresentation, fraud, intentional infliction of emotional distress, and outrageous conduct arising “outside the course of [appellee’s] employment.” Complaint — Civil Action of Plaintiff (Appellee) at ¶¶ 24, 25, 27, 41, 42, 44. Surely, such conduct does not fall within the ambit of conduct that is merely “unreasonable.”

In addition, as I stated in my dissenting opinion in Poyser v. Newman & Company, Inc., 514 Pa. 32, 40, 522 A.2d 548, 552 (1987) (Larsen, J., dissenting, joined by Papadakos, J.), “ ‘workmen’s compensation law does not address losses incurred by intentional injury by employee or employer.’ [Kline v. Arden H. Verner Co.,] 503 Pa. [251] at 255, 469 A.2d [158] at 160 [ (1983) ].” In spite of the fact that the majority held to the contrary in Poyser, that case has no application herein, because the defendant (appellant) is not the employer. Rather, the defendant (appellant) is a third party. The injury that has been alleged is a separate matter of bad faith, misrepresentation, fraud, intentional infliction of emotional distress, and “outrageous conduct between the insurance carrier and the claimant, not the employer. As appellee has alleged intentional wrongdoing *180on the part of appellant, the employer’s compensation insurance carrier, I would find that he is not precluded from maintaining an action in trespass for the separate injury he has incurred.

Accordingly, I would affirm the order of the Superior Court, reversing the grant of appellant’s preliminary objections and remanding for further proceedings.

PAPADAKOS, J., joins this dissenting opinion.

. Although the courts in other jurisdictions have reached conflicting results on this issue, a majority has held that claimants may bring an independent action against a workmen’s compensation insurer who has wrongfully delayed or refused to make compensation payments. *179See cases collected at Annotation, Tort Liability of Worker’s Compensation Insurer for Wrongful Delay or Refusal to Make Payments Due, 8 A.L.R. 4th 902.

. 77 P.S. § 717.1 provides for interest to be paid on due and unpaid compensation. 77 P.S. § 991 provides for the assessment of additional interest where employers and insurers have caused "unreasonable or excessive delays.” 77 P.S. § 996 provides for the payment of a claimant’s legal fees where there is no reasonable basis for an insurer's contest of liability.