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Employees Injured on the Job May Claim Benefits Through Their Own UIM Coverage, But Not Their Employer’s

Author: Blaire Bayliss

Guest Editors: Wendy Skillman, Ashley Kaye

January 11, 2021 9:00am

Colorado’s Workers Compensation Act is the “exclusive remedy” for obtaining compensation from employers for work injuries. Injured employees receiving worker’s compensation benefits are barred from suing employers or co-workers for additional damages. [1] This law, often referred to as the exclusive remedy defense, is intended to prevent employees from “double dipping” by claiming both worker’s compensation benefits as well as other benefits for a single on-the-job injury. The law benefits employers by making clear there is only one remedy for on-the-job injuries, often preventing costly litigation regarding negligence or breach of contract. Of course, the law also benefits injured employees by ensuring complete and competitive injury compensation through worker’s compensation.

However, the waters are somewhat murkier when an employee with an on-the-job injury attempts to collect through uninsured/underinsured motorist (UM/UIM) coverage. If an employee sustains injury on the job in a vehicle accident driven by an employer or co-worker, the employee may potentially make claims under both worker’s compensation as well as under the employer or coworker’s UM/UIM coverage. May insurance providers offering UM/UIM coverage refuse a claim if the claimant was an employee injured on the job who received worker’s compensation for the injuries? In Colorado, the answer depends on one factor: the party who purchased the relevant UM/UIM coverage.

Colorado Revised Statutes section 10-4-609, which regulates UM/UIM coverage, states coverage applies only if the claimant is “legally entitled” to damages. Colorado courts have consistently held employers and co-workers are immune from civil liability to an employee receiving workers compensation benefits under the exclusive remedy provision of the Worker’s Compensation Act. Because the employee would not have standing to bring suit against the employer or co-worker, an injured employee is not “legally entitled” to damages from the employer or co-worker. Therefore, the employee cannot make a claim under the employer or co-worker’s UM/UIM coverage for any on-the-job incident for which the injured employee received worker’s compensation benefits. [2]

However, if the claimant attempts to collect damages through his own UM/UIM coverage, he will be allowed to make a UM/UIM claim while receiving worker’s compensation benefits. The Colorado Court of Appeals held in American Family Mutual Insurance v. Ashour, No. 16CA0822 (Colo. App. 2017) that the Workers’ Compensation Act’s exclusivity clause does not bar an injured employee’s recovery of UM/UIM benefits from his personal insurer. The insurer must provide UM/UIM coverage if the employee can prove the employer or co-worker was at fault for his injuries and the extent of his damages in excess of coverage offered him under the Colorado Workers’ Compensation Act. [3] This analysis centers, again, on the language of the phrase “legally entitled.” Although an employee is not “legally entitled” to damages from an employer or co-worker under the exclusive remedy, an employee is still entitled to the benefits of his or her own insurance and would be “legally entitled” to bring suit to enforce this right, as the relationship between the injured employee and his private insurance does not fall within the scope of the exclusive remedy. The United States District Court for the District of Colorado succinctly summarized the issue in Markel Ins. Co. v. Hollandsworth, 400 F. Supp. 3d 1155, 1160 (D. Colo. 2019) when it wrote, “…the difference in who procured the UM/UIM policy is dispositive.”

Takeaway

For employers, these cases confirm the scope of the exclusive remedy and support the long-existing policy purposes behind the law: to prevent the need for employees to double-dip into benefits through litigation, and instead ensure comprehensive worker’s compensation benefits. Employers should be assured to know their UM/UIM coverage will likely not be implicated if an employee is injured in a vehicle accident while on the job. Workers, too, should be assured in knowing their co-workers will be prevented from making claims through their own personal UM/UIM insurance for accidents which may occur on the job. For those risk-averse individuals who may wish to have their own UM/UIM insurance through which to make claims in case of vehicular injury on the job, this should further confirm age-old advice: it is better to be over-insured than under-insured.

 

[1] Colorado Revised Statutes section 10-4-609

[2] See Ryser v. Shelter Mutual Insurance Company, 2019 COA 88, 2019 WL 2454861 (Colo. App. 2019); State Farm Mut. Auto. Ins. Co. v. Brekke, 105 P.3d 177, 188 (Colo. 2004); Coleman-Domanoski v. St. Paul Guardian Ins. Co., 456 F. Supp. 3d 1250 (D. Colo. 2020); Briggs v. American Family Mutual Insurance Co., 833 P.2d 859, 861-62 (Colo. App. 1992).

[3] See also Borjas v. State Farm Mut. Auto. Ins. Co., 33 P.3d 1265, 1266 (Colo. App. 2001).

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