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Workers' compensation ensures that employees injured on the job have a pool of resources available that can help them cover medical expenses, lost wages and other types of related losses. But, workers' compensation is not always the only legal remedy injured workers can turn to.
In addition to Pennsylvania workers' comp benefits, injured employees may have a legal claim for compensation against a responsible third party or certain insurance providers. For Frank Heller, a municipal worker in Sugarcreek Borough, a severe accident turned into a legal battle for the benefits he needed when an insurer denied his claim because he had already received workers' compensation. Brought all the way to the highest court in the state, Heller's case was finally decided, finally giving him access to the funds he deserved and setting a precedent that will protect similarly situated Pennsylvania workers in the future.
The Court Case Heller v. Pennsylvania League of Cities and Municipalities
Frank Heller's career as a police officer for Sugarcreek Borough was cut tragically short when he was involved in a violent on-the-job automobile accident. Heller suffered extensive disabling injuries.
Workers' compensation paid Mr. Heller's medical expenses and two-thirds of his salary; Sugarcreek Borough covered the remainder of his salary. In addition, Heller was able to recover $25,000 from the driver who had been at fault in the accident ($25,000 was the policy limit on the driver's liability insurance policy). However, Heller's losses and damages still far exceeded his recovery from these sources.
Fortunately, Heller was also covered by an underinsured motorist policy issued through Penn PRIME Trust to the Pennsylvania League of Cities and Municipalities. This policy provided UIM coverage of up $100,000. There was just one problem: Penn Prime denied Heller's claim based on a policy exclusion for anyone covered by workers' compensation benefits.
Heller and his wife filed a court action challenging Penn Prime's policy, arguing that as written Penn Prime's policy provided no real coverage, as the workers' comp exclusion would apply to essentially every borough employee seeking to collect on their underinsured motorist coverage. Ultimately, the case reached the Supreme Court of Pennsylvania.
The Supreme Court agreed with Heller's arguments, and ruled that Penn Prime's treatment of individuals receiving workers' compensation was contrary to public policy. As a result, Heller should finally receive the full amount of benefits he deserves.
Heller Case Clarifies Relationship between Auto Insurance and Workers' Comp, but Obstacles Still Abound For Injured Workers
The full impact of Frank Heller's case will be felt in courtrooms and at negotiating tables throughout Pennsylvania: as a ruling of the Supreme Court, lower courts are compelled to abide by its reasoning. This means it should be easier for victims of job-related car accidents to collect both workers' compensation benefits, and payouts from any applicable auto insurance policies.
While Heller's case may make it easier to get payment from both auto insurers and workers' comp, injured workers should still be wary of the many potentials pitfalls of receiving compensation for work-related injuries. Among other things, claims can be denied, you may be pressured to settle for less than you deserve or the extensiveness of you injuries may be downplayed. If you have been hurt while working, make sure you get the full amount of compensation you need by seeking the services of an experienced Pennsylvania workers' compensation attorney.
