The Georgia Insurers Insolvency Pool’s demand for a refund from an injured worker must first be addressed by the state workers’ compensation board, the Georgia Court of Appeals has decided.
The comp board should now decide if Victoria Palmer, who was seriously injured in an automobile accident in 2017, will have to repay thousands of dollars, including more than $21,000 that was paid directly to medical providers.
After the accident, the workers’ comp insurer for Palmer’s employer became insolvent. The state insolvency pool issued payments of $26,600 on her claim. Only about $3,200 was paid to Palmer for wage-loss benefits, the court explained in Palmer vs. Georgia Insurers Insolvency Pool, published this month.
But because Palmer also settled with the at-fault driver’s insurance company for the policy limits of $25,000, and her own insurer for $50,000 in underinsured motorist coverage, the Insolvency Pool filed a subrogation suit, seeking reimbursement of its own comp benefits payments.
The pool sought a set-off of $75,000 and a full refund from Palmer. The Superior Court of DeKalb County agreed, and Palmer appealed. Palmer has said that she has incurred medical bills of more than $85,000 since the accident.
The appeals court noted that while state law appears to allow the insolvency pool to seek reimbursement for other insurers’ payments on a claim, it does not authorize the pool to seek remedy in trial court before the Board of Workers’ Compensation has made a determination. The matter is still pending before the comp board, the appellate court explained.
“To the extent that the insolvency pool wishes to litigate the issues raised in this case at this time, it must do so before the Board,” Appeals Court Judge John Pipkin wrote in the opinion. “For these reasons, we vacate the Superior Court’s grant of summary judgment to the insolvency pool and remand this case to the Superior Court with direction to dismiss the insolvency pool’s complaint.”
Topics Workers' Compensation
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