Insurer had no right to reimbursement from legal malpractice settlement proceeds arising from a failure to file an action arising from a work related injury as the employe's injury from the malpractice was the loss of a legal right not a physical injury. Smith v. Long, 178 W (2d) 797, 505 NW (2d) 429 (Ct. App. 1993).
Damages for a child's loss of a parent's society and financial support are not subject to allocation under sub. (1). Cummings v. Klawitter, 179 W (2d) 408, 506 NW (2d) 750 (Ct. App. 1993).
The traditional 4-prong Seaman test for determining whether a person was a "loaned employe" subject to the exclusive remedy provisions of this chapter applies to temporary employes not covered by sub. (6). Bauernfeind v. Zell, 190 W (2d) 701, 528 NW (2d) 1 (1995).
Pecuniary damages recovered in a third-party wrongful death action are subject to distribution under this section. Johnson v. ABC Ins. Co. 193 W. (2d) 35, 532 NW (2d) 130 (1995).
An insurer is entitled to reimbursement under sub. (1) from an employe's settlement with his or her employer where the employer's basis for liability is an indemnification agreement with a 3rd party tortfeasor. Houlihan v. ABC Insurance Co. 198 W (2d) 133, 542 NW (2d) 178 (Ct. App. 1995).
Sub. (5) extends the statute of limitations only when s. 893.54 is the applicable statute; it does not extend the statute of another state when it is applicable under s.893.07. That sub. (5) only applies to cases subject to the Wisconsin statute is not unconstitutional. Bell v. Employers Casualty Co. 198 W (2d) 347, 541 NW (2d) 824 (Ct. App. 1995).
The Seaman loaned employe test has 3 elements but is often miscast because the Seaman court indicated that there are four "vital questions" which must be answered. The 3 elements are consent by the employe, entry by the employe upon work for the special employer and power of the special employer to to control details of the work. When an employe of one employer assists the employes of another employer as a true volunteer, a loaned employe relationship does not result. Borneman v. Corwyn Transport, Ltd. 212 W (2d) 25, 567 NW (2d) 887 (Ct. App. 1997).
In a 3rd party action filed by an insurer under sub. (1), the insurer has the right to maintain an action for payments it has or will make to the employe by claiming all the employes' damages including pain and suffering. Threshermens Mutual Insurance Co. v. Page, 217 W (2d) 451, 577 NW (2d) 335 (1998).
The allocation of a settlement to various plaintiffs cannot be contested by an insurer who defaults at the hearing to approve the settlement. An insurer does not lose its right to share in the proceeds by defaulting, but it does forfeit its right to object to the application of settlement proceeds to specific claims. Herlache v. Blackhawk Collision Repair, Inc. 215 W (2d) 99, 572 NW (2d) 121 (Ct. App. 1997).
Problems in 3rd party action procedure under the Wisconsin worker's compensation act. Piper. 60 MLR 91.
Impleading a negligent employer is a third-party action when the employer has provided workman's compensation benefits. 1976 WLR 1201.
Product liability in the workplace: The effect of workers' compensation on the rights and liabilities of 3rd parties. Weisgall. 1977 WLR 1035.
Preoccupation with Work Defense to Contributory Negligence. Parlee. Wis. Law. May 1995.
Worker's Compensation Act No Longer Protects Against Employment Discrimination Claims. Skinner. Wis. Law. March 1998.
Other insurance not affected; liability of insured employer. 102.30(1)(1)
This chapter does not affect the organization of any mutual or other insurance company or the right of the employer to insure in mutual or other companies against such liability or against the liability for the compensation provided for by this chapter.
An employer may provide by mutual or other insurance, by arrangement with employes or otherwise, for the payment to those employes, their families, their dependents or their representatives, of sick, accident or death benefits in addition to the compensation provided under this chapter. Liability for compensation is not affected by any insurance, contribution or other benefit due to or received by the person entitled to that compensation.
Unless an employe elects to receive sick leave benefits in lieu of compensation under this chapter, if sick leave benefits are paid during the period that temporary disability benefits are payable, the employer shall restore sick leave benefits to the employe in an amount equal in value to the amount payable under this chapter. The combination of temporary disability benefits and sick leave benefits paid to the employe may not exceed the employe's weekly wage.
Regardless of any insurance or other contract, an employe or dependent entitled to compensation under this chapter may recover compensation directly from the employer and may enforce in the person's own name, in the manner provided in this chapter, the liability of any insurance company which insured the liability for that compensation. The appearance, whether general or special, of any such insurance carrier by agent or attorney constitutes waiver of the service of copy of application and of notice of hearing required by s. 102.17
Payment of compensation under this chapter by either the employer or the insurance company shall, to the extent thereof, bar recovery against the other of the amount so paid. As between the employer and the insurance company, payment by either the employer or the insurance company directly to the employe or the person entitled to compensation is subject to the conditions of the policy.
The failure of the assured to do or refrain from doing any act required by the policy is not available to the insurance carrier as a defense against the claim of the injured employe or the injured employe's dependents.
The department may order direct reimbursement out of the proceeds payable under this chapter for payments made under a nonindustrial insurance policy covering the same disability and expenses compensable under s. 102.42
when the claimant consents or when it is established that the payments under the nonindustrial insurance policy were improper. No attorney fee is due with respect to that reimbursement.
An insurer who issues a nonindustrial insurance policy described in par. (a)
may not intervene as a party in any proceeding under this chapter for reimbursement under par. (a)
Discussion of medical insurer's right to reimbursement under (7). Employers Health Ins. Co. v Tesmer, 161 W (2d) 733, 469 NW (2d) 203 (Ct. App. 1991).
Worker's compensation insurance; policy regulations. 102.31(1)(a)(a)
Every contract for the insurance of compensation provided under this chapter or against liability therefor is subject to this chapter and provisions inconsistent with this chapter are void.
Except as provided in par. (c)
, a contract under par. (a)
shall be construed to grant full coverage of all liability of the assured under this chapter unless the department specifically consents by written order to the issuance of a contract providing divided insurance or partial insurance.
Liability under s. 102.35 (3)
is the sole liability of the employer, notwithstanding any agreement of the parties to the contrary.
An intermediate agency or publisher referred to in s. 102.07 (6)
may, under its own contract of insurance, cover liability of employes as defined in s. 102.07 (6)
for an intermediate or independent news agency, if the contract of insurance of the publisher or intermediate agency is endorsed to cover those persons. If the publisher so covers, the intermediate or independent news agency need not cover liability for those persons.
A contract procured to insure a partnership may not be construed to cover the individual liability of the members of the partnership in the course of a trade, business, profession or occupation conducted by them as individuals. A contract procured to insure an individual may not be construed to cover the liability of a partnership of which the individual is a member or to cover the liability of the individual arising as a member of any partnership.
A contract procured to insure a limited liability company may not be construed to cover the individual liability of the members of the limited liability company in the course of a trade, business, profession or occupation conducted by them as individuals. A contract procured to insure an individual may not be construed to cover the liability of a limited liability company of which the individual is a member or to cover the liability of the individual arising as a member of any limited liability company.
An insurer who provides a contract under par. (a)
shall file the contract as provided in s. 626.35
No party to a contract of insurance may cancel it within the contract period or terminate or not renew it upon the expiration date until a notice in writing is given to the other party fixing the proposed date of cancellation or declaring that the party intends to terminate or does not intend to renew the policy upon expiration. Except as provided in par. (b)
, when an insurance company does not renew a policy upon expiration, the nonrenewal is not effective until 60 days after the insurance company has given written notice of the nonrenewal to the insured employer and the department. Cancellation or termination of a policy by an insurance company for any reason other than nonrenewal is not effective until 30 days after the insurance company has given written notice of the cancellation or termination to the insured employer and the department. Notice to the department may be given either by personal service of the notice upon the department at its office in Madison or by sending the notice by facsimile machine transmission or certified mail addressed to the department at its office in Madison. The department may provide by rule that the notice of cancellation or termination be given by certified mail or facsimile machine transmission to the Wisconsin compensation rating bureau rather than to the department. Whenever the Wisconsin compensation rating bureau receives such a notice of cancellation or termination it shall immediately notify the department of the notice of cancellation or termination.
In the event of a court-ordered liquidation of an insurance company, a contract of insurance issued by that company terminates on the date specified in the court order.
Regardless of whether the notices required under par. (a)
have been given, a cancellation or termination is effective upon the effective date of replacement insurance coverage obtained by the employer or of an order exempting the employer from carrying insurance under s. 102.28 (2)
The department may examine from time to time the books and records of any insurer insuring liability or compensation for an employer in this state. The department may require an insurer to designate one mailing address for use by the department and to respond to correspondence from the department within 30 days. Any insurer that refuses or fails to answer correspondence from the department or to allow the department to examine its books and records is subject to enforcement proceedings under s. 601.64
If any insurer authorized to transact worker's compensation insurance in this state fails to promptly pay claims for compensation for which it is liable or fails to make reports to the department required by s. 102.38
, the department may recommend to the commissioner of insurance, with detailed reasons, that enforcement proceedings under s. 601.64
be invoked. The commissioner shall furnish a copy of the recommendation to the insurer and shall set a date for a hearing, at which both the insurer and the department shall be afforded an opportunity to present evidence. If after the hearing the commissioner finds that the insurer has failed to carry out its obligations under this chapter, the commissioner shall institute enforcement proceedings under s. 601.64
. If the commissioner does not so find, the commissioner shall dismiss the complaint.
If any employer whom the department exempted from carrying compensation insurance arbitrarily or unreasonably refuses employment to or discharges employes because of a nondisabling physical condition, the department shall revoke the exemption of that employer.
The department has standing to appear as a complainant and present evidence in any administrative hearing or court proceeding instituted for alleged violation of s. 628.34 (7)
If the department by one or more written orders specifically consents to the issuance of one or more contracts covering only the liability incurred on a construction project and if the construction project owner designates the insurance carrier and pays for each such contract, the construction project owner shall reimburse the department for all costs incurred by the department in issuing the written orders and in ensuring minimum confusion and maximum safety on the construction project.
The Wisconsin compensation rating bureau shall provide the department with any information it requests relating to worker's compensation insurance coverage, including but not limited to the names of employers insured and any insured employer's address, business status, type and date of coverage, manual premium code, and policy information including numbers, cancellations, terminations, endorsements and reinstatement dates. The department may enter into contracts with the Wisconsin compensation rating bureau to share the costs of data processing and other services.
Sub. (1) (b) does not apply to a joint venture and insurance written in the name of one adventurer is sufficient to cover his joint liability. Insurance Co. of N. A. v. ILHR Dept. 45 W (2d) 361, 173 NW (2d) 192.
Continuing liability; guarantee settlement, gross payment.
In any case in which compensation payments have extended or will extend over 6 months or more from the date of the injury (or at any time in death benefit cases), any party in interest may, in the discretion of the department, be discharged from, or compelled to guarantee, future compensation payments as follows:
By depositing the present value of the total unpaid compensation upon a 7% interest discount basis with a credit union, savings bank, savings and loan association, bank or trust company designated by the department; or
By purchasing an annuity within the limitations provided by law, in such insurance company granting annuities and licensed in this state, as may be designated by the department; or
By making payment in gross upon a 7% interest discount basis to be approved by the department; and
In cases where the time for making payments or the amounts thereof cannot be definitely determined, by furnishing a bond, or other security, satisfactory to the department for the payment of compensation as may be due or become due. The acceptance of the bond, or other security, and the form and sufficiency thereof, shall be subject to the approval of the department. If the employer or insurer is unable or fails to immediately procure the bond, then, in lieu thereof, deposit shall be made with a credit union, savings bank, savings and loan association, bank or trust company designated by the department, of the maximum amount that may reasonably become payable in these cases, to be determined by the department at amounts consistent with the extent of the injuries and the law. The bonds and deposits are to be reduced only to satisfy claims and withdrawn only after the claims which they are to guarantee are fully satisfied or liquidated under sub. (1)
Any insured employer may, within the discretion of the department, compel the insurer to discharge, or to guarantee payment of its liabilities in any such case under this section and thereby release himself or herself from compensation liability therein, but if for any reason a bond furnished or deposit made under sub. (4)
does not fully protect, the compensation insurer or uninsured employer, as the case may be, shall still be liable to the beneficiary thereof.
If compensation is due for permanent disability following an injury or if death benefits are payable, payments shall be made to the employe or dependent on a monthly basis. The department may direct an advance on a payment of unaccrued compensation or death benefits if it determines that the advance payment is in the best interest of the injured employe or his or her dependents. In directing the advance, the department shall give the employer or the employer's insurer an interest credit against its liability. The credit shall be computed at 7%.
No lump sum settlement shall be allowed in any case of permanent total disability upon an estimated life expectancy, except upon consent of all parties, after hearing and finding by the department that the interests of the injured employe will be conserved thereby.
Department forms and records; public access. 102.33(1)(1)
The department shall print and furnish free to any employer or employe such blank forms as it shall deem requisite to facilitate efficient administration of this chapter; it shall keep such record books or records as it shall deem required for the proper and efficient administration of this chapter.
Except as provided in par. (b)
, the records of the department related to the administration of this chapter are subject to inspection and copying under s. 19.35 (1)
Notwithstanding par. (a)
, a record maintained by the department that reveals the identity of an employe who claims worker's compensation benefits, the nature of the employe's claimed injury, the employe's past or present medical condition, the extent of the employe's disability, the amount, type or duration of benefits paid to the employe or any financial information provided to the department by a self-insured employer or by an applicant for exemption under s. 102.28 (2) (b)
is confidential and not open to public inspection or copying under s. 19.35 (1)
. The department may deny a request made under s. 19.35 (1)
or, subject to s. 102.17 (2m)
, refuse to honor a subpoena issued by an attorney of record in a civil or criminal action or special proceeding to inspect and copy a record that is confidential under this paragraph, unless one of the following applies:
The requester is the employe who is the subject of the record or an attorney or authorized agent of that employe. An attorney or authorized agent of an employe who is the subject of a record shall provide a written authorization for inspection and copying from the employe if requested by the department.
The record that is requested contains confidential information concerning a worker's compensation claim and the requester is an insurance carrier or employer that is a party to any worker's compensation claim involving the same employe or an attorney or authorized agent of that insurance carrier or employer, except that the department is not required to do a random search of its records and may require the requester to provide the approximate date of the injury and any other relevant information that would assist the department in finding the record requested. An attorney or authorized agent of an insurance carrier or employer that is a party to an employe's worker's compensation claim shall provide a written authorization for inspection and copying from the insurance carrier or employer if requested by the department.
The record that is requested contains financial information provided by a self-insured employer or by an applicant for exemption under s. 102.28 (2) (b)
and the requester is the self-insured employer or applicant for exemption or an attorney or authorized agent of the self-insured employer or applicant for exemption. An attorney or authorized agent of the self-insured employer or of the applicant for exemption shall provide a written authorization for inspection and copying from the self-insured employer or applicant for exemption if requested by the department.
A court of competent jurisdiction in this state orders the department to release the record.
The requester is the subunit of the department that administers child and spousal support or a county child support agency under s. 59.53 (5)
, the request is made under s. 49.22 (2m)
and the request is limited to the name and address of the employe who is the subject of the record, the name and address of the employe's employer and any financial information about that employe contained in the record.
The department of revenue requests the record for the purpose of locating a person, or the assets of a person, who has failed to file tax returns, who has underreported taxable income or who is a delinquent taxpayer; identifying fraudulent tax returns; or providing information for tax-related prosecutions.
Every employer and every insurance company that fails to keep the records or to make the reports required by this chapter or that knowingly falsifies such records or makes false reports shall forfeit to the state not less than $10 nor more than $100 for each offense.
Any employer, or duly authorized agent thereof, who, without reasonable cause, refuses to rehire an employe injured in the course of employment, or who, because of a claim or attempt to claim compensation benefits from such employer, discriminates or threatens to discriminate against an employe as to the employe's employment, shall forfeit to the state not less than $50 nor more than $500 for each offense. No action under this subsection may be commenced except upon request of the department.
Any employer who without reasonable cause refuses to rehire an employe who is injured in the course of employment, where suitable employment is available within the employe's physical and mental limitations, upon order of the department and in addition to other benefits, has exclusive liability to pay to the employe the wages lost during the period of such refusal, not exceeding one year's wages. In determining the availability of suitable employment the continuance in business of the employer shall be considered and any written rules promulgated by the employer with respect to seniority or the provisions of any collective bargaining agreement with respect to seniority shall govern.
History: 1975 c. 147
; 1977 c. 29
Employer cannot satisfy (3) by rehiring with intent to fire at later date. Dielectric Corp. v. LIRC, 111 W (2d) 270, 330 NW (2d) 606 (Ct. App. 1983).
Employer has burden to prove rehiring was in good faith. West Allis School Dist. v. DILHR, 116 W (2d) 410, 342 NW (2d) 415 (1984).
One-day absence from work due to injury triggered rehire provision under (3). Link Industries, Inc. v. LIRC, 141 W (2d) 551, 415 NW (2d) 574 (Ct. App. 1987).
Standards for determination of employer liability under sub. (3) summarized. Universal Foods Corp. v. LIRC, 161 W (2d) 1, 467 NW (2d) 793 (Ct. App. 1991).
Sub. (3) does not bar an employe from seeking arbitration under a collective bargaining agreement to determine whether termination following an injury violated the agreement. Sub. (3) relates to harm other than worker injuries and is not subject to the exclusive remedy provision of s. 102.03 (2); the "exclusive liability" language in sub. (3) does not bar law suits but imposes a penalty for refusal to hire on the employer. County of Lacrosse v. WERC, 182 W (2d) 15, 513 NW (2d) 708 (1994).
LIRC interpretation of sub. (3), that a violation requires an employe who is unable to return to his prior employment to express an interest in reemployment in a different capacity, was reasonable. Hill v. LIRC, 184 W (2d) 110, 516 NW (2d) 441 (Ct. App. 1994).
If an employer shows that it refused to rehire an injured employe because the employe's position was eliminated to reduce costs and increase efficiency, reasonable cause has been shown under sub. (3). Ray Hutson Chevrolet, Inc. v. LIRC, 186 W(2d) 118, 519 NW (2d ) 649 (Ct. App. 1994).
An attendance policy which includes absences due to work-related injuries as part of the total of absences allowed before termination violates sub. (3). Great Northern Corp. v. LIRC, 189 W (2d) 313, 525 NW (2d) 361 (Ct. App. 1994).
Every employer of 3 or more persons and every employer who is subject to this chapter shall keep a record of all accidents causing death or disability of any employe while performing services growing out of and incidental to the employment. This record shall give the name, address, age and wages of the deceased or injured employe, the time and causes of the accident, the nature and extent of the injury, and any other information the department may require by general order. Reports based upon this record shall be furnished to the department at such times and in such manner as it may require by general order, upon forms approved by the department.
History: 1975 c. 147
; 1985 a. 83
Records of payments; reports thereon.
Every insurance company which transacts the business of compensation insurance, and every employer who is subject to this chapter but whose liability is not insured, shall keep a record of all payments made under this chapter and of the time and manner of making the payments, and shall furnish reports based upon these records to the department as it may require by general order, upon forms approved by the department.
General orders; application of statutes.
The provisions of s. 103.005
relating to the adoption, publication, modification and court review of general orders of the department shall apply to all general orders adopted pursuant to this chapter.
History: 1995 a. 27