Merchants Insurance Group v. Spicer, et al. (Lawyers Weekly No. 11-134-15)
NOTICE: All slip opinions and orders are subject to formal revision and are superseded by the advance sheets and bound volumes of the Official Reports. If you find a typographical error or other formal error, please notify the Reporter of Decisions, Supreme Judicial Court, John Adams Courthouse, 1 Pemberton Square, Suite 2500, Boston, MA, 02108-1750; (617) 557-1030; SJCReporter@sjc.state.ma.us 14-P-798 Appeals Court MERCHANTS INSURANCE GROUP vs. KEVIN SPICER[1] & others.[2] No. 14-P-798. Suffolk. March 4, 2015. – September 9, 2015. Present: Cohen, Hanlon, & Sullivan, JJ. Insurance, Workers’ compensation insurance. Workers’ Compensation Act, Coverage, Jurisdiction of court, Jurisdiction of Industrial Accident Board. Jurisdiction, Superior Court, Administrative matter. Administrative Law, Exhaustion of remedies. Practice, Civil, Declaratory proceeding. Civil action commenced in the Superior Court Department on June 19, 2012. The case was heard by Elizabeth M. Fahey, J., on a motion for relief from judgment. Darrel Mook (Patricia B. Gary with him) for the plaintiff. Douglas S. Martland for the intervener. COHEN, J. The central question presented in this appeal is whether an insurer may bring an action in Superior Court to retroactively void a workers’ compensation policy while an injured employee’s claim under that policy is pending in the Department of Industrial Accidents (DIA). The plaintiff, Merchants Insurance Group (Merchants), claiming fraud in the inducement, initiated such an action, and, there being no opposition from the insured employer or the injured employee, secured a declaratory judgment in its favor. Subsequently, however, a judge of the Superior Court reopened the case at the request of the employee and the Workers’ Compensation Trust Fund (Fund)[3] and dismissed Merchants’ complaint, without prejudice, for lack of subject matter jurisdiction. Upon review of Merchants’ appeal from the judgment of dismissal, we conclude that the judge correctly ruled that its claim for rescission of the workers’ compensation policy was subject to the doctrine of exhaustion of administrative remedies, and could not be pursued in the Superior Court. For this and other reasons explained below, we affirm the judgment of dismissal. Background. On December 30, 2011, Joel Estaban Perez was seriously injured while working for Kevin Spicer, doing business as Uptown Landscaping (Spicer).[4] Perez sought workers’ compensation benefits under a policy issued by Merchants to Spicer, and Merchants contested the claim.[5] After an informal conference, a DIA administrative judge ordered Merchants to pay Perez weekly temporary total incapacity benefits, pursuant to G. L. c. 152, § 34, and medical benefits, pursuant to G. L. c. 152, §§ 13, 30, pending an evidentiary hearing on the merits. Both parties appealed the interim conference order and requested a formal hearing pursuant to G. L. c. 152, § 11. In June, 2012, while Perez’s DIA case was awaiting the formal […]