Posts tagged "Lumbermens"

Lumbermens Mutual Casualty Company v. Workers’ Compensation Trust Fund (Lawyers Weekly No. 11-128-15)

NOTICE:  All slip opinions and orders are subject to formal revision and are superseded by the advance sheets and bound volumes of the Official Reports.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   13-P-1982                                       Appeals Court LUMBERMENS MUTUAL CASUALTY COMPANY  vs.  WORKERS’ COMPENSATION TRUST FUND. No. 13-P-1982 Suffolk.     June 2, 2015. – September 3, 2015.   Present:  Vuono, Grainger, & Blake, JJ. Workers’ Compensation Act, Reimbursement of insurer.  Insurance, Insolvency of insurer.  Administrative Law, Primary jurisdiction, Exhaustion of remedies, Agency’s interpretation of statute.     Civil action commenced in the Superior Court Department on May 21, 2013.   The case was heard by Heidi E. Brieger, J.     W. Frederick Uehlein for the plaintiff. Douglas S. Martland, Assistant Attorney General, for the defendant.      GRAINGER, J.  Lumbermens Mutual Casualty Company in liquidation (Lumbermens) appeals from the Superior Court judgment dismissing its claim against the Workers’ Compensation Trust Fund (trust fund).  Lumbermens sought partial reimbursement from the fund for workers’ compensation payments made pursuant to G. L. c. 152, §§ 37 and 65.  A Superior Court judge dismissed the claim under the doctrine of primary jurisdiction.  We affirm. Background.  We summarize the undisputed facts.  Lumbermens, an Illinois Corporation, was licensed to issue workers’ compensation insurance policies in Massachusetts.  Payments under these policies included so-called “second injury” benefits awarded pursuant to G. L. c. 152, § 37.[1]  The trust fund is authorized by that statute to provide partial reimbursement to insurers for second injury payments.  Between 2000 and 2008 Lumbermens and the trust fund entered into agreements in six separate cases, referred to as Form 123 agreements,[2] establishing the reimbursement percentage to be applied to “second injury” payments made by Lumbermens in each case. In July, 2012, Lumbermens was placed into rehabilitation, also referred to as a “run-off” period, whereby it could not issue new policies but continued to administer existing policies.  The trust fund, which had made reimbursement payments pursuant to the Form 123 agreements until Lumbermens entered the run-off period, thereafter refused further payment.  The trust fund asserted that Lumbermens was no longer entitled to reimbursement once the run-off period commenced because it was no longer an “insurer” able to issue policies, as that term is defined in G. L. c. 152, § 1(7). Ten months later, in May, 2013, Lumbermens was placed in liquidation. Approximately one year thereafter Lumbermens filed a complaint for enforcement of the six Form 123 agreements in Superior Court.  A Superior Court judge dismissed the complaint, finding that Lumbermen’s claims were more properly heard before the reviewing board (board) of the Department of Industrial Accidents (DIA) under the […]

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Posted by Massachusetts Legal Resources - September 4, 2015 at 7:46 am

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