Procedure when worker or beneficiary elects to bring action
- release of liability and lien of paying agency in certain cases
Source:
Section 656.593 — Procedure when worker or beneficiary elects to bring action; release of liability and lien of paying agency in certain cases, https://www.oregonlegislature.gov/bills_laws/ors/ors656.html.
Notes of Decisions
“Damages recovered” means settlement amount less any benefits paid to insurer as personal injury protection reimbursement. Northwestern Pacific Indemnity v. Canutt, 280 Or 375, 570 P2d 1182 (1977)
Where insurer paid claim of employee injured while working in Oregon for Washington corporation, settlement agreement for payment by Washington to reimburse Oregon insurer was not recovery of damages and therefore not subject to distribution provisions. McCutchen v. Workers’ Comp. Dept., 35 Or App 697, 582 P2d 56 (1978)
In indemnification action by chemical supplier against employer whose employee was killed by chemical, supplier was not entitled to relief from employer’s worker’s compensation lien against damages recovered from supplier by worker’s estate, because employer’s culpability in worker’s death was irrelevant. Boldman v. Mt. Hood Chemical Corp., 288 Or 121, 602 P2d 1072 (1979)
Attorney fees claimant recovers against insurer after prevailing in hearing on insurer’s denial of claim are not recoverable by insurer as “other cost” of claim. Schlecht v. SAIF, 60 Or App 449, 653 P2d 1284 (1982)
After third party recovery, when insurance carrier retained no amount for estimated future medical expenditures, it gave up its right to reimbursement from the proceeds. SAIF v. Parker, 61 Or App 47, 656 P2d 335 (1982)
No portion of proceeds of claimant’s third party damage action can be distributed to person who has separate claim outside workers’ compensation system. SAIF v. Cowart, 65 Or App 733, 672 P2d 389 (1983)
Reserve for future expenses must be reduced to actuarial present value of amounts to be expended, not current cost of anticipated services. Denton v. EBI Companies, 67 Or App 339, 679 P2d 301 (1984)
Recovery in action on policy against insurance company of third person was distributable as arising out of “negligence or wrong of third person.” Shipley v. SAIF, 79 Or App 149, 718 P2d 757 (1986), Sup Ct review denied
SAIF’s lien against proceeds of recoveries by injured workers in third-party actions does not attach to payments to worker by Oregon Insurance Guarantee Association acting in place of insolvent insurer. Corvallis Aero Service v. Villalobos, 81 Or App 137, 724 P2d 880 (1986), Sup Ct review denied
Claimant and paying agency have right to rely on each other’s pertinent representations in negotiating settlement with third party. Estate of Troy Vance v. Williams, 84 Or App 616, 734 P2d 1372 (1987)
Paying agency’s right to lien on third-party recovery attaches only to share distributed to workers’ compensation claimant. Scarino v. SAIF, 91 Or App 350, 755 P2d 139 (1988), Sup Ct review denied; Worthen v. Lumbermen’s Underwriting, 137 Or App 368, 904 P2d 1088 (1995)
Where claimant brought third party action combining compensable injury claim with other tort claims, paying agent’s lien was limited to recovery on compensable injury claim. Robertson v. Davcol, Inc., 99 Or App 542, 783 P2d 43 (1989)
Notwithstanding fact that worker was injured or killed in jurisdiction that does not allow such reimbursement, paying agency is entitled to reimbursement from proceeds of any settlement for amounts it paid on behalf of injured or deceased workers. Allen v. American Hardwoods, 102 Or App 562, 795 P2d 592 (1990), Sup Ct review denied
Board has authority to determine whether insurer qualifies as “paying agency.” SAIF v. Wright, 312 Or 132, 817 P2d 1317 (1991)
Distribution of settlement proceeds is to beneficiaries as class, not to individuals, so recovery on lien is against total award. Liberty Northwest Ins. Corp. v. Golden, 116 Or App 64, 840 P2d 1362 (1992), Sup Ct review denied
Workers’ Compensation Board has authority to determine whether defendants in suit are “third parties.” Toole v. EBI Companies, 314 Or 102, 838 P2d 60 (1992)
Paying agency had lien against action for attorney malpractice based on attorney’s negligent failure to recover compensation for injured worker directly from responsible third party. Toole v. EBI Companies, 314 Or 102, 838 P2d 60 (1992)
Payment received under claim disposition agreement was “compensation” and therefore subject to determination of reimbursibility. Turo v. SAIF, 131 Or App 572, 888 P2d 1043 (1994)
Board can use tort law principles to determine that just and proper distribution limits insurer recovery to benefits paid only to certain parties. Liberty Northwest Ins. Corp. v. Urness, 138 Or App 388, 909 P2d 893 (1996), Sup Ct review denied
Law Review Citations
32 WLR 217 (1996)
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