Charlton, M. v. PMA Insurance Group ( 2015 )

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NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT I.O.P. 65.37
MATTHEW CHARLTON IN THE SUPERIOR COURT OF
PENNSYLVANIA
Appellant
v.
PMA INSURANCE GROUP AND MYLENE
ZIMMERMAN
No. 618 EDA 2015
Appeal from the Order January 21, 2015
In the Court of Common Pleas of Philadelphia County
Civil Division at No(s): December Term, 2013 No. 000914
BEFORE: PANELLA, J., WECHT, J., and STRASSBURGER, J.*
MEMORANDUM BY PANELLA, J. FILED NOVEMBER 06, 2015
Appellant, Matthew Charlton, appeals from the order that granted
judgment on the pleadings to Appellees, PMA Insurance Group and Mylene
Zimmerman, in Charlton’s action alleging that the Appellees had
intentionally inflicted emotional distress upon him. Charlton contends that
the trial court erred in concluding that emotional distress suffered as the
result of threats of disclosure childhood sexual abuse made by a workers’
compensation insurer is an “injury arising in the course of employment,”
therefore restricting Charlton’s remedies to those provided under the
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*
Retired Senior Judge assigned to the Superior Court.
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Workers’ Compensation statute. We agree with Charlton, and therefore
reverse and remand.
When reviewing a challenge to an order granting judgment on the
pleadings, we must accept all well-pleaded allegations in the complaint as
true. See Guerra v. Redevelopment Authority of City of Philadelphia,
27 A.3d 1284, 1288-1289 (Pa. Super. 2011). We therefore set forth the
factual basis for this matter as alleged in Charlton’s complaint.
In 1986, Charlton was injured in a workplace accident that left him
physically and emotionally injured. From that time to the present, PMA has
provided Charlton with benefits pursuant to the Workers’ Compensation Act.
One of these benefits is psychiatric treatment by Timothy Michals, M.D.
During the course of Dr. Michals’s treatment, Charlton disclosed that he had
been sexually abused as a child. Dr. Michals never treated Charlton for the
childhood sexual abuse, and instead referred Charlton to another mental
healthcare professional. However, Dr. Michals’s treatment notes recorded
Charlton’s disclosure and the subsequent referral.
Several years later, Zimmerman, a senior account claims
representative employed by PMA, requested Dr. Michals’s treatment notes
for Charlton, in order to review Charlton’s continuing eligibility for benefits.
Dr. Michal complied with the request, and Zimmerman subsequently
contacted Charlton. During the course of their conversation, Zimmerman
stated, “we are tired of paying for something that happened to you as a
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child.” Charlton immediately recognized this as a reference to his childhood
sexual abuse and became agitated and anxious, as he believed this to be a
threat to shame him with his childhood sexual abuse if he did not settle his
workers’ compensation claim. In fact, Zimmerman concluded the
conversation with a demand that Charlton settle his claim.
Shortly thereafter, Zimmerman left a voice mail message for Charlton,
which contained the following.
Matthew, this is Mylene calling from PMA. When you get a
minute and you can talk please give me a call back at []. The
only thing that is in question is the recent request for your
surgery that we don’t feel is related to the original injury back
several … back in 1986 because of current things that have gone
on with your current work[,] your repetitive motion, you lifting,
that sort of thing.
What we talked about the other day actually is done and over.
That will never ever be discussed again and that was something
that was brought up to me, I brought up to you[.] And that is
the only group of people who will be discussing that. So if you
want to give me a call back I’d appreciate it. Bye.
Charlton suffered debilitating anxiety, humiliation, fear, and feelings of
betrayal from Zimmerman’s reference to his childhood sexual abuse.
Charlton subsequently filed a complaint asserting that Zimmerman, as
an agent for PMA, had intentionally inflicted emotional distress on him.
Appellees filed preliminary objections, which the trial court overruled.
Appellees filed an answer with new matter, asserting that Charlton’s claim
was subject to the exclusivity provisions of the Workers’ Compensation Act.
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Appellees then filed a motion for judgment on the pleadings, which the trial
court granted. This timely appeal followed.
On appeal, Charlton argues that the trial court erred in concluding that
the exclusivity provisions of the Workers’ Compensation Act (“the Act”)
applied to his claims. The exclusivity provision of the Act states that
[t]he liability of an employer under this act shall be exclusive
and in place of any and all other liability to such employe, his
legal representative, husband or wife, parents, dependents, next
of kin or anyone otherwise entitled to damages in any action at
law or otherwise on account of any injury or death as defined in
§ 301(c)(1) and (2) or occupational disease as defined in § 108.
77 P.S. § 481(a). Thus, the Act bars any tort action “flowing from any work-
related injury.” Taras v. Wausau Ins. Companies, 602 A.2d 882, 884
(Pa. Super. 1992) (citation omitted). The exclusivity provision is a
fundamental part of the statutory scheme whereby employers assume
liability without fault for work-related injuries, but are relieved of the risk of
the possibly larger verdicts that might result from tort litigation. See Lewis
v. School District of Philadelphia, 538 A.2d 862, 867 (Pa. 1988).
Furthermore, it is well established that “insurance carriers are entitled
to the same immunity [from tort claims] in processing a compensation claim
as the employer.” Taras, 602 A.2d at 885; see also 77 P.S. 501(a)(1). In
return, the Act provides specific remedies to claimants against insurers who
improperly handle a compensation claim. See 77 P.S. §§ 701-797. Thus, a
claimant whose work-related injuries are exacerbated by an insurer’s
improper conduct in handling the claim is restricted to the remedies provided
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in the Act. See Santiago v. Pennsylvania Nat. Mut. Cas. Ins. Co., 613
A.2d 1235 (Pa. Super. 1992). “[A]s the appellee’s claim is ultimately based
upon an injury compensable under [the Act], he is limited to the remedies
provided within the framework of the [A]ct.” Kuney v. PMA Insurance
Companies, 578 A.2d 1285, 1288 (Pa. 1990).
In contrast, a claim that an insurer’s conduct in handling a claim
exacerbated a non-work-related injury is not subject to the exclusivity
provisions of the Act. See Tropiano v. Travelers Ins. Co., 319 A.2d 426(Pa. 1974); Taras, 602 A.2d at 886. The boundaries of the exclusivity
provisions of the Act “are determined by the nature of the injury alleged and
the role of the carrier with respect to that injury.” Taras, 602 A.2d at 887.
In Taras, the plaintiff, Taras, claimed that the insurance company and
its agent were “negligent in directing and coordinating his medical care[]”
subsequent to a work-related injury suffered in an automobile accident. Id.,
at 883. Specifically, Taras asserted that the insurer had required him to
treat with a doctor who subjected him to electric shock treatment.
Subsequently, a different doctor diagnosed Taras as suffering from post-
traumatic stress disorder (“PTSD”) due to his service in the Vietnam War.
This subsequent diagnosis further opined that the electric shock treatment
had been inappropriate and therefore exacerbated Taras’s PTSD. See id.The trial court granted the insurer’s preliminary objections on the
grounds of the exclusivity provisions of the Act. See id. This Court
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reversed, noting that Taras’s claim was not based on the work-related
injury. See id., at 886. Taras was not pursuing a claim that the insurer had
wrongfully denied or discontinued his benefits. See id., at 887.
Furthermore, he was not seeking the types of damages, past due benefits,
interest, costs, and fees, that would flow from such a claim. See id. Thus,
the Act was inapplicable. See id.Here, Charlton has alleged that Zimmerman intentionally caused him
injury by referencing a non-work-related psychological injury. See
Complaint, filed 12/5/13, at ¶¶ 27-29.1 This injury exacerbated the harm
caused by the non-work-related psychological injury. See id., at ¶ 52. He
seeks damages in the form of pain and suffering, treatment costs, and
future wages. See id. As such, we conclude that Charlton’s claim is not
based upon a work-related injury, and that Charlton is not seeking the types
of damages that would flow from such a claim. We therefore conclude that
Taras is directly on point and controls the outcome of this legal question.
Order reversed. Case remanded for further proceedings consistent
with this memorandum. Jurisdiction relinquished.
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1
The issue of whether Charlton’s allegations satisfy the requirements for the
tort of intentional infliction of emotional distress, an issue raised by
Appellees in their preliminary objections which were overruled by the trial
court, is not currently before this Court.
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Judgment Entered.
Joseph D. Seletyn, Esq.
Prothonotary
Date: 11/6/2015
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