In Meeks v. Guarantee Insurance Co., 2017 OK 17, the employee sued the insurer for bad faith refusal to timely comply with several orders of the Workers’ Compensation Court awarding employee temporary total disability benefits after insurer–without good cause–withheld employee’s benefits on twenty-six separate occasions. The insurer moved for dismissal, asserting employee failed to obtain a certification order from the Workers’ Compensation Court–a jurisdictional prerequisite for commencing a bad-faith action in district court. The District Court granted insurer’s motion and the Supreme Court reversed and remanded the case.
This appeal was retained to reiterate the proper application of this Court’s decision in Summers v. Zurich Am. Ins. Co., 2009 OK 33, 213 P.3d 565, to monetary awards–although paid–not provided as ordered. Today, this Court reemphasizes that an order of the Workers’ Compensation Court (WCC) that clearly identifies previously ordered benefits and finds that insurer failed to demonstrate good cause for its delay in, or noncompliance with, providing court ordered benefits satisfies the certification requirements delineated in Summers. Because the certification requirements were met here, employee may proceed in district court on his bad-faith claim against insurer for insurer’s alleged bad faith refusal to provide temporary total disability benefits as ordered by the WCC.
WCC assessed penalties for Insurer’s late payment of prior TTD awards. However, the WCC denied certification under section 42(A) “due to respondent’s carrier paying said penalty requested by claimant, prior to the hearing today.” The Oklahoma Supreme Court explained there are two alternative categories for certification: 1) failure to pay an award, or 2) failure to provide benefits as ordered. The insurer bears the burden to demonstrate why benefits were not provided as ordered. The certification procedures for an insurer’s unpaid, late payment of, or outright refusal to pay a final monetary benefit award still owing are two fold: employee must (1) first utilize the mechanism provided in section 42(A)1 of the Workers’ Compensation Act and (2) have the award certified for enforcement as a judgment of the district court pursuant to Rule 582 of the Workers’ Compensation Court rules. Section 42(A) only applies when there is a dollar amount still owing, and does not apply to bad faith claims.
So, just as an outright refusal to pay a monetary award is beyond the purview of section 42(A), a wilful or intentional refusal to provide benefits as ordered is beyond the statutory remedies found in the Workers’ Compensation Act. Id. Resultantly, an insurer’s bad-faith conduct in complying with any benefits awarded to an injured employee lies in tort and will be judged by the same standard applicable to the bad-faith conduct by any other insurer.
The Supreme Court concluded:
¶18 Although the June 26, 2014 WCC Order denied employee’s section 42(A) request for certification as employer had paid the penalties prior to the hearing, that order satisfied the second recognized certification category under Summers–benefits not provided as ordered. This Court holds that the June 26, 2014 WCC Order, finding Insurer in violation on twenty-six (26) separate occasions in its duty to comply with previously authorized TTD benefits absent good cause, satisfies the certification prerequisites for commencing a bad-faith action in district court.
¶19 Having found that Meeks satisfied the certification requirements of Summers, this Court holds that the district court erred in granting Insurer’s motion to dismiss in lieu of answer. Barring Meeks from pursuing a bad-faith claim against Insurer for Insurer’s crafty gamesmanship clearly violates Summers and the policy rational underlying the Oklahoma Workers’ Compensation Act.