Henderson v. Oak Leaf Realty, Inc.
MEMIC and AETNA
February 12, 2020
CategoriesJurisdiction Procedure Jurisdiction Procedure
Waiver of Coverage Owner Injury 14-Day Violation Multiple Insurers
Summary from the Troubh Heisler Attorneys
Henderson owned several businesses and waived WC coverage for himself under two of them. He contracted to chip brush under power lines in the town of Hancock and occasionally visited the site where his employees were performing the work. While at the job site on March 2, 2011, he learned that his daughter’s vehicle was stuck in snow on a nearby road. He drove his company trucks to help his daughter and was struck by a snow plow, causing injuries that required multiple surgeries and permanent disability.
Henderson filed petitions and alleged a 14-day violation. Judge Hirtle denied his petitions, finding that he had not met his burden of proof that, at the time of his injury, he was working for Oak Leaf, the only one of his companies that covered him for WC claims. Judge Hirtle also found no 14-day violation because Henderson did not prove that he told his insurer he was claiming workers’ comp benefits, which starts the 14-day period running. Judge Hirtle also declined to decide whether the WC insurer owed a defense to Oak Leaf. Henderson appealed.
The appellate panel upheld Judge Hirtle’s decision in all respects. The panel noted that Judge Hirtle reviewed all the relevant contracts, paperwork and testimony, including from his office manager, and concluded that Henderson had not demonstrated he was working for Oak Leaf rather than one of his other businesses on the day of the accident. Obviously, another issue was whether his injury arose out of and in the course of his employment, but Judge Hirtle declined to address that issue, given his decision on the coverage issue. The panel discussed in detail the 14-day rule and reiterated that it is not enough for the employer to have notice or knowledge of an injury and lost-time – the employee must actually make a “claim for benefits” to start the 14 days running.