Supreme Court rules SEC can recoup money in fraud cases

Legal Exams

The Supreme Court on Monday preserved an important tool used by securities regulators to recoup ill-gotten gains in fraud cases.

By an 8-1 vote, the justices ruled that the Securities and Exchange Commission can seek to recover the money through a process called disgorgement. Last year, the SEC obtained $3.2 billion in repayment of profits from people who have been found to violate securities law.

“The Court holds today that a disgorgement award that does not exceed a wrongdoer’s net profits and is awarded for victims is equitable relief permissible" under federal law, Justice Sonia Sotomayor wrote for the court.

Justice Clarence Thomas dissented. The Supreme Court in 2017 unanimously limited the SEC’s ability to go after profits where alleged fraud has been going on for years before authorities file charges. That case left open the question the high court answered Monday, that courts have the authority to order disgorgement of profits. The SEC has continued to aggressively pursue defendants’ profits in fraud cases.

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Workers’ Compensation Subrogation of Administrative Fees and Costs

When a worker covered by workers’ compensation makes a claim against a third party, the workers’ compensation insurance retains the right to subrogate against any recovery from that third party for all benefits paid to or on behalf of a claimant injured at work. When subrogating for more than basic medical and indemnity benefits, the Texas workers’ compensation subrogation statute provides that “the net amount recovered by a claimant in a third‑party action shall be used to reimburse the carrier for benefits, including medical benefits that have been paid for the compensable injury.” TX Labor Code § 417.002.

In fact, all 50 states provide for similar subrogation. However, none of them precisely outlines which payments or costs paid by a compensation carrier constitute “compensation” and can be recovered. The result is industry-wide confusion and an ongoing debate and argument with claimants’ attorneys over what can and can’t be included in a carrier’s lien for recovery purposes.

In addition to medical expenses, death benefits, funeral costs and/or indemnity benefits for lost wages and loss of earning capacity resulting from a compensable injury, workers’ compensation insurance carriers also expend considerable dollars for case management costs, medical bill audit fees, rehabilitation benefits, nurse case worker fees, and other similar fees. They also incur other expenses in conjunction with the handling and adjusting of workers’ compensation claims. Workers’ compensation carriers typically assert, of course, that, they are entitled to reimbursement for such expenditures when it recovers its workers’ compensation lien. Injured workers and their attorneys disagree.

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