State Farm Won't Back Mean Mom
National News
State Farm says a policyholder, a mother, suggested her daughter taunta girl the daughter doesn't like by writing insults, including "bitch,""whore," "slut" and "you have no friends," on disposable diapers andstrewing them about the girl's yard. The girl attempted suicide and washospitalized after the mom bought the diapers, helped write theinsults, drove her daughter to the victim's house and helped her strewthem in the yard, State Farm says. It claims it has no obligation todefend the woman.
State Farm claims that the defendant, JulieHefner-Phipps, admitted to police that she directed and participated inthe diaper insults.
The girl's family sued Hefner-Philips.
StateFarm says the victim tried suicide the day she saw the insultingdiapers, one of which stated, "move-bitch." She was placed in intensivecare and then sent to a psychiatric hospital.
State Farm saysit's not obligated to defend Hefner-Phillips because the policyexcludes "bodily injury or property damage ... which is the result ofwillful and malicious acts of the insured."
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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.