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You are here: Home / Arbitration / Court Decisions / Reinsurance Claims / Appellate Court of Massachusetts Finds That Reinsurer Must Pay Workers’ Compensation Benefits of Bankrupt Self-Insured Employer

Appellate Court of Massachusetts Finds That Reinsurer Must Pay Workers’ Compensation Benefits of Bankrupt Self-Insured Employer

June 28, 2018 by Rob DiUbaldo

In a recent opinion, a Massachusetts appeals court was required to determine who is liable to pay workers’ compensation benefits owed by a self-insured employer that has gone bankrupt? In a choice between the state created Workers’ Compensation Trust Fund and a reinsurer of that bankrupt employer, the court chose the reinsurer.

The case involved benefits due to Robert Janocha, whose employer at the time of his injury was self-insured for workers’ compensation claims. In compliance with Massachusetts law, the employer had ensured its ability to pay such claims with a $2.4 million surety bond and a reinsurance contract with ACE American Insurance Company, which had a $400,000 retention provision applicable to each injured employee. In 2007, the employer went bankrupt, and in 2012 the surety bond was exhausted. However, Mr. Janocha’s benefits had not reached the $400,000 retention floor, and ACE argued that, until that floor was reached, his benefits were the responsibility of the Workers’ Compensation Trust Fund under a statute requiring the Trust Fund to pay benefits for claims against employers “uninsured in violation” of the law. The court found that this statute only applied when the employer was uninsured at the time of the injury in question, however, and did not apply when the lack of insurance was the result of bankruptcy. Thus, the Trust Fund was not obliged to pay the benefits. The court then found that ACE was statutorily required to pay benefits in the event the self-insured employer became insolvent, and that the retention provision would not be enforced because “a party is unable to contract away its statutory obligations.” Thus, ACE was required to pay Mr. Janocha’s benefits.

Janocha’s Case, No. 16-P-1181 (Mass. App. Ct. May 2, 2018)

This post written by Jason Brost.

See our disclaimer.

Filed Under: Reinsurance Claims

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