Case Update: Insurer Not Obligated to Pay Underinsured Motorist Benefits When Workers' Compensation Lien Exceeds Judgment Balanc


This recent decision concerns an appeal from the Circuit Court of Prince George's County of its decision denying a Motion to Enforce Judgment. That appeal arose out of a third party claim filed by Mr. Ross against Mr. Agurs and Progressive Casualty Insurance Company for damaged sustained in an MVA allegedly caused by Mr. Agurs, at which time Mr. Ross was acting in the course and scope of his employment. Mr. Ross sought benefits through a UIM policy issued by Progressive to his employer. Mr. Ross also filed a workers' compensation claim for his injuries sustained in the MVA. After the Defendant offered his policy limits ($25,000), Progressive advised it would not consent to accept that offer and then tendered a check for $25,000 to Mr. Ross, pursuant to Md. Code Ann. INS. Section 19-511. The parties went to trial and a jury awarded a verdict in excess of $91,000. After deducting Progressive's $25,000 payment, the balance of the judgment amount to slightly over $66,500.00. At that time, the unreimbursed workers' compensation lien held by the workers' compensation carrier amounted to approximately $84,400.00. Progressive denied payment of any additional portion of the judgment and Mr. Ross subsequently filed a Motion to Enforce Judgment, requesting the trial court order Progressive to pay the balance owed.

On appeal, the Court of Special Appeals discussed Parry v. Allstate Insurance Co., which examined the interplay between INS. Section 19-513 and LE Section 9-902, and specifically, the role of Section 9-902 serving to prevent injured employees from receiving a windfall recovery when bringing third party actions after successfully obtaining workers' compensation benefits. The court also rejected the argument that any workers' compensation lien must be reduced by attorney fees, instead noting that precedent has clearly established that the amount of reimbursement under INS. Section 513(e) is determined by the amount of benefits received.

In Parry, the court determined that the amount of benefits received by the injured employee (which is also the amount of the workers' compensation lien being asserted by the carrier) was the reimbursement amount under INS. Section 513(e). Accordingly, the court determined that the amount of the workers' compensation lien being asserted in this case would also serve as the amount of reimbursement, and therefore held that Progressive was not obligated to make payments to Mr. Ross under INS. Section 513(e) as the amount of the unreimbursed workers' compensation lien exceeded the remaining balance of the judgment.

Ross v. Agurs & Progressive Casualty Ins. Co., No. 978 September term 2011 (Md. App. September 9, 2013)