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Fleming v. National Union Fire Insurance Co.11/23/2005
Suffolk.
September 8, 2005
Present: Marshall, C.J., Greaney, Ireland, Spina, Cowin, Sosman, & Cordy, JJ.
Jurisdiction. Workers' Compensation Act, Average weekly wages, Jurisdiction of court, Employer's misconduct.
Civil action commenced in the Superior Court Department on January 9, 2004.
The case was heard by Paul E. Troy, J., on a motion to dismiss.
The Supreme Judicial Court granted an application for direct appellate review.
The plaintiffs, three workers on the Central Artery/Harbor Tunnel construction project (Big Dig), were injured during the course of their employment and were paid benefits under the Workers' Compensation Act (Act), G. L. c. 152, by their workers' compensation insurer, National Union Fire Insurance Company, and its claims processing company, AIG Claim Services, Inc. (collectively, the defendants). On January 9, 2004, the plaintiffs brought an action against the defendants for monetary and injunctive relief, alleging that, for purposes of determining an injured employee's level of workers' compensation benefits, the defendants' practice of computing "average weekly wages" without including the value of certain fringe benefits constituted an unfair and deceptive business practice in violation of G. L. c. 176D and G. L. c. 93A. The plaintiffs further alleged that the defendants engaged in unfair or deceptive business practices when they (1) misrepresented to the plaintiffs that their workers' compensation benefits were significantly less than those to which they were entitled pursuant to G. L. c. 152, § 1 (1), and G. L. c. 149, §§ 26, 27; (2) paid the plaintiffs benefits that did not include the value of certain fringe benefits; (3) compelled the plaintiffs to litigate their claims in order ultimately to receive the benefits to which they were entitled and which included the value of certain fringe benefits; and (4) delayed payment of the correct amount of benefits, thereby depriving the plaintiffs of the use of those funds.
The defendants filed a motion to dismiss the plaintiffs' complaint under Mass. R. Civ. P. 12 (b) (1), 365 Mass. 754 (1974), for lack of subject matter jurisdiction, or, alternatively, under Mass. R. Civ. P. 12 (b) (6), 365 Mass. 754 (1974), for failure to state a claim on which relief could be granted. A judge in the Superior Court allowed the defendants' motion based on lack of subject matter jurisdiction, concluding that the Legislature intended violations of G. L. c. 152 to be remedied within the comprehensive statutory and regulatory framework of the Act, and that the exclusivity provision of G. L. c. 152, § 24, barred the plaintiffs' cause of action. We granted the plaintiffs' application for direct appellate review. At issue is whether the Superior Court had subject matter jurisdiction over the plaintiffs' action, brought pursuant to G. L. c. 93A, for alleged violations of G. L. c. 176D by the defendants in their handling of the plaintiffs' claims for workers' compensation benefits. For the reasons that follow, we affirm the judgment of dismissal.
1. Comprehensive Framework of G. L. c. 152
The thrust of the plaintiffs' argument is that this case is more than a mere administrative dispute over the calculation of workers' compensation benefits for injured employees of the Big Dig. The plaintiffs contend that the defendants engaged in unfair or deceptive claim settlement practices, in violation of G. L. c. 176D, § 3 (9), and point out that "any person whose rights are affected by another person violating the provisions of [G. L. c. 176D, § 3 (9),] may bring an action in the superior court" for relief under G. L. c. 93A. G. L. c. 93
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