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James v. SCR Medical Transportation, Inc.

Court of Appeals of Illinois, First District, Fourth Division

September 1, 2016

COREY JAMES, Plaintiff-Appellant,
SCR MEDICAL TRANSPORTATION, INC.; PACE SUBURBAN BUS SERVICE, a Division of the Regional Transportation Authority (RTA); EMPIRE FIRE AND MARINE INSURANCE COMPANY; and GEMINI INSURANCE COMPANY, Defendants (SCR Medical Transportation, Inc.; Pace Suburban Bus Service, a Division of the Regional Transportation Authority (RTA); and Empire Fire and Marine Insurance Company, Defendants-Appellees).

         Appeal from the Circuit Court of Cook County 12-CH-08565 Honorable Peter Flynn, Judge Presiding

          JUSTICE McBRIDE delivered the judgment of the court, with opinion. Justices Howse and Cobbs concurred in the judgment and opinion.


          McBRIDE JUSTICE.

         ¶ 1 Plaintiff Corey James, a van driver employed by SCR Medical Transportation, Inc. (SCR), to drive a Pace paramedical transportation vehicle, suffered personal injuries in Chicago on March 9, 2010, in a collision with a motorist he contends was underinsured. After receiving the $50, 000 limit of the other motorist's insurance coverage and a $28, 608 settlement in workers' compensation benefits from his own employer, James requested underinsured motorist (UIM) coverage from his employer's business automobile liability insurer, Empire Fire and Marine Insurance Company (Empire). Empire denied the claim because SCR's UIM coverage was limited to $50, 000, which was the amount James had already received from the other driver, meaning that he was not "underinsured" within the meaning of Empire's policy. James then filed this suit seeking declaratory relief entitling him up to $1 million in UIM coverage from SCR, Pace, and Empire, on grounds that when SCR contracted to provide drivers for Pace vans, SCR agreed to maintain $1 million in UIM coverage. He made four attempts at pleading a cause of action. James appeals from a trial court order dismissing his third amended complaint with prejudice pursuant to section 2-619 of the Code of Civil Procedure. 735 ILCS 5/2-619 (West 2010).

         ¶ 2 We note that one of the named defendants, Gemini Insurance Company (Gemini), is not participating in this appeal because its dismissal from the suit is not being challenged. Gemini provided excess umbrella insurance to James' employer, SCR, and James included Gemini's name in the caption of his original, first amended, and second amended complaints, but made no allegations against the company. The trial court granted Gemini's motion to dismiss. James neither appealed from that ruling nor included Gemini in his third amended complaint.

         ¶ 3 Motor vehicle liability, UIM coverage, and uninsured motorist (UM) coverage are statutorily required forms of insurance. Phoenix Insurance Co. v. Rosen, 242 Ill.2d 48, 68, 949 N.E.2d 639, 652 (2011) (citing 215 ILCS 5/143a, 143a-2(4) (West 2004), and 625 ILCS 5/7-601(a) (West 2004)).The term "underinsured motor vehicle" means a motor vehicle whose ownership, maintenance, or use has resulted in bodily injury or death of the insured, as defined in the policy, and for which the sum of the limits of liability under all bodily injury liability insurance policies or under bonds or other security required to be maintained under Illinois law applicable to the driver or to the person or organization legally responsible for such vehicle and applicable to the vehicle, is less than the limits for UIM coverage provided the insured as defined in the policy at the time of the accident. 215 ILCS 5/143a-2 (West 2004). The purpose of UIM coverage is to protect the insured and any additional insureds from the risk that a negligent driver of another vehicle who causes injury to the insured or the additional insureds will have inadequate liability coverage to compensate the injuries caused by his or her negligence. In re Estate of Anderson, 408 Ill.App.3d 428, 432, 945 N.E.2d 661, 665 (2011). UIM and UM are both intended "to place the insured in the same position he [or she] would have occupied if the tortfeasor had carried adequate insurance." (Internal quotation marks omitted.) Phoenix Insurance Co., 242 Ill.2d at 68, 949 N.E.2d at 652.

         ¶ 4 The first substantive issue we address is whether James may bring a claim against his employer. Five of the nine counts were directed at SCR. In count I, James sought a declaratory judgment to the effect that the SCR-Pace contract regarding paratransit service required $1 million in UIM coverage and that a purported oral modification of that requirement was "against public policy and void." Count IV consisted of allegations that SCR, Pace, and Empire engaged in a civil conspiracy to "circumvent" the $1 million UIM requirement. Count V was a proposed class action seeking a declaratory judgment on behalf of all injured passengers and drivers of SCR-Pace vans who had been denied more than $50, 000 in UIM coverage. There were two counts labeled as "Count VI, " the second of which sought a declaratory judgment that SCR had "an obligation to provide $1, 000, 000 UIM benefits and has breached this obligation." Count VII was similar, but recast the allegations "AS TO THE CLASS OF PERSONS AGGRIEVED" and described the proposed class of plaintiffs as "all van drivers and handicapped passengers" who have not been paid "the $1, 000, 000 UIM benefits to which they are entitled."

         ¶ 5 We apply de novo review to the dismissal of the claims against SCR pursuant to section 2-619 of the Code of Civil Procedure. Martinez v. Gutmann Leather, LLC, 372 Ill.App.3d 99, 101, 865 N.E.2d 325, 327 (2007). Under section 2-619, the defendant admits to all well-pled facts in the complaint, as well as any reasonable inferences which may be drawn from those facts, but asks the court to conclude that there is no set of facts which would entitle the plaintiff to recover. Martinez, 372 Ill.App.3d at 101, 865 N.E.2d at 327. Given the de novo standard, we may affirm on any basis or ground for which there is a factual basis in the record regardless of whether the trial court relied on that reasoning. Guinn v. Hoskins Chevrolet, 361 Ill.App.3d 575, 586, 836 N.E.2d 681, 691 (2005). In other words, we are reviewing the ruling, not the trial court's reasons for entering that ruling. See also Barney v. Unity Paving, Inc., 266 Ill.App.3d 13, 18, 639 N.E.2d 592, 595 (1994) (in de novo review of summary judgment proceeding, appellate court reviewed propriety of ruling, not trial judge's explicit findings). Accordingly, we will not set out the numerous arguments that were made for and against the dismissal of James' fourth complaint or the remarks which the trial judge made about the arguments.

         ¶ 6 James contends he may sue SCR because he is exempt from the principle that an employee injured on the job normally cannot sue his Illinois employer, provided the employee is entitled to receive workers' compensation benefits from the employer or the employer's insurer. Illinois Insurance Guaranty Fund v. Virginia Surety Co., 2012 IL App (1st) 113758, ¶ 16, 979 N.E.2d 503. The Act specifies that an employee has no right to sue his or her employer but may instead automatically recover for injuries arising out of and in the course of his or her employment without regard to any fault on his or her part. Illinois Insurance Guaranty Fund, 2012 IL App (1st) 113758, ¶ 16, 979 N.E.2d 503; Fregeau v. Gillespie, 96 Ill.2d 479, 486, 451 N.E.2d 870, 873 (1983) (indicating the workers' compensation system "was designed to provide speedy recovery without proof of fault for accidental injuries" that occur in the work place during the course of work); 820 ILCS 305/5(a) (West 2008) ("No common law or statutory right to recover damages from the employer *** for injury or death sustained by any employee while engaged in the line of his duty as such employee, other than the compensation herein provided, is available to any employee who is covered by the provisions of this Act ***."); 820 ILCS 305/11 (West 2008) (workers' compensation "shall be the measure of the responsibility of any employer").

         ¶ 7 Under the statutory system, the employer is compelled to pay the employee and cannot assert various defenses that could be pled in a tort suit, however, the employer's liability is capped under the Act's comprehensive schedule of recovery. Illinois Insurance Guaranty Fund, 2012 IL App (1st) 113758, ¶ 16, 979 N.E.2d 503. Therefore, when an accident occurs, an employer assumes a new liability with regard to fault but avoids the prospect of a large civil damage award (Meerbrey v. Marshall Field & Co., 139 Ill.2d 455, 462, 564 N.E.2d 1222, 1225 (1990) (discussing purpose of and exceptions to the Act)) and the employee receives prompt compensation for his or her injuries (Illinois Insurance Guaranty Fund, 2012 IL App (1st) 113758, ¶ 16, 979 N.E.2d 503).

         ¶ 8 In order to escape the exclusive-remedy rule, an employee must allege and prove one of four exceptions: his or her injury (1) was not accidental, (2) did not arise from his or her employment, (3) was not received during the course of his or her employment, or (4) was noncompensable under the Act, such as being discharged in retaliation for filing a claim for workers' compensation. Meerbrey, 139 Ill.2d at 463, 564 N.E.2d at 1225; Fredericks v. Liberty Mutual Insurance Co., 255 Ill.App.3d 1029, 1031, 627 N.E.2d 782, 785 (1994).

         ¶ 9 James argues that he may sue SCR because he is "not suing SCR for 'injuries' but for [SCR's] failure to have and maintain [$1 million] in UIM coverage." Truly, however, what James is suing over is SCR's failure to have and maintain $1 million in UIM coverage with which to compensate him for his injuries. Thus, his claim against SCR comes within the scope of the Act and is barred by it, even if he had not accepted compensation through that system.

         ¶ 10 Secondly, as we outlined above, the record indicates that James filed a workers' compensation claim on March 17, 2010, which was a week after the accident, and accepted temporary total disability payments totaling $8, 026 from SCR while he was "intermittently" disabled until October 12, 2010, as well as a final, lump sum payment of $20, 582 from SCR about 15 months after the accident. Accordingly, our second reason for rejecting James' carefully worded argument is that he elected to take workers' compensation benefits on grounds that his injuries were compensable under the Act and he cannot now allege that the same injuries were not compensable under the Act. Collier v. Wagner Castings Co., 81 Ill.2d 229, 234, 408 N.E.2d 198, 200 (1980) (once the employee takes the express position that an injury is compensable under the Act, he is barred from taking the mutually exclusive position that his injury is an exception to the Act); Copass v. Illinois Power Co., 211 Ill.App.3d 205, 210, 569 N.E.2d 1211, 1214 (1991) (an injured employee is not permitted to seek workers' compensation benefits on a claim that the injuries are compensable and pursue a common-law action on grounds that the injury is noncompensable). James' compensation claim and James' lawsuit are legally inconsistent.

         ¶ 11 In addition, when James settled his workers' compensation claim against SCR on June 8, 2011, he indicated he did not anticipate further medical treatment and expense and he expressly gave up the right to pursue further compensation from SCR, even if his condition worsened. In the settlement contract, the parties specified:

"This represents a full and final settlement of all claims under the Workers' Compensation Act for injuries allegedly incurred on or about 3/10/2010, including any results, developments or sequelae, fatal or non-fatal, allegedly resulting from such accidental injuries.[1] Issues exist as to whether these injuries are compensable, and this settlement is made to settle these issues. The settlement includes liability for temporary total compensation and all medical, surgical and hospital expenses incurred or to be incurred allegedly resulting from the accidental injury, for all of which the Petitioner [James] assumes responsibility.
The parties believe that petitioner shall not have the need for future medical expenses related to the claimant's injury and therefore have not allocated any sum for future medical expenses. ***
There are disputed questions of law and fact concerning the claim for injuries allegedly sustained by petitioner on 3/10/2010. In order to avoid further litigation and as a purchase of peace between the parties, the parties hereto have agreed to compromise, adjust, and to settle any and all claims for benefits under the Workers' Compensation Act arising out of the accident of 3/10/2010 upon payment of all obligations stated herein. The Respondent [SCR] is herby [sic] released, acquitted and discharged from ...

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