Plaintiff appeals from separate written orders
The second amended complaint (hereinafter for convenience referred to as "complaint") names as defendants Truck Insurance Exchange (Truck), Farmers Insurance Group (Farmers), William Baker and Lawrence Marino
The first count, purporting to state a cause of action on a theory of negligence, alleges in substance as follows: Defendants Truck and Farmers were and are insurance companies authorized to transact workmen's compensation insurance in California. Defendants Baker and Marino were and are "individuals or partners" engaged in the business of investigating industrial accident claims. At all times mentioned defendants and each of them "were the agents, servants and employees of each other, and were acting within the scope of and pursuant to such agency and employment."
On March 31, 1960, plaintiff injured her back while working for an employer insured under the workmen's compensation laws by defendant Truck. Subsequently she underwent four surgeries on her back and her condition deteriorated, causing extreme pain and requiring treatment. At all times mentioned defendants "had knowledge of plaintiff's physical and mental condition and medical history."
About April 10, 1964, defendants, and their employees, acting in the scope of their employment, placed plaintiff under surveillance in Long Beach. Defendant Baker "befriended the plaintiff and did in the City of
Plaintiff did not know at any time that she was under surveillance, that defendant Baker had misrepresented his capacity, or that defendant Marino was photographing her activities. At the instance and invitation of Baker, plaintiff had been caused "to become emotionally interested" in him.
On April 30, 1964, defendants negligently exhibited at a hearing of the Industrial Accident Commission (now the Workmen's Compensation Appeals Board)
Counts Two to Five
The second, third, and fourth counts, purporting to state causes of action on theories of assault, conspiracy and intentional infliction of emotional distress, incorporate by reference the allegations of the first count. The second count alleges that at the times described above defendants intentionally and wilfully assaulted and battered plaintiff. The third count alleges that defendants conspired to perform the acts described. The fourth count alleges that defendants "wilfully, wantonly and intentionally" inflicted emotional distress on plaintiff by the acts alleged. The fifth count, incorporating by reference the allegations of the preceding four counts, alleges
Defendants (except Marino — see fn. 2, ante) demurred to the complaint asserting that the complaint and each count thereof failed to state facts sufficient to constitute a cause of action, in that it appeared on the face of the complaint that the court had no jurisdiction over the subject matter of the action, as the Board had and continues to have exclusive jurisdiction. As previously noted, the court sustained the demurrers without leave to amend and dismissed the action. This appeal followed.
At the outset, we dispose of two procedural questions raised by plaintiff. First, she contends that the court erred in ordering her to file the second amended complaint, thereby restoring defendants' opportunity to demur. Her point is that defendants had waived their right to demur to the first amended complaint and by ordering her to file a new complaint the court deprived her of "immunity from attack by demurrer."
Second, plaintiff contends that the court, in its minute order sustaining the demurrers, improperly took judicial notice of certain determinations previously made by a trial referee of the Board when plaintiff was seeking workmen's compensation benefits for her back injury and its aggravations.
Defendants did not at any time make the request specified by section 453. Nevertheless, at the hearing on the demurrers, defendants' attorney did say that workmen's compensation had been awarded plaintiff, as the court file would reveal. The court indicated that counsel should make an appropriate request that judicial notice be taken.
We turn to the merits. The crucial question before us is whether an industrially injured employee can maintain against the workmen's compensation insurance carrier of her employer a common law action for damages for the negligent or intentional acts of such carrier. Plaintiff's appeal is
We first examine count one of the complaint. Section 3601 of the Labor Code provides in pertinent part: "Where the conditions of compensation exist, the right to recover such compensation, pursuant to the provisions of this division is ... the exclusive remedy for injury or death of an employee against the employer...." Thus, it is settled that the Board has exclusive jurisdiction to determine the extent of recovery for an injury suffered when the "conditions of compensation concur." (Lab. Code, § 3600; Scott v. Industrial Acc. Com., supra, 46 Cal.2d 76, 83.) Conversely the employer is immunized under sections 3600 and 3601 from an action at law brought by the employee for such injury.
Plaintiff argues that when a compensation insurance carrier negligently fails to control the scope and manner of a nonmedical investigation of an industrial accident claim, it changes its proper role as delineated by sections 3850 and 3852 and becomes a "person other than the employer" rather than the alter ego of the employer. This change of personality would permit the injured employee to invoke the jurisdiction of the superior court. Defendants, on the other hand, analogize to cases in which compensation insurers have been held to retain "employer" immunity from an action at law for other types of alleged negligence. (Fitzpatrick v. Fidelity & Casualty Co. (1936) 7 Cal.2d 230 [60 P.2d 276] (negligent medical treatment); Noe v. Travelers Ins. Co. (1959) 172 Cal.App.2d 731 [342 P.2d 976] (negligent delay in providing medical care); Hazelwerdt v. Industrial Indem. Exchange (1958) 157 Cal.App.2d 759 [321 P.2d 831] (negligence and conspiracy in providing medical treatment); State Comp. Ins. Fund v. Superior Court (Breceda), supra, 237 Cal.App.2d 416 (negligent safety inspection of employer's premises); Burns v. State Compensation Ins. Fund (1968) 265 Cal.App.2d 98 [71 Cal.Rptr. 326] (negligent safety inspection of employer's premises).) Plaintiff counters with the argument that the policy implications of these cases are distinguishable from the insurer's role in the instant case. The precise question which the parties pose is one of first impression in California.
It is convenient to note at this point that this issue before us pertains only to defendant Truck, the sole compensation carrier of plaintiff's employer. Defendants Farmers and Wishman, its agents, are clearly not the employer's insurers and at least on the face of the complaint
Having disposed of this appeal as to all other parties defendant, we now inquire whether the superior court's jurisdiction over the controversy extended to defendant Truck, the employer's insurer. In Fitzpatrick v. Fidelity & Casualty Co., supra, 7 Cal.2d 230, an action for damages was brought against the employer's compensation carrier for the wrongful death of an injured employee allegedly caused by negligent medical treatment by the carrier's doctor. We held that "the aggravation of an industrial injury or the infliction of a new injury resulting from its treatment or examination are compensable under the provisions of the Workmen's Compensation Act and, therefore, within the exclusive cognizance of the Industrial Accident Commission." (Id. at p. 232.) Although we recognized that the doctor was liable for his own acts, we upheld the sustaining of a demurrer by the carrier on the rationale that "the superior court may not entertain an action for damages against the employer or his insurance carrier...." (Id. at p. 233.)
Two Court of Appeal decisions — Hazelwerdt v. Industrial Indem. Exchange, supra, 157 Cal.App.2d 759 and Noe v. Travelers Ins. Co., supra, 172 Cal.App.2d 731 — applied Fitzpatrick to substantially similar facts. In Hazelwerdt the complaint asserted that the insurer refused to provide medical and hospital care and conspired with its doctor in so refusing; in Noe the complaint alleged that the insurer had negligently delayed in providing medical treatment for an industrial injury. In each case it was held that the alleged activities did not render the insurer a third party under section 3852. In each case, the appellate court decided that the employer was precluded from bringing a common law action for damages against the carrier because the latter even though acting negligently, had not stepped out of its proper role as an insurer in the compensation scheme.
In State Comp. Ins. Fund v. Superior Court (Breceda), supra, 237 Cal.App.2d 416, it was held that an employee sustaining an industrial injury could not maintain a common law action for damages against his employer's
In the instant case, plaintiff contends that the covert investigation during April 1964 went far beyond its permissible scope and that defendant Baker fraudulently enticed plaintiff to Disneyland, where he inveigled her into undertaking various activities of which his associate took motion pictures. Thus by analogy to our reasoning in Redner v. Workmen's Comp. Appeals Bd. (1971) 5 Cal.3d 83 [95 Cal.Rptr. 447, 485 P.2d 799], she urges that, by negligently failing to control the investigation, Truck was acting beyond its normal role as insurer, and in effect became a third party within
First, as has been discussed, the insurer's role in carrying out the nonmedical investigation of claims is as important to the compensation system as its role in providing medical services and performing safety inspections. As the cases just discussed point out, the nature of the insurer's role is not changed merely because its usual functions may have been performed negligently. A holding to the contrary might significantly deter insurance companies from providing workmen's compensation insurance and seriously impair a compensation scheme designed for the benefit of the workman. As the court declared in Noe: "[W]e must point out that if delay in medical service attributable to a carrier could give rise to independent third party court actions, the system of workmen's compensation could be subjected to a process of partial disintegration.... The uniform and exclusive application of the law would become honeycombed with independent and conflicting rulings of the courts. The objective of the Legislature and the whole pattern of workmen's compensation could thereby be partially nullified." (Noe v. Travelers Ins. Co., supra, 172 Cal. App.2d at p. 737.) A negligent investigation of an employee's claim may well be an aberration in the carrier's normal activities, but when it does have a harmful effect on the employee, we see no reason why it cannot be treated by the Board as a compensable aggravation of the original injury, if the evidence so warrants. This result provides for prompt and effective relief within the compensation scheme without disturbing the administrative process. We can find no justification either in statutory or policy considerations for treating the negligent carrier as no longer acting as a carrier but rather as a third party.
We recognize that while the basic theory of count one is negligence, its underlying allegations assert deceitful conduct on the part of Baker. In Redner v. Workmen's Comp. Appeals Bd., supra, 5 Cal.3d 83, we recently set forth our views on the reprehensible character of such conduct when engaged in by carriers and their private investigators. Without qualifying Redner in any way, we conclude that what we there said cannot transform the negligence count into something the pleader did not intend. As will appear, the reasoning of Redner does apply to our consideration of the counts which assert intentional torts.
Nor, contrary to plaintiff's claim, does the fraudulent nature of the investigation itself change the role of the insurer, for purposes of the negligence count, on the basis of any reasoning analogous to the "dual capacity" rationale of Duprey v. Shane (1952) 39 Cal.2d 781 [249 P.2d 8]. In that case plaintiff, a nurse, sustained an industrial injury while employed by the defendant, a chiropractor. Although he carried workmen's compensation
However, it would be unrealistic in the instant case to deem the insurer to have a dual personality merely on the ground of the negligence count herein. The Noe, Hazelwerdt, and Breceda courts all found Duprey v. Shane reasoning to be inapplicable to the negligence alleged on the part of the respective insurers.
Finally, the first count cannot survive demurrer on the authority of Ramey v. General Petroleum Corp. (1959) 173 Cal.App.2d 386 [343 P.2d 787], cited by plaintiff in support of the proposition that fraud provides an exception to the exclusive remedy rule of Labor Code sections 3600 and 3601. In Ramey the employer and a third party tortfeasor conspired to conceal from the industrially injured employee the fact that the latter had a common law action for damages against the third party for the injury. The court held that sections 3600 and 3601 did not preclude a civil action against the employer since the "fraud injury" was distinct from the earlier physical injury and did not arise out of or in the course of the employment, observing that "the Legislature never intended that an employer's fraud was a risk of employment." (173 Cal. App.2d at pp. 402-403.) The count we are now examining is distinguishable since its gravamen is not fraud but negligence which, as we have explained, has a relationship to the original injury.
We turn now to consider the legal sufficiency of the second and fourth counts which allege intentional torts: assault and battery and intentional infliction of emotional distress, respectively. It has been held that an employee cannot bring an action at law against his employer for damages for
We begin by observing that the rationale of the Noe-Hazelwerdt-Breceda line of cases, which we found persuasive in reaching our conclusion as to the first count, by its very nature is not persuasive here. Those cases spoke in the context of the insurer's negligence. We found them compelling in this context, reasoning as to the first count that the insurer, although negligent, was still acting as an insurer. We felt that the clear purpose of section 3850 should not be overridden by the "third party" policy statement of section 3852.
We thus conclude that the second and fourth counts of the complaint state facts sufficient to constitute a cause of action against Truck as a
We next take up the third count, which, after incorporating the first count, alleged that defendants conspired to perform the acts therein described.
In Hazelwerdt v. Industrial Indem. Exchange, supra, 157 Cal.App.2d 759, 763, which, as we have explained, dealt with the failure of an insurer to provide an industrially injured employee with medical care, the court rejected a contention that the allegations of a conspiracy in that case were sufficient to take the case outside the exclusive jurisdiction of the Industrial Accident Commission and entitle the employee to bring a civil action against the insurance carrier. The court correctly observed: "The allegations of conspiracy do not alter the nature of defendant's alleged acts and omissions. [Fn. omitted.] Whether or not a conspiracy existed, the wrong of which plaintiff complains is the defendant's failure to provide him with the required care." (Id. at p. 763.)
In summary, then, we hold that the second, fourth and fifth counts of the complaint state facts sufficient to constitute a cause of action against defendant Truck.
However, Truck contends that the superior court does not have jurisdiction of plaintiff's action on the ground that the Board had exclusive jurisdiction to grant relief. It is argued that the Board made an award
"The doctrine of res judicata precludes parties or their privies from relitigating a cause of action that has been finally determined by a court of competent jurisdiction." (Bernhard v. Bank of America (1942) 19 Cal.2d 807, 810 [122 P.2d 892]; see also Martin v. Martin (1970) 2 Cal.3d 752, 758 [87 Cal.Rptr. 526, 470 P.2d 662].) We have stated on a number of occasions that the final determinations of the Board, like those of the superior court, are "res judicata in all subsequent proceedings, including court actions, between the same parties or those privy to them." (Scott v. Industrial Acc. Com., supra, 46 Cal.2d at p. 83; italics added; French v. Rishell (1953) 40 Cal.2d 477, 479-480 [254 P.2d 26]; Duprey v. Shane, supra, 39 Cal.2d 781, 790.)
In Scott we considered the application of res judicata to a cause of action asserted, as here, in two tribunals, the superior court and the Board. We pointed out that "the two tribunals involved ... do not have concurrent jurisdiction over the whole of the controversy, and one of them will be without jurisdiction to grant any relief whatsoever, depending upon whether or not the injuries were suffered within the course and scope of an employment relationship and so covered by the workmen's compensation laws. In other words, as already indicated, the only point of concurrent jurisdiction of the two tribunals appears to be jurisdiction to determine jurisdiction; jurisdiction once determined will be exclusive, not concurrent. [Citations.] If at the time of the accident there was no workmen's compensation coverage, then the commission is without jurisdiction to grant relief, and if there was such coverage then the superior court is without jurisdiction and must leave the parties to pursue their remedies before the commission." (Scott v. Industrial Acc. Com., supra, 46 Cal.2d at pp. 82-83; original italics.) We concluded that "if there is a final determination as to the matter of coverage (i.e., of jurisdiction) in either the commission or the superior court proceedings, such determination will be res judicata in subsequent proceedings before the other tribunal between the same parties or those privy to them." (Id. at p. 83.)
Applying these principles to the instant case, we observe that the Board was the first tribunal to assume jurisdiction to determine jurisdiction with
It is manifest that since this determination was res judicata in any subsequent proceedings in the superior court between the same parties, it would have prevented plaintiff from bringing a common law action for damages against her employer (Sun Val Market) on the same cause of action had she attempted to do so. For the same reason and upon the authorities already discussed, plaintiff cannot bring such an action against the employer's insurance carrier (here Truck) where in its performance of the acts complained of the carrier is not "really stepping from its role as insurer." (State Comp. Ins. Fund v. Superior Court (Breceda), supra, 237 Cal.App.2d 416, 424; see also Noe v. Travelers Ins. Co., supra, 172 Cal. App.2d at pp. 735-736 and Hazelwerdt v. Industrial Indem. Exchange, supra, 157 Cal. App.2d at pp. 764-766.)
However, we have held that as to the second, fourth and fifth counts defendant Truck did not remain within its proper role as a compensation carrier. Thus, under the facts pleaded in those intentional torts counts, Truck was and is actually a "person other than the employer" (Lab. Code. § 3852), against whom plaintiff is entitled to bring a civil action for damages. We now conclude that this holding precludes the operation of the principles of res judicata set forth above.
No reported case has to our knowledge decided this precise question. However, this court dealt with a similar problem in Duprey v. Shane, supra, 39 Cal.2d 781. In Duprey, as has been discussed (see text accompanying fn. 12, ante), the plaintiff, a nurse, sustained an industrial injury
We noted that the Board had exclusive jurisdiction not only over plaintiff's claim against the employer with respect to the initial industrial injury, but also over her claim against the employer or his insurance carrier for further recovery because of the aggravation of that injury by the negligence of the attending physician. We also took cognizance of the settled rule that where the attending physician is negligent in the treatment of an industrial injury and causes a new injury, "`the employee may not only sue the employer [or the carrier] before the commission, but may also sue the doctor for malpractice.'" (Duprey v. Shane, supra, 39 Cal.2d at p. 790; italics added.) Thus we faced in Duprey the precise question of whether the plaintiff-employee was entitled to sue at common law her chiropractor-employer.
We rejected in Duprey the defendant's contention of res judicata and upheld the plaintiff's entitlement to bring a civil action. We reasoned as follows: "`[T]he employer-doctor is a "person other than the employer" within the meaning of section 3852 of the Labor Code above quoted. In treating the injury Dr. Shane did not do so because of the employer-employee relationship, but did so as an attending doctor, and his relationship to [ ] [plaintiff] was that of doctor and patient.
"`[ ] [Defendants] say that such a result can be reached only on the theory that Dr. Shane had a dual legal personality — that is, Dr. Shane the employer, and Dr. Shane the doctor, and contend that the law frowns upon the creation of such dual legal personalities, citing such cases as Walker v. City & County of San Francisco , 97 Cal.App.2d 901 [219 P.2d 487], and Park v. Union Mfg. Co. , 45 Cal.App.2d 401 [114 P.2d 373]. It is true that the law is opposed to the creation of a dual personality, where to do so is unrealistic and purely legalistic. But where, as here, it is perfectly apparent that the person involved — Dr. Shane — bore towards his employee two relationships — that of employer and that
The facts pleaded in the case at bench are analogous.
Nothing that we have said should be construed to be an approval of a double recovery. In the event that plaintiff obtains a judgment, defendant shall be entitled to a set-off, to the extent that it has already paid compensation to plaintiff in proceedings before the Board for the subsequent injuries which are the subject of the instant action, together with medical and other benefits relating only to such injuries. (Cf. Duprey v. Shane, supra, 39 Cal.2d at p. 796; Heaton v. Kerlan (1946) 27 Cal.2d 716, 719, 722-723 [166 P.2d 857].) In other words, any set-off should be limited to the amount of compensation benefits which the employer or insurance carrier was required to pay because of the aggravation of the original industrial injury produced by the intentional torts.
Carter, recognizing the holding of this court in Scott v. Industrial Acc.
Azevedo, upholding an award of the Board and a dismissal of the civil action, rejected the employee's claim that in cases of the employer's assault upon the employee there are "a concurrent pair of liabilities and concurrent jurisdiction on the part of the two tribunals in this limited class of cases, the ultimate damage award to be diminished by the compensation award." (Azevedo v. Abel, supra, 264 Cal. App.2d at p. 458.) The court held that in such cases the employee cannot bring an action at law for damages.
Azevedo and Carter are clearly distinguishable from the instant case, since in both of those cases the employee sought to maintain an action at law for the initial industrial injury against the employer, the same party against whom he had already brought proceedings for compensation benefits before the Board. In the case at bench, plaintiff did not seek damages at law for the initial industrial injury, but for injuries subsequently occurring from entirely distinct events. Nor, as to the second, fourth and fifth counts, is she seeking damages from the same party, because defendant Truck is as to those counts a "person other than the employer."
The judgment (order of dismissal) dated February 5, 1970, and filed February 27, 1970, as to defendants Farmers Insurance Group and Robert A. Wishman, is reversed as to all counts of plaintiff's second amended complaint, and as to defendant Truck Insurance Exchange is affirmed as to the first and third counts thereof and reversed as to the second, fourth
Wright, C.J., McComb, J., Peters, J., Tobriner, J., and Burke, J., concurred.
Section 431.5 of the Code of Civil Procedure provides: "When the ground of demurrer is based on a matter of which the court may take judicial notice pursuant to Sections 452 or 453 of the Evidence Code, such matter must be specified in the demurrer, or in the supporting points and authorities for the purpose of invoking such notice, except as the court may otherwise permit."
Hereafter, unless otherwise indicated, all section references are to the Labor Code.