Iowa: No Claim for Bad-Faith Denial Could Be Maintained Where Insurer Had Reasonable Basis for Initial Denial

Acknowledging that Iowa law recognized a common-law cause of action against an insurer for bad-faith denial or delay of insurance benefits, and the tort has been extended to include workers' compensation cases, an Iowa appellate court nevertheless affirmed summary judgment in favor of an insurer who initially denied a worker’s petition for workers’ compensation benefits on the grounds that she had not provided medical evidence indicating her symptoms were related to her employment, but one year later entered into a settlement agreement stipulating that the worker had suffered an injury arising out of and in the course of her employment. Citing Larson’s Workers’ Compensation Law, § 9.01, for the proposition that idiopathic falls onto level surfaces are generally not compensable, the appellate court observed that in the worker’s initial explanation of the injury, she had contended she slipped on ice at the employer’s premises, that photographic evidence of the scene taken at the time of the injury failed to show the existence of any such ice, that other accounts of the incident indicated she had merely lost her footing for no apparent reason—perhaps for idiopathic reasons—and that under those circumstances, therefore, her claim for benefits was “fairly debatable as a matter of law.”  The employer and insurer had an objectively reasonable basis to question whether the fall and subsequent injury was indeed work related.

Thomas A. Robinson, J.D., the Feature National Columnist for the LexisNexis Workers’ Compensation eNewsletter, is a leading commentator and expert on the law of workers’ compensation.

LexisNexis Online Subscribers: Citations below link to Lexis Advance. Bracketed citations link to lexis.com.

See Saltern v. HNI Corp., 2014 Iowa App. LEXIS 852 (Aug. 13, 2014) [2014 Iowa App. LEXIS 852 (Aug. 13, 2014)]

See generally Larson’s Workers’ Compensation Law, § 104.05 [104.05]

Source: Larson’s Workers’ Compensation Law, the nation’s leading authority on workers’ compensation law.

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