Two employees begin to fight at work and at least on is sent to the hospital to get injuries treated. My intention is to reject the claim due to the fact that the injuries were not sustained "in and out of the course of employment". Our comp carrier states the strategy may or may not work, but probably have a legitimate basis to deny the claim. Anyone ever had a similar situation, and how did you handle it??
From what I've read of similar cases, you have a good chance of your denial sticking. Precedent seems to be on your side. Good luck.
Stupidity happens when one chooses to ignore the consequences of his/her actions. By the way, and just out of curiosity, were the EE's male or female or both?
Here's a fly in the ointment - if it's not workers' comp, then your company risks getting sued for something like negligent retention. Bubba could claim that your company knew or should have known that Elroy was dangerous but you didn't do anything about it. If it's workers' comp, then your state probably would bar a negligence lawsuit.
It's a long shot, but no telling what someone will do after a bruising termination.
You would still have to convince your w/c insurer to accept the claim.
But as James says, the "w/c only" remedies can be a lifesaver should you get sued. It depends on your situation, I guess, on whether you go for it or not.
James, As Rosanne Rosanna Dan used to say "if its not one thing, its another..." We chose to terminate the agressor, disciplined the other participant in the fight after witnesses said he really did not insitgate anything, but was more or less defending himself. If the terminated employee wants to challenge his termination, I'm willing to bet we "win" that one, after, of course, spending gazillions of dollars justifying our actions to some legal or regulatory entity. You're right about the negligent retention angle and we are not willing to try to rehab his anger outbursts (did someone say potetnial ADA angle?)This is, of course, also inviting a possible retaliation claim for terminating him for filing a comp claim. Other than that, its a slam dunk...
We had a similar situation. Both ees claimed the other started it, but one ended up with a cut on his scalp and a broken finger that required surgery. Our W/C carrier denied the claim but the injured ee was happy enough just to keep his job with a disciplinary write-up. The aggressor, who was a CDL driver, was coincidentally selected for random drug testing at the same time, flunked his drug test and was fired for the combination of the fight and the positive drug test. He filed for UI, was denied, and didn't show up for the hearing of his appeal.
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