Wisconsin Worker’s Compensation Act

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WI Court of Appeals – District III

Case Name: Francis G. Graef v. Applied Underwriters, Inc.

Case No.: 2023AP000420

Officials: Stark, P.J.

Focus: Wisconsin Worker’s Compensation Act

After a workplace accident in 2012—for which Graef received worker’s compensation benefits—he continued to suffer from both physical injuries as well as depression. Graef alleged that Continental’s—and later Applied Underwriters’—refusal to cover the cost of his depression medication in June 2015, a cost he was unable to shoulder on his own, resulted in worsening depression and caused him to suffer a self-inflicted, nonfatal gunshot wound to the head on August 9, 2015. Graef appeals from an order granting Applied Underwriters, Inc.’s motion to dismiss Graef’s personal injury lawsuit. Applied Underwriters had contracted with Graef’s worker’s compensation insurance carrier, Continental Indemnity Company, to adjust its worker’s compensation claims. Graef sued Continental, and later Applied Underwriters, seeking damages for injuries he claimed were caused by Applied Underwriters’ denial of medication under the Wisconsin Worker’s Compensation Act (the Act).

In this appeal, the question presented was whether Applied Underwriters should also be immune from liability under the Act’s exclusive remedy provision, similar to Continental. The Court of Appeals found in favor of Applied Underwriters, citing a precedent in Walstrom v. Gallagher Bassett Services, Inc., which established that agents and representatives of a worker’s compensation insurance carrier are covered by the Act’s exclusive remedy provision. Consequently, since Applied Underwriters acted as an agent for Continental, it stood in the same position regarding immunity from liability.

The court affirmed the lower court’s dismissal of Graef’s complaint against Applied Underwriters, supporting the position that the worker’s compensation system provided the exclusive remedy for his claims. This decision reinforced the principle that worker’s compensation laws, viewed as a balance of interests between employers and employees, provide comprehensive coverage for work-related injuries while protecting affiliated insurers and their agents from additional liability.

Affirmed.

Decided 04/09/24

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