Legal Trends

Going and Coming Rule Found Exempt in Workers’ Compensation Case

A Pennsylvania court calls into question the limitations on the going and coming rule.
By: | January 10, 2018 • 4 min read

The “going and coming” rule states that workers’ compensation benefits do not apply to injuries sustained while commuting to or from work, but that line in the sand can get a little blurred when the employee is driving a company-owned vehicle.

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Such was the case when Shawn Fields and Herman Strother, two employees of Carl G’s Total Cleanouts, transported debris from a job site to a scrapyard. While in transit, the men crashed. Strother was fine, but Fields was injured in the incident.

Fields filed for workers’ compensation, believing his injury occurred on the job. Carl G’s, however, did not see it that way. The demolition and excavation company said that because Fields was off the property at time of injury it was not liable for his comp coverage.

The case was brought before a workers’ compensation judge, who asked Fields to explain how his injury arose in the “course and scope of employment.”

Fields explained the scenario: He and Strother were working at the same job site for about three weeks. One day, when the crew finished up, they decided to take the company truck filled with waste materials and drop them off at a nearby scrapyard. Afterwards, Strother would drop Fields off at home and return the vehicle to the Carl G’s job site.

But instead, the men were involved in an accident. In his argument, Fields said he was an exception to the going and coming rule; he was working for Carl G’s at the time of the accident and injury.

The judge looked to his predecessors. In previous rulings of similar nature, the court found the going and coming rule applied to when there was a fixed place of work. Fields, the judge ruled, had a fixed place of work — Carl G’s crew had been at the same location for three weeks. The judge determined the going and coming rule applied because it was a fixed location, and Carl G’s was not responsible for workers’ comp coverage.

Fields appealed.

The “going and coming” rule states that workers’ compensation benefits do not apply to injuries sustained while commuting to or from work, but that line in the sand can get a little blurred when the employee is driving a company-owned vehicle.

The Commonwealth Court of Pennsylvania looked at the judge’s ruling, re-examining the “course and scope” clause.

“The WCJ concluded that Claimant had failed to demonstrate that the injury occurred in the course and scope of employment because Claimant was commuting home from work at the time of the accident,” the court said. “The WCJ … focused the inquiry on whether Claimant’s place of work was fixed because of the ad hoc nature of his employment.”

The court reviewed Pennsylvania’s exceptions to the going and coming rule, particularly the one in which an employee would receive benefits if they were acting under the company.

Fields was, in this case, traveling to and from a scrapyard for work. His injuries stemmed from part of his job duties and not from a personal commute home, the court decided.

“Based on the facts found by the WCJ and the supporting evidence, there is substantial evidence to support the legal conclusion that Claimant was furthering the business of Employer when he was injured,” it concluded.

Carl G’s was responsible to pay workers’ comp benefits to Fields.

Exceptions to the Rule

There are several exceptions to the going and coming rule that most states acknowledge and turn to when the rule is up for debate.

When an employee is using a company vehicle to commute to or from a location, then the going and coming rule doesn’t apply. In Fields’s appeal, the court looked to this exception when it overturned the workers’ comp judge’s ruling.

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Other exceptions include:

If an employee’s job description requires them to be on the road. An example would be someone working in the postal service or cross-country as a truck driver.

If an employee is traveling between multiple job sites. An example would be a computer technician driving from one office building to the next. This does not include the worker’s commute to and from work each day, but instead looks at time spent on the road during a shift.

If an employee is traveling commercially. An example would be a person traveling on a business trip. Typically, the entire time spent away from the office — from beginning of travel to journey’s end — is covered under workers’ comp policies for most businesses.

If an employee is sent out on a special errand. An example would be an employee being asked to grab the manager a cup of coffee from a local shop or pick up lunch for the team.

Knowing the exceptions can better prepare employees and employers on duties that can be performed under the going and coming rule.

To read the full court opinion on Fields’s case, see Shawn Fields vs. Workers Compensation Appeal Board.

Autumn Heisler is the digital producer and a staff writer at Risk & Insurance®. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

High Net Worth

High Net Worth Clients Live in CAT Zones. Here’s What Their Resiliency Plan Should Include

Having a resiliency plan and practicing it can make all the difference in a disaster.
By: | September 14, 2018 • 7 min read

Packed with state-of-the-art electronics, priceless collections and high-end furnishings, and situated in scenic, often remote locations, the dwellings of high net worth individuals and families pose particular challenges when it comes to disaster resiliency. But help is on the way.

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Armed with loss data, innovative new programs, technological advances, and a growing army of niche service-providers aimed at addressing an astonishingly diverse set of risks, insurers are increasingly determined to not just insure against their high net worth clients’ losses, but to prevent them.

Insurers have long been proactive in risk mitigation, but increasingly, after the recent surge in wildfire and storm losses, insureds are now, too.

“Before, insurance was considered the only step in risk management. Now, our client families realize it is one of the many imperative steps in an effective risk management strategy,” said Laura Sherman, founding partner at Baldwin Krystyn Sherman Partners.

And especially in the high net worth space, preventing that loss is vastly preferable to a payout, for insurers and insureds alike.

“If insurers can preserve even one house that’s 10 or 20 or 40 million dollars … whatever they have spent in a year is money well spent. Plus they’ve saved this important asset for the client,” said Bruce Gendelman, chairman and founder Bruce Gendelman Insurance Services.

High Net Worth Vulnerabilities

Laura Sherman, founding partner, Baldwin Krystyn Sherman Partners

As the number and size of luxury homes built in vulnerable areas has increased, so has the frequency and magnitude of extreme weather events, including hurricanes, harsh cold and winter storms, and wildfires.

“There is a growing desire to inhabit this riskier terrain,” said Jason Metzger, SVP Risk Management, PURE group of insurance companies. “In the western states alone, a little over a million homes are highly vulnerable to wildfires because of their proximity to forests that are fuller of fuel than they have been in years past.”

Such homes are often filled with expensive artwork and collections, from fine wine to rare books to couture to automobiles, each presenting unique challenges. The homes themselves present other vulnerabilities.

“Larger, more sophisticated homes are bristling with more technology than ever,” said Stephen Poux, SVP and head of Risk Management Services and Loss Prevention for AIG’s Private Client Group.

“A lightning strike can trash every electronic in the home.”

Niche Service Providers

A variety of niche service providers are stepping forward to help.

Secure facilities provide hurricane-proof, wildfire-proof off-site storage for artwork, antiques, and all manner of collectibles for seasonal or rotating storage, as well as ahead of impending disasters.

Other companies help manage such collections — a substantial challenge anytime, but especially during a crisis.

“Knowing where it is, is a huge part of mitigating the risk,” said Eric Kahan, founder of Collector Systems, a cloud-based collection management company that allows collectors to monitor their collections during loans to museums, transit between homes, or evacuation to secure storage.

“Before, insurance was considered the only step in risk management. Now, our client families realize it is one of the many imperative steps in an effective risk management strategy.” — Laura Sherman, founding partner, Baldwin Krystyn Sherman Partners

Insurers also employ specialists in-house. AIG employs four art curators who advise clients on how to protect and preserve their art collections.

Perhaps the best known and most striking example of this kind of direct insurer involvement are the fire teams insurers retain or employ to monitor fires and even spray retardant or water on threatened properties.

High-Level Service for High Net Worth

All high net worth carriers have programs that leverage expertise, loss data, and relationships with vendors to help clients avoid and recover from losses, employing the highest levels of customer service to accomplish this as unobtrusively as possible.

“What allows you to do your job best is when you develop that relationship with a client, where it’s the same people that are interacting with them on every front for their risk management,” said Steve Bitterman, chief risk services officer for Vault Insurance.

Site visits are an essential first step, allowing insurers to assess risks, make recommendations to reduce them, and establish plans in the event of a disaster.

“When you’re in a catastrophic situation, it’s high stress, time is of the essence, and people forget things,” said Sherman. “Having a written plan in place is paramount to success.”

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Another important component is knowing who will execute that plan in homes that are often unoccupied.

Domestic staff may lack the knowledge or authority to protect the homeowner’s assets, and during a disaster may be distracted dealing with threats to their own homes and families. Adequate planning includes ensuring that whoever is responsible has the training and authority to execute the plan.

Evaluating New Technology

Insurers use technologies like GPS and satellite imagery to determine which homes are directly threatened by storms or wildfires. They also assess and vet technologies that can be implemented by homeowners, from impact glass to alarm and monitoring systems, to more obscure but potentially more important options.

AIG’s Poux recommends two types of vents that mitigate important, and unexpected risks.

“There’s a fantastic technology called Smart Vent, which allows water to flow in and out of the foundation,” Poux said. “… The weight of water outside a foundation can push a foundation wall in. If you equalize that water inside and out at the same level, you negate that.”

Another wildfire risk — embers getting sucked into the attic — is, according to Poux, “typically the greatest cause of the destruction of homes.” But, he said, “Special ember-resisting venting, like Brandguard Vents, can remove that exposure altogether.”

Building Smart

Many disaster resiliency technologies can be applied at any time, but often the cost is fractional if implemented during initial construction. AIG’s Smart Build is a free program for new or remodeled homes that evolved out of AIG’s construction insurance programs.

Previously available only to homes valued at $5 million and up, Smart Build recently expanded to include homes of $1 million and up. Roughly 100 homes are enrolled, with an average value of $13 million.

“In the high net worth space, sometimes it takes longer potentially to recover, simply because there are limited contractors available to do specialty work.” — Curt Goetsch, head of underwriting, Private Client Group, Ironshore

“We know what goes wrong in high net worth homes,” said Poux, citing AIG’s decades of loss data.

“We’re incenting our client and by proxy their builder, their architects and their broker, to give us a seat at the design table. … That enables us to help tweak the architectural plans in ways that are very easy to do with a pencil, as opposed to after a home is built.”

Poux cites a remote ranch property in Texas.

Curt Goetsch, head of underwriting, Private Client Group, Ironshore

“The client was rebuilding a home but also installing new roads and grading and driveways. … The property was very far from the fire department and there wasn’t any available water on the property.”

Poux’s team was able to recommend underground water storage tanks, something that would have been prohibitively expensive after construction.

“But if the ground is open and you’ve got heavy equipment, it’s a relatively minor additional expense.”

Homes that graduate from the Smart Build program may be eligible for preferred pricing due to their added resilience, Poux said.

Recovery from Loss

A major component of disaster resiliency is still recovery from loss, and preparation is key to the prompt service expected by homeowners paying six- or seven-figure premiums.

Before Irma, PURE sent contact information for pre-assigned claim adjusters to insureds in the storm’s direct path.

“In the high net worth space, sometimes it takes longer potentially to recover, simply because there are limited contractors available to do specialty work,” said Curt Goetsch, head of underwriting for Ironshore’s Private Client Group.

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“If you’ve got custom construction or imported materials in your house, you’re not going to go down the street and just find somebody that can do that kind of work, or has those materials in stock.”

In the wake of disaster, even basic services can be scarce.

“Our claims and risk management departments have to work together in advance of the storm,” said Bitterman, “to have contractors and restoration companies and tarp and board services that are going to respond to our company’s clients, that will commit resources to us.”

And while local agents’ connections can be invaluable, Goetsch sees insurers taking more of that responsibility from the agent, to at least get the claim started.

“When there is a disaster, the agency’s staff may have to deal with personal losses,” Goetsch said. &

Jon McGoran is a novelist and magazine editor based outside of Philadelphia. He can be reached at [email protected]