Fiona Bulanadi filed a lawsuit against Permanente Medical Group, and several entities involved in the administration of her workers’ compensation claim, a claims adjuster, Sedgwick Claims Management Services, Inc., and Sedgwick’s employee, Fia Kyono.
She alleged that the Permanente Medical Group induced her to accept employment with the company and to remain employed there by repeatedly assuring her it would pay her workers’ compensation benefits, if and when it became necessary. Allegedly representatives of Permanente Medical Group assured Fiona, orally and “in paperwork that was provided to her,” that “if she was injured on the job that she could count on the prompt provision of worker[s’] compensation benefits.”
On February 7, 2014 a car hit Fiona while she was walking on a footpath at a Kaiser facility. Fiona was on the footpath because Permanente Medical Group required its employees to “take walks and engage in invigorating activities during lunches and breaks.”
Fiona filed a workers’ compensation claim. Permanente Medical Group gave the claim to Kaiser Foundation Health Plan, which in turn assigned it to Sedgwick. Sedgwick sent Fiona a letter allegedly falsely identifying Kaiser Foundation Health Plan as her employer, purporting to deny her workers’ compensation claim, but suggesting the claim was “still open.” According to Fiona, the defendants investigated her workers’ compensation claim in bad faith, looked for ways to avoid paying her benefits, and denied the claim for patently false reasons.
Fiona sued Permanente Medical Group for “damages for being willfully uninsured or not permissibly self-insured,” breach of her employment contract, and unfair business practices. She sued all of the defendants for fraud, negligent misrepresentation, and intentional infliction of emotional distress. She sued Sedgwick, Kyono, and Kaiser for interference with contract, and she sued Kaiser for premises liability negligence.
The court sustained defendants demurrer to all of the Bulanadis’ causes of action on the ground they were barred by the exclusive remedy provision of the Workers’ Compensation Act. The court of appeal reversed in the unpublished case of Bulandi v. Southern California Permanente Medical Group.
Fiona alleged Permanente Medical Group was willfully uninsured or not permissibly self-insured. If that allegation is true, her employer is not protected by workers’ compensation exclusivity, and Fiona may bring a civil action for damages for her work-related injuries. If that allegation is not true, at least some of Fiona’s causes of action may be barred by the Workers’ Compensation Act.
The trial court ruled on demurrer that Permanente Medical Group was self-insured by taking judicial notice of two documents: (1) a DIR certificate of consent to self-insure issued to Permanente Medical Group in 1965 and (2) a document in portable document format posted on the DIR website listing Permanente Medical Group, among others, as a self-insured employer. Because these documents did not indisputably establish Permanente Medical Group was self-insured, however, the trial court erred.