Who pays when a workers’ comp claim’s facts change mid-case? Kentucky’s top court just clarified insurer liability in a long-running dispute between two carriers.
The Supreme Court of Kentucky’s Oct. 23, 2025 decision involved Roger Hall, a former teacher and substitute at Letcher County High School, who filed for workers’ compensation after developing mesothelioma. Hall’s initial claim named Kentucky Employers’ Mutual Insurance (KEMI) as the carrier, based on exposure dates from 1976 to 2003. Later, Hall amended his claim to state that his last asbestos exposure occurred on April 18, 2014, his final day as a substitute teacher.
This amendment shifted the focus to Encova Mutual Insurance Group (formerly Brickstreet Mutual Insurance Company), which insured the Letcher County Board of Education in 2014. KEMI argued that Encova should be liable for Hall’s benefits. Encova responded that it had not been properly joined as a party and that the motion to certify it as the responsible carrier was untimely.
The Administrative Law Judge denied KEMI’s motion, citing untimeliness and lack of authority. The Workers’ Compensation Board affirmed, stating that neither KEMI nor Encova had standing because neither had been formally joined as a party. The board suggested that such disputes should be resolved in circuit court.
The Kentucky Court of Appeals reversed, and the Supreme Court affirmed that reversal. The high court held that the Administrative Law Judge and Workers’ Compensation Board have the authority under the Workers’ Compensation Act to determine and certify the proper insurance carrier when facts change, such as a new last date of exposure.
The decision referenced Kentucky statutes requiring that workers’ compensation insurance policies contain clauses binding the insurer to any judgment against the employer, with notice to the employer considered notice to the insurer. The court stated that the insurer’s obligation to pay is not affected by procedural issues around notice or party status if the policy was in force at the time of exposure.
Encova’s arguments regarding fairness, lack of notice, and procedural delay were rejected. The court found that the statutory framework is designed to ensure prompt payment of benefits and that insurer liability is determined by the existence of a valid policy and the timing of exposure.
The Supreme Court affirmed the Court of Appeals’ decision and remanded the case to the Workers’ Compensation Board for proceedings consistent with its opinion. The ruling clarifies that insurers are bound by their policies and statutory obligations, even if they were not initially joined or given direct notice, when the facts of a workers’ compensation claim change during litigation.
