April 19, 2024
Volume XIV, Number 110
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Following Seventh Circuit’s Lead, Pennsylvania Court Holds Insurance Claims Examiner To Be Exempt Administrative Employee
Tuesday, March 18, 2014

Though courts have generally disfavored such claims, from time to time insurance adjusters and examiners allege that the FLSA’s administrative exemption does not apply to their work because their work either: 1) does not relate to business operations of their employer; or 2) does not require the exercise of discretion and independent judgment.  Rejecting such a challenge, Judge Mitchell S. Goldberg of the Eastern District of Pennsylvania recently applied the exemption and granted summary judgment to the employer.  Estrada v. Maguire Ins. Agency, Inc., 2014 U.S. Dist. LEXIS 25785 (E.D. Pa. Feb. 28, 2014).

In Estrada, plaintiff was responsible for handling “fast track” automobile claims, meaning auto accidents involving a single vehicle and modest damages.  However, plaintiff had the authority to settle claims up to $10,000 without supervisory involvement, a similar level of authority as possessed by the adjusters at issue in Roe-Midgett v. CC Servs., Inc., 512 F.3d 865 (7th Cir. 2008)(finding exempt status).  He also: 1) maintained detailed notes regarding each claim; 2) investigated claims through interviews of the claimants, insureds, witnesses and law enforcement; 3) set reserves on his claims; 4) and, retained third-party appraisers to provide estimates where appropriate.  Further, his performance evaluations (which he acknowledged were accurate depictions of his work) reflected that he performed these tasks with a minimal amount of supervision.  Judge Goldberg found that these duties reflected office or non-manual work related to the management or general business operations of the agency, and that the foregoing duties “clearly demonstrate that he compared and evaluated possible courses of conduct, and made decisions” reflecting discretion and independent judgment.

Industry employers must stay abreast of the case law applying white collar exemptions to the various common positions in their industry.

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