Judge Denies Hartford Ins. Co.’s Attempts to Escape Responsibility after Delaying Worker’s Compensation Benefits to Injured Worker
A federal judge recently denied Hartford Ins. Co. of the Midwest’s (“Hartford”s) multiple summary judgment motions designed to dismiss plaintiff’s suit for its wrongful denial of compensation benefits. Other defendants include Gallagher Bassett (“Gallagher”) – Hartford’s third-party claims handler, and Gallagher’s claim representative assigned to plaintiff’s case file.
Our client, a customer service representative for Stanley Steemer, tripped and fell on a set of stairs leading to her workstation within the company’s call center on January, 9, 2012. Our client injured her knees, hip, and twisted her back in the incident. After being assisted to her feet from a co-worker, she reported the injury to her supervisor who initiated a work injury report.
The following day, an examination from a nurse practitioner prescribed a week of work restrictions due to an inability for our client to sit at a desk, walk up stairs, or stand for long periods due to worsening pain. February 6, the nurse practitioner concluded our client should remain off work. This nurse then referred plaintiff to a pain clinic for further assistance, but this visit was denied by the claims adjuster who said she “didn’t believe this would benefit the employee.”
In violation of defendants’ duty to handle claims “in good faith and fair dealing,” the adjuster denied disability benefits claiming there was a “lack of documentation,” though she never asked the nurse for her findings or sought evidence to support our client’s position. Benefits were rejected though the insurance company’s own medical examiner agreed to the suggested work restrictions. The duty of “good faith” requires a worker’s compensation insurer accept undisputed evidence and only provide denials if there is a reasonable basis or adequate investigation performed.
Within Hartford’s motions for summary judgment it sought to remove the claims processor who was charged with aiding the insurer’s unlawful actions.The Court denied this motion finding that an agent is not excused from liability when he or she
Doyle Raizner Obtains Verdict For Commercial Plaintiff Harmed By American Family Mutual’s Improper Claims Processing Actions Following Arizona Hailstorm
The massive October 5, 2010, Arizona hailstorm spawned significant damage to consumers and business owners across Maricopa County, as well as jury verdicts against those insurance companies that refused to live up to their promises to timely and properly pay for the full amount of damages sustained by their insureds. American Family Mutual Insurance Company (“American Family”), one of the largest property insurers in Arizona and across the western United States, was recently unanimously found guilty by a federal jury in Phoenix of breaching its contract for full replacement coverage of our client’s commercial office building in the Scottsdale Airpark business park owned after undervaluing the damage by over $210,000. The jury’s verdict confirmed that American Family’s adjusters at Pacesetter, as well as its home office adjusters and managers, undervalued the damage caused by the wind, hail, and rain to our client’s property by insisting that no more than $30,000 worth of damage to the building’s roof, windows, and exterior was sustained in the storm, despite overwhelming evidence of much more significant losses.
Our client depended on American Family to keep its promises to provide full replacement coverage in return for the premiums paid. The storm caused roof damage that led to serious leaking inside the building that began on the date of the storm and continued with every significant rain thereafter, resulting in ongoing interior damage. The storm also caused leaking through windows, marred the building’s exterior and damaged the carports. The building’s air conditioning (HVAC) units also required replacement after the storm, and American Family refused to pay for more than minor repairs. The evidence at trial confirmed that American Family’s initial adjuster spent less than 90 minutes at the property before issuing his evaluation, and refused every effort to secure a more thorough and comprehensive evaluation of the impact on the property.
The jury found that American Family breached its contract with our client and that as
The Jones Act is an extremely important law for anyone who works on the sea. It allows people who work as seamen and are injured on the job to have a trial by jury to sue for damages. It’s very similar to the same rights that railroad workers have. However, not everyone that works on the sea is classified as a seaman by the law.
According to a Supreme Court decision in 1995, a worker has to be out on the sea more than 30% of the time to be classified as a seaman. This means that many people who work on the docks and face many of the same dangers do not get the benefits of the Jones Act.
This issue may be taken up again by the Supreme Court soon. In 2008, a worker sued his employer after getting silicosis from sandblasting vessels. The fine sand got into his lungs and caused him to lose his job. His employer claimed that he didn’t qualify for Jones Act protections since he spent most of his time on the docks. In 2012, the worker died and his widow is now trying to take the case to the Supreme Court.
The worker did spend time out on the sea. When he wasn’t doing dock duties, he was taking pilots out to commercial vessels so local pilots could drive the boats out of Chesapeake Bay. The question is whether his boat maintenance work counts as being out on the sea.
Courts around the country are split about whether dock work counts as being out on the sea for the purposes of the Jones Act. The justices are scheduled to discuss whether to take the case or not. Resolving this issue in favor of the workers could open many companies to lawsuits.
The Mirenda IUD was introduced to the market in 2000, and since then women have complained about severe complications with the intrauterine device. Just last month, another couple has sued Bayer Healthcare Pharma Inc. for damages due to the device. In this particular case, the device had wandered out of the plaintiff’s womb and into her abdominal cavity. Surgery was required to remove the device.
The lawsuit alleges that Bayer didn’t adequately warn about the possible complications from Mirenda. They are seeking damages for defective design, defective manufacturing, failing to warn, strict products liability, negligence, violation of express and implied warranties, negligent misrepresentation, fraud, and fraudulent concealment.
The Mirenda IUD has been marketed as safe for over a decade now. The device is a T-shaped piece of plastic that releases a form of progestogen into the womb to prevent pregnancy. The device is supposed to last for around five years.
However, many lawsuits have been filed against Bayer surrounding complications from the device. The major complications linked to the device are spontaneous movement, perforation of the uterus, and infections. These problems can be life-threatening and require surgery.
If you believe you have been injured due to complications from the Mirenda IUD, get legal help. The lawyers at Doyle Raizner LLC are ready to hear your case. Contact our offices if you have been injured by the Mirenda IUD or another medical device.
Anticoagulants are used every day in hospitals to prevent blood clots from forming in patients. Many people also take them daily after leaving the hospital to prevent complications. Unfortunately, there have been some new anticoagulant drugs that have proven to cause more harm than good. Pradaxa is one of these drugs.
In May, the maker of the drug, Boehringer Ingelheim, settled around 4,000 claims in US court for around $650 million dollars, but did not agree to any liability. The side effect at the heart of the matter was uncontrolled bleeding. Pradaxa was meant to be a replacement for an older drug called warfarin, but unlike warfarin there is no antidote for Pradaxa in the case of uncontrolled bleeding. According to a study done in January 2012 and published by the Archives of Internal Medicine, the increase in risk was 27 to 33 percent higher than warfarin, enoxaparin, or placebo.
Additionally, there were other adverse side effects reported in much higher numbers than expected. These side effects included heart attack, cerebral hemorrhaging, and gastrointestinal issues. Despite these risks, the FDA has not taken this drug off the market. However, they are conducting continuing safety reviews and evaluating the evidence.
We have experience in pharmaceutical litigation here at Doyle Raizner LLC. Several of our lawyers have previously worked on behalf of pharmaceutical companies. We know their legal teams are very strong, but we also know how to fight them. If you have experienced pain and suffering due to the side effects of a prescription drug, consider contacting our legal team for advice.
Last month there was an explosion at a BP refinery in Whiting, Indiana. Fortunately, in this case there was only minor problems. The fire was put out in a couple hours and only one person had to be taken to the hospital. It was done as a precaution and he was later released. They were very fortunate there was no further damage since the explosion was reportedly powerful enough to shake pictures off of walls.
This wasn’t the first explosion to happen in Whiting. In 1955, a fluid hydroformer unit experienced a series of explosions that killed two people at a Standard Oil refinery. Oil refineries are dangerous places to work. Toxic chemicals, explosions, steam, heavy equipment, and other factors are pose a threat to the health and safety of workers.
The difficulty in oil and gas refinery accident cases is determining just who was at fault and why. Refineries are incredibly complex and difficult to maintain. If structures aren’t maintained properly, an explosion could result. There’s also the possibility of neglect by the owner to train workers properly and follow industry codes. Plus, the worker or a third party could have made an error that put their life and the lives of others at risk.
It takes a skilled attorney with experience in analyzing refinery explosions to defend workers who have been injured. Doyle Raizner LLC has that experience. Don’t let the negligence of your employer go without adequate compensation. Call our offices today for a consultation.
Railroad workers perform their jobs under dangerous conditions every day. According to the Bureau of Labor Statistics, the fatal injury rate on trains and in switchyards is double the national average. It’s so dangerous that a law was passed in 1908 called the Federal Employers Liability Act or FELA that specifically compensates railroaders injured on the job.
FELA is a replacement for standard worker’s compensation. In a FELA case, if a jury decides that a railroad company was legally negligent at least in part in causing the injury, they can award monetary payouts for pain and suffering. One major source for FELA cases is solvent exposure on freight trains.
Railroad unions are keen on keeping workers healthy and safe so FELA cases aren’t needed. That could be one reason why SMART-TD, the largest railroad union in the US, is protesting a plan by BNSF Railway to operate some freight trains with a single employee. BNSF claims that new collision-avoidance technology means that the conductor position can be eliminated on some trains, leaving only an engineer.
The plan is so unpopular that even railway workers not involved in the union and family members are expressing concern. There is fear about lost jobs, but there is also worry about the lack of help in case of an emergency. Freight trains operate in isolated conditions. If there was an injury or other medical problem with the single employee, no one would be there to help.
Railroading is a dangerous profession, and remains so even today. Having freight trains run under the guidance of a single employee seems foolhardy, and an opening for future FELA lawsuits. If you or a loved one have been injured in a railroad accident, contact Doyle Raizner LLC to see if you may qualify for a FELA lawsuit filed on your behalf. Railroad companies shouldn’t put their workers at risk.
Texas is known for severe hailstorms and tornadoes during the summer season. When these natural disasters strike a major building, the costs for repair can be astronomical. Having adequate insurance coverage on a commercial building is essential to have peace of mind when these storms come.
Last April in Denton, an estimated $300 million in damage was incurred due to softball-sized hail that rained down from multiple storm systems. About 24,000 vehicles and 12,000 structures were damaged by the storm according to the Insurance Council of Texas. Three small tornados were also seen touching down during this storm.
After an incident like this, it’s up to insurance companies to fairly inspect the damage and pay out on policies if the damage is covered. However, there are insurance companies that will act in bad faith and not properly pay out on policies. Some of the tactics we’ve seen include:Administrative and bureaucratic delays Untrained adjusters Bogus claims that the damage was from wear and tear Improper delays in payment that are inconsistent with legal requirements
While bad insurance companies delay the process, businesses and landlords lose money. A condemned building due to hail damage can shutter a business completely, robbing people of their livelihood and robbing the community of an economic driver.
If you own a commercial building, church, apartment complex, or government building and your insurance company isn’t meeting their contractual responsibilities, that’s when you need an experienced commercial property insurance lawyer on your side. The lawyers at Doyle Raizner LLC have decades of experience and have gained millions of dollars for our clients. Make the insurance companies pay what you need. Call us today.
In June of this year, a major hail storm hit Abilene, Texas. The size of the hailstones that rained down ranged from golf ball to softball-sized hail. Here’s just some of the damage that was reported by the city:Damage from fallen trees and power lines Hendrick Medical Center had approximately 20 broken windows and skylights Hotel Wooten’s foyer skylight was shattered Hardin-Simmons University had broken windows The Abilene Police suffered damage on 46 vehicles Fire Station 4 was shuttered due to the damage
When storms like this come through, roofing companies and insurance adjusters come in their wake. Hailstorms are big business for roofers and they are quick to give estimates. However, insurance companies will sometimes take the estimate of the roof repair alone and push that as the amount that they owe on the policy.
This doesn’t take into account things like damaged commercial air conditioning units, glazing, screens, siding, interior damage, and other factors. When a commercial building is damaged by hail, everything needs to be paid for, not just what the roofer will repair. We’ve even seen insurance companies try to force substandard materials and repair procedures to lower costs instead of paying the money necessary to do the job right.
If you own a commercial building that was damaged in a hailstorm, don’t hesitate to get skilled legal help on your side. Doyle Raizner LLC can bring in independent adjusters to inspect the damage and counter the offer given by the insurance companies. If they don’t accept, we can take them to court and get you the settlement your business needs to get back on its feet.
Last week, the city of Phoenix and other locations in Arizona and California met with the remnants of Hurricane Norbert. The result in Phoenix has been compared by Mayor Alex Finter as a “mini-Katrina”. Flash flooding is very common in the desert when just a little rain falls, but the amount of rain that fell has shattered the all-time record since 1895.
The City of Phoenix has declared a state of emergency after the incident. Wind speeds of up to 40 mph combined with the force of the flooding caused extensive damage to structures and roads. I-10 is washed out in places due to mud and rock slides, snarling commercial trucking and halting business activity and schooling. Thousands are without power due to washed out power lines. At least one supermarket roof has collapsed and there are many reports of water entering structures. Two women are known to have died due to the flooding.
When historic storms like this happen, it can be a real nightmare to discover that your building insurance doesn’t cover flood damage. You may think that the desert is the last place to expect a flood, but actually flash flooding is very common in these regions. The dry desert soil becomes almost like stone from all the heat. When rain falls, the ground is quickly saturated and causes flooding. Even as little as an inch of rain in a short period can cause a flood to occur, let alone the 3 to 5 inches of rain that happened with this storm.
If you’re worried about whether your commercial policy can cover this amount of damage, or if you’re afraid that the insurance company will reject your claim, we can help. Our independent adjusters will go to your site and assess the damage so you can go to the insurance company with confidence. If they don’t accept the results, Doyle Raizner LLC can and will defend your