Archive for March, 2011
Business Interruption Claims Begin Arising in Natural Gas Shortage in New Mexico and Texas
The natural gas shortage affecting businesses in New Mexico and Texas resulted in thousands of medium and small businesses without the ability this winter to heat their buildings, manufacture products, or otherwise operate normally. Besides basic operations, closed businesses also lost out on key opportunities.
The losses incurred by business–whether in operations or in lost opportunities–are often covered by business interruption insurance. Under many policies, the loss of utilities can be a covered business interruption claim.
A claim due to a loss of electricity, gas, or other utility can be very complex. The first steps are to determine whether your business’s policy has the appropriate policy provision and to file a claim.
If your business interruption claim has been wrongfully denied, contact an attorney to preserve your rights.
Texas Third District Court of Appeals Sides with Injured Worker’s Surviving Wife, Affirms Lower Court
On March 30, 2011, the Texas Court of Appeals, Third District, at Austin, ruled against Zurich American Insurance Company (Zurich) and found that an injured employee’s wife was entitled to his benefits for an on-the-job injury. The Appeals court’s ruling affirmed the findings of both the 33rd District Court of Burnet County and the Texas Department of Insurance, Division of Workers’ Compensation (DWC).
The employee in this case had been killed in a car accident on the job. Zurich had denied death benefits to the injured employee’s wife by stating he was not actually working when he was killed, even though his accident occurred while in a company car and in route to a mandatory company meeting. Zurich’s position went against the Texas labor code and rules, as well as the established decisions of DWC.
Even after winning his case before DWC, Zurich sued the employee’s wife in civil court to try to get the case overturned again. As the lower court ruled, and the appeals court correctly confirmed, the injury did occur on the job and the employee’s family should be entitled to workers’ compensation benefits. Unfortunately, this case also shows the lengths to which insurance companies will go, including suing surviving widows, to avoid paying claims that should not be disputed in the first place.
Doyle Raizner Launches Maritime Injury iPhone App
Doyle Raizner has lauched its first iPhone app, a Maritime Injury Law Center aimed at providing resources and easy access to emergency tools in the event of an offshore injury.
The app is available now for free at the Apple iTunes Store.
The Maritime Injury Law Center App features include:
- Offshore injury report form to capture details of an accident
- Photo and audio capture to submit with the form
- Access to Doyle Raizner video and social media
- Ability to easily contact our attorneys from your iPhone
Doyle Raizner Files Workers’ Compensation Bad Faith Claim Against Liberty Mutual
On March 25, 2011, Doyle Raizner filed a workers’ compensation bad faith lawsuit against Liberty Mutual Fire Insurance Company and its adjuster, on behalf of an employee who was injured on the job in April 2009. After Liberty Mutual had accepted the employee’s claim and acknowledged his injury, Liberty Mutual decided to cancel treatment and surgery in spite of its pre-authorizations.
Further, the law suit includes a wrongful dischage claim against the injured employee’s former employer, who fired the employee in retaliation for his reporting his on-the-job injury to Liberty Mutual.
Doyle Raizner is proud to assist this injured employee, who prevailed in hearings before the Texas Department of Insurance, Division of Workers’ Compensation, in holding accountable Liberty Mutual, its adjuster, and his former employer for their actions.
Doyle Raizner Files Workers’ Compensation Bad Faith Suit Against Zurich
Doyle Raizer filed a workers’ compensation insurance bad faith suit on March 23, 2011, against American Zurich Insurance Company (Zurich) and its adjuster. The suit was filed on behalf of an employee who was physically assaulted while working on the job in December 2009. In spite of a wealth of medical and other evidence, Zurich denied the claim, failing to complete even a basic, reasonable investigation. As a result, the injured employee was left without the medical care and income benefits she was entitled to under the law until winning her case at a hearing in front of the Texas Department of Insurance, Division of Workers’ Compensation.
Doyle Raizner stands with this injured employee in seeking justice due to the groundless dispute in her case by Zurich and its adjuster.
TDI Releases February 2011 Workers’ Compensation Violators
The Texas Department of Insurance on March 9, 2011, released final disciplinary decisions for violations of Division of Workers’ Compensation rules. Among these fines were the following insurer violations:
-Liberty Mutual [three fines for a total of $21,000]: Failure to timely pay income benefits; Failure to comply with TDI orders to pay income benefits; Failure to pay correct income benefit amount; Failure to timely pay medical bill.
These are fines paid to the state for violations of DWC rules and the Texas Insurance Code. Doyle Raizner is committed to helping individuals who have been harmed by such violations when they amount to bad faith activity by an insurance carrier. Click here for more information about the wrongful handling of workers compensation cases.
The complete list of fines is available here.
TDI Releases Biennial Report on Workers’ Compensation to Texas Legislature
The Texas Department of Insurance, Division of Workers’ Compensation (DWC), recently released its Biennial Report to the Texas Legislature. The report highlights what DWC considers “significant improvments in the system.” These “improvements” include the following:
- Decrease in workers’ compensation insurance premiums of 40% since 2003;
- Increased number of employers who are workers’ compensation policyholders;
- Increased number of workers’ compensation health care networks; and
- Decrease in non-fatal workers’ compensation claims of 19% since 2005.
While these and many of the other statistics from DWC’s report may appear promising at first glance, the report merely presents statistics and does not analyze several areas of Texas workers’ compensation law where change is most urgently needed. The report is focused on selected statistics, and even those numbers do not tell the whole story.
The expansion of health care networks has removed some of the best-qualified doctors from injured employees’ access, and it has stripped injured employees of the ability to choose and retain a doctor of their own choice. They are left with a few doctors that have been hand-picked by their insurance companies to cut corners and prematurely cut off care to injured employees.
Injured employees in rural areas are especially hard hit, and they are frequently left without a nearby network doctor and cannot even get travel reimbursements from their insurer.
A mere decrease in claims fails to account for an increase in the number of claims that are not pursued due to insurer denials. And the report does not even present denial statistics, besides to note that they are being “tracked.” Moreover, this statistic is unreliable due to decreased economic activity overall.
And Texas still remains the only state in the nation that permits employers to opt out of workers’ compensation coverage, leaving 17% of Texas employees uncovered by workers’ compensation insurance if they are injured on the job.
DWC is focused on statistics, but
Doyle Raizner Files Workers’ Compensation Bad Faith Suit Against Liberty Mutual
On March 4, 2011, Doyle Raizner filed a workers compensation bad faith suit against Liberty Mutual insurer Wausau Business Insurance Corporation and its adjuster on behalf of an employee who was injured on the job in June 2009. Wausau initially approved only some of the medical care requested by the injured employee’s doctors, including denying medical attention for the injured employee’s spinal injuries. At the same time, after initially approving treatment for the employee’s other injuries, Wausau denied follow-up treatment for the employee’s pre-approved surgery, including complications that caused permanent and grave damage to the employee’s urinary and reproductive systems. Wausau even denied income benefits to the employee while he was recovering from this injury.
Doyle Raizner is proud to help this injured employee in his fight to recover from the damage caused by Wausau and its adjuster.
