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ACE American Insurance Company (“ACE American”), Sedgwick Claims Management Services (“Sedgwick”), Liable for Breaching the Duty of Good Faith for Denying Workers’ Compensation Benefits

On January 5, 2015 the United States District Court of Arizona ruled that ACE American Insurance Company (“ACE American”), acting through its adjusters at Sedgwick Claims Management Services (“Sedgwick”), is liable for breaching the duty of good faith and fair dealing for denying workers’ compensation benefits to our client.  The matter is now set for trial on the issues of compensatory and punitive damages.

Our client, a hard-working employee of Boeing Company, was injured on the job as the result of fall on a concrete floor. The fall resulted in damage to both the head and knee of our client. The injury Plaintiff sustained meant Plaintiff was unable to return to work for an extended period of time. During this period of labor inactivity, plaintiff sent a claim to ACE American and Sedgwick (Boeing’s contracted worker’s comp provider).

The straightforward worker’s compensation claim of Plaintiff incited a difficult and unnecessary battle against this insurance company for owed insurance benefits. Even though ACE American and Sedgwick admitted the obligation to pay benefits, the representative of ACE American and Sedgwick grossly miscalculated the monthly benefits owed to our client. Plaintiff recognized the significant error and took action to remedy the situation with the assistance of counsel.  Nonetheless, the Sedgwick’s adjuster refused to correct the miscalculation for months.  As a result, our client was forced to seek redress from the Industrial Commission of Arizona (“ICA”), where ACE American was ordered to pay a significant amount of past-owed benefits.

In spite of this ICA decision, ACE American and Sedgwick still delayed payment of the back benefits owed. Rightfully, the United States District of Arizona recognized that ACE American’s conduct was in breach of the duty of good faith and fair dealing as a matter of law.  As a result, a trial will be held to allow a jury to determine the extent of mental, physical, and financial damages caused by ACE American and Sedgwick’s wrongful denial of benefits.  The jury will also be asked to determine whether ACE American and Sedgwick should be punished through punitive damages.

Doyle LLP – Trial Lawyers is proud to represent this client in her fight against the wrongful denial of insurance benefits.  If you or someone you know has been injured on the job, and is struggling to receive promised support from the workers’ compensation insurer, please do not hesitate to contact us.