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Arizona Workers’ Comp Bad Faith Lawsuit Filed Against Ace American and Gallagher Bassett

Doyle LLP has filed a workers’ compensation bad faith lawsuit in Maricopa County, Arizona, on behalf of a privately employed firefighter. The firefighter injured his leg in the scope of his employment.

The plaintiff was a fire captain and union representative for Rural Metro, a private sector company providing ambulatory and fire services for underserved areas.   After an injury in the line of duty, the plaintiff submitted a workers compensation claim for medical benefits and was assigned an adjuster by Gallagher Bassett, a third-party administrator. The adjuster then denied that the injury occurred at work.  Gallagher Bassett then forced the injured worker to attend an independent medical examination (IME).  The IME doctor issued a report that the injury was work related.  The plaintiff also submitted affidavits of co-workers attesting that the injury was work-related.  The day before the hearing before the Industrial Commission of Arizona, Gallagher Bassett accepted coverage but did not authorize surgery and instead offered rehab for the plaintiff.

The plaintiff accepted rehab because he had received no medical treatment for six months.  After a few months of rehab, it became apparent he still needed surgery.  He requested the surgery and was denied.  In late July, the IME doctor supplemented a report that stated the surgery was needed, so Gallagher Bassett finally accepted the claim for surgery.

In essence, Gallagher Bassett forced the plaintiff through needless and improper delays at every stage in an effort to approach the claim as “outcome driven.”  The company would not rely on the medical opinion of the plaintiff’s treating physician but instead only relied on the doctor they paid.  Gallagher Bassett also doubted the plaintiff’s credibility even though every witness and medical professional confirmed his work-related injury.

Doyle is committed to assisting this first responder in his fight against an insurance company and third-party administrator who placed profits over individuals and their medical needs. If you or someone you love has experienced bad faith tactics in their Arizona workers’ compensation claim, please contact an attorney at Doyle LLP.