The Texas Department of Insurance on June 13, 2011, released final disciplinary decisions for violations of Division of Workers’ Compensation rules. Among these fines were the following insurer violations:
On June 16, 2011, Doyle filed a workers’ compensation bad faith lawsuit against Fidelity & Guaranty Insurance Company, third-party adjuster Gallagher Bassett Services, and their adjuster, on behalf of an employee injured on-the-job in March 2010. Fidelity and Gallagher Bassett denied the claim, even though the employee’s accident was witnessed by several co-workers, including the employee’s supervisor, who took the employee to the hospital after his accident.
On August 3, 2011, the Texas Court of Appeals, Third District at Austin, ruled against Texas Mutual Insurance Company and found that an injured employee was entitled to his pursue a claim for bad faith arising out of Texas Mutual’s delays in providing surgery for his on-the-job injury.
The ABA Journal has released an article detailing the poor elements of the Texas workers’ compensation system–and its incentives for insurers to engage in bad faith behavior–denying and delaying the benefits owed to injured employees as often as possible. As detailed in the article, insurers take advantage of the workers’ compensation system to craft denials of financial and medical benefits to injured employees in manners that the system never could have anticipated. A symptom of this is the small number of workers’ compensation attorneys who continue to be able to afford fighting on behalf of injured employees.
Westlaw Journal has published an article on Texas Mutual Insurance Company v. Ruttiger appearing in its September 16, 2011. The article appears on the front section of the Westlaw Journal dedicated to Insurance Coverage.