Doyle has filed a workers’ comp bad faith case against Gallagher Bassett and Ace American Insurance on behalf of an injured worker whose claim for benefits was wrongfully denied and unreasonably delayed. Ace American Insurance issued the workers’ comp insurance coverage under the Arizona Workers’ Compensation Act. Gallagher Bassett adjusts insurance claims on behalf of Ace American under the same act.
The plaintiff was injured in the scope and course of his employment in 2011, when another vehicle hit at a high rate of speed the truck he was driving. The collision resulted in traumatic brain injury, post-traumatic headaches, post-concussion syndrome, chest injuries, cervical spine injuries, among other injuries.
The plaintiff’s claim for benefits was initially accepted by Ace American and Gallagher Bassett. However, Ace American and Gallagher Bassett began to ignore their obligation to timely and appropriately approve reasonable and necessary medical treatment recommended by the plaintiff’s treating physician. Due to the denial of timely benefit payments to which the plaintiff was entitled, an attorney was hired to help secure the workers’ compensation benefits. A final and binding order was issued by the Industrial Commission of Arizona and required Ace American and Gallagher Bassett to provide the treatments. The commission noted the carrier had no evidence to controvert the plaintiff’s right to treatment and had not even bothered to appear to attempt to justify its wrongful conduct.
Ace American, as the plaintiff’s workers’ compensation insurer, breached their duty of good faith and fair dealing by refusing to properly investigate and effectively denying necessary medical care and other benefits, without any reasonable basis to do so. Gallagher Bassett acts and omissions were performed by it in its individual capacity and as an agent for Ace American. Gallagher Bassett knew the claim was not fairly debatable and substantially assisted or encouraged Ace American in delaying or denying the claim without a reasonable basis.
Ace American and Gallagher Bassett placed unnecessary financial strain and burden on an injured worker while abusing the litigation process and procedures of the Industrial Commission of Arizona. Doyle stands behind our client in their fight against a company more interested in profits than honoring their obligation.