Doyle LLP Trial Lawyers has filed an insurance bad faith suit under Arizona law in Maricopa County Superior Court against Ace American Insurance Company, Gallagher Bassett Services, Inc., and their adjusters.
The suit arises from Ace American and Gallagher Bassett’s wrongful handling of the Plaintiff’s workers’ compensation claim. After a work injury at FedEx in May 2014, the Plaintiff was owed benefits due to serious shoulder and back injuries. The case alleges that the Defendants wrongfully closed the injured worker’s claim based upon the misuse of the Independent Medical Exam (IME) process. First, Defendants closed the claim based upon the report of Dr. Zoltan. However, Dr. Zoltan’s opinions had already been rejected by the Industrial Commission of Arizona (ICA) in an Award that was entered in June 2016. And then, recognizing this unreasonable and bad faith basis to close the claim, Defendants attempted to manufacture a new basis to deny the claim and sent the Plaintiff for an IME with Dr. Theiler. Arizona law holds that insurers and adjusters may not use the IME process in bad faith. The lawsuit alleges that the Defendants engaged in this conduct by using an already-rejected IME report and then using the IME process to generate another excuse to deny the insurance claim in bad faith.
It was only through proceedings before the Industrial Commission of Arizona and with the assistance of an attorney that Plaintiff was able to force Ace American and Gallagher Bassett to reverse their denial. On March 6, 2018, the Industrial Commission of Arizona entered an award finding that Defendants’ closure of Plaintiff’s claim was unfounded and that Ms. Mable was entitled to the benefits that had been unreasonably denied by Defendants, including income benefits and disability benefits. Nonetheless, Defendants’ bad faith conduct did not end there. Defendants repeatedly refused to follow the orders of the Industrial Commission of Arizona and ignored multiple written communications and telephone calls to Defendants and their attorney asking them to honor the award and pay the owed benefits. It was not until approximately 11 months later, on or about, February 5, 2019, that Defendants issued the payment. Not surprisingly, the Industrial Commission of Arizona found that the Defendants had acted in bad faith and ordered payment of $8,251.81 as a penalty. However, the suit further alleges that the Defendants have continued their bad faith conduct and refused to pay the bad faith penalty that was ordered by the Industrial Commission of Arizona.
Plaintiff’s suit alleges that this conduct amounts to a breach of the duty of good faith and fair dealing under Arizona law.
Doyle LLP Trial Lawyers is a firm that focuses its practice on holding insurance companies responsible for wrongfully withholding benefits and engaging in bad faith conduct. If you or a family member need advice on the wrongful handling of your insurance claim, Doyle LLP’s lawyers are available to discuss your claim at no cost to you.