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In July 2020, Doyle Dennis Avery LLP filed suit against Praetorian Insurance Company and Sedgwick Claims Management Services Inc. on behalf of the wife of a deceased worker. She has been the victim of bad faith handling of her workers’ compensation claim with regard to her husband’s death.  The suit, which was filed in the United States District Court for the District of Arizona, Phoenix Division, states that Praetorian Insurance Company and Sedgwick Claims Management Services violated the duty of good faith and fair dealing, under Arizona law.

The duty of good faith and fair dealing requires insurance companies, including Arizona workers’ compensation carriers, to complete a reasonable investigation of a workers’ compensation, without delay.  This means that the insurance company and its adjusters must gather documents, interview witnesses, and review the file in an unbiased way.  After the reasonable investigation is complete, the duty of good faith and fair dealing holds that an insurance carrier may not deny a claim, unless it has a reasonable basis to do so.  Arizona courts have held that this means that an insurance company should not handpick information and must take an unbiased and impartial view of all of the facts of the claim.

In this suit, Doyle Dennis Avery LLP has alleged on behalf of its client, who was the wife of an employee of XP Services, that North Pointe Insurance Company and Sedgwick Claims Management Services denied her April 16, 2019 workers’ compensation claim in bad faith.  Doyle Dennis Avery LLP Client’s husband’s death occurred when he was fatally injured in a helicopter crash, while in the course and scope of his employment. As his common law wife, Doyle Dennis Avery LLP ’s client was entitled to spousal benefits under the works’ compensation policy cover her late husband’s work. Despite the evidence, North Pointe and Sedgwick ignored their obligation to timely and appropriately approve reasonable and necessary benefits. Indeed, on July 9, 2019, Defendants denied the claim.  This had the effect of denying income benefits, medical benefits and death benefits that were necessary to meet living expenses for the deceased’s family. Doyle Dennis Avery LLP ’s client also faced significant economic impact, economic, physical and mental distress from the wrongful and unjustified delay. Doyle Dennis Avery LLP ’s client also had to seek out an attorney to go through rigorous and costly legal proceedings to prove a claim that was easily apparent and known. The approval and background of the claim was also supported from the beginning with evidence from the Employer, XP Services, of the deceased.

It was only through proceedings with the assistance of an attorney in the Superior Court of the State of Arizona and for the County of Yavapai the that North Pointe and Sedgwick took action to investigate the claim further.  However, by that point, as the suit alleges, the damage had been done.  The delay in providing benefits resulted in mental, physical, and financial consequences from which Doyle Dennis Avery LLP ’s client is still attempting to recover.

If you are an injured worker who has suffered from the delay in payment of workers’ compensation benefits, life insurance benefits, death benefits, property damage benefits, or other insurance payments, you may have a claim for insurance bad faith.  Doyle Dennis Avery LLP Trial Lawyers would like to offer you a free initial evaluation of your claim helping you understand your rights and potential case.