Doyle LLP has filed a workers comp bad faith lawsuit against Zurich American Insurance Company and Sedgwick CMS. The plaintiff was an employee of Starwood Hotels & Resorts at the time of his injury.
The plaintiff was a cook for Starwood and was injured while in the kitchen. He suffered a fall against a freezer and injured his shoulder. Upon examination by an orthopedic surgeon, it was found the plaintiff had suffered a torn rotator cuff. The surgeon recommended surgery to repair the tear and ensure long-term recovery.
There was conflicting information on how the plaintiff fell, however, the Industrial Commission of Arizona during proceedings cited Arizona law confirming that the mechanism of injury is irrelevant; and that there was no legitimate dispute that the plaintiff did in fact get injured while in the scope and course of his employment.
Upon submitting a claim to Zurich American Insurance Company, the claim was handed to Sedgwick CMS, a third party claims administrator. Sedgwick assigned an adjuster who denied the claim. The adjuster did not properly investigate the claim and improperly denied the claim despite the fact the plaintiff was promised workers compensation as an employee of Starwood Hotels & Resorts. The plaintiff initiated proceedings with the Industrial Commission of Arizona who ordered the benefits paid.
These benefits do not fully compensate for the failure of Zurich and Sedgwick to timely recognize and acknowledge the nature and extent of the plaintiff’s injury, and to follow the law. The two companies also failed to accept the undisputed evidence regarding the claim. The companies’ representatives worked in an “outcome-driven” approach claim and created reasons to deny and delay his claim.
Doyle supports this plaintiff in his pursuit of justice against an insurance company and third party administrator who chose to breach their duty of good faith and fair dealing to an injured worker in need of compensation for an injury sustained while in the scope of his employment. If you or someone you know has sustained an injury at work and have been denied benefits, please contact the lawyers at Doyle.