Engaged by defense counsel to assess plaintiff’s valuation of Workers Compensation subrogation claims against Commercial Auto and Umbrella policies resulting from a fatality trucking accident. The valuation process was complicated by plaintiff’s Workers Compensation being structured as a large deductible retroactively rated program requiring extensive reserves and data analysis. Attorney Gene Ward, Cotten Schmidt, L.L.P. (361) 336-2321. Valley Transit v. Kommited Transportation, Civil Action No. 2:23-CV-00080 in United States District Court Southern District of Texas Corpus Christi Division.
Category: Workers Compensation
01
Apr2024
Engaged by plaintiff’s counsel to analyze allegations of Commercial Auto Insurance Bad Faith claims regarding a multiple fatality motor vehicle accident, including interaction with Hired/Nonowned autos coverage and Workers Compensation. Plaintiffs were the survivors of one of the deceased. Attorney Jeff Richter, Cesar Ornelas Law, PLLC (210) 957-2103. Villareal v. Independence TX LLC, Cause No. 23-03-1083 IN THE 143rd Judicial District Loving County, Texas.
April 1, 2024burld
30
Sep2023
Engaged by carrier’s defense counsel to analyze allegations of Insurance Bad Faith for carrier actions in revising Workers Compensation class codes to accurately assign payroll to NCCI class codes. Case required analysis of years of policyholder failing to apply payrolls accurately to NCCI class codes for audits and renewal policies. Attorney Frank Fox (602) 908-1707. Arizona Labor Force v. WCF National Insurance Company, Case No. CV2022-009615 In the Superior Court of the State of Arizona, County of Maricopa.
September 30, 2023burld
30
Aug2023
Engaged by carrier’s defense counsel to analyze claims handling of an Underinsured Motorist claim resulting from a low-speed accident. The claim was complicated by the policyholder’s son having his own Personal Auto Policy, reporting the injury 5 months after the accident, whether he was a household resident, and the possibility the injury was work related. Attorneys Philip Overcash and Tyler Milliron, Kutak Rock LLP (480) 429-5000. Wintrow v. USAA, Case No. CV2022-050974 In the Superior Court of the State of Arizona, County of Maricopa.
August 30, 2023burld
28
Feb2023
Engaged by counsel for receiver/policyholder to evaluate Commercial General Liability and Pollution Liability relative to Insurance Bad Faith claims handling under 1980s policies with no pollution exclusions. The case was complicated by overlay of workers compensation coverage, contractual liability, and Reservations of Rights issues. Attorneys Brad Nes and Cullen Pick, Morgan, Lewis & Bockius, LLP (214) 466-4116. Standard Insulation v. Liberty Mutual Insurance Company, Civil Action No. 2022-CP-40-01241 In the Court of Common Pleas Fifth Judicial Circuit State of South Carolina, County of Richland.
February 28, 2023burld
30
Nov2022
Engaged by defense counsel as an insurance expert witness to evaluate whether a ship repairer had complied with vendor contract insurance requirements for Commercial General Liability. Dispute arose when a harbor patrol officer capsized an upgraded boat during sea trials, injuring several of the ship repairer’s employees, who eventually sued the City of Norfolk. Attorneys John Buford and Sara Bugbee, Hancock, Daniel & Johnson, P.C. City of Norfolk Virginia v. Willard Marine, Case Nos. 2:17-cv-00109 and 2:17-cv-00110 In United States District Court For The Eastern District of Virginia.
November 30, 2022burld
28
Aug2022
Engaged by plaintiff’s counsel to analyze Insurance Bad Faith claims handling relative to a drilling company after its transition to self-insured and Workers Compensation coverage (previously provided by its PEO) and Commercial General Liability. Carrier provided the initial Excess Workers Compensation policy to cover catastrophic claims above plaintiff’s large deductible. After a rig fire resulted in multiple fatality claims, carrier delayed and then denied coverage. Attorneys Lisa Molsbee and Clay Christensen, Christensen Law Group, P.L.L.C. (405) 232-2020. Dan D v. New York Marine, Case No. CJ-2015-33 In The District Court of Grant County State of Oklahoma.
August 28, 2022burld
08
Jan2022
Engaged by carrier counsel pursuing an Insurance Agent Errors & Omissions action for Bad Faith to recover claim payments made under a Workers Compensation policy underwritten based on agent’s material misrepresentations on the application. After a tree trimming worker was seriously injured it was discovered the agent had withheld critical underwriting information relative to eligible NCCI classifications and guidelines for the Workers Compensation program. Case required analysis of NCCI class codes and disparate answers provided on multiple Workers Compensation applications. Attorneys Brad Burns and Amanda Newman, Dickinson Wright, PLLC (602) 285-5000. FirstComp v. Ensign, Case No. CV2020-007001 In the Superior Court Of The State of Arizona In And For The County Of Maricopa.
January 8, 2022burld
30
Nov2021
Engaged by policyholder’s defense counsel to analyze whether carrier actions constituted Insurance Bad Faith relative to assigning improper Workers Compensation and Commercial General Liability class codes and processing inaccurate premium audits. Case required analysis of carrier’s failure to determine and apply correct NCCI class codes for 4 years of audits and renewals. These deficiencies resulted in significant lost business opportunities due to wildly inaccurate NCCI Experience Modifiers 50-220% higher than actual, erratic premiums accounting, and disputes over revised audits premiums. Attorneys Lindsay Wright Brett, Brendan Cook and Lola Ojeniyi, Baker & McKenzie (713) 427-5000. Zurich v. TxEx Energy, Case No. 4:20-cv-3622 In United States District Court for the Southern District of Texas Houston Division.
November 30, 2021burld
01
Mar2019
Retained by carrier’s defense counsel to review allegations of Insurance Bad Faith Claims Handling for a Workers Compensation claim denial. Case required opinions regarding whether claim denial was reasonable, based on inconsistencies in employee’s version of how and where the injury occurred, and ceasing communications shortly after the alleged injury. Attorneys Paul Gerding and Andrew McNichol, Kutak Rock LLP (480) 429-5000; Ndwiga v. Plaza Insurance Company, Case No. 2:18-cv- 02324-SPL In United States District Court For The District of Arizona.
March 1, 2019burld