Alleged Independent Injuries May Now be Exclusively Under the Texas Workers’ Compensation Claim Remedy Process
Austin, TX (Law Firm Newswire) May 21, 2015 – In re Crawford & Company is a stunning decision by the Texas Supreme Court that could have serious ramifications for injured workers in the future.
“This particular case may cause some serious ripples with regard to the Texas Workers’ Compensation claim remedy process,” points out Perlmutter & Schuelke partner and Workers’ Compensation attorney, Brooks Schuelke. The court stood firmly behind the concept of exclusive jurisdiction for the Texas Division of Workers’ Compensation Act to respond to and deal with all processes in any investigation, even outside the claims system, settling or handling of a claim. This also includes any events that allegedly exist outside of the claims system.
The statement of claim read like a laundry list and included failure to provide notices relating to coverage, denial of benefits, delay of benefits, misrepresentation of coverage, insurance fraud accusations, negligence, intentional fraud and misrepresentation, emotional distress, malicious prosecution, deceptive trade practices, breach of contract and violations of the Texas Insurance Code.
The case began when Glenn Johnson sustained critically serious injuries on-the-job in 1998. Plaintiff Johnson and his third-party administrator (Crawford & Company) had many disagreements over the years regarding their handling of his claims, the scope and the rights to certain benefits. Johnson also sued Crawford & Company, et al., alleging that for a period of ten years, they “engaged in a battle plan to delay, discourage and deny benefits.”
In this case, the Johnsons were not seeking recovery for injuries sustained in the accident. Instead, the Johnsons were arguing that Crawford & Company’s conduct in handling the claim and failing to settle the claim in a reasonable manner caused the Johnson family to incur additional losses and injuries.
The interesting thing about this particular case is that the Supreme Court expanded the intent of the existing legislation, rather than limiting it per a prior decision in Texas Mutual Insurance Co. v. Ruttiger, 381 S.W.3d 430 (Tex. 2012). “The Court stated whether or not the Act applies ‘does not depend on the label of the cause of action asserted,’ but rather damages not related to benefits under the Act are to receive the same rigorous analysis as if the unrelated claim were a part of the claims-settlement process,” Schuelke explains.
The decision appears to give workers’ compensation insurance carriers a free pass in how they handle claims. No matter how poorly they treat claimants, engaging in conduct which most assumed was prohibited by existing law, the decision seems to give carriers protection.
“If this decision survives, there is a chance it may end up being used in other jurisdictions; a move that may change the face of workers’ compensation law across the U.S. If you are struggling with a workplace injury claim, make sure to connect with a knowledgeable personal injury attorney with experience in this area to determine your legal rights,” adds Schuelke.Learn more at http://www.civtrial.com