Insurance Bad Faith Results in $145M+ Verdict
There are many safeguards in place across all industries to ensure that workers are kept safe. Occasionally, injuries still occur, and in those cases worker’s compensation plans usually come in to help. Unfortunately, they don’t always have the best interests of the employee in mind and try to minimize what they have to pay out. Sean Claggett of Claggett & Sykes took over a case where a painter from Colorado had fallen off a ladder while on the job in Utah and sustained a head injury. He was found to have severe intracranial injuries and was transferred from the initial hospital to the University of Utah Hospital. He was in a coma for a month post-injury, and when he awoke, progress was measured by him being able to breathe and eat on his own again, at which point his treating physician at the hospital recommended he be transferred to a long-term specialized rehab facility upon discharge. The insurer denied it based upon a fabricated misrepresentation that the employee was not employed by the employer, despite the employer admitting the employee was employed by the company. The employer even provided proof of employment and payroll records. This denial was made in bad faith and as a result he was denied transfer from University of Utah to Craig Hospital, and instead sent him home, still badly disabled, on a commercial flight to be cared for by family. The next 12-18 months were critical to prevent him from being permanently disabled, but the insurer refused to pay for such care.
The insurer claimed that they had met their obligations with what they had already paid out for his care, plus the amounts they would pay over time in wages and benefits. They insisted they had acted responsibly despite the dozens of denials they issued regarding critical care the worker needed. They made a pre-trial offer of $750K, which Claggett’s team rejected. A demand was made in the range of $15M to $56.6M. Claggett, co-author of JuryBall, has built a reputation of using big data in his cases to determine value, and this case was no different. The data from his extensive research was showing that the verdict would be in excess of $114M, so once trial commenced, he wouldn’t take less than $75M.
To help support them at trial, Claggett came to Focus Graphics for multiple exhibits, some to show the imaging and the extensive damage in his client’s brain and other injuries, and another to show the timeline and right way/wrong way that occurred throughout the treatment. The most difficult aspect of the case would be proving that the bad faith denial of the claim that prevented his client from being transferred to an inpatient program was ultimately what caused his permanent physical impairment. As expected from the Claggett & Sykes team’s research, the jury found in favor of the plaintiff with a $145+ million verdict, $60 million of which were in punitive damages.
“This trial essentially started out in a ‘zero-offer’ position due to the very low offers the defense was presenting. We were implementing cutting edge data analysis throughout the trial in real time, and this was a fascinating look at how real evidence impacts verdicts and decision-making. The simple truth is that injured workers and their employers are taken advantage of and candidly screwed over every day by greedy insurance companies, and this jury was very courageous to stand up to a massive insurance company with their decisive verdict.”
~Sean Claggett, Esq., Las Vegas, NV | Claggett & Sykes Law Firm
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