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Drone Gone Wild

VN:R_U [1.9.1_1087]
+9 (9 votes)

Claimant was sitting at her desk at her office when an out of control drone smashed the window and hit her in the face, causing injury. Work comp paid, but it was surely the craziest claim the company ever had. Previously, the desk job hazards were sitting too long at computers and picking up heavy stacks of files.

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Stalker

VN:R_U [1.9.1_1087]
+7 (9 votes)

One of our Claimants was stalking the claims adjuster who denied no fault benefits. He’d wait for her by her car and stop by the office and sit in the lobby until he was told to leave. Eventually, there was a hearing on the matter and Claimant won. Claimant didn’t stop his stalking behavior and so the adjuster filed for a TRO. At the TRO hearing, the Claimant said he was hoping to ask the adjuster out on a date. The Judge told him this attention wasn’t appropriate. He didn’t grant the TRO, but instead told the Claimant to put his efforts into treating his car accident injuries. After the hearing, the stalking ceased.

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Youtube Stunt Gone Wrong

VN:R_U [1.9.1_1087]
+8 (8 votes)

It seemed like a simple claim—a slip and fall on a wet office lobby floor where a warning cone had been placed. However, the injuries were severe. Claimant had become a paraplegic, because of a fractured spine and severed spinal cord. The surveillance camera wasn’t operating and so that didn’t help. Several weeks into the investigations, one of our younger adjusters found a video posted on Youtube, showing claimant doing a back flip in the lobby and falling. It turned out, Claimant had been filming a stunt for his Youtube channel when it went horribly wrong. We were able to deny the claim, but it was a sad case as the young man had made a horrible error in judgment.

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Widow Files Claim For Emotional Distress After Finding Dead Husband At Work

VN:R_U [1.9.1_1087]
+6 (8 votes)

From the headlines…

Background: On July 16, 2011, Austin Irwin was repairing a large all-terrain vehicle while working for All Habitat Services, a mosquito control company in Branford that uses the ATVs to spray pesticides in remote wooded areas.

While he was lying on the ground working on the ATV, the vehicle slipped off of the jacks and crushed the 77-year-old Irwin to death. Shortly afterward, his wife, Jenny Velecela, arrived to bring her husband lunch and she discovered his body underneath the ATV. According to her lawyer, Kevin Dehgahni, of Dehgahni & Associates in New Haven, what Velecela witnessed caused her severe emotional distress.

Velecela alleged that her husband’s death was caused by the employer’s negligence and claimed damages for bystander emotional distress in Superior Court. She had already received $300,000 in workers’ compensation survivor’s benefits.

All Habitat asserted by way of a special defense that the bystander emotional distress claim was barred by the exclusivity provision of the state’s Workers’ Compensation Act. The act provides that once an employer compensates an employee or his dependents for personal injury or death, the employer shall not be liable for any further damages arising from the injury or death.

But Dehgahni argued that the workers’ compensation statute did not bar her bystander emotional distress claim because the workers’ comp benefits she received were to compensate her for her husband’s death and not her own emotional injuries. She also argued that her emotional distress claim was independent and not derivative of the workers’ compensation claim.

Superior Court Judge Matthew Frechette granted summary judgment to All Habitat. While there is no Connecticut appellate court authority addressing whether the workers’ comp statute bars bystander emotional distress claims, Frechette wrote that court rulings in other states supports the conclusion that it does.

“To hold that the plaintiff may now bring a claim for her emotional injuries—after participating in the compensation claim process [and] signing the stipulation, and accepting benefits—would do violence to both the purpose of the act, and the reasonable expectations of the defendant,” the judge wrote. Further, Frechette opined that allowing such lawsuits would “obstruct the orderly settlement of claims.”

“Allowing legal actions for emotional injuries could slow countless workers’ compensation claims while employers would be forced to identify and obtain releases from persons related to the injured employee,” concluded Frechette.

Velecela appealed the ruling, claiming Frechette wrongly interpreted the exclusivity provision of the workers’ compensation statute. The state Supreme Court agreed to take up the case.
In his court briefs, Dehgahni argued that the lower court ruling essentially shuts the door on bystander emotional distress claims related to workplace injuries or death. Interpreting the Workers’ Compensation Act as Frechette did will “leave a whole class of injuries uncompensated in Connecticut because claimants, such as [Velecela], will be left in a Catch-22 situation where they cannot make a direct claim for emotional distress injuries under the Workers’ Compensation Act, when at the same time they will be barred from asserting those claims in court because the employer will claim—as it has done here—that they are barred from doing so under the exclusivity provision of the Workers’ Compensation Act,” wrote Dehgahni.

All Habitat is represented on the appeal by Michael Deakin, of Deakin, Edwards & Clark in Woodbridge. He echoed the trial court ruling, arguing that workers’ compensation would bog down if court claims are permitted after workers’ comp benefits are paid out.

“The trade-off for limiting remedies to the benefits of workers’ compensation is that the injured party or their representatives and/or dependents need not prove liability and are compensated in a swifter and less costly manner than if they needed to look to the judicial system for damages,” wrote Deakin.

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Honest Claimant

VN:R_U [1.9.1_1087]
+6 (8 votes)

Claimant suffered a back injury. However, the adjuster felt the details of causation were sketchy and so she asked counsel to take an examination under oath. The Claimant was honest and admitted that the back injury was not from the auto accident, but rather from slipping on water on his kitchen floor a few hours after the accident. He wasn’t making a claim under his no fault insurance.

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Fast Food Bag Snatcher

VN:R_U [1.9.1_1087]
+10 (10 votes)

Plaintiff filed a lawsuit against the driver of the car that hit him while he was a pedestrian. At first, the adjuster handling the claim set the reserves high, because of the claimed injuries. However, with discovery, questions of liability arose. Defendant was pulling up to the drive thru window at a busy fast food restaurant when Plaintiff darted in front of his car. Defendant, who was traveling less than 5mph, couldn’t stop in time and hit him. It turned out that Plaintiff was homeless and would grab fast food bags out of employee’s hands and run. The case was settled for a nominal amount.

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It Was No One’s Fault

VN:R_U [1.9.1_1087]
+6 (8 votes)

Plaintiff was injured in a boat accident, when another boat collided with his. He was interviewed on T.V. shortly after the accident on five different occasions. In each interview, Plaintiff said he didn’t blame the other boat operator and called the accident “no one’s fault”. A year later, Plaintiff filed a lawsuit against the other boat operator (our insured), claiming he was negligent. We intend to use Plaintiff’s statements as part of the defense.

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Fire Claim Sends a Man To Jail

VN:R_U [1.9.1_1087]
+9 (9 votes)

A lawyer purchased a box of very expensive cigars and turned around and insured them against fire among other things. Two months later after having smoked each of the, the lawyer filed a claim against his policy.
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The lawyer indicated on the claim form that the cigars were lost “in a series of small fires.” The claim was denied due to what obviously was the fact that the man had consumed the cigars. He filed a lawsuit and ultimately won. The judge found that the claim was frivolous but stated that the lawyer held a policy from the company in which it had warranted that the cigars were insurable and also guaranteed that it would insure them against fire, without defining what is considered to be “unacceptable fire.” The carrier was obligated to pay the claim.
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The insurance company paid $15,000.00 to the lawyer for his loss of the cigars lost in the “fires.” But… After the lawyer cashed the check, the insurance company had him arrested on 24 counts of ARSON! With his own insurance claim and testimony from the previous case used against him, the lawyer was convicted of intentionally burning his insured property and was sentenced to 24 months in jail and a $24,000.00 fine.

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