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Judge rules against insurer that fired adjuster after comp claim

Posted On: Feb. 14, 2018 1:41 PM CST

A federal judge in Chicago on Tuesday ruled against an insurance company’s summary judgment in a suit filed by a former employee fired after an 11-month, unresolved workers comp claim.

Timothy Buhe worked as a claims adjuster for Lincoln, Rhode Island-based Amica Mutual Insurance Co. when in early 2013 he fell off a roof while investigating a homeowner’s claim, according to court documents in Timothy Buhe v. Amica Mutual Insurance Co., filed in U.S. District Court in Illinois’s Eastern Division.

Mr. Buhe suffered injuries to his lower limbs and shoulder, requiring several surgeries and rehabilitation. His employer began contacting him in October of that same year, asking when he planned to return to work. In discussions with two Amica representatives, Mr. Buhe indicated he needed at least two surgeries and was “confused” by the company policy on disability leave, according to court documents.

Complicating matters, Mr. Buhe ran a mortgage business on the side, one which his employer had known about. In November, an adjuster with Amica’s workers comp insurer Chubb Ltd. contacted the company to inform them that Mr. Buhe had been surveilled and was working for his own company while collecting workers compensation.

Mr. Buhe told Amica human resources that “someone else” oversaw the office activities of his mortgage firm and that he was “leery” of discussing the matter without an attorney.

In 2016, Mr. Buhe filed for bankruptcy, failing to disclose his workers compensation claim and subsequently claimed he did not know he was supposed to, according to court documents.

He then filed the suit against Amica, asserting claims of discrimination under the Americans with Disabilities Act when the company alleged failed to accommodate him, and retaliatory discharge and promissory estoppel, related to his bankruptcy filing.

Amica followed with a summary judgment against his claims.

Judge Jorge Alonso ruled in part against the summary judgment, finding merit in both claims related to the ADA and retaliatory termination: “…A disability leave of absence that an employee seeks as a reasonable accommodation ‘is a factual issue well suited to a jury determination,’ ” his ruling stated.

He also found that “a reasonable jury could conclude that the real reason for plaintiff's termination was not the violation of company policy but the fact that plaintiff had filed a workers compensation claim against defendant. Buhe had initiated litigation in connection with his workers' compensation claim before the Illinois Workers Compensation Commission, boosting the potential for retaliatory animus.

“A jury could interpret (an evidentiary company) email to show that Amica viewed an extended workers compensation claim as a problem, and, around the time of plaintiff's termination, Amica had recently received information indicating how long and drawn out the treatment for plaintiff's injuries was likely to be. A jury could reasonably conclude that Amica seized on the pretext of a violation of company policy as soon as it presented itself in order to terminate plaintiff, but that the real reason for the termination was retaliatory animus against plaintiff for pursuing a workers compensation claim. There is a genuine issue of material fact as to plaintiff's claim of retaliatory discharge, and defendant's motion for summary judgment on this claim is denied.”

Judge Alonso granted the summary judgment related to the estoppel claim, as Mr. Buhe voluntarily requested to dismiss this part of his suit, according to court records.