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Case against insurer over alleged uncooperative injured worker tossed

Posted On: Mar. 28, 2019 1:27 PM CST

injured worker

A federal appeals court on Wednesday affirmed a summary judgment in favor of a workers compensation insurer who claimed an injured truck driver did not provide evidence of his injury and was alleged to be “not forthcoming” with information.

Manuel Roman fell from a Shipper’s West Truckline Inc. truck in 2013 and later claimed to have suffered a head injury. He went to the emergency room four days later and was ultimately diagnosed with hypertension and a concussion. Two months later, he filed a claim with the Industrial Commission of Arizona, claiming a “brain injury” and “blood clot in the brain,” according to documents in Manual Roman v. Berkshire Hathaway Homestate Insurance Co., filed in the 9th U.S. Circuit Court of Appeals in Phoenix. 

The company’s comp insurer, Berkshire Hathaway Homestate Insurance Co., was not notified of the claim following the injury — it first received notice from the state commission two months after the accident, according to documents.

A ruling by the U.S. District Court in Phoenix, which granted summary judgment in favor of the insurer, details more than a year during which a claims adjuster sought documents of the injury from medical providers. Mr. Roman’s original 2015 bad-faith complaint against Berkshire blamed the insurer for delays and argued that the insurer instructed its adjusters to “target and deny claims” — claims the earlier court deemed to not have merit, according to records.

The appeals court ruled similarly, writing “we agree with the district court that Roman failed to offer sufficient evidence that Berkshire Hathaway handled his claim in bad faith.”

Attorneys involved and the insurer could not immediately be reached for comment.