Centeno v. American Liberty Insurance Company

CourtDistrict Court, D. Arizona
DecidedOctober 1, 2019
Docket2:18-cv-01059
StatusUnknown

This text of Centeno v. American Liberty Insurance Company (Centeno v. American Liberty Insurance Company) is published on Counsel Stack Legal Research, covering District Court, D. Arizona primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Centeno v. American Liberty Insurance Company, (D. Ariz. 2019).

Opinion

1 WO 2 3 4 5 6 IN THE UNITED STATES DISTRICT COURT 7 FOR THE DISTRICT OF ARIZONA

9 Jeanette Centeno, No. CV-18-01059-PHX-SMB

10 Plaintiff, ORDER

11 v.

12 American Liberty Insurance Company,

13 Defendant. 14 15 Pending before the Court is Defendant American Liberty Insurance Company’s 16 (hereinafter “American Liberty”) Motion for Summary Judgement. (Doc. 95, “Mot.”). 17 Plaintiff Jeanette Centeno (“Centeno”) filed a Response. (Doc. 104, “Resp.”). American 18 Liberty filed a Reply. (Doc. 108, “Reply”). American Liberty filed a Separate Statement 19 of Facts in Support of his Motion. (Doc. 96, “DSOF”). Centeno also filed an Additional 20 Statement of Facts in Support of her Response, (Doc. 105, “PSOF”), and included a 21 controverting statement of facts as required by LRCIV 56.1(b). Oral argument was held 22 on September 13, 2019. The Court has read and considered the Motion, Response, and 23 Reply and enters the following Order. 24 I. BACKGROUND 25 Centeno worked as a traveling nurse for Beech Home Care (“Beech”), providing 26 medical care and treatment to patients in their homes. (PSOF at 2). On Friday, August 5, 27 2016, while retrieving medical supplies from her vehicle to continue treatment of a patient, 28 Centeno allegedly fell and injured her back. (Id.). The injury was not witnessed. 1 Immediately following her accident, Centeno returned to the patient’s home and continued 2 treatment with fellow nurse, Roxanne Jeuckstock. (PSOF at 2). The two nurses left 3 separately but reconvened shortly thereafter to treat the last patient of the day. (Id.). 4 Centeno first reported her alleged injury to Beech the following Monday, August 8, 2016 5 and first sought medical care later that day at Chandler Regional Medical Center. (DSOF 6 ⁋ 6). The reports of Centeno’s attending physician and radiologist who both administered 7 treatment that day differ as to whether the injury occurred during or after work. (DSOF 8 Exh. 10 at 1 (Physician’s Report); DSOF Exh. 10 at 110-111 (Radiologist’s Report)). 9 Three weeks passed before Centeno next sought medical treatment by visiting her personal 10 physician on August 25, 2016. (DSOF ⁋ 9). After complaining of continued back and 11 neck pain to supervisors, Centeno visited a Workers Compensation clinic with Beech’s 12 leave on August 29, 2016, after which she was recommended for light duty. (DSOF ⁋ 10). 13 On September 1, 2016, nearly a month after her accident, Centeno’s injury was reported to 14 Defendant, American Liberty Insurance Company (“American Liberty”) for the first time. 15 (Id.). 16 American Liberty immediately assigned the claim to adjuster Randi Kerner 17 (“Kerner”) of S&C Claim Services (“S&C”). (DSOF ⁋ 11). Kerner initiated an 18 investigation, contacted Centeno, Beech, and Centeno’s medical providers, and determined 19 the claim was initially compensable on September 13, 2019. (Id.). Centeno was then 20 assigned a nurse case manager to coordinate further medical evaluation with a supervising 21 physician. (DSOF ⁋ 17). Shortly thereafter, the initial approval of Centeno’s claim was 22 thrown into doubt by two co-workers’ independent reports indicating that Centeno’s injury 23 was not job-related.1 (DSOF ⁋⁋ 18-22). On September 19, 2016, Beech disclosed to 24 Kerner that Centeno had told a fellow employee, Karen Katsaros, that the injury was caused 25 by a fall in Centeno’s home on Sunday, August 7, 2019. (DSOF ⁋ 18). Consistent with 26 this report, on September 30, 2016, Beech provided Kerner with the written statement of 27 1 Centeno did not depose either Katsaros or Jeuckstock. In their interviews with DBA, 28 both nurses indicate that their statements to Beech were voluntary and unprompted. See (Doc. 96, Exh. 2 at 64 (Katsaros), 76 (Jueckstock)). 1 Roxanne Jueckstock, the nurse being trained by Centeno on the day of the alleged accident. 2 (DSOF ⁋⁋ 20, 22). Among other things, Jueckstock insisted that Centeno did not exhibit 3 any signs or symptoms or injury, nor complain of an injury either before or after the time 4 of alleged accident. (DSOF ⁋ 21). Of note to Kerner, the two nurses had treated every 5 patient together that day, including one patient immediately after Centeno’s accident. 6 (PSOF at 2). Also on September 30, 2016, S&C asked a third-party adjuster, Dan Boozer 7 Adjustment (“DBA”), to investigate these adverse reports while continuing to approve 8 Centeno’s medical treatment for what was diagnosed as pre-existing spinal stenosis 9 aggravated by the accident. (DSOF ⁋ 23). S&C continued to authorize Centeno’s medical 10 treatment to include the scheduling of physical therapy sessions, pre-operative surgical 11 appointments, and the setting of a tentative surgery date of October 20, 2016. (DSOF ⁋ 12 24). 13 On October 13, 2016, noting the upcoming Industrial Commission of Arizona 14 (“ICA”) final claim determination deadline of October 18, 2016, S&C denied Centeno’s 15 claim, in part due to the conflicting accounts of co-workers indicating the injury occurred 16 outside of work and therefore was non-compensable. (DSOF ⁋ 44). S&C also cited the 17 minimal medical treatment sought in the three-week period immediately following the 18 accident and Centeno’s delay in reporting the claim to American Liberty as additional 19 support for claim denial. (DSOF ⁋ 36). Despite denying Centeno’s claim, S&C continued 20 to investigate the conflicting co-workers reports.2 DBA interviewed Katsaros on October 21 13, and Jueckstock on October 20, considering both their accounts credible.3 S&C 22 maintains that the timing of the denial—five days before the ICA claim deadline—was 23 motivated by a desire to meet the ICA deadline and allow Centeno to pursue other surgery 24 options given her approaching surgery date. (DSOF ⁋ 46). Following denial of her claim, 25 Centeno postponed surgery. She contested her claim denial on October 31, 2016. (DSOF 26 2 The parties disagree as to whether S&C was prepared to reverse its declination if the 27 interviews of Jueckstock and Katsaros “uncovered any additional information supporting compensability.” (DSOF ⁋ 48; PSOF at 7). 28 3 DBA also conducted an interview with Centeno on October 11, 2016. S&C considered this interview in claim denial. (DSOF ⁋⁋ 38-40). 1 ⁋ 43). 2 On June 7, 2017, the ICA reversed and determined that Centeno’s claim was 3 compensable. (DSOF ⁋ 45).4 4 II. LEGAL STANDARD 5 Summary judgment on a claim or defense is appropriate “if the movant shows that 6 there is no genuine dispute as to any material fact and the movant is entitled to judgment 7 as a matter of law.” Fed. R. Civ. P. 56(a). In order to prevail, a party moving for summary 8 judgment must show the absence of a genuine issue of material fact with respect to an 9 essential element of the non-moving party’s claim, or to a defense on which the non- 10 moving party will bear the burden of persuasion at trial. See Celotex Corp. v. Catrett, 477 11 U.S. 242, 257 (1986). If the movant fails to carry its initial burden, the nonmovant need 12 not produce anything. Nissan Fire & Marine Ins. Co. v. Fritz Cos., 210 F.3d 1099, 1102– 13 03 (9th Cir. 2000). 14 However, if the movant meets its initial responsibility, the burden shifts to the 15 nonmovant to establish the existence of a genuine issue of material fact. Id. at 1103. The 16 nonmovant need not establish a genuine issue of fact conclusively in its favor, but it “must 17 do more than simply show that there is some metaphysical doubt as to the material facts.” 18 Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 586 (1986). Bare 19 assertions, standing alone, are insufficient to create a genuine issue of material fact and 20 defeat a motion for summary judgment.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Deese v. State Farm Mutual Automobile Insurance
838 P.2d 1265 (Arizona Supreme Court, 1992)
Noble v. National American Life Insurance
624 P.2d 866 (Arizona Supreme Court, 1981)
Thompson v. Better-Bilt Aluminum Products Co.
832 P.2d 203 (Arizona Supreme Court, 1992)
Trus Joist Corp. v. Safeco Insurance Co. of America
735 P.2d 125 (Court of Appeals of Arizona, 1986)
Zilisch v. State Farm Mutual Automobile Insurance
995 P.2d 276 (Arizona Supreme Court, 2000)
Aetna Casualty & Surety Co v. Superior Court
778 P.2d 1333 (Court of Appeals of Arizona, 1989)
Rawlings v. Apodaca
726 P.2d 565 (Arizona Supreme Court, 1986)
In Re Marriage of Benge
726 P.2d 1088 (Court of Appeals of Arizona, 1986)
Young v. Allstate Insurance
296 F. Supp. 2d 1111 (D. Arizona, 2003)
Nardelli v. Metropolitan Group Property & Casualty Insurance
277 P.3d 789 (Court of Appeals of Arizona, 2012)
Milhone v. Allstate Insurance
289 F. Supp. 2d 1089 (D. Arizona, 2003)
ECHANOVE v. Allstate Ins. Co.
752 F. Supp. 2d 1105 (D. Arizona, 2010)
Knoell v. Metropolitan Life Insurance
163 F. Supp. 2d 1072 (D. Arizona, 2001)
Alegent Health-Immanuel Medical Center v. Sebelius
917 F. Supp. 2d 1 (District of Columbia, 2012)
Espinoza v. Whiting
8 F. Supp. 3d 1142 (E.D. Missouri, 2014)

Cite This Page — Counsel Stack

Bluebook (online)
Centeno v. American Liberty Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/centeno-v-american-liberty-insurance-company-azd-2019.