Rajabi v. Sedgwick Claims Management Services, Inc.

Court of Appeals for the Tenth Circuit·Decided January 14, 2026·No. 24-1326·Unpublished

Opinion

Appellate Case: 24-1326 Document: 59-1 Date Filed: 01/14/2026 FILED Page: 1

United States Court of Appeals Tenth Circuit

UNITED STATES COURT OF APPEALS January 14, 2026

FOR THE TENTH CIRCUIT Christopher M. Wolpert _________________________________ Clerk of Court

CYRUS RAJABI, Plaintiff - Appellant,

v. No. 24-1326 (D.C. No. 1:21-CV-00422-GPG-JPO)

SEDGWICK CLAIMS MANAGEMENT (D. Colo.) SERVICES, INC.; TRISTAR GROUP, d/b/a Tristar Managed Care, d/b/a Tristar Risk Management,

Defendants - Appellees.

ORDER AND JUDGMENT *

Before MATHESON, EBEL, and EID, Circuit Judges.

Cyrus Rajabi sued Sedgwick Claims Management Services, Inc. and Tristar Group (collectively, the “Claims Administrators”) for breach of the duty of good faith and fair dealing under Colorado law. The district court entered summary

*

After examining the briefs and appellate record, this panel has determined unanimously that oral argument would not materially assist in the determination of this appeal. See Fed. R. App. P. 34(a)(2); 10th Cir. R. 34.1(G). The case is therefore ordered submitted without oral argument. This order and judgment is not binding precedent, except under the doctrines of law of the case, res judicata, and collateral estoppel. It may be cited, however, for its persuasive value consistent with Fed. R. App. P. 32.1 and 10th Cir. R. 32.1.

judgment against Mr. Rajabi, concluding he lacked sufficient evidence to prove his claim.

On appeal, Mr. Rajabi argues the court (1) erred in granting summary judgment and (2) abused its discretion in denying him a stay of the litigation and an extension of discovery deadlines. Exercising jurisdiction under 28 U.S.C. § 1291, we affirm.

I. BACKGROUND

A. Factual History 1

On April 23, 2017, Mr. Rajabi—a volunteer firefighter—was injured during a training exercise with the Arvada Fire Protection District. “He dislocated three fingers, tore ligaments and a tendon, and sustained an avulsion fracture and nerve damage.” Rajabi v. Sedgwick Claims Mgmt. Servs., Inc., No. 21-cv-422, 2024 WL 3835697, at *1 (D. Colo. July 12, 2024). Mr. Rajabi reported the incident to his employer, Arvada Fire, which “filed a claim with its Workers’ Compensation Carrier.” App., Vol. I at 71. “Tristar—a third-party claims administrator—handled [Mr. Rajabi’s] claim from the date initially submitted to July 2020,” when Sedgwick took over claims-handling duties. Rajabi, 2024 WL 3835697, at *1.

“Because this case arises from an appeal of summary judgment, we present the 1

following factual background in the light most favorable to [Mr. Rajabi] as the non-moving party, unless contradicted by the record.” Litzsinger v. Adams Cnty. Coroner’s Off., 25 F.4th 1280, 1284 (10th Cir. 2022).

Following the incident, Mr. Rajabi was diagnosed with Complex Regional Pain Syndrome (“CPRS”)—chronic pain that develops after an injury or other traumatic event. Id. From 2017 to 2022, he received extensive medical treatment. His treating physicians sought authorization from the Claims Administrators for coverage of Mr. Rajabi’s medical treatments. Relying on reports from their consulting physicians, the Claims Administrators denied authorization when the reports concluded that treatment was not medically reasonable and necessary or causally related to the April 23, 2017 injury.

B. Legal Background

Colorado law requires an insurer “to treat an insured with good faith.”

Sandoval v. Unum Life Ins. Co. of Am., 952 F.3d 1233, 1236 (10th Cir. 2020); see Am. Family Mut. Ins. Co. v. Allen, 102 P.3d 333, 342 (Colo. 2004) (en banc). An insured may sue for breach of this duty. See Peden v. State Farm Mutual Auto. Ins. Co., 841 F.3d 887, 890 (10th Cir. 2016). To prevail, “the insured must prove that the insurer (1) acted ‘unreasonably under the circumstances’ and (2) ‘knowingly or recklessly disregarded the validity of the insured’s claim.’” Id. (quoting Goodson v. Am. Standard Ins. Co. of Wis., 89 P.3d 409, 415 (Colo. 2004) (en banc)). “The reasonableness of the insurer’s conduct must be determined objectively, based on proof of industry standards,” which “often require[s]” the “aid of expert witnesses.” Goodson, 89 P.3d at 415.

In making a reasonableness determination, courts may consider a fairly-debatable standard. It provides that “[i]f a reasonable person would find that

the insurer’s justification for denying or delaying payment of a claim was ‘fairly debatable’ (i.e., if reasonable minds could disagree as to the coverage-determining facts or law), then this weighs against a finding that the insurer acted unreasonably.” Sanderson v. Am. Fam. Mut. Ins. Co., 251 P.3d 1213, 1217 (Colo. App. 2010). But even though “fair debatability” may help the insurer, it is not “outcome determinative.” Id. at 1218. The insurer still “must exercise reasonable care and good faith” in handling the claim. Id. (quotations omitted). “[A]n insurer will be found to have acted in bad faith only if it has intentionally denied, failed to process, or failed to pay a claim without a reasonable basis.” Zolman v. Pinnacol Assur., 261 P.3d 490, 497 (Colo. App. 2011). 2 C. Procedural History

On October 23, 2020, Mr. Rajabi filed his complaint in state court. The Claims Administrators removed the case to federal court based on diversity jurisdiction. Rajabi, 2024 WL 3835697, at *1.

The Complaint Mr. Rajabi’s complaint alleged that the Claims Administrators “wrongfully delayed and/or failed to pay for Mr. Rajabi’s medical treatment . . . and/or denied medical treatment for Mr. Rajabi.” App., Vol. I at 23. He alleged that, “[i]nstead of relying on [Mr. Rajabi’s] treating physicians,” the Claims Administrators “would

2 Because the district court concluded that Mr. Rajabi failed to put forth “any competent summary judgment evidence” supporting his claim, it did not analyze the fairly-debatable standard. Rajabi, 2024 WL 3835697, at *4.

default to . . . ‘independent’ medical exams or record reviews performed by physicians known by [the Claims Administrators] to provide reports favorable to [their] position in contested workers’ compensation claims.” Id. at 21. The complaint asserted his “workers’ compensation benefits were improperly delayed and/or denied,” id. at 23, but it did not provide specifics.

Pre-Summary Judgment Litigation On September 22, 2022, the district court entered a scheduling order, including discovery deadlines. The Claims Administrators served requests for admissions.

In March 2023, Mr. Rajabi’s counsel moved to withdraw and for an extension of the deadlines. The district court extended the deadlines by three months and granted counsel’s motion to withdraw. The Claims Administrators sought to schedule Mr. Rajabi’s deposition and rejected his request to stay the deadlines due to his medical treatments. After his original counsel withdrew, Mr. Rajabi did not request a stay or a discovery extension that complied with the local rules.

In November 2023, Sedgwick moved for summary judgment. The district court scheduled a status conference, but Mr. Rajabi failed to appear. He later explained that his poor health limited his participation. In January 2024, Tristar moved for summary judgment.

In February 2024, a new counsel entered a limited appearance for Mr. Rajabi and moved for a six-month stay. The district court struck the motion for failure to comply with the local rules. The court stated clear instructions on how to request a 60-day stay, but Mr. Rajabi failed to do so.

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