Sullivan v. Insurance Company of North America

CourtDistrict Court, D. Delaware
DecidedMarch 24, 2022
Docket1:21-cv-01564
StatusUnknown

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

Bluebook
Sullivan v. Insurance Company of North America, (D. Del. 2022).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF DELAWARE RICHARD SEENEY, ) ) Plaintiff, ) ) v. ) Civil Action No. 21-1564-MN-SRF ) INSURANCE COMPANY OF ) NORTH AMERICA, et al., ) ) Defendants. ) REPORT AND RECOMMENDATION I. INTRODUCTION Presently before the court in this insurance bad faith breach of contract action are motions to remand the action to state court (D.I. 3; D.L. 6)! and to strike Defendants’ answer and Defendants’ opposition to Plaintiff's motion for default judgment (D.I. 9)’ filed by Plaintiff Richard Seeney (“Plaintiff’),? and a motion to vacate the partial default judgment filed by Defendants Insurance Company of North America (“INA”), ACE Property and Casualty Insurance Company (“ACE”), and ESIS, Inc. (“ESIS”) (collectively, “Defendants”) (D.I. 26).* As indicated in the chart, infra, and for the reasons that follow, the court recommends

' The briefing for Plaintiff's motion to remand is as follows: Plaintiff's opening brief (D.I. 3), Defendants’ answering brief (D.I. 12), and Plaintiff's reply brief (D.I. 13). For purposes of this Report and Recommendation, the court treats Plaintiff's motion to amend the motion to remand (D.I. 6) as an amendment rather than a separate motion, as the responsive briefs address all arguments raised therein. 2 The briefing for Plaintiff's motion to strike is as follows: Plaintiff's opening brief (D.I. 10), Defendants’ answering brief (D.I. 17), and Plaintiff's reply brief (D.I. 18). 3 During the pendency of the motions, Defendants filed a Notice of Suggestion of Death of Plaintiff, indicating that Plaintiff died March 7, 2022. (D.I. 40) ‘ The briefing for Defendants’ motion to vacate the partial default judgment is as follows: Defendants’ opening brief (D.I. 26), Plaintiff's answering brief (D.I. 27), and Defendants’ reply brief (D.I. 28).

DENYING Plaintiffs motion to remand and motion to strike and GRANTING Defendants’ motion to vacate. Ee Motion es Recommendationt a0. □□ Motion to Remand (D.I. 3; D.I. 6 DENY Motion to Strike Defendants’ Answer and DENY Defendants’ Response in Opposition to Motion for Default (D.I. 9 Motion to Vacate Partial Default Judgment D.I. 26

Il. BACKGROUND In 1969, Plaintiff Seeney was catastrophically injured in an industrial accident while working for Marvel Construction Company (“Marvel”).> (D.I. 1, Ex. A at J 1, 16-17) His injuries included, inter alia, complete severance of his spinal cord at the T12 vertebra, complete paralysis of everything below his umbilicus, and complete kidney failure involving both kidneys. (Id. at] 16) Asa result of the accident, Plaintiff met the criteria for catastrophic loss as defined under 19 Dei. C. § 2326(e), was entitled to medical treatment for life, and was presumed to be entitled to lifetime total disability under 19 Del. C. §§ 2324 and 2326(e). (Ud. at 917) Defendant INA provided worker’s compensation insurance to Plaintiff's employer. (/d. at J] 2, 12) Defendant ACE is the parent company of INA. (/d. at 3) Defendant ESIS is also wholly owned by ACE and is the third-party administrator (“TPA”) responsible for handling the claim arising from Plaintiff’s industrial accident. (/d. at JJ 4, 12) The complaint alleges that “for decades” the Defendants repeatedly failed to timely pay the Plaintiff's medical expenses, services, treatment and supplies in violation of their obligations under 19 Del. C. § 2322F(h). (Ud. at 27-28) The Plaintiff presented claims for his medical

> Plaintiff adopts the name of his employer as it appears in Industrial Accident Board documents. (D.I. 1, Ex. A at J 1 n.1)

expenses to Delaware’s Industrial Accident Board (“I.A.B.” or “Board”) and received an award on July 20, 2021, which included the costs for ongoing kidney treatment provided by Fresenius as of July 24, 2020. (D.I. 34 at 165-67)® The I.A.B. found that Marvel accepted compensability of the kidneys on the first day of the hearing, March 12, 2021. Ud. at 167) Notwithstanding its acceptance of compensability, Defendants did not pay the medical costs for the kidney treatment. (D.I. 1, Ex. A at ff 26-31) Defendants’ failure to pay caused the Plaintiff to make a written Huffman demand on July 22, 2021, pursuant to 19 Del. C. § 2357. Ud. at J] 31-32); See Huffman v. C.C. Oliphant & Sons, 432 A.2d 1207 (Del. 1981). A Huffman demand provides an additional remedy to an employee in which the employee may elect to proceed under 19 Del. C. § 2357 in a court of law rather than before the I.A.B. Jd. at 1210-1211. When the I.A.B. determines that certain medical expenses are compensable, the injured employee may then demand payment from the employer or its insurer, and if this demand is not satisfied within 30 days, invoke the remedies available under Section 2357 by bringing a civil suit in a court of competent jurisdiction. See Correa v. Pa. Mfrs. Ass’n Ins. Co., 618 F. Supp. 915, 921 (D. Del. 1985).’ The Plaintiff claims that, despite his Huffman demand, the kidney treatment bills remained unpaid, and the Plaintiff made six additional demands for payment through September

6 Seeney v. Marvel Constr. Co., No. 1504254 (Del. I.A.B. July 20, 2021). 719 Del. C. § 2357 provides that “If default is made by the employer for 30 days after demand in the payment of any amount due under this chapter, the amount may be recovered in the same manner as claims for wages are collectible.” 19 Del. C. § 2357. Delaware’s Wage Payment and Collection statute recites, in part, that an employer who, “without any reasonable grounds for dispute, fails to pay an employee wages. ..shall, in addition, be liable to the employee for liquidated damages in the amount of 10 percent of the unpaid wages for each day, except Sunday and legal holidays, upon which such failure continues after the day upon which payment is required or in an amount equal to the unpaid wages, whichever is smaller...” 19 Del. C. § 1103(b). Failure to satisfy a Huffman demand also results in an award of attorney’s fees and costs to the injured employee. See Huffman, 432 A.2d at 1211.

22, 2021. (D.I. 1, Ex. A at {J 33-36, 38-39) Defendants represented to the I.A.B. that Plaintiff never provided the Fresenius bills until after the time for appealing the LA.B.’s July 20, 2021 decision had expired. (D.I. 6, Ex. 2 at 1-2) Ina later hearing before the I.A.B. on September 8, 2021, the Defendants confirmed receipt of the bills as of that date. (/d. at 2) However, in the interim, on August 24, 2021, Plaintiff recorded the I.A.B.’s July 20, 2021 award of worker’s compensation benefits as a judgment in the Superior Court following the expiration of the appeal period in accordance with 19 Del. C. § 2349.? (D.L. 34 at 3) Thereafter, on September 30, 2021, Plaintiff commenced the instant lawsuit in the Superior Court. (D.I. 1, Ex. A) Plaintiff asserts claims for the failure to satisfy the Huffman demand in violation of 19 Del. C. § 2357, bad faith breach of contract, and seeks a declaratory judgment, compensatory and punitive damages, attorney’s fees and costs, all arising from Defendants alleged deficiencies in payment of Plaintiff's worker’s compensation benefits. (/d.) The Delaware Superior Court docket reflects that service of process was made on the Delaware Insurance Commissioner pursuant to 18 Del. C. § 525(a). The Superior Court docket reflects the Insurance Commissioner received service for INA and ACE on October 5, 2021, and ESIS on October 12, 2021. (D.I. 8 at ff 2-3, Ex. A) The record further indicates that the Insurance Commissioner’s office transmitted service of process to Defendant ACE’s registered agent on October 6, 2021.!° (D.I. 1, Ex. A) Plaintiff was unable to secure service of process on

8 Seeney v. Marvel Constr. Co., No. 1504254 (Del. I.A.B. Nov. 4, 2021). 919 Del. C.

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Sullivan v. Insurance Company of North America, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sullivan-v-insurance-company-of-north-america-ded-2022.