Swift v. Wesco Insurance Company

CourtDistrict Court, D. Arizona
DecidedJuly 13, 2020
Docket2:18-cv-01531
StatusUnknown

This text of Swift v. Wesco Insurance Company (Swift v. Wesco 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
Swift v. Wesco Insurance Company, (D. Ariz. 2020).

Opinion

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

9 Dale Swift, No. CV-18-01531-PHX-RM

10 Plaintiff, ORDER

11 v.

12 Wesco Insurance Company, et al.,

13 Defendants. 14 15 Pending before the Court is Defendants’ Motion for Summary Judgment. (Doc. 46.) 16 Plaintiff Dale Swift brought this lawsuit against Wesco Insurance Company and Amtrust 17 North America, Inc. (collectively “Defendants”), raising various claims arising out of 18 Defendants’ delay in paying Plaintiff’s workers’ compensation claim. (Doc. 1.)1 19 Defendants move for entry of summary judgment on Plaintiff’s bad faith and punitive 20 damages claims. (Doc. 46.) Defendants’ Motion for Summary Judgment is now fully 21 briefed, with Plaintiff having filed a Response (Doc. 57) and Defendants having filed a 22 Reply (Doc. 62). For the reasons explained below, the Court will deny Defendants’ Motion 23 for Summary Judgment as to Plaintiff’s bad faith claim and grant the Motion for Summary 24 Judgment as to Plaintiff’s claim for punitive damages.2 25 . . . .

26 1 Plaintiff’s claims against claims adjuster Sebastian Lara were dismissed previously. (Doc. 33.) 27 2 Although Defendants request the Court hold oral argument on their Motion for Summary 28 Judgment, the Court finds that the briefing adequately sets forth the issues and that this matter is suitable for disposition without oral argument. 1 I. Background3 2 On February 28, 2017, Plaintiff slipped and was injured while working for Biltmore 3 Properties as a maintenance technician at an apartment building in Yuma, Arizona. (Doc. 4 47 ¶ 1). Plaintiff reported his injury to his supervisor, who informed Creative Business 5 Resources (“CBR”), a company that handled human resources and workers’ compensation 6 matters for Biltmore Properties. (Id. ¶ 3.) CBR instructed Plaintiff to go to Pinnacle 7 Healthcare to have his injury examined. (Id. ¶ 3.) Plaintiff states that he could not find 8 Pinnacle Healthcare, and so instead went to Family and Injury Care. (Id. ¶ 4.) Plaintiff 9 asserts that he chose to go to Family and Injury Care only because Biltmore had previously 10 sent him there for treatment of a previous work-related injury. (Doc. 53, SSOF ¶ 6.)4 John 11 Smock, a physician assistant with Family and Injury Care, examined Plaintiff and 12 recommended certain temporary work restrictions. (Doc. 47 ¶¶ 5-6.) Plaintiff returned to 13 work briefly but claimed that he continued to experience pain. (Id. ¶ 7.) His supervisor 14 instructed him again to go to Pinnacle Healthcare, which he did. (Id. ¶ 8.) Marlena Lopez, 15 a nurse practitioner with Pinnacle Healthcare, examined Plaintiff, confirmed his injury, and 16 released him to light duty with work restrictions similar to those required by Physician 17 Assistant Smock at Family and Injury Care. (Id. ¶¶ 9-10.) 18 The next day, CBR contacted Plaintiff and advised him that his employer was 19 offering him a light duty position consistent with the restrictions approved by Pinnacle 20 Healthcare, and that his rate of pay and scheduled work hours would remain the same. (Id. 21 ¶¶ 11-12.) The same day, Plaintiff was evaluated by Chiropractor Donald Cradic, who had 22 also previously seen Plaintiff after a prior work-related accident. (Id. ¶ 14.) Chiropractor 23 Cradic gave Plaintiff a temporary “no work” status, and Plaintiff informed CBR that he 24 would not return to light duty because of this recommendation. (Id. ¶¶ 15-16.) 25 On March 7, 2017, Plaintiff spoke with Sebastian Lara, a claims adjuster with his 26 employer’s workers’ compensation carrier. (Id. ¶ 17.) Defendants state that Mr. Lara

27 3 Unless otherwise noted, the facts recounted here are undisputed.

28 4 Docket entry 53 contains both Plaintiff’s Response to Defendant’s Statement of Facts (“RSOF”) and Plaintiff’s Separate Statement of Facts (“SSOF”). 1 informed Plaintiff during that conversation that Plaintiff could not rely upon Chiropractor 2 Cradic’s “no work” recommendation unless he petitioned the Industrial Commission of 3 Arizona for a change of treating doctor. (Id. ¶¶ 18-19.) Plaintiff denies that Mr. Lara said 4 this. (Doc. 53, RSOF ¶¶ 18-19.) Plaintiff had previously gone through the process of 5 officially changing his treating doctor but did not do so again because he believed he still 6 had the right to choose his own doctor without going through this process. (Doc. 47 ¶¶ 21- 7 23.) 8 In emails dated March 15 and March 17, CBR informed Plaintiff that his employer 9 was revoking its offer of a light-duty position and was now requiring a “full duty release” 10 before he would be allowed to return to work. (Id. at ¶ 28.) Defendant Lara was not 11 contemporaneously copied on these emails. (Id. at ¶ 29.) A letter from CBR to Plaintiff 12 dated March 20, 2017, also explained that Defendants would require “a Fitness for Duty 13 with ‘no restrictions’ form from your chiropractor before you return to an active work 14 status.” (Doc. 53, SSOF ¶ 13.) On March 21, 2017, Mr. Lara denied temporary 15 compensation benefits, stating that Plaintiff’s employer was able to accommodate the 16 restrictions set by Nurse Practitioner Lopez. (Doc. 47 ¶ 25; Doc. 53 ¶ 25.) Mr. Lara states 17 that he was not aware that Plaintiff’s employer was now requiring a full duty release, and 18 he asserts that he would have released temporary benefits to Plaintiff if he had known. (Id. 19 ¶ 30.) 20 In late March of 2017, Mr. Lara began receiving records from Chiropractor Cradic. 21 (Id. ¶ 31.) On April 17, 2017, Mr. Lara scheduled Plaintiff to undergo a medical 22 examination with John Beghin, MD, an orthopedic surgeon. (Id. ¶¶ 32-33.) After the 23 examination and a later MRI, Dr. Beghin opined that Plaintiff did not need ongoing 24 chiropractic care and that Plaintiff could perform light duty work with certain restrictions. 25 (Id. ¶¶ 34-35.) 26 On May 18, 2017, Plaintiff filed a Request for Hearing challenging the denial of his 27 temporary benefits. (Id. at ¶ 36.) The Request for Hearing noted that Plaintiff’s employer 28 was not offering him light duty and that Plaintiff’s doctor (i.e., Chiropractor Cradic) had 1 him on temporary total disability. (Id. ¶ 37.) Mr. Lara received the Request for Hearing, 2 and states that he “checked his file” to confirm that Plaintiff had been offered a light duty 3 job but turned it down. (Id. ¶ 38.) Plaintiff asserts that whatever investigation Mr. Lara did 4 was objectively unreasonable because he did not obtain or review CBR’s communications 5 to Plaintiff that a “full duty release” was required for Plaintiff to return to work. (Doc. 53, 6 RSOF ¶ 38.) 7 On March 28, 2018, following hearings and the submission of evidence, an 8 Administrative Law Judge (“ALJ”) awarded Plaintiff temporary compensation benefits. 9 (Doc. 47 ¶¶ 39-41.) The award became “final” after no objections were made after 30 days, 10 and Mr. Lara paid the award on May 15, 2018, approximately 18 days later. (Id. ¶¶ 42-45.) 11 Mr. Lara claims that the delay in paying the award was “unintentional” and happened 12 because he “was used to receiving awards like this directly from the industrial 13 commission,” but instead received this award from Plaintiff’s attorney and so 14 “inadvertently overlooked it.” (Id. ¶¶ 44-47.) 15 II. Summary Judgment Standard 16 A court must grant summary judgment “if the movant shows that there is no genuine 17 dispute as to any material fact and the movant is entitled to judgment as a matter of law.” 18 Fed. R. Civ. P. 56(a); see also Celotex Corp. v. Catrett, 477 U.S. 317, 322–23 (1986).

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Swift v. Wesco Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/swift-v-wesco-insurance-company-azd-2020.