D'Amico v. Ace Financial Solutions, Inc., No. AC 30124 (Conn. App. Ct. 06/29/10).
Ruling: The Connecticut Appellate Court held that an officer's claims for breach of contract, breach of the implied covenant of good faith and fair dealing, negligent infliction of emotional distress, and violations of state law were barred by the exclusivity provision of Connecticut workers' compensation law, even if the claims administrator was an "independent third party."
What it means: The exclusivity provision of Connecticut's workers' compensation law extends to claims against independent third-party claims administrators when the claims arise from the workers' compensation claims process.
Summary: A correction officer sustained injuries to his neck, back, shoulder, arm and hand while attempting to restrain an inmate. He also suffered from post-traumatic stress disorder, depression, fibromyalgia, hypertension, and reflex sympathetic dystrophy of his right arm. The officer received benefits for all but his hypertension claim. The claims administrator notified the officer that his psychiatric and fibromyalgia treatments would no longer be paid. The officer sued the claims administrator for breach of contract, breach of the implied covenant of good faith and fair dealing, negligent and intentional infliction of emotional distress, and violations of the Connecticut Unfair Insurance Practices Act and the Connecticut Unfair Trade Practices Act. The Connecticut Appellate Court held that the officer's claims were barred by the exclusivity provision.
The officer argued that his case was distinguishable from Connecticut cases holding that there was no cause of action for bad faith processing of a workers' compensation claim because his case involved an "independent third party" and no agency relationship existed between his employer and the claims administrator. The court stated that a line of cases extended the exclusivity provision to insurers and third-party administrators. Additionally, the officer's alleged injuries arose from the workers' compensation claims process, the court noted.
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September 16, 2010
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