Resources

Federal District Court Case Employers Insurance Company v. Redlands Christian Migrant Association, ___F. Supp. ____ (M.D. FL 9/2/20) Retroactive Ins. Contracts/Motions to Dismiss The District Court denied Wassau/Employers’ Motion to Dismiss, based upon SOL.  Wassau/Employers sued Redlands for failing to pay premiums under a retrospective insurance contract.  In such a policy, the insured pays small premiums during the policy term, but after the term, the insurer examines the loss activity and charges a retrospective premium.  Here Employers assessed a 500k... View More

MCC / Burden of Proof Scott Miller / Bill Rogner The DCA reversed the JCC’s finding that the claimant failed to prove his 2004 workplace accident was the MCC of lumbar spine treatment recommended in 2018. Claimant began working with the employer in 1991. In 2004, the E/C authorized orthopedist Dr. Cohen to evaluate the lumbar spine. Later that year, the lumbar spine injury was consolidated with two other injuries with the employer.  By 2014, a new servicing agent took... View More

JCC Forte (Ft. Lauderdale) – (Andy Borah)(9-3-2020). Granted E/C’s Motion for Sanctions. The claimant’s attorney filed a PFB for reimbursement of mileage of $1.11 and attorney’s fees and costs. The claimant’s attorney faxed a good faith request to the E/C on July 3, 2020 and filed the PFB five hours later. The JCC determined that faxing a good faith request to an office closed in observance of a national holiday did not meet the statutory requirements of good faith.  The... View More

Does this sound familiar…?  A good faith letter faxed over the morning of a legal holiday (Independence Day, 2020) …  five hours later, the claimant attorney files a PFB for the same benefit, complete with certification that a “good faith” attempt was made to resolve the issue.  Recently, a JCC agreed with Andy Borah that such circumstances are not in good faith. After Andy’s proposed motion for sanctions, the claimant attorney allowed the 21-day safe harbor period to lapse without... View More

JCC Almeyda –(Miami)(Paul Terlizzese)(8-24-2020)– Denied misrepresentation defense and denied TPD.  The claimant reported injuries to the knee and upper extremities, and only later her back. She had been involved in seven prior MVAs, but only recalled two.  EMA Dr. Hodor evaluated the claimant. Although he found the claimant had restrictions during the period in question, the JCC found the claimant had worked light duty with the employer, later abandoned her employment with no further contact, and that the employer continues... View More