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The Client:
A large national TPA.
The Situation:
A workers’ compensation claimant alleged that he sustained work-related shoulder and back injuries, as well as cardiac complications, resulting from an attack by a co-worker. The allegations were denied and during the course of litigation, we raised the affirmative defense of "personal animus.” A personal animus defense requires the defendant to prove that the injury occurred as the result of personal animosity between the claimant and the assailant.
The Chartwell Solution:
At trial, through presentation of three witnesses describing the pre-existing animosity between the claimant and the co-worker involved in the altercation, Chartwell established the personal animus defense. Claimant’s testimony was discredited through effective examination of witnesses and the presentation of recorded statements obtained by the insurance carrier during the initial investigation.
The Results:
The Workers’ Compensation Judge denied the claim, which was a significant victory for the TPA. The victory on the personal animosity defense eliminated the need to present a medical defense, which significantly reduced the cost of the litigation. Moreover, the successful outcome provided the TPA with significant savings in future benefits given the potential exposure of approximately $100,000 based upon the alleged injuries, the treatment/medical bills at issue and alleged ongoing disability.
