South Dakota Supreme Court Reverses Dismissal of Bad Faith Insurance Lawsuit
The
At the insurer's request, Mordhorst was later examined by an "independent" medical examiner (IME), who concluded that the only injury sustained was a "strain" that had resolved 18 days after the accident. The insurer used the IME's report as its basis for terminating Mordhorst's workers' compensation benefits on
"Workers' compensation and auto insurers both often hire 'independent' doctors to examine injured people," explained
Mordhorst subsequently sued the insurer for bad faith, alleging it had been unreasonable in denying him benefits. The circuit court granted the insurer's motion to dismiss because it concluded that the insurer necessarily was justified in relying on the IME report to deny benefits. Reversing the circuit court, the Supreme Court noted that jurors are routinely expected to evaluate expert opinions and weigh them against countervailing evidence, saying insurers can be expected to do the same. The Court found that "an insurer's basis for denial is not necessarily reasonable simply because the insurer relies on the opinion of a medical practitioner."
"When an insurance company fails to consider all the relevant evidence before denying coverage, it can leave injured workers with little access to the medical care they deserve," said
If you believe your insurance company acted in bad faith when denying your claim, contact the experienced attorneys at Turbak Law Office. We can help you navigate the legal process and ensure you are protected both personally and professionally.
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