Workers’ Compensation Closed File Review

The Challenge:

This workers’ compensation claim was identified by Spartan via a closed file review and involved a Claimant who suffered an injury to his right ear/hearing due to an explosion while working on property owned by a subcontractor in North Carolina. The Worker’s Compensation carrier paid $20,815.88 in medical and indemnity payments. The carrier initially reviewed the claim for subrogation but abandoned its efforts due to what they felt was a lack of evidence and other legal issues, inclusive of the fact that the claimant had signed a liability waiver before entering the adverse premises. In addition, the contractor no longer employed the individual most directly responsible for the incident and so it was not possible to obtain a statement from him. Finally, the physical evidence had not been retained by any parties subsequent to the loss and was assumed to have been destroyed. The claimant never pursued a third party action on his own separate from his Worker’s Compensation claim due to some or all of the above challenges.

 

The Outcome:

Despite the above difficulties, Spartan retained subrogation counsel and immediately commenced a Direct Action against the contractor/owner of the premises where the loss occurred. An extensive investigation was undertaken to obtain all original documentary evidence associated with the loss as well as detailed statements from the claimant and other parties. With the help of local counsel, Spartan obtained a settlement from the insurer of the contractor in the amount of $50,000.00. The settlement reflected a 100% recovery of the medical and indemnity benefits paid, legal fees and additional funds for the injured claimant.