14.5 Million Dollar Jury Verdict Awarded Against State Farm Insurance
Headline Legal News
A six-week trial in Hamilton County Court ended yesterday afternoon with the award of a $14.5 million jury verdict for Joseph Radcliff and his restoration company, CPM Construction of Indiana, against State Farm Insurance.
State Farm had filed suit for insurance fraud and RICO (Racketeer Influenced and Corrupt Organizations) claims against Radcliff and CPM. The case arose out of work done by Radcliff and CPM following the April 2006 hailstorm. Radcliff and CPM’s allegations were that after State Farm received negative publicity in the Indianapolis media for denying hail damage claims, State Farm made unfounded claims of fraud against Radcliff and instigated the filing of felony charges against him. Those charges were dismissed by the Marion County Prosecutor, but the negative publicity resulted in Radcliff’s personal reputation and business being destroyed.
Not only did the jury find that State Farm’s claims against Radcliff were baseless, but they also found that the Radcliff’s allegations of being defamed by State Farm were true. The jury ordered State Farm to pay Radcliff $14.5 million.
Radcliff was represented by Will Riley, lead trial counsel of the law firm Price Waicukauski & Riley, LLC along with attorneys Joe Williams, James Piatt and Jamie Kendall of the same firm and Mark McKinzie, Partner in the law firm Riley Bennett & Egloff LLP.
Riley stated, “It was a tribute to the American jury system that one man can take on the largest insurance company in the nation and win.” McKinzie agreed, stating “This sends a strong signal to Bloomington, Illinois that Hoosiers will not put up with this sort of conduct.” Radcliff commented “I am grateful to those who believed in me and helped me get the true facts before the jury and to the jury for giving me, and my failed company, justice.”
Price Waicukauski & Riley, LLC is a law firm known for its representation of clients in complex litigation. Riley Bennett & Egloff, LLP is a law firm known for advising and representing businesses and their owners in various litigation matters.
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Workers’ Compensation Subrogation of Administrative Fees and Costs
When a worker covered by workers’ compensation makes a claim against a third party, the workers’ compensation insurance retains the right to subrogate against any recovery from that third party for all benefits paid to or on behalf of a claimant injured at work. When subrogating for more than basic medical and indemnity benefits, the Texas workers’ compensation subrogation statute provides that “the net amount recovered by a claimant in a third‑party action shall be used to reimburse the carrier for benefits, including medical benefits that have been paid for the compensable injury.” TX Labor Code § 417.002.
In fact, all 50 states provide for similar subrogation. However, none of them precisely outlines which payments or costs paid by a compensation carrier constitute “compensation” and can be recovered. The result is industry-wide confusion and an ongoing debate and argument with claimants’ attorneys over what can and can’t be included in a carrier’s lien for recovery purposes.
In addition to medical expenses, death benefits, funeral costs and/or indemnity benefits for lost wages and loss of earning capacity resulting from a compensable injury, workers’ compensation insurance carriers also expend considerable dollars for case management costs, medical bill audit fees, rehabilitation benefits, nurse case worker fees, and other similar fees. They also incur other expenses in conjunction with the handling and adjusting of workers’ compensation claims. Workers’ compensation carriers typically assert, of course, that, they are entitled to reimbursement for such expenditures when it recovers its workers’ compensation lien. Injured workers and their attorneys disagree.