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Wrongful Claim Denial


While the injured motorcycle officer remained in a medically-induced coma, this insurance company moved quickly in defiance of Massachusetts insurance laws in an attempt to deprive him and his family from much needed compensation. The compensation consisted of $1 million from a motor vehicle liability insurance policy which covered the automobile which cut off and struck the officer’s motorcycle head on. As you will see from the following article, the sooner I get involved the better. As a consequence of its misdeeds, I sued this insurance company and eventually compelled it after two and a half years of litigation to pay much more than the original $1 million limit which covered the automobile which cut off the officer. The injured officer and his family received over $2 million in settlement. These funds will help support them as the officer’s police career came to an abrupt end with this accident. It is imperative that injured officers learn quickly about their legal rights and then protect those rights. I am always available to consult for free with injured officers and their families by telephone and email. (In order to protect the privacy of the injured officer and witnesses, all names have been changed. Any resemblance to names of real persons, past or present, is merely coincidental and not intended. The injured officer agreed to have this article published in order that police officers around the Commonwealth be better educated about their legal rights to compensation when injured on duty).

On July 28, 2004, at approximately 8:30 pm, Officer James Blue was returning to his station riding a department motorcycle. At the same time, a car being prepared for sale by a used car lot was being operated by one of its young employees, Fred White. Mr. White was test driving the vehicle (which had a dealer plate attached), when he crossed a double yellow line to turn left, failing to yield to Officer Blue who was approaching in the opposite direction. The car collided head on with Officer Blue’s motorcycle, causing him to be thrown off the motorcycle and destroying the motorcycle in the process. Emergency personnel, the police and Mr. White’s employer quickly responded to the scene of the accident. As Officer Blue was removed by ambulance it was unclear whether he would survive the accident. The next morning the used car lot employer notified its insurance agent of the very serious accident, with the expectation that the $1 million in liability coverage would be available to cover Officer Blue for this accident.

Officer Blue suffered multiple fractures and injuries which would require numerous surgical procedures. He would spend many weeks in the hospital, most of which was spent in a medically-induced coma. He then was transferred to a rehabilitation hospital where he spent a month before being able to return home to continue his rehabilitation. While he was in the hospital, we were hired to represent him and his family. We quickly learned about the $1 million dollar insurance policy which covered the used car lot’s dealer plates, which provided a degree of comfort to Officer Blue and his family, as Officer Blue continued to undergo additional surgeries and recuperate from his injuries. That degree of comfort evaporated when in late September, 2004, the insurance company notified the used car employer and our law firm that the insurance company was denying coverage for the accident. The insurance company stated orally and in writing that it discovered the $1 million dollar insurance policy issued to the used car lot had been cancelled for non-payment of premium on July 26, 2004, just two days before the July 28, 2004 accident. Officer Blue and his family were devastated by this news. Without this insurance coverage they would have to rely upon the comparatively small amount of uninsured motorist benefits on the family vehicle which had limits of $50,000.00.

It is a reality that insurance policies are sometimes cancelled for non-payment of premiums and then days or weeks later an accident occurs and there is no coverage due to the cancellation. Massachusetts set up a statutory framework of cancellation steps including a twenty day grace period to make sure that such cancellations are the exception and not the norm. The grace period gives the owner of the insured vehicle 20 days to assemble and pay funds in order to keep the important coverage in place. After the insurance company denied coverage for non-payment of premium, it appeared to Officer Blue and his family he would have to rely on the relatively small amounts provided by his uninsured motorist benefits coverage, his disability insurance and social security since his career was over. While the Blues suffered from the grim news of the insurance cancellation, I was suspicious that something was amiss. With my associate, Attorney John McMaster, we commenced an aggressive lawsuit against the used car lot and the driver and sought an injunction preventing the used car lot from doing further business. We immediately obtained all of its insurance documents as part of our initial litigation.

I was immediately struck by the fact that there appeared to be two identical, but overlapping, insurance policies issued to the used car lot by this same insurance company for its dealer plates: one policy was effective for one year from February 26, 2004 and the second policy appeared to prematurely replace the first policy with an effective date which began just two days before the accident on July 26, 2004. This was the same day which the insurance company claimed the insurance coverage provided to the used car lot’s dealer plates was cancelled for non-payment of premium. When the insurance company denied coverage in late September, it never disclosed the existence of the first policy which was issued on February 26, 2004. Nor did it disclose that the second policy, which was cancelled on July 26, 2004, was made effective the same day. Thus began two and a half years of intensive litigation in order to find the truth and obtain justice for Officer Blue and his family.

I learned that prior to the accident, the insurance company regretted insuring the used car lot feeling it was a bad risk. In the month before the accident the insurance company conspired with the insurance agent to prematurely cancel the policy and then replace it with a new policy which would be transferred to the high risk pool (“HRP”). It set a plan in motion where it instructed the used car lot in early July not to pay its remaining insurance premium which was due on July 26, 2004. By not paying its bill by July 26, 2004, the insurance company could then orchestrate what appeared a routine cancellation at the end of the twenty day grace period some time in August, 2004. The insurance company knew that sometime after July 26, 2004, when the premium payment wasn’t received, its home office would issue the statutory notice of impending cancellation giving the used car lot a grace period in which to pay its bill. If the bill was not paid in time, the cancellation would be effective on the last day of the grace period which would be some time in late August, 2004, depending upon the date the notice of cancellation was mailed. Once the first policy cancelled at the end of the grace period, the insurance company planned to simultaneously issue a new policy to the used car lot which would go straight to HRP. The used car lot went along with the surprising instruction not to pay the premium trusting its insurance agent wouldn’t leave it without coverage and fearing it had no other choice if it was to be covered by insurance.

After two separate lawsuits, reviewing hundreds of pages of documents, approximately one hundred hours of deposition testimony from multiple witnesses, reviewing thousands of pages of HRP manuals, over a hundred hours of legal research and investigation and a dozen motions and hearings in Court, I ultimately uncovered ‘the when and how’ by which the insurance company attempted to deprive Officer Blue of the $1 million policy coverage. Documents obtained revealed that on July 29, 2004, the morning after the accident, the used car lot promptly reported the serious accident to its insurance agent. That notice was immediately followed by an urgent email between the insurance agent and the insurance company’s underwriter. On August 2, 2004, while Officer Blue laid in his medically-induced coma, the underwriter for the insurance company ordered her assistant to send a memorandum to their home office which would override the home office’s computer system. The assistant, following orders, prepared the memorandum which would instruct the home office to enter a backdated cancellation of the first policy to July 26, 2004 for non-payment of premium, which was two days before the accident occurred. The change in the home office insurance company’s computer system nullified the date provided for in the eventual notice of cancellation for non-payment of premium, which was sent out at the same time which provided for a cancellation effective date of August 17, 2004. The underwriter then instructed her assistant to issue the second policy on August 2, 2004 and backdate it with an effective date covering the one year period beginning on July 26, 2004. The assistant was also instructed to immediately transfer the new policy online through HRP’s computer system on August 2, 2004, with the backdated effective date of July 26, 2004. These steps would have the effect of transferring the responsibility of paying the $1 million of coverage from the insurance company under the first policy to HRP (high risk pool) under the second policy.

We believe this backdating plan went awry, because in its haste of backdating documents, the insurance company failed to follow HRP’s technical procedures. After August 2, 2004, HRP refused to accept liability for the July 28, 2004 accident. The insurance company was now back where it started, which was being liable to pay Officer Blue $1 million from its own funds. It could no longer shift responsibility to HRP of having to pay the $1 million. To complicate an already tangled web, the used car lot failed to pay the bill due in August, 2004 for the second policy and then failed to pay the premium due before the grace period expired on September 17, 2004. With the premium unpaid on the second policy, the insurer took the unusual step of cancelling the policy with a retroactive date of July 26, 2004, rather than the last day of the grace period. The insurance company, of course, never disclosed to us that it backdated the cancellation for non-payment of premium from September 17, 2004 to July 26, 2004. When it denied coverage to us in formal letters, it made it appear that the policy cancelled for non-payment of premium on July 26, 2004 in the usual course, after the presumed twenty day grace period had expired. There was no reference to backdating or the existence of the prior policy. One can only assume the insurance company counted on us walking away from the claim after receiving their denial. We would then be left only to pursue the uninsured motorist benefits protection of $50,000.00 provided by the Officer’s own personal automobile insurance policy, thereby saving the insurance company the $1 million in coverage.

To make a very long and technical story short, we obtained our proof and brought numerous and very aggressive motions in Court in our second lawsuit filed directly against the insurance company which included allegations of deceit, deceptive trade practices and various violations of Massachusetts insurance laws. After hearings on our summary judgment motions and before the Court entered its rulings, the insurance company agreed to go to mediation and after several weeks of negotiations the case settled for over $2 million dollars. The amount was agreed upon and intended to compensate Officer Blue’s and his family’s actual losses which resulted from the accident.

Injured officers throughout Massachusetts should always consider seeking a free consultation with us to determine his or her rights, benefits, and the probability of making a successful claim. I am always available by telephone, email or a personal meeting. Once I evaluate the case and the officer’s chances of success, the decision whether to go forward rests with the officer. If the injured officer is out of work, the decision when to return to work rests, as it should, with the officer and his or her doctor. We do not believe in, nor do we have any interest in, keeping officers out injured any longer than necessary to heal from their injuries. As it is, many of our injured officers never miss a day of work and are still able to receive substantial compensation for their injuries which continue to nag at them during long hours spent behind the wheel of a cruiser and/or standing on a road job.

As with all claims involving an officer's injury on duty, there are no guarantees. Many police injury cases involve sophisticated legal issues, problems of proof, technical insurance policy coverage disputes, and issues that arise under Massachusetts General Laws c. 41, §100 and §111F, Chapter 152, State Police Article 8 and/or other related laws.

When we work on these cases, we work on a contingent fee basis. That means the injured officer pays nothing up front and while the case is pending. He or she only need pay for legal services and expenses at the end of the case, if we successfully collect money on the claim. We typically will receive one-third of the money collected. In the off-chance we are unable to collect money for the injured officer, the officer owes nothing for our legal services.


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