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The Collaborative Clearinghouse for Lawsuits and Other Claims Against ACE Group Insurance Companies

ACE Group Unit ESIS Sued Once New Settlement Provisions Arise

October 22nd, 2012 - A Maryland woman has filed suit charging that ESIS Inc. improperly allowed after-the-fact conditions to be placed on a claim settlement even though she had not agreed to them.

Lucienne Avissar filed her suit in U.S. District Court for the District of Maryland against the ACE Group unit and General Motors LLC. She asked for $400,000 in damages, which was the original settlement she said she had accepted but that the carmaker and ESIS - which handles claims on behalf of clients such as GM or insurers - have refused to pay once she balked at the new conditions.

Avissar had in 2007 bought a 2005-model year Cadillac CTS. On Dec. 5, 2010, she was reaching into the trunk of the car to retrieve her purse when the trunk lid suddenly fell onto her head. This was, Avissar noted, due to the failure of the struts that held the trunk lid in place.

Avissar contended in her lawsuit that there was a “known history” of trunk strut failures on GM vehicles that led to injuries. She said that GM had failed to notify owners of the problem, issue a recall, or notify any competent regulatory authority.

The injuries caused to Avissar required her to undergo four separate surgeries, including the placement of two separate titanium plates in her cranium. She spent nearly a month in the hospital and racked up a $133,000 bill.

Avissar sent a claim to GM, and said that on Aug. 3, 2012, a claims adjustor for ESIS, offered her $400,000. Avissar accepted the deal five days later, but said that GM and ESIS then tried to impose hitherto unmentioned conditions including that the settlement would remain confidential and that payment of the claim would be withheld until a third-party claim against GM from Medicare was settled.

Avissar accused GM and ESIS of materially breaching their agreement with her, and asked for the $400,000 plus interest and costs.
 

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