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

PEDERSEN v. ACE AMERICAN INSURANCE CO., et al

ATTENTION: It is possible that this information may no longer be current and therefore may be inaccurate. The index contains both open and closed cases and is not a complete list of cases in which an ACE Insurance Group company is involved. This information is provided to give interested persons an idea of the issues disputed in the indexed cases. For a full understanding of a case, one should read the rest of the court file, including the response. For the most up-to-date and complete information on a case, visit www.pacer.gov or contact the clerk of the relevant court.

Case Number: 
9:11-cv-00139 Search Pacer
ACE Group party(s): 
Opposing Party: 
Elisa Pedersen
Court Type: 
Federal
US District Court: 
District of Montana
Date Filed: 
Oct 17 2011

"COUNT I - VIOLATION OF MONTANA'S UNFAIR TRADE PRACTICES ACT

43.  All of the foregoing allegations are incorporated by reference in this Count as though fully set forth herein.

44.  Montana's Unfair Trade Practices Act ("UTPA") prohibits an insurer from engaging in trade practices that are unfair or deceptive. An insurer must promptly and fairly investigate, evaluate, and settle insurance claims. Defendants violated the UTPA when they failed to fairly and promptly handle Elisa's claim for workers' compensation benefits.

COUNT II - COMMON LAW BAD FAITH

45. All of the foregoing allegations are incorporated by reference in this Count as though fully set forth herein.

46. Montana common law prohibits an insurer from engaging in bad faith when handling insurance claims. An insurer must promptly and fairly investigate, evaluate, and settle insurance claims. Defendants violated Montana common law when they failed to fairly and promptly handle Elisa's claim for workers' compensation benefits.

47. Throughout the course of the handling, adjustment and supervision of this claim, the Defendants allowed Elisa's employer to be involved in the handling and direction of Elisa's workers' compensation claim, in violation of §39-71-2203, MCA and Hernandez v. National Union Fire Ins. Co. of Pittsburgh, 2003 MTWCC 5.

48. Defendants had an obligation and duty to exclude the employer from Elisa's workers' compensation claim and their failure to do so on multiple occasions amounts to negligence per se and violates Montana's Unfair Trade Practices Act and Montana's common law of good faith and fair dealing.

49. Defendants failed to have a resident adjuster with full settlement authority in Montana and allowed an out-of-state adjuster to handle, direct and adjust Elisa's workers' compensation claim, in violation of ARM §24.29.804.

50. Defendants' violation of ARM §24.29.804 is evidence of negligence and is a violation of the UTPA and Montana's common law of good faith and fair dealing.

COUNT III - EMOTIONAL DISTRESS

51. All of the foregoing allegations are incorporated by reference in this Count as though fully set forth herein.

52. A party suffering harm as a result of the negligent or intentional infliction of serious or severe emotional distress by another party is entitled to recover damages from that party for such harm. When the Defendants failed to fairly and promptly handle Elisa's claim, it was reasonably foreseeable she would suffer severe emotional distress. When Defendant Hilton invaded Elisa's privacy by insisting on seeing private confidential medical information and when it harassed her in her attempts to return to work and delayed paying her wages, it was reasonably foreseeable that she would suffer severe emotional distress.

53. As a result of the Defendants' actions, Elisa suffered severe or serious emotional distress.

COUNT V - PUNITIVE DAMAGES

54. All of the foregoing allegations are incorporated by reference in this Count as though fully set forth herein.

55. Montana law provides for punitive damages when the defendant has committed actual fraud and actual malice as defined in § 27-1-221, MCA. Defendants committed actual fraud or actual malice when they failed to fairly and promptly adjust Elisa's claim for workers' compensation benefits.

56. Defendants engaged in actual malice. Defendants knew that their claims handling practices created a high probability of injury to Elisa. Defendants deliberately proceeded to act in conscious or intentional disregard of the high probability of injury to Elisa. Defendants deliberately proceeded to act with indifference to the high probability of injury to Elisa. Defendants intentionally disregarded the fact that their failure to pay Elisa's workers' compensation benefits created a high probability of injury to Elisa. Defendants deliberately proceeded to act in conscious or intentional disregard of the high probability of injury to Elisa. Defendants deliberately proceeded to act with indifference to the high probability of injury to Elisa. Defendants disregarded medical information.

57. Defendants engaged in actual fraud. Defendants concealed material facts regarding Elisa's workers' compensation benefits with the purpose of depriving Elisa of her workers' compensation benefits or otherwise causing her injury. Defendants delayed or denied paying owed TTD, TPD, medical benefits and rehabilitation benefits. Defendants repeatedly delayed and denied medical benefits to Elisa, despite knowing that such delay and denial was exacerbating her pain, delaying her recovery and her return to work. Defendants failed to process owed disability benefits, although they knew Elisa was impoverished. As a result, there is a long history of Defendants proceeding with indifference to Elisa's serious problems and claim."

The provided text is an excerpt from a document filed in this case. For a full understanding of the case, one should read the complete court file, including the response.

Javascript is required to view this map.