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What Happens If Your Employer’s Insurance Company Claims it Has No Duty to Defend Your Workers’ Compensation Claim?

— KFEEJB Persuades Illinois Appellate Court to Stop Insurer from Ducking its Obligations….

The 1st District Appellate Court recently reversed a finding that a workers compensation insured lacked coverage due to the insured’s lack of cooperation with the insurer’s investigation of an employee’s alleged injury.
The case is Country Mutual Insurance Co. v. Under Construction & Remodeling, Inc., 2021 IL App (1st) 210600 (Dec. 22). The injured worker, an employee of Under Construction, was represented by A-R Igbadume and David Barish of Katz, Friedman, Eagle, Eisenstein, Johnson, Bareck & Bertuca P.C.

Our client was injured while working for his employer and filed a workers’ compensation claim. Plaintiff, the employer’s workers’ compensation insurer, contacted the employer for information about the claim, but employer failed to respond. Insurer filed declaratory judgment action, claiming that it owed no duty to defend or indemnify employer because it had breached the policy’s cooperation clause. Although the injured worker appeared and defended, the employer did not, and the court entered a default judgment against the company. Country Mutual then filed a motion for summary judgment which was granted by the circuit court arguing again that Under Construction’s lack of cooperation voided its coverage. The appellate court however reversed the circuit court’s decision and found that the record does not show that the insurer exercised reasonable diligence in seeking employer’s participation or that employer willfully refused to participate in investigation. The insurer did nothing to discover alternative methods of contacting employer, and its rote efforts to reach employer were not sufficient to show Plaintiff’s diligence or that employer willfully refused to cooperate.

KEY TAKEAWAY
This case shows that an insurer can seek to avoid its responsibilities to their insured placing the injured employee at a significant disadvantage through no wrongdoing of their own. We at KFEEJB pride ourselves on preventing this type of injustice to injured employees and will ensure an insurer cannot escape its duties through procedural loopholes like this.

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