A worker may pursue his allegations of delay in bad faith, denial of workers' compensation, and emotional misconduct against the third party administrator Helmsman Management Services LLC, Delaware Superior Court ruled.
Ferrari v Helmsman Management Services LLC denied on Wednesday an interlocutory appeal lodged by the company.
Andrew Ferrari worked for a solar company that removed shingles from the roofs. He said he suffered cervical injuries from the cumulative repeated tensions at work and eventually received fusion surgery. Ferrari's employer quickly filed the claim, but Helmsman did not agree to accept it for four months. Meanwhile, Ferrari was out of work and paid for treatment out of pocket and through his group health plan.
Mr. Ferrari filed a complaint against Helmsman for delayed bad faith, denial of workers' compensation benefits and intentional supply of emotional distress.
Helmsman moved for a brief assessment, claiming that as a third party administrator it was not a party to the workers' agreement and could not be sued. In June, the Delaware Superior Court rejected the proposal, finding that Ferrari had provided sufficient evidence to survive a brief assessment of his allegations of bad faith and claims for criminal damages. The court also found that there remained questions about Helmsman 'unreasonably and unfairly delaying the approval' of Ferrari's claims
Helmsman requested an interlocutory appeal on the question of whether TPA could be held responsible for a lack of belief in an insurance contract, but the court refused to certify the appeal. The court ruled that Helmsman could be held liable for breach of contract as a TPA and that its decision was not a "material deviation" from the client.