Killion v. Cigna Insurance
June 10, 2011
A Heygood, Orr & Pearson partner represented Steve Killion in an insurance bad faith lawsuit that resulted in a judgment in excess of $1.8 million. The verdict, which came after a week-long jury trial before 136th District Judge Milton Gunn Shuffield of Beaumont.
Steve Killion suffered an on-the-job back injury and Cigna was his employer’s worker’s compensation carrier. The Worker’s Compensation Commission ordered Cigna to provide Mr. Killion lifetime medical coverage for his injury. Mr. Killion tried conservative treatment for his injury for several years but eventually needed surgery. Cigna denied coverage for the surgery claiming that Mr. Killion suffered an intervening injury while feeding a horse.
Under Texas law, a subsequent injury cannot serve as a basis for denial by a worker’s compensation insurance company of medical treatment unless the subsequent injury is the “sole cause” of the need for treatment. At trial, Mr. Killion contended that Cigna had no legitimate reason to believe he was injured while feeding a horse and that Cigna was simply relying upon the fact that he felt worse after feeding his horse as a subterfuge to avoid payment of his medical bills.
In the lawsuit, Mr. Killion claimed that Cigna engaged in bad faith insurance practices and sought damages for the worsening of his condition because he did not receive the surgery that his physician recommended. The jury evidently agreed awarding $545,000 in actual damages and $900,000 in punitive damages. After pre-judgment interest and court costs, the trial court entered a judgment against Cigna for approximately $1,800,000.
The case was reversed on appeal. The Court of Appeals reasoned that Mr. Killion was not entitled to bring a lawsuit against Cigna for bad faith insurance practices because the Texas Worker’s Compensation Commission is the exclusive venue for determinations of whether Mr. Killion needed the surgery recommended by his doctor.
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