Wayne Davis was a longtime employee for Burger King Corporation as a “sales, profit and operations” manager. His job required him to travel and visit various Burger King stores for approximately 80 to 90 present of his work day. While on his way to visit one of the Burger King locations, he was struck by another driver who was distracted. Unfortunately Wayne Davis was Killed as a result of the accident. He leaves behind his 30 year old wife and two small children, age 5 and 1. As part of his position with Burger King, he was provided a company vehicle. He was operating the company vehicle at the time of the accident. He often used his cell phone to make work related calls when he was on his way to visit a store location. On the day of the accident, he was scheduled to make an unannounced visit to one of his employer’s store locations. In light of the overwhelming evidence showing he was clearly working and entitled to workers compensation benefits at the time of his death, the workers compensation Insurance company, ACE Insurance denied his widow’s claim for death, dependency and burial expenses. In the insurance company’s notice of denial, they claimed Wayne was not in the “course of his employment”. In other words, they claimed he was “off the clock”
Some studies show that almost 1/2 of all initial workers compensations are initially disputed by the workers compensation insurance company. As a result of the improper denial of benefits, Wayne’s widow went without payments for close to one year and was unable to provide for her children’s basis needs. Even after she filed a workers compensation claim and the workers compensation court sided in her favor, ACE Insurance appealed the court order. They claimed when the accident occurred, he was not on the “most direct path” to the store. Ultimately, ACE Insurance withdrew the appeal and Wayne’s Widow was able to get the benefits she desperately needed.
This is an unfortunate case where a workers compensation insurer wrongfully denies a legitimate case causing a serious financial and emotional toll on the family. In many states, workers compensation insurance carriers can deny just deny legitimate claims and not be subject to unfair and deceptive consumer protection laws. If you or a loved one is involved in a workers compensation claim and you think the insurance company has unfairly denied the claim, it is imperative you speak with an experienced workers compensation attorney, such as Attorney Michael O. Smith to make sure you know your rights.