$3.3 Million Settlement Gets Injured Laborer Extracontractual Liability after Workers’ Compensation Gets Denied

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Mario Jose Leon* set out to build a better life for his family. His travels took him far and wide while he learned to apply his skills in various trades. Eventually, Mario settled in Florida’s Treasure Coast and found work in construction. There, he would meet his future wife and ultimately build a family of his own.

Mario eventually found employment as a laborer for a company serving as a labor broker that provided workers for other companies’ construction projects. Mario’s employer got a labor request from a local shell contractor that had short term labor needs. Shell contractors are sometimes hired by larger home construction firms to build the walls and roof during new home construction. Mario’s employer provided him to the shell contractor as a temporary worker. Mario was sent off to work on a home being built in Martin County by a national home builder.

When Mario arrived at the job site on November 20, 2017, no one provided him with training, supervision, or even detailed instructions on how to do the work. Mario brought his own ladder to the job site, which he placed up against the home being built. As he climbed the ladder, it began to sink into the soil at the base of the home’s wall which had been softened by the previous night’s rain. Realizing he was going to fall from approximately twelve feet and tilting toward a fence, Mario decided it best to jump off the ladder. Unfortunately, he landed on a clean out drain, which struck his lower back. Mario found himself on the ground, unable to move.

Fire rescue rushed to Mario’s aid. He was transported by helicopter to a local hospital. Initially, the hospital did not want to perform surgery until their business office confirmed that Mario would be covered under his employer’s workers’ compensation policy. Eventually, the doctors decided that they could no longer wait for Mario’s employer to respond with insurance clearance; his injuries were severe, and time was of the essence. A CT scan confirmed that Mario had sustained a burst fracture to one of the vertebrae in his lumbar region. Doctors performed an open reduction and internal fixation under fluoroscopy. Unfortunately, Mario’s injuries were catastrophic. He spent the next twenty-five days in a rehabilitation center trying to regain the use of his legs.

Doctors told Mario there was no hope that he would ever walk again. Mario and his family were devastated. They did not know where or to whom to turn. His employer visited Mario at the hospital and told him that if he would sign a blank form his medical bills would be resolved. Suspicious, Mario called Reich & Mancini, P.A., a prestigious law firm in the Treasure Coast area which focuses on workers’ compensation claims. The attorneys at Reich & Mancini immediately jumped into action, but their efforts to secure workers’ compensation coverage from Mario’s employer were unsuccessful. Accordingly, they contacted the shell contractor who hired Mario’s employer to provide labor and argued they were Mario’s statutory employer and had to provide him with workers’ compensation benefits. Unfortunately, that insurance carrier also denied Mario’s claim. Finally, Reich & Mancini contacted the general contractor’s workers’ compensation carrier. They, too, denied Mario’s workers’ compensation claim.

At that point, Mario had a decision to make. He could either pursue workers’ compensation benefits despite the denials of his claim. Alternatively, he could file a third-party claim for the negligence that caused his injuries. In the workers’ compensation claim, Mario’s benefits would be limited to his medical expenses. However, in his third-party negligence claim, Mario would be entitled to recover economic and non-economic damages against the various entities who denied his workers’ compensation claim, each of which bore fault for his injuries. Mario choose the latter.

Reich & Mancini filed a negligence lawsuit on behalf of Mario. Soon thereafter, they contacted David Sampedro at Panter, Panter & Sampedro, P.A. to help them in the pursuit and prosecution of the third-party claim. Josh Wintle and David amended the complaint to include counts of direct negligence as well as counts for vicarious liability. They also argued that the general contractor served as an owner builder and therefore was responsible for Mario’s injuries. Mario’s lawsuit was based upon the failure to provide appropriate training, supervision, and safety equipment needed for the work he was expected to complete.

Despite all companies involved denying Mario benefits, the defendants claimed they were entitled to workers’ compensation immunity simply because Mario’s employer had verified it had secured an appropriate insurance policy. Josh and David argued that some of the defendants had waived certain affirmative defenses such as comparative negligence, assumption risk, and the negligence of others because they had denied Mario workers’ compensation benefits. The case presented monumental challenges, not the least of which was that of insurance coverage. Most liability insurance policies provide for exclusions where workers’ compensation benefits should have applied. Accordingly, while Mario could win the battle, he might ultimately lose the war. Mario faced a real possibility of proving that the defendants were liable for his damages but having their various insurance policies exclude coverage for his injuries.
David and Josh were able to successfully argue that the indemnification agreements contained in the defendant’s contracts with each other created insurance consequences resulting in Mario’s damages being covered. As a result, a policy that excluded coverage for the direct liability of one defendant provided coverage for another defendant for its vicarious responsibility.

In the midst of the COVID-19 pandemic and with cross motions for summary judgments pending, the parties went to mediation. Unfortunately, because of the many moving parts and complicated issues, the mediation concluded with an impasse. David and Josh continued to work tirelessly on behalf of Mario throughout the following weeks.

Eventually, on the eve of the hearing on the various motions for summary judgment, the case was settled for $3,300,000.00. This included the policy limits for two liability carriers as well as the employment liability policy, also known as Coverage B, under the workers’ compensation policy. With the threat of a subsequent bad faith claim, David and Josh were also able to secure extra-contractual payments toward the settlement based upon the initial wrongful denial of Mario’s claim for benefits.

Through this litigation, Mario continued to work tirelessly on his health. Eventually, Mario was able to regain some movement in his legs. He is thrilled that today he is able to stand for short periods of time and even slightly move his feet. Mario hopes to be able to use the funds from his settlement to be able to continue to pay for long term physical therapy in the hopes that he will one day be able to walk his daughter down the aisle when she gets married.

*The party’s names have been changed to protect their identity as required by a confidential settlement agreement.


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