In the case of Seguro-Suarez v. Key Risk Ins. Co. (17-697), a North Carolina man has brought suit against his employer’s insurance company for actions in a Workers’ Compensation (WC) claim that resulted in his arrest. In their decision, the North Carolina Court of Appeals rejected the company’s motion to dismiss and allowed the suit to proceed.
The Injury
Mario Seguro-Suarez worked for an optical fiber network company when he fell 18 feet onto concrete. Striking his head; he broke several bones and suffered a traumatic brain injury which left him comatose. His injuries required emergency neurosurgery to relieve pressure on his brain.
The Recovery
While Mr. Seguro-Suarez eventually emerged from his coma, his injuries required ongoing physical, speech, and occupational therapy. He now suffers from severe cognitive, behavioral, and functional deficits—and requires support in nearly all daily activities.
The Claim
Key Risk Insurance Company used private investigators in a surveillance program to reduce or dismiss the man’s WC claim, which the North Carolina Industrial Commission (NCIC) required they continue to pay. The company then instructed their investigators to provide authorities with surveillance footage in a successful attempt to have Mr. Seguro-Suarez arrested for fraud.
The Decision
The State of North Carolina—having confirmed the man’s traumatic brain injury as consistent with medical evidence—dismissed all charges against Mr. Seguro-Suarez. The Court of Appeals decision allows him to seek punitive damages against Key Risk Insurance on the grounds of:
- Malicious Prosecution
- Abuse of Process
- Unfair Trade Practices
- Deceptive Trade Practices
While insurance companies commonly use surveillance to verify Workers’ Compensation claims, the egregious actions of Key Risk Insurance fall well outside the provisions of the Workers’ Compensation Act—and have now become a matter for the civil justice system.
We Can Help
If you have questions, Henson Fuerst has answers.
If an insurance company stands between you and the Workers’ Compensation benefits you need, Henson Fuerst will stand up to them for you. Learn how our experienced North Carolina Workers’ Compensation Attorneys can help you get the Workers’ Compensation benefits you need. Call us today at (919) 781-1107 or complete a free initial consultation form. There’s no obligation, and our phone lines are open 24/7.
