Defense Base Act Compensation Blog

The Modern Day DBA Casualty

Posts Tagged ‘Private investigators’

Defense Base Act War Hazards Act: Overly Zealous Representation in Defending Against a DBA Claim

Posted by defensebaseactcomp on June 27, 2012

employer/carrier’s inadequate or overly zealous representation in defending against a DBA claim may be grounds for denying all or some portion of a request for WHCA reimbursement.

So Mr Rayburn how many War Hazards reimbursements has the DFEC denied

in part or whole over the following

Overly Zealous DBA Insurance Company Defense Tactics ?

The use of repeated Defense Medical Examinations with Doctors Over Paid to produce a report detrimental to the claimant, to run them through the drill

—————————————————

The claims process being drug out for as long as nine years with no end in sight while the defense racks up ever more legal fees, the insco keeps charging administrative fees, not to mention the claimants attorneys fee’s, while the claimant goes without  medical and/or indemnity

—————————————————

Unnecessary mileage, airfare, lodging, expenses paid out due to due coercing claimants to travel as far as five states away to attend Defense Medical Examinations, Mediations, Depositions, Hearings

—————————————————

The use of private investigators, some even criminals themselves, to stalk and intimidate injured contractors and their families far beyond simply confirming a claimants status

—————————————————

The use of  Third Party Administrators to handle claims processes that could easily be done without the added expense and fees.

—————————————————

Unnecessary fines and interest due to non payment or late payment of  indemnity

—————————————————-

The financial ruination of injured contractors and their families caused by the overly zealous controverting of legitimate claims

—————————————————-

The Temporary Disabilities which are now Permanent due to their failure to provide medical care under the guise of investigating clearly legitimate claims.  Now the US taxpayer is responsible for disabilities far beyond what they ever had to be.

—————————————————

The PTSD Suicides caused by the Insurance Companies, their claims examiners, and their attorneys

—————————————————

The break up of families caused the constant pressure and abusive tactics used by the Employer/Carrier

—————————————————

The forced acceptance of inadequate settlements or stipulated agreements due to starving the claimant out for years on end and/or threatening the claimant and family that if they do not accept the inadequate settlement they will make them miserable for the rest of their lives (see The Weaponization of the Defense Medical Examination)

—————————————————

Unfairly denying the claimants attorneys fees in order to discourage good attorneys from handling these claims

————————————————–

FECA BULLETIN NO. 12-01

XI. Miscellaneous

1. DFEC requires, before acceptance of any WHCA reimbursement claim, that the employer/carrier has made only reasonable and prudent efforts in presenting all meritorious defenses against a DBA claim without regard to whether the case is eligible for WHCA reimbursement. An employer/carrier’s inadequate or overly zealous representation in defending against a DBA claim may be grounds for denying all or some portion of a request for WHCA reimbursement.

CECILY A. RAYBURN
Director, Division of Planning, Policy and Standards

Posted in ACE, AIG and CNA, Chartis, Civilian Contractors, Contractor Casualties and Missing, DBA Attorneys Fees, Defense Base Act, Defense Base Act Attorneys, Defense Base Act Insurance, Defense Base Act Law and Procedure, Defense Base Act Lawyers, Delay, Deny, Department of Labor, Hope that I die, Injured Contractors, KBR, Political Watch, PTSD and TBI, Suicide, Veterans, War Hazards Act | Tagged: , , , , , , , , , , , , , , , , , | 7 Comments »

WARNING to DBA claimants/ injured civilian contractors in Georgia, Florida, South Carolina and Alabama:

Posted by defensebaseactcomp on November 9, 2010

AIG (via the taxpayer) is paying this firm to spy on you for days on end, and what’s worse is they guarantee “well over a 90% video success rate on all files … Unheard of in the industry.”
In other words over 90% of us are lying about our injuries, or they either grossly exaggerate and/or photoshop and manipulate the video surveillance which is a far more likely scenario.

Private Dick

Your Claims Defense Specialist !!

Alliance Investigations,
P. O. Box 1451, Bainbridge, Georgia 39818
Telephone – (229) 400-0841 Fax – (229) 246-7229 Contact: Darrell D. Cox (President)
It’s surely just a matter of time before someone gets hurt in the ongoing despicable practice of stalking and filming DBA claimants, many of whom suffer from PTSD, TBI and other war-related trauma known to significantly reduce impulse control. The fact that two insurance whores now team up to spy on claimants at any given time is just making matters worse.
The latest culprits making their living by spying on injured contractors for AIG are S.R. Stone and M.A. Wheatley presumably of Bainbridge, GA. If anyone can dig up mug shots please send to us asap.
Case No.: 2009-LDA-00055
S.R. Stone testified that he is a private investigator for Alliance Investigations performed video surveillance of the Claimant from 4:37 PM, September 24, 2008 through September 27, 2008.
He identified EX 23 as an accurate report of his activities during his surveillance of the Claimant as well as containing the previous surveillance attributable to his associate Mr. Weatley. Mr. Stone testified that he was working another case when he was called on September 24, 2008, and assigned to assist Mr. Wheatley in the surveillance of the Claimant.
On re-cross examination, Mr. Stone testified that at some points in time he was five to ten feet away from the Claimant while the Claimant operated the motorcycle and sometimes he used the zoom-lens on the camera.
Testimony of M.A. Wheatley (TR 35-46)
Mr. M.A. Wheatley testified that he is a self-employed licensed private investigator and has been an investigator since May 1995. He is licensed in Georgia, South Carolina and Florida. He reported that he conducted surveillance of the Claimant for a day and a half on September 23 and 24, 2008.
He stated that the portion of EX 23 from 2:07 to 5:14 PM, September 24, 2008,
reflected the observation he and Mr. Stone made since they were both observing the same
activity together at that time.
NOTE to the computer-savy among us, the software they use is Trackops.

MORE FROM THEIR WEBSITE:
Alliance Investigations is a specialized investigative agency, specifically focused on the needs and demands of the insurance industry. We provide services to clients in Georgia, Florida, South Carolina, and Alabama and operate on an old-fashioned philosophy whereby success is achieved through quality work, honesty and an unwavering commitment to customer satisfaction. In addition to our commitment to quality, our clients also receive an industry-exclusive product quality guarantee for surveillance investigations.

(Are they guaranteeing to produce positive results for the insurance company whether they exist or not?)
Quality Assurance Policy
On any 2-day surveillance budget in which we fail to obtain documentation of your CLAIMANT, we will continue with additional surveillance at no cost to your office. How do we do it? Our Investigators are without peers. Simply put, we can afford to guarantee you results on your Worker’s Compensation or Liability claims investigations because our field Investigators are just that good.
As an adjuster or defense attorney, you’ve heard that phrase, said it yourself many times and by now, probably believe it to be true.
While other companies may take that slogan to heart, we at Alliance Investigations make it our mission to limit the misses and amplify the hits.
AND we have become quite good at it. In fact, as a company we maintain well over a 90% video success rate on all files … Unheard of in the industry.

Posted in AIG and CNA, Civilian Contractors, Injured Contractors, PTSD and TBI, spykids | Tagged: , , , , , | 2 Comments »

AIG Known as a Street Fighter When it Comes to Paying Claims

Posted by defensebaseactcomp on May 14, 2010

Scorched Earth

Despite Hornby’s conviction, Wyndham and AIG have battled the girl’s parents over damages for almost five years. They have sparred over psychological and medical exams, access to lists of other children entrusted to Hornby’s care, and the use of private investigators to probe the parents’ marketing business and the girl’s friendships and behavior at school. “They have done everything they can to ruin these people. This has been scorched earth,” says Ernie Allen, president of the National Center for Missing & Exploited Children, who has followed the case closely.

June 6, 2005

American International Group (AIG ) — the massive insurance firm now notorious for its aggressive accounting — is also known as a street fighter when it comes to paying claims. Insurance analyst J. Paul Newsome of A.G. Edwards & Sons Inc. (AGE ), who follows AIG, says the company has a reputation in the industry for playing hardball. “That’s part of the reason companies buy insurance from AIG,” he says. “They want to put up a vigorous defense if they think they’re right

How vigorous? Lawyers and advocates for abused children say that AIG and client Wyndham International Inc. (WBR ) have conducted an unusual and highly aggressive defense in a civil case involving the molestation of a 9-year-old girl by an employee of the Wyndham Sugar Bay Resort & Spa in the Virgin Islands. As the case moves to trial in federal court in St. Thomas in early June, the underlying strategy of Wyndham and AIG remains unclear. But, says Jay W. Waks, a specialist in employment law at the New York firm of Kaye Scholer, the defendants may figure that “unless they defend this as best they can, others will make claims against them.”

The total potential liability that Wyndham faces is hard to quantify, but it could go beyond damages in the case now headed for trial. Two more families have sued the hotel chain, charging that their daughters were molested at the resort. And other alleged victims could come forward with lawsuits: Wyndham has identified 150 families whose children were cared for by the pedophile formerly in its employ.

In three molestation cases involving clerics, juries have awarded $6 million to $15 million per plaintiff in compensatory and punitive damages. And the Virgin Islands is known as plaintiff-friendly. Mark A. Kelegian, a partner at Kelegian White & Reed in Los Angeles and an expert on sexual assault claims, says that if he was taking the Wyndham case before a jury, he’d ask for $5 million to $10 million in damages. AIG says its policy limit is $5 million, no matter how many suits are filed.

The suit is heading for trial at a pivotal time for both Wyndham and AIG. The insurer is under investigation by the SEC, New York Attorney General Eliot Spitzer, and the New York State Insurance Dept. over allegations of improper accounting. Wyndham, meanwhile, posted a first-quarter loss of $23.48 million just before The Wall Street Journal reported on May 10 that the company is up for sale. The company will not comment on the report.

The incident behind the lawsuit is every parent’s nightmare. In April, 2000, a British couple living in Falls Church, Va., Paul Gayter and his wife, Flora Nicholas, went on a family vacation to the U.S. Virgin Islands with their 9-year-old daughter and 7-year-old son. Soon after they got home, the girl picked up a copy of the children’s book Chicken Soup for the Kid’s Soul and read that kids should alert an adult if they’ve been touched inappropriately. The girl went to her parents with a disturbing tale: The then-22-year-old director of the resort’s children’s program had kissed her, cuddled her on his lap, and fondled her genitals. Gayter and Nicholas immediately called the local police.

“SCORCHED EARTH”
Bryan Hornby, director of the Kids Klub at the Wyndham resort, was promptly arrested and convicted in 2001 of unlawful sexual contact with the hand and sentenced to five years in a Virgin Islands prison. Denied parole in December, 2003, he is scheduled for release in 2006.

Despite Hornby’s conviction, Wyndham and AIG have battled the girl’s parents over damages for almost five years. They have sparred over psychological and medical exams, access to lists of other children entrusted to Hornby’s care, and the use of private investigators to probe the parents’ marketing business and the girl’s friendships and behavior at school. “They have done everything they can to ruin these people. This has been scorched earth,” says Ernie Allen, president of the National Center for Missing & Exploited Children, who has followed the case closely.

For its part, AIG maintains that it’s simply fulfilling its duty. AIG is not a defendant in the suit but is paying seven law firms — from California to Washington to the Virgin Islands — to represent Wyndham and Hornby under a policy issued by its AIG WorldSource unit. “We have an obligation under the terms of the policy to defend Wyndham, and this is part of the defense,” says AIG spokesman Chris Winans. Wyndham spokeswoman Darcie M. Brossart says: “We want the judicial course to play out, and with the trial so close to being under way, we’re not going to comment publicly.” The Gayter family has a high-powered legal team from the Washington firm of Williams & Connolly.

The central issues in the case are whether Wyndham failed to take necessary precautions when it hired Hornby in November, 1999, and whether it adequately supervised him. According to testimony in the case, during Kids Klub “movie nights,” Hornby put the girl on his lap in the back row of the resort’s theater and molested her. The family charges that he was the only adult in the theater with 10 or more children. Hotel employees said in depositions that Hornby encouraged children to wear their pajamas to movie nights and often wore his own.

A native of Zimbabwe, Hornby spent two seasons at the Wyndham Palmas del Mar resort in Puerto Rico as a beach attendant and Kids Klub helper. A Web site from the resort dated June, 1999, and still available on the Net, refers to Hornby as a “sometimes eccentric babysitter.”

Given Hornby’s conviction, “This is a loser in front of a jury,” says Waks. “Unless [the defense] feels that the judge will intervene on a point of law, you’re looking at a possible runaway jury verdict, and punitive damages could be huge.”

Gayter says Wyndham offered the family “an absolutely insulting pittance” to settle. A source familiar with the case says the offer was “somewhere north of $800,000.” To Gayter, his family has paid a much higher price. “From the number of people they’ve deposed, they’ve effectively taken away [my daughter’s] anonymity,” says Gayter. His daughter feels that she can’t open up to her counselors, Gayter adds, for fear that private confessions will end up in court records. “They’re looking for dirt,” he says. “We had our garbage stolen about a month before a deposition, and then when I was being deposed, there was this whole thing about why didn’t we feed our kids properly and why did we eat so much take-away pizza?”

Gayter won’t say what the family is demanding. “We’re prepared to see this thing through so that the spotlight is on these companies,” he says. Later, he adds: “Of course, to a point, we’d be willing to settle.”

Gayter spoke to BusinessWeek on the record but requested that the name of his daughter, now 14, not be published. However, a January, 2004, article in People not only used the girl’s name with her parents’ permission but also quoted her. While the publicity obviously could help in his lawsuit, Gayter says discussing the case helps his daughter. “It’s powerful for her.”

After protracted haggling, Wyndham gave attorneys for Gayter and Nicholas a list of 150 families whose children participated in Kids Klub activities under Hornby’s supervision at either Sugar Bay or the Puerto Rico resort. But the judge who ordered the list turned over also barred Gayter and Nicholas from telling the families that their daughter had been molested. So far, the family says it hasn’t contacted anyone on the list.  Original Here

Posted in AIG and CNA, Contractor Casualties and Missing | Tagged: , , , , , | Leave a Comment »

 
%d bloggers like this: