Spencer v. Annett Holdings, Inc., No. 12-4048 (8th Cir. 2014)
Annotate this CasePlaintiff filed suit against his former employer, Annett, alleging that the company acted in bad faith when it failed to provide medical care and refused to pay him healing-period benefits. Annett counter-claimed for fraud. The court concluded that the district court correctly ruled that plaintiff was required to exhaust his claim with the commissioner; under Iowa law, Annett had a reasonable basis to believe that it could request plaintiff to undergo an examination by the company's chosen physician and plaintiff's refusal to submit to the examination made the propriety of the company's denial of healing-period benefits at least fairly debatable; therefore, the district court properly granted summary judgment for Annett on plaintiff's bad-faith failure to pay benefits claim; and, under either Iowa law or federal law, Annett was judicially estopped from proceeding against plaintiff because Annett had admitted liability in plaintiff's alternate care petition. Accordingly, the court affirmed the judgment of the district court. Annett's motion to strike portions of plaintiff's supplemental appendix was denied as moot.
Court Description: Civil case - Insurance. The district court correctly ruled that plaintiff had to exhaust his claim that defendant denied his claim for medical care in bad faith through the administrative process provided in Iowa's workers' compensation law; district court properly granted summary judgment to defendant on plaintiff's bad-faith failure to pay benefits claim as defendant had a reasonable basis to believe it could require plaintiff to undergo an exam by the company's chosen doctor, and plaintiff's refusal to submit to the exam made the propriety of the company's denial of healing-period benefits reasonable; the district court did not err in granting plaintiff summary judgment on the company's counterclaim for fraud on the ground of judicial estoppel.
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