Houston, TX asked in Contracts, Criminal Law and Insurance Bad Faith for Texas

Q: Yes my question is about an Trucker's Group Insurance Policy on the job that fall under an Occupational Accident Policy

an o/o trucker who is leased to this trucking co. this policy is in the trucking co. name only , they is the owner of your policy. and they make up they own rules if they want to pay or not and it is most no to be. I have a stroke on the job back in July 28, 2009 why on the job at work and they wouldn't file a claim on me until 40 days later and that because I call them up to let them know I were going to file a lawsuit on them . They would call up the trucker insurance co. at all.

So on that note I was then set up with a telephone number to call myself for help. This was with ''SRS'' they own insurance for they worker's. I had to pay onto a trucker's policy. So this cause my 17 days in a hospital and they knew about my stroke the very next day when the open . All I 'm told was that GOD cause my stroke and that fall under an Act Of God and that so they don't pay for that. But me being slow in thinking , I didn't know who they were until I got an letter from ''SRS'' who is TDI,

2 Lawyer Answers
Roy Lee Warren
Roy Lee Warren
Answered
  • Criminal Law Lawyer
  • San Marcos, TX
  • Licensed in Texas

A: Thank you for your question. I am certain that you are aware you will need legal representation that is particularly skilled in WC law. However, I am sure that is not why you came to this site. I will attempt to assist you because I understand the dire predicament you are in.

SRS is not the Division of WC (DWC) for TDI, but you are correct in that SRS is not there to help you establish your claim against it. Insurance carriers (IC) are in the business of collecting premiums, NOT PAYING CLAIMS. If you so desire, the DWC will appoint an ombudsman to assist you with your claim and the help is free.

Strokes are considered an "ordinary disease of life" so you will have a more difficult burden to prove the relationship to your employment was such that the conditions of your employment were such that it was a "substantial contributing cause" of the stroke, rather than the "natural progression" of a disease. Do not misunderstand, it is not impossible, just more difficult.

Unfortunately, some people have a very hard time understanding wc law/rules and the interplay of the medical care/terminology with the application of the facts. I represented a fellow a few years back that fell off a trailer he was loading because he suffered a stroke. He hit his head on the asphalt causing very debilitating injuries but even after we won the decision and DWC ruled the injuries/stroke was compensable, the medical providers refused to award the injured worker any impairment rating (income benefits are paid based on the impairment rating) so we ultimately were required to change doctors to someone that would comply. For that fellow the stroke resulted in what is known as an "idiopathic fall" off the truck trailer and the instrumentality of his injury was the asphalt parking lot owned by the employer. I hope you have doctors that will fight for you. Best of luck.

Roy Lee Warren
Roy Lee Warren
Answered
  • Criminal Law Lawyer
  • San Marcos, TX
  • Licensed in Texas

A: I meant to include that once you report your injury to your employer it is duty bound to report the injury to the IC or the employer can lose rights to dispute your claim. Even if you beg the employer not to report your injury they are required to report the wc claim if you lose time from work. They cannot pass that duty to you nor are they allowed to pass the costs of wc coverage on to employees.

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