Judge Rejects York Risk Services Demand for Dismissal of Firefighters RICO Case in Arizona

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Injured Phoenix firefighters, represented by Doyle Raizner LLP, continue their case against York, after Industrial Commission of Arizona (ICA) determined that York wrongfully denied care or payments for care to the firefighters.

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"We are honored to represent these men and women who sought only what the law requires when a firefighter or police officer is injured in the line of duty."

A federal district judge has rejected York Risk Services Group’s request to dismiss a case bought by Phoenix firefighters against York, their workers compensation claims administrator.    Represented by Doyle Raizner LLP, a group of eight City of Phoenix first responders sued York on July 15, 2013. The Phoenix firefighters have asserted that York, working in concert with others, violated the Racketeer Influenced and Corrupt Organizations Act (RICO) by establishing a pattern and practice of improperly denying workers compensation claims York is a third-party administrator of workers compensation and other types of insurance claims management for the City of Phoenix, as well as many other governmental agencies and private companies. In refusing the request for dismissal, United States District Judge John W. Sedwick also rejected York’s request that the case be delayed for an interlocutory appeal.

According to court documents, each of the eight City of Phoenix firefighters allege they sustained on the job injuries, and followed the proper administrative procedures to assert their claims with York and the governing Industrial Commission of Arizona (ICA) (Miller, et al. v. York Risk Services Group, United States District Court District of Arizona 2:13-cv-1419 JWS). York denied each firefighter’s claim and York allegedly refused and delayed these first responders necessary medical treatment, or left the firefighter with massive unpaid medical bills, for on the job injuries sustained helping the residents of Phoenix. According to court documents, each firefighter appealed York’s denial to the ICA, the agency that administers state laws relating to workers’ compensation, and in each individual appeal, the ICA determined that York wrongfully denied care or payments for care to the firefighter.

As part of York’s claims process, firefighters were often sent for an Independent Medical Examination (IME) by a doctor of York’s choice. Under Arizona law, the examination should be unbiased and not controlled by or influenced by an insurance claims company. The lawsuit asserts that York expressly or impliedly manipulated the process to delay or deny necessary care. For each of these plaintiffs, York allegedly pursued a consistent scheme to falsely claim that the injuries were non-existent, not work related, or pre-existing, contrary to Arizona workers compensation laws.

The lawsuit asserts that each first responder was harmed financially, medically and emotionally. York’s alleged fraudulent denial and lack of timely payments for the medical care of one firefighter resulted in her family losing their home shortly before her death from cancer caused by her work fighting fires. Another firefighter also lost her home due to financial hardship due to York’s alleged denial of supportive care for the on the job injury. The lawsuit asserts that York ignored the ICA’s ruling that rejected the denial for coverage, and continued to refuse payment in defiance of the law and administrative orders.

“We are honored to represent these men and women who sought only what the law requires when a firefighter or police officer is injured in the line of duty,” said firm partner Michael P. Doyle. Mr. Doyle further alleges, “York’s conduct toward them has been disappointing, and it’s our responsibility to hold them accountable for this terrible violation.”

Doyle Raizner LLP stands behind these firefighters in their fight against an insurance entity it alleges breached its legal responsibilities to the men and women who serve the Phoenix community every day. With offices in Houston, Texas and Phoenix, Arizona, Doyle Raizner LLP is a national law firm whose core practice includes the representation of working men and women whose workers’ compensation claims have been wrongfully denied.

They can be contacted at:
Doyle Raizner LLP Phoenix office, L2929 E. Camelback Road, Suite 126
Phoenix, AZ 85016, 713-571-1146, http://www.doyleraizner.com

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Jeffrey Raizner
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