Suit against insurer says benefit delay caused permanent nerve damage

Kelly Holleran Oct. 18, 2010, 7:26am

A Beaumont woman has filed suit against the insurance company she claims delayed her workers' compensation benefits, causing her to experience irreparable nerve damage.

Stacy Jo Maxey claims she suffered disabling injuries to her cervical spine, arm and shoulder while working on Nov. 20, 2007.

After the incident, Maxey needed cervical surgery, but defendants East Texas Educational Insurance Association and Cas-Claims Administrative Services refused to approve payment for the surgery, according to the complaint filed Oct. 5 in Jefferson County District Court.

Unable to pay for the surgery herself, Maxey could not receive the surgery, the suit states.

Finally, Maxey's physician, Dr. David W. Wimberley, filed a formal complaint with the Texas Department of Insurance and, subsequently, the defendants approved the surgery in May 2009, the complaint says.
Maxey claims she eventually received the triple fusion with bone grafting surgery, but because of the delay in the surgery, she experienced permanent and irreparable nerve damage.

"Plaintiff alleges that she would not have experienced same if the surgery had been approved and performed on a daily basis," the suit states.

Maxey blames the defendants for refusing to conduct a reasonable investigation before denying her benefits, for refusing to acknowledge that Maxey had sustained a compensable injury, for violating the Texas Insurance Code and for asserting unfounded reasons to deny payment.

In addition to the insurance agencies, Maxey names Ann Barron as a defendant, saying she worked for the agencies to delay payment of Barron's claim.

In her complaint, Maxey is seeking an unspecified judgment, plus interest, pre- and post-judgment interest, costs and other relief the court deems just.

Tommy L. Yeates of Moore Landrey in Beaumont will be representing her.

The case has been assigned to Judge Bob Wortham, 58th District Court.

Jefferson County District Court case number: A188-534

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