PHILADELPHIA – A federal judge granted summary judgment to an insurance provider in a disability discrimination and wrongful termination action filed by a Delaware County paramedic – who in a separate-but-related lawsuit, alleged he was fired by the City of Philadelphia soon after beginning his employment.
In a July 19 decision, U.S. District Court for the Eastern District of Pennsylvania Judge Jan E. DuBois granted a motion for summary judgment from Provident Life and Accident Insurance Company, and against plaintiff Chase Frost.
On Aug. 11, 2007, Frost suffered catastrophic injuries when he was trapped inside a collapsed, burning building while employed as a volunteer firefighter, which caused him to sustain extensive 4th degree burns to over 60 percent of his body and ultimately resulted in having his left arm and right leg amputated.
At the time of the accident, plaintiff was insured under an Emergency Responder Blanket Accident Insurance Policy, issued by the defendant. The policy provides for payment of disability benefits for five years if the insured is unable to perform his own occupation.
After payment of disability benefits for five years, benefits are payable under the Policy only if an insured “is not able to engage in any gainful occupation in which he…might reasonably be expected to engage because of education, training, or experience.”
The defendant learned in the fall of 2016 from Dr. Linwood Haith, a general surgeon and the Chief of Burn Surgery for Crozer Keystone Health System who was part of the team that treated Frost for his injuries, that he no longer had any restrictions on his activities – and thus, denied him continued disability benefits coverage in January 2017.
In a separate action filed in October 2017, Frost filed a disability discrimination and wrongful termination case against the City of Philadelphia. However, Frost lost the case on the grounds that he failed to show that the City’s justification for terminating him – the fact that he failed a re-test” at the Fire Academy – was pre-textual, according to U.S. District Court for the Eastern District of Pennsylvania Judge Michael M. Baylson.
On Dec. 23, 2019, plaintiff filed the instant complaint, alleging that the defendant breached the policy by terminating his disability benefits. On Jan. 15 of this year, the parties filed cross-motions for summary judgment, with responses to follow on Feb. 24.
Frost argued that he continued to be disabled under the terms of the policy, while the defendant countered that Baylson’s ruling from the other lawsuit should ensure that collateral estoppel prevents Frost from making that claim.
DuBois concurred with that assessment.
“Judge Baylson’s determination in Frost v. City of Philadelphia that plaintiff was able to perform an occupation with reasonable accommodations was ‘essential to the prior judgment’ in that case. A final judgment in Frost v. City of Philadelphia could not be reached without addressing and deciding that issue. For the foregoing reasons, collateral estoppel bars plaintiff from re-litigating the issue of whether he is able to perform an occupation with reasonable accommodations,” DuBois said.
DuBois concluded that Frost was not eligible for disability benefits coverage, and a result of that determination, nor was he entitled to receive attorney’s fees.
“The Court concludes that there is no coverage under the policy if plaintiff can return with reasonable accommodations to ‘any gainful occupation’ in which he might be expected to engage because of his education, training, and experience. As discussed supra, Judge Baylson has issued a ruling on this issue – plaintiff is able to perform the duties of Fire Services Paramedic, a gainful occupation, with reasonable accommodations,” DuBois said.
“In view of his years of experience and education as a paramedic, this Court concludes that Fire Services Paramedic is an occupation in which plaintiff might be expected to engage with accommodations because of his education, training, and experience. Accordingly, plaintiff is not entitled to disability benefits under the Policy.”
U.S. District Court for the Eastern District of Pennsylvania case 2:19-cv-01199
From the Pennsylvania Record: Reach Courts Reporter Nicholas Malfitano at nick.malfitano@therecordinc.com