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Saturday, July 2, 2011

Injured Worker Sues Insurance Company for Malicious Prosecution

A workers' comp claimant has been allowed by the Massachusetts Supreme Court to sue AIG for malicious prosecution as a result of the insurance companies fraud investigation. The workers' compensation insurance company conducted a fraud investigation of the injured worker and forwarded it onto the State agency for prosecution.

"In this proceeding we consider the appeal of AIG Domestic Claims, Inc. (AIGDC), from the denial of its motion for summary judgment. Jesse Maxwell, a workers' compensation claimant, brought suit against AIGDC regarding the company's conduct in referring his claim to the insurance fraud bureau (IFB), communicating with fraud investigators and prosecutors regarding his activity and claim, and using criminal processes to gain leverage in dealings with him. Maxwell sought recovery on theories of malicious prosecution, infliction of emotional distress, abuse of process, and violation of G.L. c. 93A and G.L. c. 176D. In July, 2007, AIGDC filed a special motion to dismiss the suit pursuant to G.L. c. 231, § 59H, the so-called “anti-SLAPP” statute. That motion was denied and AIGDC's appeal was unsuccessful. See Maxwell v. AIG Domestic Claims, Inc., 72 Mass.App.Ct. 685, 893 N.E.2d 791 (2008). On remand, the parties conducted discovery and AIGDC filed a motion for summary judgment in August, 2009. Summary judgment was denied. AIGDC appealed under the doctrine of present execution, and we granted its application for direct appellate review.

"We conclude that AIGDC enjoys qualified immunity regarding its reporting of potentially fraudulent activity but that summary judgment is inappropriate because all of Maxwell's claims rely, at least in part, on conduct falling outside the scope of the immunity. We also conclude that portions of Maxwell's claims may be barred by workers' compensation exclusivity under G.L. c. 152, but that not one of Maxwell's counts is barred entirely such that the Superior Court would be without subject matter jurisdiction. Accordingly, we affirm the order of the Superior Court denying summary judgment and remand the case for further proceedings consistent with this opinion.

Maxwell v. AIG Domestic Claims, Inc., Mass. , --- N.E.2d ----, 2011 WL 2556944 (Mass 2011) Decided June 30, 2011

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