had obtained a certificate of insurance
verifying that MDR had workers’ compensation insurance through Pinnacol.
A few months later, Pinnacol sent a letter to MDR stating that the insurance was
going to be cancelled if payment was not
received by March 2, 2011. MDR’s owner
said that he never received the letter and
that a relative had signed for it. Pinnacol’s
agent, Bradley Insurance Agency—which
had issued the certificate to Alliance—
also received a copy of the letter.
MDR did not pay the outstanding premium, and the policy was cancelled. Cancellation letters were sent to MDR and
Bradley but not to Alliance. The policy cancellation effective date was March 3, 2011,
and Hernandez fell on March 10, 2011. On
March 11, 2011, MDR’s owner paid to have
the policy reinstated and signed a no-loss
letter, even though he was aware that a loss
had occurred the previous day.
The policy was reinstated, and MDR
filed a claim for Hernandez’s injuries. Pin-
How Hail Damage Turned
Into a Workers’ Comp Claim
Following the brutal winter many of us have just experienced, the idea of spring is a welcome change. However, spring can bring its own set of problems, from an increase in tornadic
activity to heavy rains.
While coverage for direct physical loss
of or damage to covered property caused
by or resulting from windstorm or hail is
a standard feature of property insurance
forms, there are other ongoing losses
that may result from windstorm and hail
damage that should also be considered.
Water damage, mold and the effects of
power outages can come into play once
the storm is over. But there are some less
obvious perils in the aftermath of a storm
that insureds may also face.
For example, a homeowner who suffered hail damage to her roof probably
did not expect to become embroiled in a
workers’ compensation suit, but that’s exactly what happened in Hoff v. Industrial
Claim Appeals Office, No. 13CA1798, 2014
WL 5034507 (Colo. App. Jan. 15, 2015).
Norma Hoff owned a house she used
as a rental property. She and her husband
contracted with Alliance Construction
to repair hail damage to the roof of the
home. Without Hoff’s knowledge, Alliance subcontracted the work to MDR
Roofing, Inc. Hernan Hernandez, an employee of MDR, was working on Hoff’s
roof when he fell 25 feet from the top of
a ladder and sustained serious injuries.
When he made a claim for medical and
temporary total disability, MDR’s insurer—Pinnacol—denied the claim because
the policy had lapsed due to failure to
pay premiums. Hoff and Alliance did not
carry workers’ compensation insurance.
Before starting the roofing job, Alliance