Injured worker framed for insurance fraud gets split ruling on appeal

The Court of Appeals of North Carolina has ruled that an injured worker whose insurer knowingly provided false information to police to frame him for insurance fraud, resulting in his arrest, incarceration and indictment on felony charges, can pursue malicious prosecution, abuse of process and unfair and deceptive trade practices claims, but not bad faith and civil conspiracy claims. In 2003, Mario Seguro-Suarez was working for Southern Fiber when he fell from a height of approximately 18 feet onto concrete, striking his head and suffering several broken bones and severe traumatic brain injury, according to court documents in Seguro-Suarez Ex Rel. Connette v. Key Risk Insurance Co. He was rendered comatose and underwent emergency neurosurgery to relieve pressure on his brain. He eventually emerged from his coma, but the brain injury changed his personality, requiring physical, speech and occupational therapy. He currently suffers from significant behavioral and memory deficits, and his injuries rendered him dependent on others for dressing, feeding and other self-care activities. Southern Fiber and Key Risk, as Southern Fiber’s insurance carrier, admitted that his injuries were compensable, according to the ruling.