The family of a Puyallup, Wash., firefighter has filed a lawsuit claiming the city of Puyallup and its insurer illegally denied health benefits after the worker contracted a disease on the job that ultimately led to his death.
David Potter, a 20-year veteran of the force, was diagnosed on August 22, 2005, with T-cell Lymphocytic Leukemia, a form of cancer.
Considered an occupational disease for firefighters, state law mandates that any firefighter who contracts Leukemia be entitled to benefits including medical treatment without co-pays or deductibles.
Studies have shown a link between T-cell Lymphocytic Leukemia and exposure to toxic smoke, fumes and chemicals encountered by firefighters.
However, the suit alleges the city and its insurance company intentionally denied Potter’s claim until after the leukemia took his life on June 1, 2006, to avoid paying what could have totaled more than $1 million in medical costs. Potter was diagnosed with leukemia and applied for benefits with the city on August 22, 2005, but according to the complaint, the city and its insurer, Safety National Casualty immediately began delaying the processing of his claim.
“This is the most cynical manipulation of a person’s life I’ve ever witnessed,” said Ron Meyers, an attorney representing the Potter family. “We have abundant evidence that will show that the city and its insurance company played God with David’s life, simply to test the boundaries of the law and save the costs of his treatment.”
The family’s contention is borne out in a series of e-mail documents uncovered during the investigation. According to the law firm representing the family, the complaint cites a memo from insurer SNC sent on April 26, 2006, which reads: “As it stands right now, we could be exposed to $750 million to $1 million case when you take into consideration the costs of chemotherapy, bone marrow transplants and the cost of the pension.”
A second memo on May 3, 2006, appears to validate the insurer’s desire to avoid payment by saying, “it appears the crux of the problem is the insured’s inability to identify another cause for the cancer,” the firm stated.
According to attorney Meyers, Potter and his family fought to try and get the city to live up to its obligations. On May 23, 2006, they convinced the Washington State Department of Labor and Industries (L&I) to order the city and SNC to authorize medical treatment, but the city appealed L&I’s decision. According to the complaint, David Potter died from a treatable condition on June 1, 2006.
Meyers said it wasn’t until Jan. 3, 2007, the day before the appeal hearing, that the city and its insurer agreed to honor Potter’s claim.
The city of Puyallup is self-insured, covering most medical costs out of its budget, but relying on Safety Northern Casualty to pay claims over a specific dollar figure. Penser North America is Puyallup’s administrator, which manages claims for the city.
David Potter became a firefighter in 1985 and joined the Puyallup Fire Department in 1989, eventually being named battalion chief.
Stritmatter Kessler is a law firm with offices in Seattle and Hoquiam and is representing the Potter family.
Source: Stritmatter Kessler