Courtesy of Workers' Compensation InsiderMay 05, 2006
It's a sunny, mild Friday and the mind wanders away from work, to the ballpark. The Insider has been thinking about Jeff Bagwell.
For Red Sox fans, Bagwell will always be the one who got away, traded in 1990 to the Houston Astros in an ill-advised deal of legendary proportions. The Sox acquired the services of an aging relief pitcher named Larry Anderson for a couple of months. Anderson was gone by the end of the season.
Bagwell went on to a stellar career with Houston, ringing up huge numbers with his bat. His lifetime batting average is near .300. He is ranked among the top five first basemen of all time. Now, in the twilight of his career, his skills are diminishing. The question has become, does a man who can barely throw a baseball 35 feet meet the definition of disabled?
Bagwell's disability is the subject of a lawsuit between the Houston Astros, who say he's disabled, and Connecticut General Life Insurance, who says he was not disabled during the period the disability policy was in effect.
To acquire disability coverage, the Astros paid $2,409,343 in premiums. (You have to wonder how underwriters and actuaries determine premiums for this type of risk.) Bagwell makes about $18 million a year. (We are a nation with awesomely aligned priorities, that's for sure!) The terms of the Policy are relatively straightforward. It provides a schedule of benefits payable to the Astros in the event (a) Mr. Bagwell becomes totally disabled and (b) the terms of and conditions of the Policy are met.
$86K a day!
Under the Policy, the Astros are to receive $85,748 for each regular season day that Mr. Bagwell misses due to total disability. (In the world of workers comp, where indemnity is tied to the state average weekly wage, $86K represents the total lifetime settlement figure for a major disability.)
Bagwell, who is currently on the 15-day disabled list with arthritis and bone chips in his right shoulder, was deemed disabled as a professional baseball player by two physicians in January. Based on those reports, the Astros filed their insurance claim on January 27, just four days before the policy ended.
On March 13, Connecticut General sent a denial letter to the Astros, based upon the fact that Bagwell was an active player in last year's world series and then showed up for spring training this year. In other words, he was not disabled in the fall and he was not disabled in the spring. They don't accept the January finding. The Astros counter that Bagwell's being on the series roster was in honor of his years of service to the team, not his very limited capabilities last fall. And even though he tried to play in spring training, his injuries prevented him from doing so.
Unfortunately for the carrier, the Astros play in the National League, where there is no provision for a designated hitter. Even though Bagwell's bad shoulder prevents him from throwing the ball well enough to play the field, he might be able to swing a bat. But that "reasonable accommodation" would be an option only in the American League.
So no modified duty for Bagwell. It's full duty or nothing. The amount of money at stake in this situation is mind-boggling. On a common sense level, it's simply absurd. It's enough to make you shut down your computer and head home, where you can set up a portable TV on the patio, pop open your favorite brew and catch the first pitch of the weekend series.
Posted by Jon Coppelman at 10:34 AM
Workers' Compensation Insider