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Agenda Item: 15(c) |
Prepared By: Alan L. Gabriel, Esq. |
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Business: Resolution |
Department: City Attorney |
Subject:
Title
Resolution - Approving the James Jay Workers Compensation Settlement
Body
BACKGROUND:
James Jay (Jay) was previously employed by the City as a firefighter. On January 11, 2020, Jay was injured in the course of his firefighting duties and thereafter sought workers compensation benefits pursuant to Florida Statutes.
Since 2020, as a result of this injury, the City through its third-party insurance administrators has provided certain workers compensation benefits to Jay. Jay filed a workers’ compensation claim which is now pending in the State of Florida, Division of Administrative Hearings, Fort Myers District. The claim sought various benefits including past and future permanent total disability benefits, plus attorney’s fees and costs. Jay initially alleged that the potential value of all past and future permanent total disability benefits is in excess of $1,000,000.
At the time of the injury, the City’s workers' compensation insurance was through Preferred Governmental Insurance Trust (PGIT), which policy has a $350,000 self-insurance limit. The PGIT polity is an indemnity type policy which reimburses the City after benefits are paid. The party’s (Jay, the City and PGIT) have just concluded court ordered mediation which resulted in Jay, the City and PGIT agreeing to the compromise of all claims for past, present and future workers compensation indemnity benefits arising only from this injury for the total settlement amount of $407,850.00, inclusive of attorney’s fees and cost.
PGIT has agreed to indemnify the City for the entire settlement amount of $407,850.00. At the time of this settlement, the City’s self-insurance limit has been exhausted, and PGIT has previously reimbursed the City for those benefits which have already provided to Jay in excess of the self-insurance amount. PGIT has advised the City that it will reimburse the City the full amount of the agreed $407,850.00 settlement amount.
The Administrative Hearings Judge approved the attorney’s fee settlement on November 19, 2025. The City has 30 days (December 18, 2025) from the date of the Order to deliver the total settlement payment to avoid a 20% penalty, plus interest. Since the PGIT policy is an indemnity type policy, the City has to issue the payment first. Once that payment has been made by the City, PGIT will immediately process and deliver the reimbursement payment to the City (excluding any penalty and interest incurred).
FUNDING SOURCE / FISCAL IMPACT:
Since the total settlement amount ($407,850.00) will be reimbursed to the City by its workers’ compensation carrier, there is no fiscal impact to the City.
RECOMMENDATION: Approval of Resolution 25-60
POTENTIAL MOTION: “I move to approve Resolution 25-60.”