A college football player, who suffered a catastrophic injury on the field, sued an insurance company for breach of contract, violations of the Texas Insurance Code, and violations of the Texas Deceptive Trade Practices Act after the defendant, Certain Underwriters of Lloyd of London, “delayed and failed to pay [him] the benefits he is entitled to receive under the terms of [an insurance] policy.”
The plaintiff is represented by Christian Dennie of the Dennie Firm.
By way of background, Sevyn Banks, the plaintiff, was a 4-star high school football player, who was widely recruited as one of the top defensive backs in the country. He ultimately accepted a full scholarship to play football for Ohio State University. Banks began his career with the Buckeyes in the fall of 2018.
Four years later, as a graduate transfer, he transferred to Louisiana State University to play football for the SEC school. Then, on October 1, 2022, during the opening kickoff in LSU’s game against Auburn, Banks “went to make a tackle and collided head-to-head with the ball carrier,” according to the complaint.
“At the time of the collision and for a significant period of time thereafter, Banks was paralyzed. He was taken from the field on a stretcher and transported to a hospital in Auburn.” Banks never played another down of the football. This was tragic in that he had been projected to be a first-round pick in the NFL draft, according to the complaint.
Five days after the head-to-head collision, on October 6, 2022, an “athlete’s disability application – proposal” was submitted to the defendant on Banks’ behalf. In the application, Banks “disclosed a litany of previous injuries, surgeries and medical treatment, including specifically the cervical spine injury sustained” during his last game and his ongoing treatment for that injury. He also submitted a “medical” application in which his injury was “disclosed in more detail by an LSU physician.” Specifically, the application detailed that the injury occurred at the C4-C5 level and as a result Banks experienced significant side effects, including paralysis. The complaint summarized the LSU’s physician’s findings, noting that Banks “remains mere centimeters away from being paralyzed from the neck down if he sustains hard pressure to the head.”
On October 24, 2022, Banks obtained a permanent total disability policy, underwritten by the defendant with a lump sum benefit for $1 million for the period of September 16, 2022 through August 1, 2023. This policy period began 15 days before the injury in question. The description of benefits outlined coverage for temporary and permanent total disability benefit.
Central to the plaintiff’s claim was the fact that the policy “expressly states that all pre-existing conditions declared to the insurance company will be covered unless otherwise excluded in a special exceptions rider.” The spinal cord injury was not mentioned.
Banks sent “a notice and demand” to the defendant’s agent on October 17, 2024, seeking “a full lump sum benefit of $1 million due to the spinal cord injury preventing him from pursuing his chosen profession.” Supporting documentation with the notice included an “attending physician’s statement of disability,” which suggested Banks never play football again because of the injury.
Despite this, the defendant “delayed and failed to pay Banks the benefits he is entitled to receive under the terms of the policy,” according to the plaintiff.
In the complaint, the plaintiff argued the defendant breached its contract (count 1), as well as violated the Texas Insurance Code (count 2) and the Deceptive Trade Practices Act (count 3).
Under count 1, the plaintiff alleged that he entered into a contract that required the defendant “to pay [him] a lump sum benefit of $1 million for any injury sustained during the policy period that resulted in permanent total disability.”
Regarding count 2, the plaintiff maintained that “since being alerted to the failure, breaches, acts, and omissions, [the] defendant has failed to make an offer to pay the damages obviously incurred by plaintiff and covered by the [insurance] policy. In fact, [the] defendant has knowingly and intentionally wasted time and failed to enter into productive communications with plaintiff.”
As for count 3, he maintains that the defendant’s “actions and inactions constitute false, misleading and deceptive acts,” which are “a producing cause of plaintiff’s damages.”
