Home/Case Law/JOHN KOCH vs. R.E. STATE ENGINEERING, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for FREMONT INSURANCE GROUP, in liquidation
Regular DecisionWorkers' Compensation

JOHN KOCH vs. R.E. STATE ENGINEERING, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for FREMONT INSURANCE GROUP, in liquidation

Filed: Feb 03, 2012
San Diego
ADJ1521373 (SFO 0475882)

CompFox AI Summary

In this workers' compensation case, the applicant's employer sought reimbursement from CIGA for benefits paid to the applicant following an industrial injury. The applicant was entitled to benefits under both California workers' compensation law and the federal Longshore and Harbor Workers' Compensation Act (LHWCA). CIGA argued it was not liable because the applicant claimed benefits under the LHWCA, which is excluded from CIGA's covered claims. The Appeals Board, however, affirmed the WCJ's decision, finding that the employer's claim for reimbursement of California statutory benefits was a "covered claim" and CIGA was liable due to the insolvency of the employer's insurer, Fremont. The Board reasoned that the employer's payment of LHWCA benefits did not make them "other insurance" and the claim was for benefits due under California law, not the LHWCA itself.

Full Decision Text1 Pages

In this workers' compensation case, the applicant's employer sought reimbursement from CIGA for benefits paid to the applicant following an industrial injury. The applicant was entitled to benefits under both California workers' compensation law and the federal Longshore and Harbor Workers' Compensation Act (LHWCA). CIGA argued it was not liable because the applicant claimed benefits under the LHWCA, which is excluded from CIGA's covered claims. The Appeals Board, however, affirmed the WCJ's decision, finding that the employer's claim for reimbursement of California statutory benefits was a "covered claim" and CIGA was liable due to the insolvency of the employer's insurer, Fremont. The Board reasoned that the employer's payment of LHWCA benefits did not make them "other insurance" and the claim was for benefits due under California law, not the LHWCA itself.

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