Home/Case Law/RAYMUNDO PITONES vs. MEL CAST LITHO, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, SEDGWICK CLAIMS MANAGEMENT SERVICES
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RAYMUNDO PITONES vs. MEL CAST LITHO, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, SEDGWICK CLAIMS MANAGEMENT SERVICES

Filed: Sep 25, 2015
ADJ3816448 (LAO 0789900) ADJ335314 (LAO 0818843) ADJ1177078 (LAO 0789901)

CompFox AI Summary

This case involves CIGA, the California Insurance Guarantee Association, seeking to be absolved of liability for workers' compensation benefits for an injured worker, Raymundo Pitones. CIGA argues that a settlement with another insurer for a subsequent, overlapping injury constitutes "other insurance" that should relieve CIGA of its obligations. The Workers' Compensation Appeals Board denied CIGA's petition, finding that the subsequent settlement did not fully cover all of Pitones' injuries, particularly those that did not overlap. Therefore, CIGA remains liable for the benefits not covered by the prior settlement to ensure the applicant can recover his full benefits.

Full Decision Text1 Pages

This case involves CIGA, the California Insurance Guarantee Association, seeking to be absolved of liability for workers' compensation benefits for an injured worker, Raymundo Pitones. CIGA argues that a settlement with another insurer for a subsequent, overlapping injury constitutes "other insurance" that should relieve CIGA of its obligations. The Workers' Compensation Appeals Board denied CIGA's petition, finding that the subsequent settlement did not fully cover all of Pitones' injuries, particularly those that did not overlap. Therefore, CIGA remains liable for the benefits not covered by the prior settlement to ensure the applicant can recover his full benefits.

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