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Access over workers' compensation decisions, including En Banc, Significant Panel Decisions, and writ-denied cases.

Case No. ADJ158556 (MON 0206719) ADJ1611743 (MON 0222554) ADJ137665 (MON 0271624) ADJ1710332 (MON 0247216) ADJ716421 (MON 0222553)
Regular
Jun 27, 2011

Neil M. Lamont vs. BOEING, AIG/CHARTIS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for FREMONT INSURANCE COMPANY

This case involves apportionment of permanent disability benefits for multiple industrial injuries sustained by the applicant, Neil M. Lamont. The defendant, Chartis, sought reconsideration of an award finding them liable for reimbursement from CIGA, arguing the medical evidence was insufficient. The Appeals Board denied reconsideration, adopting the arbitrator's report. The Board found that due to the "inextricably intertwined" nature of the applicant's disabilities, as testified by the agreed medical examiner, apportionment of causation was impossible. Therefore, a joint and several award was justified, making the solvent defendant (Chartis) solely liable, thus relieving CIGA.

Workers' Compensation Appeals BoardReconsiderationFindings and OrderArbitratorSubstantial EvidenceInextricably Intertwined DisabilityApportionment of LiabilityCalifornia Insurance Guarantee Association (CIGA)Insolvent Insurance CarrierCovered Claims
References
9
Case No. ADJ244571 (VEN 0110022) ADJ3315572 (VEN 0110023) ADJ3817980 (OXN 0145232) ADJ2004405 (OXN 0145234) ADJ4239471 (OXN 0145235)
Regular
Jan 19, 2010

DIANA HARDMAN vs. COMMUNITY MEMORIAL HOSPITAL, AIG DOMESTIC CLAIMS, INC./CHARTIS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, BROADSPIRE, CALIFORNIA COMPENSATION INSURANCE COMPANY, FREMONT COMPENSATION INSURANCE COMPANY, American Home Assurance

This case involves five workers' compensation claims by applicant Diana Hardman against Community Memorial Hospital, with American Home Assurance (AIG) as a defendant insurer. AIG seeks reconsideration of the WCJ's findings, arguing it should only be liable for permanent disability directly arising from injuries covered by its policies, not those covered by insolvent insurers now handled by CIGA. The Appeals Board granted reconsideration, rescinded the WCJ's decisions, and returned the matter for further proceedings. Key issues include the admissibility of a deposition, the apportionment of permanent disability based on recent appellate decisions, and clarification of liability for injuries that occurred during periods covered by multiple insurers, including insolvent ones.

Workers' Compensation Appeals BoardDiana HardmanCommunity Memorial HospitalAIG Domestic ClaimsCalifornia Insurance Guarantee AssociationBroads PireCalifornia Compensation Insurance CompanyFremont Compensation Insurance CompanyOpinion and Order Granting ReconsiderationDecision After Reconsideration
References
8
Case No. MISSING
Regular Panel Decision

Lugo v. AIG Life Insurance

Plaintiff Farecilpa Lugo sued AIG Life Insurance Company and Hobart Corporation, seeking accidental death benefits under ERISA after her husband's death in 1984. AIG denied claims, citing late notice and the cause of death. Lugo argued that notice to PMI (Hobart) was sufficient, AIG waived the late notice defense, and her claim was within ERISA's statute of limitations. The court found AIG did not waive its late notice defense due to a reservation of rights clause, Lugo failed to prove PMI was AIG's agent, and the Plans' three-year limitation period, not ERISA's six-year period, applied, barring the suit. Consequently, the court dismissed the action, rendering the request for a jury trial moot.

ERISAAccidental Death BenefitsInsurance PolicyLate Notice DefenseWaiverEstoppelStatute of LimitationsAgencySummary JudgmentFederal Common Law
References
37
Case No. MISSING
Regular Panel Decision

AIG Europe (Netherlands), N v. v. UPS Supply Chain Solutions, Inc.

Plaintiff AIG Europe (Netherlands), N.V. ("AIG") initiated a subrogation action against Defendant UPS Supply Chain Solutions, Inc. ("UPS") following damage to an x-ray machine during shipment. AIG, acting as the insurer for Philips Medical Systems Nederlands, B.V., asserted claims for breach of contract, bailment obligations, and tort. UPS sought summary judgment to limit its liability to $9,479.61, while AIG cross-moved for summary judgment, arguing against the enforceability of any liability limitation and its invalidity under the Carmack Amendment. The Court denied both motions for summary judgment on the contractual liability issues, citing genuine disputes of material fact regarding the existence and terms of a binding agreement between the parties. Furthermore, the applicability of the Carmack Amendment and the material deviation doctrine could not be determined as a matter of law. However, UPS's motion for summary judgment on AIG's tort claim was granted as it was unopposed.

SubrogationContract LawBailmentTort LawSummary JudgmentCarmack AmendmentInterstate CommerceLimitation of LiabilityShipping DamageX-ray Machine
References
50
Case No. OAK 0278433 OAK 0295169 OAK 0307341 OAK 0307342 OAK 0307343 OAK 0321700
Regular
Jul 06, 2007

LATONIA PACE vs. COUNTY OF ALAMEDA/SEDGWICK CLAIMS MANAGEMENT SERVICES, INC., and COUNTY OF ALAMEDA/AIG/ TRISTAR RISK MANAGEMENT

This case involves a petition for reconsideration filed by Defendant AIG concerning prior workers' compensation decisions. The Appeals Board dismissed AIG's petition because AIG was not newly aggrieved by the Board's prior order, which affirmed the original judge's decision without amendment. AIG failed to timely petition for reconsideration of the initial judge's decision, and therefore, cannot now seek review of it through this petition.

Workers' Compensation Appeals BoardPetition for ReconsiderationDismissedCumulative TraumaBilateral ShouldersUpper BackBilateral Upper ExtremitiesPermanent DisabilityWCJ Findings and AwardAggrieved Party
References
0
Case No. ADJ1630547 (MON 0209470)
Regular
Aug 10, 2009

Raymond Burrell vs. Boeing/McDonnell Douglas, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION (CIGA), AIG

This case concerns AIG's petition for reconsideration of a supplemental workers' compensation award. The Appeals Board affirmed an administrative law judge's decision that relieved CIGA of liability and placed the full burden on AIG for an applicant's injury award. The Court found that because AIG was a solvent insurer with joint and several liability, CIGA was not responsible for benefits as it constituted a "non-covered claim" under statute. Therefore, AIG is liable for all benefits after the liquidation of CIGA's underlying insurer.

CIGAIndustrial IndemnityAIGSupplemental Findings and AwardStipulated Awardcontinuing jurisdictionLabor Code section 5803Labor Code section 5804Insurance Code section 1063.1(c)(9)covered claim
References
6
Case No. MISSING
Regular Panel Decision

Mangum v. National Union Fire Insurance

A claimant was injured in July 2000 and filed for workers' compensation after her disability claim was denied. The Workers' Compensation Board initially indexed the claim against Career Horizons, Inc., with AIG Claims Services, Inc. as its administrator. AIG failed to appear at multiple hearings, leading to the claim's establishment and penalties. After an initial appeal by AIG, the Board affirmed the establishment but remitted the case to identify the proper carrier. CNA Insurance Company was subsequently identified as the employer's true workers' compensation carrier. The WCLJ and the Board ruled that AIG was estopped by laches from denying coverage. This court, however, reversed the Board's finding of estoppel, concluding that the Board abused its discretion by not addressing evidence suggesting CNA had timely notice of the claim and basing its decision on incorrect employer/carrier identification. The matter was remitted for further proceedings.

Workers' CompensationEstoppelLachesInsurance CoverageCarrier LiabilityThird-Party AdministratorAppellate ReviewRemittalProcedural Due ProcessTimely Notice
References
9
Case No. ADJ639449 (OAK 0289033) ADJ2403931 (OAK 0288994)
Regular
Apr 16, 2009

MYRON SILVA vs. NGK METALS CORP./FM INDUSTRIES, AMERICAN HOME/AIG

The WCAB vacated its prior reconsideration order and dismissed Everest's petition as untimely. However, it granted removal to address Everest's contention that AIG should administer the award. The Board found that AIG is liable for a specific injury and the majority of a cumulative trauma period, and therefore, AIG will now administer the award with the right to seek contribution from Everest.

WCABRemovalReconsiderationAdministration of AwardContribution RightsSpecific InjuryCumulative TraumaLabor Code Section 5500.5Agreed Medical ExaminationLiability Apportionment
References
3
Case No. MISSING
Regular Panel Decision
Jul 26, 2000

AIU Insurance v. Unicover Managers, Inc.

This case involves plaintiff insurance companies, AIG, seeking a declaration that defendant ReliaStar Life Insurance Company was bound to reinsure AIG for certain workers' compensation risks based on reinsurance slips signed by Unicover Managers, Inc., ReliaStar's managing general underwriter. The Supreme Court, New York County, dismissed AIG's complaint against ReliaStar and Unicover, and ReliaStar's third-party complaint against E.W. Blanch Company. The appellate court affirmed the dismissal, finding that the parties' correspondence and conduct established that reinsurance would only be bound upon ReliaStar's own signature, negating any actual or apparent authority of Unicover or ratification by ReliaStar. Estoppel and misrepresentation claims against both defendants were also dismissed. The judgment was modified to explicitly dismiss all remaining cross claims and counterclaims, and the initial dismissal was otherwise affirmed.

Reinsurance AgreementSummary JudgmentContract InterpretationAgency AuthorityApparent AuthorityRatificationEstoppelMisrepresentationWorkers' Compensation RisksCross Claims
References
3
Case No. OAK 0251632
Regular
Aug 08, 2007

Linda Wright vs. COUNTY OF ALAMEDA, AIG

In this workers' compensation case, the Appeals Board granted removal to amend a prior order. The Board found that applicant's election to proceed against a self-insured defendant meant that AIG, as a non-elected party, could not participate in proceedings or offer evidence, thus deleting the applicant's right to rebut AIG's medical reports. The Board declined to vacate the applicant's election against the self-insured defendant, affirming the employee's unfettered right to make such an election.

Workers' Compensation Appeals BoardRemovalAgreed Medical Evaluator (AME)Labor Code Section 5500.5(c)ElectionCumulative InjuryJoint and Several LiabilityApportionmentContributionDiscovery
References
0
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