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Case Law Database

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

Case No. MISSING
Regular Panel Decision

American Home Assurance Co. v. D.P. Consulting Corp.

American Home Assurance Company (American), an insurer, commenced a declaratory judgment action against D.E Consulting Corp. (D.E) and AvalonBay Communities, Inc. (AvalonBay). American sought a declaration that it was not obligated to defend or indemnify D.E in an underlying personal injury action, Canteros v AvalonBay Communities, Inc., asserting that no 'grave injury' under Workers' Compensation Law § 11 had occurred. The Supreme Court, Kings County, denied American's motion for summary judgment on this issue. On appeal, the court affirmed the denial of summary judgment. The appellate panel concluded that D.E had successfully raised a triable issue of fact regarding whether Canteros sustained a 'grave injury,' thereby preventing a ruling, as a matter of law, that American had no potential obligation to indemnify D.E under its policy.

Declaratory judgmentIndemnificationContributionGrave injuryWorkers' Compensation LawSummary judgmentInsurance policyEmployer liabilityTriable issue of factAppellate Division
References
7
Case No. 2025 NY Slip Op 04576 [241 AD3d 563]
Regular Panel Decision
Aug 06, 2025

New York Bus Operators Compensation Trust v. American Home Assur. Co.

The New York Bus Operators Compensation Trust (NYBOCT), a self-insured entity, brought an action against its excess-of-loss insurer, American Home Assurance Co., alleging breach of contract and seeking declaratory relief. This dispute arose after American Home denied coverage for a workers' compensation claim due to untimely notice. The Supreme Court granted American Home's motion to dismiss the complaint as time-barred, which NYBOCT appealed. The Appellate Division affirmed the Supreme Court's decision, ruling that the six-year statute of limitations for breach of contract began when American Home disclaimed coverage on May 18, 2012, making NYBOCT's 2020 lawsuit untimely. The court rejected arguments related to the continuing-wrong doctrine and estoppel.

Limitation of ActionsBreach of ContractInsurance ContractDisclaimer of CoverageStatute of LimitationsWorkers' CompensationExcess-of-Loss PolicySelf-Insured TrustUntimely NoticeAppellate Review
References
29
Case No. OAK 293546, OAK 295646 OAK 295645, OAK 322365
Regular
Aug 22, 2008

LAURA BERRY vs. GOLDEN RAIN FOUNDATION, AMERICAN HOME ASSURANCE CO., AIG CLAIM SERVICES, ROSSMOOR MEDICAL CENTER, STATE COMPENSATION INSURANCE FUND

The Board denied American Home Assurance Co.'s petition and granted State Compensation Insurance Fund's petition for reconsideration, affirming the June 5, 2008 Findings, Award and Order, except for the employer's identity, which was deferred for further proceedings.

Workers' Compensation Appeals BoardPetition for ReconsiderationCumulative TraumaTemporary DisabilityPermanent and StationaryBanker for AwardEmployer IdentificationSeparate EntitiesDevelop the RecordFindings Award and Order
References
1
Case No. ADJ559526 (STK 0208625)
Regular
Jan 03, 2011

MICHAEL OZUNA vs. WEBCOR BUILDERS, ZURICH NORTH AMERICA, AMERICAN HOME ASSURANCE COMPANY

This case concerns whether Zurich North America or American Home Assurance Company provided workers' compensation coverage for an applicant's severe injury. An arbitrator initially ruled Zurich solely responsible, finding American Home's policy was limited and did not cover the claim. Zurich contends American Home's policy endorsement limiting coverage to a specific site was invalid due to non-compliance with Insurance Code requirements. The Appeals Board granted reconsideration to allow further proceedings, holding American Home bears the burden to prove its policy effectively excluded this claim.

Workers Compensation Appeals BoardReconsiderationArbitrationInsurance CoverageDefense and IndemnificationPolicy EndorsementInsurance Code Section 11657Insurance Code Section 11660Burden of ProofAffirmative of the Issue
References
1
Case No. MISSING
Regular Panel Decision

Stratus Services Group, Inc. v. Kash 'N Gold, Ltd.

An employment agency, Stratus Services Group, Inc., failed to conduct required background checks for temporary workers provided to Kash ’N Gold, Ltd. (KNG). Following a burglary at KNG's warehouse by three of these workers, KNG's insurer, American Home Assurance Company, compensated KNG for its losses. American Home, as subrogee, then sued Stratus for breach of contract. Initially, the Supreme Court found a breach but no proximate cause for the damages. However, an appellate court reversed this decision, determining that Stratus's breach was indeed a proximate cause of the damages, and awarded American Home judgment of $241,251.71 against Stratus.

Breach of contractProximate causationSubrogation claimEmployment agency liabilityFailure to conduct background checksWarehouse burglaryInsurance claimAppellate reversalContractual damagesNew York law
References
3
Case No. MISSING
Regular Panel Decision
Sep 13, 2001

American Ref-Fuel Co. of Hempstead v. Resource Recycling, Inc.

This case involves an appeal from an order in a declaratory judgment action. The original plaintiff, American Ref-Fuel Company of Hempstead, sought a declaration that various insurance companies had a duty to defend and indemnify it in an underlying personal injury action. The appeal specifically addresses the denial of motions by Universal Welding & Engineering and the Nelsen Agency (Universal's insurance broker) to dismiss a sixth cross-claim by Home Insurance for legal expenses, and the granting of Home Insurance's cross-motion for summary judgment on that cross-claim. The appellate court affirmed the lower court's decision, holding that Home Insurance, as subrogee of American Ref-Fuel and Resource Recycling, Inc., could recover defense costs from Universal under an indemnification provision in the subcontract. The court distinguished the *Inchaustegui* decision, finding it inapplicable since Home Insurance sought recovery based on contractual indemnification rather than damages for breach of an agreement to procure insurance.

SubrogationIndemnificationDuty to DefendInsurance LawBreach of Agreement to Procure InsuranceSummary JudgmentAppellate ReviewThird-Party LiabilityDefense CostsContractual Indemnification
References
10
Case No. 11 Civ. 804
Regular Panel Decision

China Media Express Holdings, Inc. ex rel. Barth v. Nexus Executive Risks, Ltd.

Plaintiff China MediaExpress Holdings, Inc., through its receiver, sued its insurers, American Home Assurance Company, China Pacific Insurance Co., and China Ping An Insurance (Hong Kong) Company Ltd., for breach of contract due to their refusal to defend and indemnify CME in underlying securities litigation. The defendant insurers moved to dismiss the complaint and compel arbitration in Hong Kong, citing arbitration clauses in their respective policies. The District Court granted the defendants' motions, finding the arbitration clauses to be broad and enforceable under the Federal Arbitration Act and the Convention on the Recognition and Enforcement of Foreign Arbitral Awards. The Court determined that all of CME's claims were subject to arbitration and, in accordance with Second Circuit precedent, stayed the proceedings pending arbitration in Hong Kong.

ArbitrationInternational ArbitrationFederal Arbitration ActConvention on the Recognition and Enforcement of Foreign Arbitral AwardsBreach of ContractInsurance Coverage DisputeSecurities LitigationStay of ProceedingsMotion to Compel ArbitrationReceiver
References
34
Case No. MISSING
Regular Panel Decision

American Home Assurance Co. v. Levy

This is a declaratory judgment action brought by American Home Assurance Company, an insurer, against Richard Levy, an insured social worker, and Pamela Damian, a patient. American Home sought a declaration that its liability for claims of sexual misconduct against Levy would be limited to $25,000, as stipulated in Levy's professional liability policy, and that it could cease his defense after expending that amount. Damian, who had an underlying malpractice action against Levy, alleged negligence but not explicit sexual misconduct in her judicial complaint, though her NASW complaint did include such allegations. The court denied American Home's motion for summary judgment, concluding that while the sexual misconduct provision was unambiguous, enforceable, and did not violate public policy, the $25,000 sublimit could not be applied at that juncture because Damian had not yet formally alleged erotic physical contact in the judicial proceeding. The court indicated the sublimit would apply if such allegations were made in future pleadings or during trial.

Professional Liability InsuranceSocial Worker MalpracticeSexual Misconduct ExclusionDeclaratory JudgmentSummary Judgment MotionPublic PolicyContract InterpretationInsurance Coverage DisputeTransference PhenomenonProfessional Ethics
References
21
Case No. MISSING
Regular Panel Decision

American Home Assurance Co. v. McDonald

This declaratory judgment action involves American Home Assurance Company seeking to limit its liability under professional liability policies issued to social workers Rory M. McDonald and Helene Ina Anisfeld, who are defendants in an underlying malpractice action brought by Randy Kamhi. Kamhi alleges sexual misconduct and professional negligence against McDonald, and vicarious liability and direct negligence against Anisfeld as McDonald's partner. American Home sought summary judgment to limit indemnification to $25,000 for sexual misconduct claims and punitive damages. The court granted summary judgment in part, affirming the $25,000 limit for McDonald's sexual misconduct and for punitive damages for both McDonald and Anisfeld. However, the court denied the request to terminate American Home's duty to defend McDonald upon exhausting the $25,000 limit and granted Kamhi's cross-motion to stay further summary judgment applications until discovery in the underlying action is complete. Crucially, the court found that extending the sexual misconduct coverage limit to non-sexual malpractice claims violates New York public policy.

Professional Liability InsuranceSexual MisconductInsurance Coverage DisputeDeclaratory JudgmentSummary Judgment MotionPublic Policy ArgumentTherapist MalpracticeDuty to DefendDuty to IndemnifyUnconscionability Claim
References
22
Case No. LAO 863258, LAO 863456
Regular
Oct 02, 2007

JULIE A. ALBRIGHT vs. SUN HEALTH CARE, AMERICAN HOME ASSURANCE COMPANY, BROADSPIRE

The Workers' Compensation Appeals Board denied reconsideration of a finding that American Home Assurance, administered by Broadspire, was liable for administering an award for applicant Julie Albright's cumulative trauma injury. Despite covering only 39% of the period, the Board found it equitable for American Home Assurance to administer the award, given their responsibility for a specific injury and the potential confusion of dual administrators. The Board also upheld the determination of the cumulative trauma injury date and the administrator's responsibility for temporary disability payments.

WCABReconsiderationPetitionFindings and AwardAmerican Home AssuranceBroadspireCumulative TraumaDate of InjuryLabor Code § 5412Labor Code § 4656 (c) (1)
References
1
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