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

Case No. 2025 NYSlipOp 06801
Regular Panel Decision
Dec 09, 2025

AmTrust N. Am., Inc. v. Insurance Specialty Group LLC

The plaintiff, AmTrust North America, Inc., appealed an order dismissing parts of its breach of contract claim against Insurance Specialty Group LLC. The dispute stems from a 2010 Managing Producer Agreement where the defendant was to administer an asset protection program for the plaintiff, with fiduciary duties. Plaintiff alleged multiple breaches, including improper underwriting and concealment of issues, which came to light in 2022. The Supreme Court dismissed claims before May 19, 2017, but the Appellate Division modified this by applying equitable estoppel. The appellate court ruled that estoppel could allow most breach of contract claims, except those solely based on the fiduciary duty to disclose, which are not subject to estoppel for time-barred breaches.

Breach of ContractEquitable EstoppelFiduciary DutyStatute of LimitationsAsset Protection ProgramUnderwriting GuidelinesInsurance AdministrationConcealmentContinuing Wrong DoctrineAppellate Division
References
8
Case No. 2025 NY Slip Op 00836 [235 AD3d 479]
Regular Panel Decision
Feb 13, 2025

TCS Constr. Corp. v. AmTrust N. Am., Inc.

The Appellate Division, First Department, reversed an order from the Supreme Court, Bronx County, which had denied summary judgment to defendants AmTrust North America, Inc., Wesco Insurance Company, and Morstan General Agency Inc. of New York. The lower court's denial meant that Wesco might have had a duty to defend or indemnify TCS Construction Corp. and Tsurishaddai Matsui. The Appellate Division found that Wesco, the insurer, had no duty to defend or indemnify based on employer's liability and independent contractor exclusions in the commercial general liability (CGL) policy. Furthermore, it ruled that Gabriel Pacheco's injuries were not

Summary judgmentInsurance coverageEmployer's liability exclusionIndependent contractors exclusionCommercial general liability policyEmployers' liability policyWorkers' Compensation Law § 11Grave injuryDuty to defendDuty to indemnify
References
6
Case No. 2024 NY Slip Op 00646
Regular Panel Decision
Feb 07, 2024

State Farm Mut. Auto. Ins. Co. v. Amtrust N. Am., Inc.

In this subrogation action, State Farm Mutual Automobile Insurance Company, as a no-fault insurer, sought to recover benefits paid to its subrogors who were also seeking workers' compensation benefits from Amtrust North America, Inc. The Supreme Court initially dismissed State Farm's unjust enrichment complaint, asserting the Workers' Compensation Board's primary jurisdiction over the coverage dispute. On appeal, the Appellate Division reversed the Supreme Court's order. The court held that the Workers' Compensation Board indeed has primary jurisdiction to determine the applicability of the Workers' Compensation Law and the causal relationship of medical expenses to the accident. Therefore, the matter was remitted to the Supreme Court for a new determination after a resolution by the Workers' Compensation Board.

SubrogationUnjust EnrichmentNo-Fault InsuranceWorkers' CompensationPrimary JurisdictionAppellate ReviewMedical ExpensesMotor Vehicle AccidentReimbursementRemittal
References
9
Case No. 14-cv-736 / 14-cv-945
Regular Panel Decision

Harris v. Amtrust Financial Services, Inc.

This case is a securities class action brought by Lead Plaintiffs Michael D. Harris and Stuart Shapiro against AmTrust Financial Services, Inc., its CEO Barry D. Zyskind, and CFO Ronald E. Pipoly. The complaint alleged violations of §§ 10(b) and 20(a) of the Securities Exchange Act of 1934 and § 11 of the Securities Act of 1933. Plaintiffs claimed AmTrust used fraudulent accounting practices to manipulate reported insured losses by misclassifying ceded losses to Luxembourg reinsurance subsidiaries, thereby misleading investors. The District Court, presided over by Judge Valerie Caproni, granted the defendants' motion to dismiss. The court found that the Amended Complaint failed to plausibly allege actionable misstatements or omissions and did not adequately establish scienter as required for the Exchange Act claims.

Securities FraudClass ActionGAAP ViolationsFinancial StatementsMisrepresentationScienterMotion to DismissExchange ActSecurities ActAccounting Practices
References
46
Case No. ADJ9361055
Regular
Dec 16, 2014

CODY GLEASON vs. MEASUREMENT DRIVEN REHABILITATION, AMTRUST

This case, Cody Gleason v. Measurement Driven Rehabilitation; Amtrust, resulted in the dismissal of the applicant's Petition for Reconsideration. The Workers' Compensation Appeals Board found the petition was not timely-filed. The Board adopted and incorporated the reasoning of the workers' compensation administrative law judge's Report and Recommendation. Therefore, the Petition for Reconsideration was dismissed.

Petition for ReconsiderationTimely-filedWorkers' Compensation Appeals BoardAdministrative Law JudgeReport and RecommendationDismissedADJ9361055Measurement Driven RehabilitationAmtrustSan Diego District Office
References
0
Case No. ADJ8905657
Regular
Nov 27, 2013

SALVADOR SANCHEZ vs. ANTONIO RAMOS CONCRETE, AMTRUST

This case involved an applicant, Salvador Sanchez, and defendants Antonio Ramos Concrete and Amtrust. The Workers' Compensation Appeals Board (WCAB) dismissed the defendant's Petition for Reconsideration because it was filed from a non-final order, specifically an Order Denying Change of Venue, which does not determine substantive rights. The WCAB also denied the petition for removal, finding no showing of substantial prejudice or irreparable harm. The defendant's attorney was admonished for filing a petition challenging a non-final order.

Petition for ReconsiderationFinal OrderSubstantive RightLiabilityInterlocutory ProceduralEvidentiary DecisionsRemovalSubstantial PrejudiceIrreparable HarmInadequate Remedy
References
6
Case No. ADJ10385904
Regular
Apr 21, 2017

DANIEL THOMAS vs. BIOLOGICAL TECHNOLOGY, AMTRUST NORTH AMERCA

This case concerns Daniel Thomas's workers' compensation claim against Biological Technology and Amtrust North America. The Workers' Compensation Appeals Board denied Thomas's petition for reconsideration, adopting the WCJ's report. The Board gave great weight to the WCJ's credibility determinations and found no substantial evidence to reject them. Crucially, the Board determined that Thomas failed to meet his burden under Labor Code Section 3600(a)(10) to demonstrate his claim was not barred by a layoff or termination notice.

Workers' Compensation Appeals BoardPetition for ReconsiderationWCJ credibility determinationsLabor Code § 3600(a)(10)notice of termination or layoffpsychiatric injuriesevidence of injurymedical recordsdate of injurypreponderance of the evidence
References
1
Case No. ADJ11225659
Regular
Mar 25, 2019

TERESA VENTURA vs. DANA POINT CLEANERS' AMTRUST, ZENITH INSURANCE

This case concerns a dispute over whether a Compromise and Release (C&R) agreement settled an applicant's claim against Zenith Insurance Company. The Board affirmed the WCJ's finding that the C&R, which named only Wasco Insurance Company (administered by Amtrust), did not settle Zenith's liability. Zenith was not a party to the C&R, and the agreement did not explicitly include Zenith, while Wasco specifically reserved its right to seek contribution from Zenith. The Board also rejected Wasco's due process argument, finding its interest in the trial regarding Zenith's liability was insufficient to grant standing.

Workers' Compensation Appeals BoardReconsiderationCompromise and ReleaseZenith Insurance CompanyAmtrust North AmericaWasco Insurance CompanyFindings and OrderWCJLabor Code Section 5005Cumulative Trauma Injury
References
5
Case No. ADJ15951486, ADJ15951487
Regular
Aug 25, 2025

JEFF CRAIL vs. AMTRUST NORTH AMERICA, HARTFORD FIRE INSURANCE COMPANY

The defendant, Amtrust North America and Hartford Fire Insurance Company, filed a Petition for Reconsideration of a Joint Findings of Fact and Orders (F&O) issued on May 20, 2025. The F&O had ordered the replacement of Panel Qualified Medical Examiner (PQME) Dr. Wiseman due to his failure to properly serve his report. The defendant argued that the court improperly interpreted Administrative Director Rule 31.5(a)(12) and that a Declaration of Readiness (DOR) does not constitute both an objection and a request for a replacement panel. The Appeals Board denied the Petition for Reconsideration, affirming the WCJ's decision to replace Dr. Wiseman. The Board's decision cited its en banc ruling in Vazquez v. Inocensio Renteria, reinforcing that a QME's failure to timely issue and serve a report, and engaging in ex parte communication by serving only one party, grants a party the right to seek replacement. The Board also emphasized the informal nature of pleadings in workers' compensation proceedings, as established in Perez v. Chicago Dogs, when addressing the applicant's DOR.

PQMEPetition for ReconsiderationJoint Findings of Fact and OrdersAdministrative Director RuleDeclaration of ReadinessIrreparable HarmMandatory Settlement ConferenceOncology PanelQualified Medical ExaminerProof of Service
References
14
Case No. ADJ9674251
Regular
Apr 17, 2015

LAURA MALED vs. DIAMOND LEARNING CENTER, INC., AMTRUST NORTH AMERICA, JAMI HAMEL DE LA CERDA, DANIEL DE LA CERDA, NATIONWIDE AGRIBUSINESS INSURANCE COMPANY

Applicant Laura Maled sought removal after the WCJ deferred ruling on a motion to quash a subpoena. The subpoena requested records from Diamond Learning Center, Inc., which AMTRUST, its insurer, claimed were overbroad and privileged. Applicant argued the deferral prejudiced her ability to conduct necessary discovery. The Appeals Board granted removal, finding the deferral caused substantial prejudice and irreparable harm. The case was remanded for a status conference to facilitate discovery resolution or a ruling on the motion to quash.

Petition for RemovalPetition for Order QuashingSubpoena Duces TecumAttorney-Client PrivilegeAttorney Work Product DoctrineDiscovery DisputeIrreparable HarmSubstantial PrejudiceWCJ DeferralAmended Application
References
0
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