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

Case No. 03 Civ. 0332(AKH)
Regular Panel Decision
Oct 29, 2004

In Re September 11th Liability Insurance Coverage Cases

This opinion and order addresses two Rule 12(c) motions regarding insurance coverage for the World Trade Center properties following the September 11, 2001, attacks. The Port Authority of New York and New Jersey sought a declaration that it is an "Additional Insured" under Zurich American Insurance Company's policies, while World Trade Center Properties LLC (WTCP) sought a declaration that Zurich is obligated to cover defense costs. The court, presided over by District Judge Hellerstein, denied both motions. It found ambiguity in the binder regarding the Port Authority's "Additional Insured" status, stating that the issue was premature without further discovery. Furthermore, the court held that New York Insurance Regulation 107 does not require rewriting Zurich's binder and policies to include defense costs, considering the unique circumstances, the sophistication of the insured, and the fact that Zurich explicitly excluded defense costs, which Silverstein (WTCP's affiliate) accepted after failing to secure conventional coverage. The court also affirmed supplemental jurisdiction over the insurance claims due to their close relation to the underlying September 11th liability cases.

Insurance CoverageSeptember 11 AttacksWorld Trade CenterRule 12(c) MotionDeclaratory ReliefAdditional Insured StatusDefense CostsInsurance BinderNew York Insurance LawRegulation 107
References
48
Case No. MISSING
Regular Panel Decision

Mauro v. General Motors Acceptance Corp.

The case addresses whether a secured party, General Motors Acceptance Corporation (GMAC), is liable for an assault committed by an independent contractor's employees, Anthony and Edward Russo from Tri-City Auto Recovery, during a vehicle repossession. Plaintiffs Maureen and John Mauro allege assault and battery, contending the repossession breached the peace. GMAC argued it was not liable due to Tri-City being an independent contractor. The court, citing UCC 9-503 and various precedents, ruled that the duty to repossess without a breach of the peace is nondelegable. Consequently, the motions for summary judgment by GMAC and Tri-City Auto Recovery, seeking dismissal of the complaint, were denied, establishing GMAC's potential liability for the actions of its independent contractor's employees.

RepossessionBreach of PeaceIndependent Contractor LiabilityUCC 9-503Nondelegable DutyAssault and BatterySummary JudgmentSecured TransactionsDebtor's RightsVicarious Liability
References
18
Case No. 2018 NY Slip Op 01591 [159 AD3d 787]
Regular Panel Decision
Mar 14, 2018

Bidnick v. Grand Lodge of Free & Accepted Masons of the State of N.Y.

Neal Bidnick, a long-standing member of the Grand Lodge of Free & Accepted Masons, was expelled following Masonic trials, despite initial reversals by the Masonic Commission of Appeals. This action arose after the Grand Lodge reinstated a guilty finding at its annual meeting, leading to Bidnick's expulsion. Bidnick sued the Grand Lodge and individual defendants for breach of contract, alleging wrongful expulsion, and defamation, claiming false statements of misappropriation. The Supreme Court's order partially dismissed the complaint. The Appellate Division modified this order, granting the dismissal of the defamation claim against the Grand Lodge, denying dismissal of the defamation claim against individual defendants in their individual capacities, and denying the dismissal of the breach of contract claim. The court's decision addressed the application of Benevolent Orders Law and the _Martin_ rule concerning the liability of unincorporated associations and their members.

Breach of ContractDefamationExpulsionUnincorporated AssociationBenevolent Orders LawMasonic LodgeIndividual LiabilityRepresentative CapacityCPLR 3211 (a) (7) MotionAppellate Review
References
11
Case No. MISSING
Regular Panel Decision

McLaughlin v. Midrox Insurance

This case involves an appeal concerning an insurance coverage dispute. Plaintiffs sought to compel Midrox Insurance Company to indemnify the Blodgett Brothers Partnerships for a $1 million judgment in an underlying personal injury action. The accident involved a motorcycle operated by plaintiff Charles R. McLaughlin and a pickup truck driven by Ronald Blodgett. Midrox had disclaimed coverage, arguing the accident occurred off insured premises and involved a registered vehicle. The court affirmed the lower court's decision, ruling that the farmowner's policy did provide coverage. The court determined that public roadways used for transporting materials between farm parcels could be considered 'insured premises' and that the pickup truck's agricultural registration did not negate coverage given its exclusive use for farming purposes.

Personal InjuryFarmowner's InsuranceInsurance CoverageAgricultural TruckPolicy InterpretationOff-Premises AccidentPublic RoadwaysSummary JudgmentIndemnificationVehicle and Traffic Law
References
5
Case No. MISSING
Regular Panel Decision

In re the Liquidation of Midland Insurance

Policyholders New York Dock Railway (NYDR) and Brooklyn Eastern District Terminal (BEDT), joined by claimants Buividas and Romacho, moved to confirm a referee's report that found coverage for their claims by the Stock Workers' Compensation Security Fund. The Superintendent of Insurance, as liquidator of Midland Insurance Company, cross-moved to disaffirm the report, arguing against Security Fund coverage based on his interpretation of relevant statutes. The court reviewed the referee's decision, finding it erroneous due to a misinterpretation of legislative history and intent regarding security fund coverage limitations, particularly concerning Chapter 801 amendments. Upholding the Superintendent's rational interpretation, the court denied the motion to confirm and granted the cross-motion to disaffirm, affirming the denial of security fund coverage.

Workers' Compensation Security FundInsurance Coverage DisputeMidland Insurance Company LiquidationFederal Employers' Liability ActJones ActLongshoremen's and Harbor Workers' Compensation ActStatutory InterpretationLegislative HistoryThird-Party IndemnificationEmployer's Liability
References
6
Case No. MISSING
Regular Panel Decision

U. P. Iron Works v. Investors Insurance

Plaintiff insured brought a declaratory judgment action against their insurer, who issued both workers' compensation and general liability policies. The dispute arose after a partner was injured, leading to a third-party products liability action against the partnership. The insurer disclaimed coverage, citing lack of coverage for a direct suit by a partner and late notice of the accident. The court found that coverage existed for the third-party claim, extending it to a partner similar to an employee. Furthermore, the court determined that the notice provided by the insured, though three years after the accident, was not unreasonably late given the complexities involved. Consequently, the court declared the policy to be in full force and effect for the accident.

Declaratory JudgmentInsurance CoverageWorkers' Compensation PolicyGeneral Liability PolicyThird-Party ClaimPartner InjuryEmployee ExclusionLate Notice DisclaimerDuty to DefendSummary Judgment Motion
References
2
Case No. MISSING
Regular Panel Decision

Hayden v. S & W Meat & Poultry

Claimant, a partner in S & W Meat & Poultry, sustained a serious injury. A workers' compensation claim was filed, but the carrier contested coverage, arguing that claimant, as a partner, had not formally elected coverage under Workers' Compensation Law § 54 (8). The Workers' Compensation Board applied estoppel, finding the carrier failed to advise the employer of the election requirement. On appeal, the court reversed this decision, holding that the employer's insurance broker, the Fear agency, was notified of the lack of coverage, and this knowledge is imputed to the employer. The court found insufficient evidence for estoppel and remitted the matter to the Board for further proceedings.

Workers' CompensationEstoppelInsurance CoveragePartnershipAgent LiabilityImputed KnowledgePremium RefundAppellate ReviewRemittalWorkers' Compensation Law § 54 (8)
References
5
Case No. MISSING
Regular Panel Decision

Claim of Cerbasi v. County Metal & Glass, Inc.

A claimant injured their left arm while working at a New York construction site for a New Jersey employer insured by New Jersey Manufacturers Insurance Company (NJMIC). A dispute arose regarding coverage, with the Workers’ Compensation Law Judge and Board determining the policy covered the accident because New York was not an explicitly excluded state and NJMIC’s attempt to amend the policy was ineffective. NJMIC appealed, arguing the Board erred in its coverage finding and that Workers’ Compensation Law § 54 (5) notice requirements did not apply to partial cancellations. The Appellate Division affirmed, finding the Board's determination on coverage implicit and that NJMIC failed to demonstrate an effective exclusion or proper cancellation under Workers' Compensation Law § 54 (5). The court also noted NJMIC's argument regarding partial cancellation was unpreserved.

Workers' CompensationInsurance CoveragePolicy ExclusionNew York LawNew Jersey BusinessStatutory ComplianceCancellation NoticeAppellate ReviewJurisdictionLeft Arm Injury
References
9
Case No. MISSING
Regular Panel Decision

Long v. Liberty Mutual Insurance

A claimant, a member of the Buffalo Destroyers football team, was injured and filed a workers' compensation claim with Liberty Mutual Insurance Company. Liberty Mutual denied coverage, arguing the claimant was not an employee of its insured, Source One Group, and that the policy could not cover a New York entity. The Workers' Compensation Board initially found the claimant a dual employee, then a special employee of the Destroyers and a general employee of Source One, entitling him to coverage. The court determined that while the claimant was not a de facto employee of Source One, Liberty Mutual was estopped from denying coverage due to its conduct, including issuing a certificate of insurance and accepting premiums. Therefore, the court affirmed the Board's decision, holding Liberty Mutual responsible for the claimant's workers' compensation benefits.

Insurance Coverage DisputeEmployer LiabilityProfessional Employee OrganizationSpecial Employment DoctrineEstoppel in InsuranceAssigned-Risk Insurance PolicySports Athlete InjuryAppellate DecisionPayroll Audit DisputeCertificate of Insurance Validity
References
11
Case No. MISSING
Regular Panel Decision

Malican v. Blue Shield of Western New York, Inc.

This case examines whether an insurance policy or Section 250 of the Insurance Law provides coverage for services rendered by a psychiatric social worker. The plaintiff sought reimbursement for his daughter's counseling sessions with a psychiatric social worker, referred by a doctor at the Buffalo Psychiatric Clinic. While the insurer accepted liability for services by a clinical psychologist to the plaintiff and his wife, it denied coverage for the psychiatric social worker's fees. The City Court and Erie County Court initially ruled in favor of the plaintiff, but the appellate court reversed these judgments. The higher court held that the explicit terms of the insurance contract did not include psychiatric social workers, defining covered professionals narrowly. Furthermore, it ruled that Section 250 of the Insurance Law, despite legislative expansions, did not implicitly extend coverage to a limitless range of unspecified practitioners beyond those specifically enumerated.

Insurance Coverage DisputePsychiatric Services CoveragePsychiatric Social Worker ServicesClinical Psychologist ServicesMedical Insurance PolicyContractual InterpretationStatutory InterpretationInsurance Law § 250Healthcare Provider DefinitionsAppellate Court Ruling
References
2
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