CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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. 2018-01-0371
Regular Panel Decision
Jan 30, 2019

Watts, Jane v. JTEKT North America

Jane Watts, an employee, reported a work-related back injury. Her treating physician indicated that her condition was likely not more than 50% related to her employment. Based on this, the employer, JTEKT North America, filed for summary judgment. The trial court denied this motion, but the Tennessee Workers' Compensation Appeals Board affirmed that the employer did not negate an essential element of the employee's claim. However, the Board vacated the trial court's order and remanded the case to determine if the employer demonstrated the insufficiency of the employee's evidence as a matter of law, adhering to Rule 56 of the Tennessee Rules of Civil Procedure.

Summary JudgmentWorkers' CompensationCausationMedical EvidenceTennessee Rules of Civil Procedure Rule 56Appellate ReviewRemandBurden of ProofWork-Related InjuryTreating Physician Opinion
References
5
Case No. MISSING
Regular Panel Decision

Bishop v. Insurance Co. of North America

Roland Dean Bishop sought workers' compensation benefits for total and permanent incapacity after sustaining an injury on August 11, 1972. The Insurance Company of North America, the workers' compensation carrier, had paid benefits for 125 weeks. Bishop pleaded a general injury, while the carrier contended the injury was confined to his left foot below the knee. A jury found temporary total incapacity for 125 weeks and permanent partial incapacity thereafter, and crucially, determined the injury was confined to his left leg below the knee. The court rendered a take-nothing judgment, which Bishop appealed. The appellate court affirmed the judgment, finding no reversible error in the jury's findings or the court's evidentiary rulings, and upheld the specific injury finding.

Workers' Compensation BenefitsSpecific InjuryGeneral InjuryJury FindingsAppellate ReviewMedical TestimonyBack InjuryAnkle FusionIncapacity BenefitsEvidentiary Dispute
References
7
Case No. MISSING
Regular Panel Decision

Bernhardt v. Tradition North America

Donald Bernhardt sued his former employers, Tradition North America Inc. and Tradition Asiel Securities, Inc., alleging breach of an implied employment contract. Bernhardt claimed he was wrongfully terminated after exposing illegal securities schemes and reporting them to the SEC, violating an implied agreement that the firm would operate lawfully. Defendants moved to dismiss the amended complaint under Rule 12(b)(6) and sought Rule 11 sanctions against Bernhardt's attorney. The court granted the motion to dismiss, ruling that Bernhardt failed to state a plausible claim for breach of an implied contract under New York's at-will employment doctrine. However, the court denied the request for Rule 11 sanctions, finding the lawsuit, while unsuccessful, did not constitute sanctionable conduct.

Implied contractEmployment at willWrongful terminationWhistleblowerSecurities law violationsMotion to dismissRule 12(b)(6)Rule 11 sanctionsFederal Rules of Civil ProcedureNew York employment law
References
18
Case No. MISSING
Regular Panel Decision

Western Co. of North America v. Grider

David C. Grider, a subcontractor, sued Western Company of North America, another subcontractor, for personal injuries sustained when he was struck by a high-pressure hose during a gas well flushing operation. The injury occurred because Western Company's employees failed to attach a rigid stalk to the hose, a violation of company procedure. A jury found Western Company negligent, awarding Grider damages. Western Company appealed, arguing that the trial court improperly excluded testimony where a 'company man' (Richard Phinney, agent of the well owner) stated the stalk was unnecessary, which was crucial for their 'borrowed servant' defense and to explain their employees' conduct. The appellate court reversed and remanded the case for a new trial, ruling that the excluded testimony was not hearsay as it was offered to explain the employees' actions, not for the truth of the statement, and its exclusion constituted reversible error.

NegligencePersonal InjurySubcontractor LiabilityHearsay ExceptionEvidence ExclusionBorrowed Servant DoctrineReversible ErrorTexas LawGas Well OperationWorkplace Safety
References
11
Case No. M2009-02579-COA-R3-CV
Regular Panel Decision
Jul 13, 2010

Gladys Davis v. Nissan North America, Inc.

Gladys Davis sued Nissan North America, Inc. for retaliatory discharge after her employment termination, alleging it was due to her numerous workers' compensation claims. Nissan argued Davis was terminated due to a high risk of re-injury based on a comprehensive medical examination by two board-certified occupational and preventive medicine physicians, Dr. Renata Bluhm and Dr. Karen Oldham. The Trial Court granted summary judgment to Nissan, finding the company had a legitimate, non-pretextual reason for termination. The Court of Appeals affirmed, emphasizing that employers can rely on competent medical advice regarding an employee's safety and that the anti-retaliation provisions do not compel re-employment for individuals posing a high re-injury risk. The court concluded there was no evidence of a causal link between Davis's workers' compensation claims and her termination.

Retaliatory DischargeWorkers' CompensationMedical Fitness for DutyRe-injury RiskSummary JudgmentAppellate AffirmanceOccupational HealthEmployment LawTennessee LawWorkplace Injury
References
16
Case No. MISSING
Regular Panel Decision

Morales v. Michelin North America, Inc.

Bairon Israel Morales appealed an agreed final judgment concerning a workers' compensation lien. Morales was injured in a truck accident while working for K & K Repair Service, LLC, and Texas Mutual Insurance Company, the workers' compensation carrier, paid his benefits. Morales sued Michelin North America and Discount Tire Company, eventually settling for $375,000. Texas Mutual intervened to recover its subrogation lien. The appellate court modified the trial court's judgment, reducing Texas Mutual's payment from the settlement proceeds by its proportionate share of expenses from $118,486.21 to $90,732.04. The court affirmed the judgment as modified but denied Morales's request for a determination of the employer's percentage of responsibility, ruling that this issue was moot due to prior settlements and nonsuits.

Subrogation LienAttorney's FeesLitigation ExpensesAppellate ReviewStatutory InterpretationTexas Labor CodeAgreed JudgmentSettlementMootness DoctrineEmployer Liability
References
18
Case No. MISSING
Regular Panel Decision

Maida v. Life Insurance Co. of North America

Plaintiff Anthony Maida sued Life Insurance Company of North America (LINA) after his long-term disability benefits were terminated. Maida initially claimed physical disability due to a fall and later asserted mental disability from post-traumatic stress disorder. The court granted LINA's motion for summary judgment on the physical disability claim, finding LINA's denial was not arbitrary and capricious based on multiple medical reports. Additionally, LINA was awarded $10,155 on its counterclaim for overpaid benefits. However, the court vacated LINA's rejection of the mental disability claim, deeming it arbitrary and capricious due to the lack of proper medical review, and remanded the matter to LINA for reconsideration, while retaining jurisdiction.

Disability BenefitsERISA LitigationSummary JudgmentArbitrary and Capricious ReviewRemand to AdministratorPost-Traumatic Stress DisorderPhysical Injury ClaimMental Health ClaimInsurance Policy DisputeOverpayment Reimbursement
References
19
Showing 1-10 of 2,008 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational