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

Case No. 2024 NY Slip Op 04268
Regular Panel Decision
Aug 21, 2024

Matter of State Farm Mut. Auto. Ins. Co. v. New York Black Car Operators' Injury Compensation Fund

This case involves an appeal by State Farm Mutual Automobile Ins. Co. against a judgment that denied its petition to vacate an arbitration award. The arbitration award had found State Farm liable for workers' compensation benefits paid by the New York Black Car Operators' Injury Compensation Fund to an injured driver. The Supreme Court confirmed this award. On appeal, the Appellate Division, applying closer judicial scrutiny due to the statutory nature of the arbitration, affirmed the lower court's judgment, concluding that the arbitrator's determination had sufficient evidentiary support and was not arbitrary or capricious.

Arbitration LawAppellate PracticeWorkers' CompensationInsurance LitigationJudicial Review of ArbitrationStatutory MandateAutomobile InsuranceDenial of PetitionConfirmation of AwardDamages Recovery
References
8
Case No. 2025 NY Slip Op 03716 [241 AD3d 101]
Regular Panel Decision
Jun 18, 2025

Matter of Doran Constr. Corp. v. New York State Ins. Fund

Doran Construction Corp. initiated a CPLR article 52 proceeding against the New York State Insurance Fund (State Insurance Fund) as a garnishee to enforce a money judgment. The State Insurance Fund appealed an order from the Supreme Court, Westchester County, which denied its cross-motion to dismiss for lack of subject matter jurisdiction. The Appellate Division, Second Department, affirmed the order, holding that Supreme Court possessed subject matter jurisdiction under CPLR 5207 and 5221 (a) (4) as the State Insurance Fund was acting as a garnishee holding funds for another, not as a judgment debtor. The Court also rejected the State Insurance Fund's arguments regarding public policy and the denial of discovery.

Subject Matter JurisdictionGarnishmentEnforcement of Money JudgmentsState AgenciesSovereign ImmunityCourt of ClaimsCPLR Article 52Appellate ReviewDiscoveryPublic Policy
References
18
Case No. 2013-2706 Q C
Regular Panel Decision
Sep 19, 2016

NYS Acupuncture, P.C. v. State Farm Mut. Auto. Ins. Co.

This case, NYS Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co., concerned an appeal from an order of the Civil Court of the City of New York, Queens County. The plaintiff, NYS Acupuncture, P.C., sought assigned first-party no-fault benefits from State Farm, which had moved for summary judgment arguing full payment according to the workers' compensation fee schedule. The Civil Court initially granted State Farm's motion. On appeal, NYS Acupuncture, P.C. contended that the fee schedule reductions were improper. The Appellate Term, Second Department, affirmed the prior ruling, finding that State Farm adequately demonstrated it had fully compensated the plaintiff for acupuncture services based on the applicable workers' compensation fee schedule for services performed by chiropractors, referencing Great Wall Acupuncture, P.C. v Geico Ins. Co.

Workers' Compensation Fee ScheduleNo-Fault BenefitsAcupuncture ServicesChiropractorsSummary JudgmentAppellate ReviewInsurance DisputeFee Schedule ReductionAssigned BenefitsMedical Billing
References
1
Case No. MISSING
Regular Panel Decision

Teamsters, Chauffeurs, Warehousemen & Helpers, Local Union No. 182 v. New York State Teamsters Council Health & Hospital Fund

Plaintiff Teamsters Local Union No. 182 (Local 182) filed an action against the New York State Teamsters Council Health & Hospital Fund and the New York State Teamsters Conference Pension and Retirement Fund (the Funds) under 29 U.S.C. § 185. Local 182 sought a declaration affirming the existence of valid collective bargaining agreements between April 1992 and March 1994, which mandated grievance and arbitration procedures, and an order compelling the Funds to arbitrate layoff-related grievances. The Union contended there was a long-standing oral agreement to adhere to applicable provisions of the National Master Freight Agreement (NMFA). The Funds moved for summary judgment, asserting a lack of subject matter jurisdiction and denying the existence of any agreement with requisite definiteness. The court denied the summary judgment motion, affirming subject matter jurisdiction and finding that Local 182 presented genuine issues of material fact concerning the existence of a collective bargaining agreement.

Collective Bargaining AgreementSummary Judgment MotionLabor DisputeUnion RightsGrievance ProcedureArbitrationSeniority RightsLayoffsNational Master Freight AgreementPension Benefits
References
24
Case No. 2017-913 K C
Regular Panel Decision
Aug 02, 2019

Oriental Health Acupuncture, P.C. v. State Farm Mut. Auto. Ins. Co.

This case concerns an appeal initiated by Oriental Health Acupuncture, P.C., acting as the assignee of Carrington, Earnel, against State Farm Mutual Automobile Ins. Co. The appeal originated from an order by the Civil Court of the City of New York, Kings County, which had granted State Farm's motion for summary judgment and dismissed the plaintiff's complaint seeking first-party no-fault benefits. The Civil Court's decision was predicated on the finding that the amounts claimed by the plaintiff exceeded the limits established by the workers' compensation fee schedule. The Appellate Term, Second Department, affirmed the lower court's order. This decision was made in conjunction with a related case, BQE Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co., decided concurrently.

No-fault benefitsSummary judgmentAppellate reviewWorkers' compensation fee scheduleAutomobile insuranceFirst-party benefitsMedical provider claimAssigned benefitsCivil Court appealAppellate Term decision
References
1
Case No. 2019 NY Slip Op 01273 [169 AD3d 1187]
Regular Panel Decision
Feb 21, 2019

Family & Educ. Consultants, LLC v. New York State Ins. Fund

Family & Educational Consultants, LLC, doing business as Partnership for Education, sought to file a late notice of claim against the New York State Insurance Fund to recover $250,000 in workers' compensation premiums. The claimant asserted that its therapists were independent contractors, not employees, and thus the premiums were improperly calculated. While the Court of Claims initially granted permission for the late filing, the Appellate Division, Third Department, reversed this decision. The appellate court held that the Court of Claims lacked subject matter jurisdiction over the core issue, which involved challenging an agency's determination of employee classification. It clarified that such determinations are properly reviewed through a CPLR article 78 proceeding in Supreme Court, which could also provide incidental relief for overpayments.

Workers' Compensation PremiumsIndependent ContractorsSubject Matter JurisdictionCourt of ClaimsAgency DeterminationCPLR Article 78Late Notice of ClaimAppellate ReviewEmployee ClassificationInsurance Disputes
References
9
Case No. MISSING
Regular Panel Decision

Methodist Hospital v. State Insurance Fund

This case concerns the constitutionality of a $190 million transfer from the State Insurance Fund (SIF) to New York State's general fund, as directed by chapter 55 of the Laws of 1982. Plaintiffs, employers insured by the SIF, challenged the transfer on multiple state and federal constitutional grounds, including impairment of contractual obligations, deprivation of property without due process, unlawful taking, and improper legislative intrusion. The defendants included the SIF, its officials, the State Comptroller, and the State. Special Term and the Appellate Division both ruled the transfer constitutional. The Court of Appeals affirmed, holding that the SIF is a State agency for which the State is responsible, not a mutual insurance pool, thereby negating any property or contractual interest of policyholders in its surplus. The Court also dismissed other constitutional challenges related to separation of powers, loan of state credit, creation of debt, and appropriation bills.

State Insurance FundConstitutional LawFund TransferState AgencyMutual InsuranceProperty RightsContract ImpairmentDue ProcessJust CompensationSeparation of Powers
References
17
Case No. MISSING
Regular Panel Decision

Bryam Hills Central School District No. 1 v. State Insurance Fund

This case involves an appeal concerning the obligations of the State Insurance Fund under insurance policies. The Bryam Hills Central School District No. 1 sought a declaratory judgment to compel the State Insurance Fund to defend actions initiated by Dorothy G. Caruolo. The initial Supreme Court judgment had granted summary judgment to the school district, mandating the State Insurance Fund to provide a defense. The appellate court modified this judgment, affirming the State Insurance Fund's duty to defend the first Caruolo action due to sufficient general negligence allegations, thereby invoking policy coverage. However, the court reversed the requirement to defend two other actions seeking salary and benefits, as these claims were rooted in contract and expressly excluded by the policy, negating any duty to defend in those specific instances.

Insurance Policy ObligationsDuty to DefendDeclaratory JudgmentSummary JudgmentAppellate ReviewContract ExclusionWorkers' Compensation ImplicationsNegligence ClaimsInsurance Coverage DisputeSupreme Court Appeal
References
4
Case No. MISSING
Regular Panel Decision
Nov 19, 1992

COMM'RS OF THE STATE INS. FUND v. Ins. Co. of N. Am.

The State Insurance Fund (SIF), an insurer, sought pro rata contribution from another insurer, Insurance Company of North America (INA), for a settlement paid in a personal injury action involving a shared insured, Clay Drywall, Inc. SIF claimed contributions for both 'fresh money' and a waived workers' compensation lien. The Appellate Division initially granted SIF summary judgment for the 'fresh money' component but denied it for the lien waiver. However, the Court of Appeals modified this decision, ruling that both of SIF's causes of action should be dismissed. The Court determined that an unambiguous exclusion clause in INA's policy, which covered claims arising from employee bodily injury on the job, precluded INA's liability for contribution in this case.

Workers' CompensationInsurance PolicyIndemnificationContributionExclusion ClauseSummary JudgmentAppellate ReviewBodily InjuryEmployer LiabilityThird-Party Action
References
5
Case No. MISSING
Regular Panel Decision
Oct 06, 2000

Royal Insurance Co. of America v. Commissioners of the State Insurance Fund

The claimant sought 50% reimbursement of defense costs from the State Insurance Fund (Fund) for litigation related to a bridge collapse, after the Fund ceased contributions. The Court of Claims granted summary judgment to the claimant, finding an implied contract. On appeal, the Fund argued State Finance Law § 112 (2) (a) precluded such a contract without Comptroller approval and that factual issues existed. The appellate court affirmed, holding the Fund acts as a private insurer in litigation and is estopped from denying the implied contract, also finding no material factual issues precluding summary judgment.

Reimbursement of Defense CostsImplied ContractState Insurance FundCo-insuranceSummary JudgmentEstoppelState Finance LawWorkers' Compensation LawAppellate ReviewGovernmental Immunity
References
6
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