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

Case No. ADJ7167333; ADJ7167413
Regular
Mar 24, 2015

ROSA LOPEZ vs. SUPERIOR CENTER CONCEPTS, INC., CARE WEST and PEGASUS RISK MANAGEMENT, PATRIOT RISK SERVICES for CIGA

In this workers' compensation case, CIGA sought reconsideration of a decision finding it liable for a portion of medical treatment and legal expenses. CIGA argued that because Care West provided "other insurance," it should not be liable. However, the Board denied CIGA's petition, upholding the original findings. This decision was based on a prior stipulation between Ullico (whose claims CIGA now administers) and Care West, which contractually apportioned liability. The Board found that CIGA is bound by this pre-liquidation stipulation, which supersedes CIGA's statutory exclusion for claims covered by other insurance.

CIGAUllicoCare WestPatriot Risk ServicesPegasus Risk ManagementSuperior Center Concepts Inc.Rosa LopezPetition for ReconsiderationFindings and OrderCompromise and Release
References
Case No. ADJ2022332 (ANA 0334821) ADJ947209 (ANA 0334822)
Regular
Feb 27, 2014

JOHN SHEA vs. PROPSERV, INC., CENTRE INSURANCE. COMPANY., CIGA For CALCOMP, In Liquidation

The California Workers' Compensation Appeals Board affirmed the Arbitrator's decision denying CIGA's requests for contribution and reimbursement from Centre Insurance Company. CIGA stipulated to liability for the injury date in 2000, and the Board found that CIGA's subsequent claims of mistake were untimely and lacked good cause to reopen a final award. The Board emphasized the importance of finality in awards and that CIGA failed to timely raise equitable arguments. Therefore, CIGA's appeal for contribution and reimbursement was unsuccessful.

CIGACalCompContributionReimbursementStipulated AwardGood CauseReopenEquitable ArgumentsPrejudgment InterestDate of Injury
References
Case No. ADJ3885934 (ANA 0349373)
Regular
Mar 01, 2010

SAUL GONZALEZ vs. REMEDY TEMP/CIGA FOR RELIANCE IN LIQUIDATION, MARRIOTT CORPORATION/MARRIOTT CLAIMS SERVICES

The Workers' Compensation Appeals Board (WCAB) granted CIGA's petition for reconsideration, reversing a prior decision that found no jurisdiction to hear CIGA's claim for reimbursement. The WCAB determined it retains supplemental jurisdiction over disputes between defendants, like CIGA and Marriott, even after the injured worker's case was dismissed for lack of prosecution. This decision recognizes that the dismissal was intended to address the applicant's failure to prosecute, not to extinguish CIGA's independent right to seek reimbursement from Marriott. The case is returned to the trial level for further proceedings on CIGA's reimbursement claim.

CIGAReimbursementJurisdictionDismissalReconsiderationSupplemental JurisdictionContributionSpecial EmploymentLack of ProsecutionStipulation
References
Case No. ADJ6656180
Regular
Aug 24, 2009

LEONARD REASON vs. MCNEAR BRICK & BLOCK, CIGA for CALIFORNIA COMPENSATION, in liquidation

The Workers' Compensation Appeals Board granted CIGA's petition for removal, reversing a prior WCJ order that denied CIGA's objection to the applicant's Declaration of Readiness to Proceed. The Board found that the WCJ erred by preventing CIGA from conducting discovery and obtaining a Qualified Medical Evaluator (QME) exam, despite the applicant filing his claim nearly eleven years after the alleged injury. The Board emphasized that CIGA has a right to discovery, even after denying a claim, and that any potential violation of administrative rules does not automatically waive these discovery rights. The case was returned to the trial level for further proceedings, allowing CIGA the opportunity to complete its discovery.

CIGAPetition for RemovalQualified Medical EvaluatorDeclaration of Readiness to ProceedObjection to Declaration of ReadinessDue ProcessDiscovery RightsRescinded OrderWorkers' Compensation Appeals BoardIndustrial Injury
References
Case No. ADJ1143803 (OXN 0128653) ADJ2709854 (OXN 0142376)
Regular
Nov 01, 2011

SALVADOR PAZ vs. MARTINEZ PAINTING & WALL COVERING, MB PAINTING, CIGA, for CREDIT GENERAL INSURANCE COMPANY, INTERCARE, CIGA for UNITED PACIFIC INSURANCE COMPANY, INTERCARE, STATE FARM INSURANCE COMPANY, ACE USA

This case involves a painter, Salvador Paz, who sustained cumulative and specific injuries to his back, shoulder, wrist, neck, and foot. The Workers' Compensation Appeals Board denied petitions for reconsideration from State Farm, CIGA, and the applicant. The Board upheld the original findings, which apportioned permanent disability at 72% to the specific injury (CIGA via Credit General) and 28% to the cumulative trauma (ACE USA and State Farm). Liability for temporary disability was also divided, and State Farm's arguments regarding an unequal division and due process were rejected.

CIGAState Farmcumulative injuryspecific injuryapportionmenttemporary disabilitypermanent disabilityvocational expertPetition for ReconsiderationCredit General Insurance
References
Case No. ADJ855136
Regular
Aug 14, 2017

ROSE SANTANA vs. STANFORD UNIVERSITY, ZURICH AMERICAN INSURANCE COMPANY, CIGA, SEDGWICK CLAIMS MANAGEMENT SERVICES, INC., RELIANCE INSURANCE COMPANY

In this workers' compensation case, CIGA sought reimbursement for benefits paid, arguing two cumulative trauma injuries were actually one and Zurich was liable. The Appeals Board affirmed the prior denial of CIGA's claim, finding CIGA was judicially estopped from disputing the existence of two distinct cumulative trauma injuries after previously stipulating to them. CIGA also failed to present sufficient medical evidence to prove that both injuries contributed to the need for temporary disability or medical treatment. Therefore, the arbitrator's original decision denying CIGA's petition for contribution/reimbursement was upheld.

Workers' Compensation Appeals BoardCIGAZurich American Insurance CompanyReliance Insurance Companyjudicial estoppelcumulative traumaapportionmentjoint and several liabilitycovered claimsinsolvent insurer
References
Case No. ADJ212916 (VNO 0334702)
Regular
Feb 09, 2011

PETER L. WASCHER vs. AIDS HEALTHCARE FOUNDATION INC., CIGA FOR CAL. COMP. (IN LIQUIDATION), STATE COMPENSATION INSURANCE FUND

This case involves a dispute over reimbursement for workers' compensation payments made by CIGA (California Insurance Guarantee Association) on behalf of an insolvent insurer. The arbitrator initially ordered State Compensation Insurance Fund (SCIF) to reimburse CIGA only $105,511.94, pending further proof of payment. CIGA petitioned for reconsideration, arguing it had provided sufficient evidence of payment for the full $719,238.12. The Workers' Compensation Appeals Board granted the petition, finding CIGA's payment records were reliable and unrebutted. Consequently, SCIF was ordered to reimburse CIGA the entire $719,238.12.

CIGASCIFreimbursementarbitrationreconsiderationindustrial injuryAids Healthcare FoundationCal Compmedical paymentsproof of payment
References
Case No. ADJ2921203 (SAC 0309350)
Regular
May 10, 2010

LORI BIANCALANA vs. FRANKLIN RESOURCES, INC., CIGA, Through Its Servicing Facility, INTERCARE INSURANCE SERVICES for HIH INSURANCE, In Liquidation, and FIREMAN'S FUND INSURANCE CO.

The Workers' Compensation Appeals Board granted reconsideration to clarify CIGA's reimbursement rights from a solvent insurer (Fireman's Fund) for benefits paid to an injured worker after the worker's primary insurer became insolvent. The Board reversed the arbitrator's decision, finding CIGA is entitled to full reimbursement for all good-faith payments made to the applicant. This decision emphasizes CIGA's role as an insurer of last resort and encourages prompt benefit payments even when subsequent claims adjustments may occur. Therefore, Fireman's Fund is now responsible for repaying CIGA the entirety of the benefits CIGA disbursed.

CIGAHIH InsuranceFireman's Fundinsolvencycovered claimsother insurancereimbursementcontributioncumulative traumatemporary disability
References
Case No. ADJ1124123 (BGN 0064929) ADJ3374432 (BGN 0061307)
Regular
Oct 22, 2018

MARY BAKER vs. SWEEETHEART CUPS; CIGA by SEDGWICK CMS for FREMONT INSURANCE in liquidation and PORTEOUS FASTENERS/PACIFIC INDEMNITY COMPANY, CHUBB INSURANCE

The Workers' Compensation Appeals Board granted CIGA's petition for reconsideration, reversing the finding that CIGA remained liable for permanent total disability indemnity and medical treatment for the applicant's industrial injuries. The Board found that because the applicant's injuries resulted in a joint and several award with a solvent insurer, Pacific Indemnity, CIGA has no obligation to pay as "other insurance" was available. The decision clarifies that CIGA is absolved of liability for medical treatment jointly caused by both injuries, but remains liable for treatment solely caused by the September 1979 injury. Pacific Indemnity is now solely responsible for all remaining permanent total disability indemnity and medical treatment costs, adjusting for payments already made by CIGA.

CIGASweetheart CupsPorteous FastenersFremont InsurancePacific IndemnityChubb InsuranceWilkinson doctrinejoint and several liabilitycovered claimsother insurance
References
Case No. LAO 0774175, LAO 0777678, LAO 0778097
Regular
Feb 26, 2008

FRANCISCO ARAU MEZA vs. PLATINUM DYEING & FINISHING, REDLAND INSURANCE COMPANY, RELIANCE NATIONAL INSURANCE COMPANY/CIGA

This case involves Redland Insurance Company's petition for reconsideration of an arbitrator's decision awarding contribution from Redland to CIGA for medical and rehabilitation expenses. Redland argued a prior decision settled all contribution rights, but the Board found that the earlier decision did not address CIGA's contribution rights and therefore CIGA did not waive them. The Board denied Redland's petition, allowing the arbitrator to determine the proper remedy for CIGA's contribution claim.

WCABRedland Insurance CompanyCIGAcontributionarbitrationCompromise & Releaseindustrial injuryback injuryneck injurycumulative trauma
References
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