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

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
1
Case No. ADJ2263363 (SAC 0291821) ADJ2654728 (SAC 0291246)
Regular
Dec 05, 2008

LEROY ARMSTRONG vs. ENVIRONMENTAL CONSTRUCTION, STATE COMPENSATION INSURANCE FUND, SLIPFORM CONCRETE, BROADSPIRE, California Insurance Guarantee Association (CIGA), Legion Insurance, State Compensation Insurance Fund (SCIF), Fireman's Fund

The Workers' Compensation Appeals Board dismissed CIGA's petition for reconsideration because the WCJ's deferral of CIGA's requested issues was not a final order, and CIGA was not aggrieved. The Board also denied CIGA's petition for removal, finding no extraordinary circumstances. Finally, the Board denied SCIF's petition for reconsideration, agreeing with the WCJ's determination that the applicant's claim against Environmental Construction was timely.

Workers Compensation Appeals BoardCIGASCIFReconsiderationRemovalPetitionFinal OrderStatute of LimitationsIndustrial InjuryDeferred Issue
References
7
Case No. ADJ1630547 (MON 0209470)
Regular
Aug 10, 2009

Raymond Burrell vs. Boeing/McDonnell Douglas, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION (CIGA), AIG

This case concerns AIG's petition for reconsideration of a supplemental workers' compensation award. The Appeals Board affirmed an administrative law judge's decision that relieved CIGA of liability and placed the full burden on AIG for an applicant's injury award. The Court found that because AIG was a solvent insurer with joint and several liability, CIGA was not responsible for benefits as it constituted a "non-covered claim" under statute. Therefore, AIG is liable for all benefits after the liquidation of CIGA's underlying insurer.

CIGAIndustrial IndemnityAIGSupplemental Findings and AwardStipulated Awardcontinuing jurisdictionLabor Code section 5803Labor Code section 5804Insurance Code section 1063.1(c)(9)covered claim
References
6
Case No. ADJ3004293
Regular
May 15, 2009

JOHN M. WILLIAMS vs. RE-BUILDERS, INC., dba RE-BUILDERS NORTH BAY and STATE COMPENSATION INSURANCE FUND, LABOR CONNECTION, INC., CAMBRIDGE INTEGRATED SERVICES GROUP, INC., CIGA for RELIANCE INSURANCE

This case concerns CIGA's liability for an applicant's workers' compensation benefits after the general employer's insurer became insolvent. The Workers' Compensation Appeals Board (WCAB) overturned a prior finding, ruling that the special employer's SCIF policy constituted "other insurance." Therefore, under Insurance Code section 1063.1(c)(9)(A), CIGA is relieved of liability. The matter was returned for determination of reimbursement between CIGA and SCIF.

CIGASCIFgeneral employerspecial employerLabor ConnectionRe-BuildersInc.Reliance Insuranceother insuranceInsurance Code section 1063.1(c)(9)(A)
References
15
Case No. ADJ1444335 (RIV 0017334), ADJ167619 (RIV 0017335), ADJ4158912 (RIV 0046324)
Regular
Sep 08, 2010

CHERYLE HUTCHINSON vs. COMMUNITY HOSPITAL OF SAN BERNARDINO, SEDGWICK CIGA GLENDALE, CHARTIS COSTA MESA, American Home Assurance Company (AHA)

The Appeals Board dismissed American Home Assurance Company's (AHA) Petition for Reconsideration regarding an order for AHA to administer three workers' compensation claims. The Board granted AHA's petition for removal, rescinded the order, and returned administration of the claims to CIGA. The Board found that the Workers' Compensation Judge prematurely ordered AHA to administer the claims, as no findings of liability or "other insurance" had been established, which are prerequisites for shifting administration away from CIGA. Therefore, CIGA will continue administering the claims until a determination of liability and coverage is made.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition for RemovalClaims AdministrationCalifornia Insurance Guarantee AssociationCIGAOther InsuranceJoinder of DefendantDate of InjuryOverlap of Injuries
References
3
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
6
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
4
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
10
Case No. ADJ1738288 (STK 0190763) ADJ2794711 (STK 0190762) ADJ1287276 (STK 0190764) ADJ1593256 (STK 0190765) ADJ2352943 (STK 0190766)
Regular
Mar 26, 2010

GLORIA VANOVER-LOPEZ vs. WESTLAND TECHNOLOGY and CIGA and ITS SERVICING FACILITY, INTERCARE INSURANCE SERVICES, for PNIC IN LIQUIDATION

The Workers' Compensation Appeals Board (WCAB) rescinded the prior award and remanded the case for further proceedings due to a due process violation against CIGA. The WCAB found that CIGA was improperly forced to trial after being dismissed and subsequently rejoined as a party without proper notice or opportunity to participate in discovery or preparation. While CIGA's arguments regarding liability were potentially flawed, fundamental fairness required CIGA to have an opportunity to be heard. The WCAB recommended a new judge be assigned for further proceedings.

CIGAReconsiderationDue ProcessJoinderDismissalStatute of LimitationsPermanent DisabilityMedical TreatmentWCJAdjudication
References
0
Case No. ADJ 536917 (PAS 0038447), ADJ 4107955 (PAS 0038446)
Regular
Jul 26, 2016

DONALD SCHILLING vs. STARLINE TOURS OF HOLLYWOOD, SCIF, CIGA FOR SUPERIOR PACIFIC CASUALTY COMPANY

The Workers' Compensation Appeals Board granted CIGA's petition for reconsideration, rescinding a prior order that held CIGA liable for 50% of the applicant's future medical treatment costs. The Board found that recent case law indicates a final apportionment award does not alter the joint and several nature of liability among insurers. CIGA argued it is not liable if other insurance, like SCIF's, is available, citing Insurance Code section 1063.1(c)(9). The matter was returned to the trial level for further proceedings to address CIGA's contentions and potential laches defense, which requires a showing of prejudice.

CIGASuperior Pacific Casualty CompanySCIFPetition for ReconsiderationFindings and OrdersApportionmentJoint and Several LiabilityOther InsuranceLachesPrejudice
References
12
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