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

Case No. ADJ11391724, ADJ11391757
Regular
Oct 03, 2019

PABLO LOPEZ DURAN vs. SOUTH HILLS ACADEMY, CHURCH MUTUAL INSURANCE COMPANY, SECURITY NATIONAL INSURANCE COMPANY, AMTRUST NORTH AMERICA, CRESCENT HOTELS & RESORTS, LLC, CHUBB INSURANCE GROUP, GALLAGHER BASSETT SERVICES, INC.

This Workers' Compensation Appeals Board case involves applicant Pablo Lopez Duran and multiple defendants including South Hills Academy, Church Mutual Insurance Company, Security National Insurance Company, Crescent Hotels & Resorts, LLC, and Chubb Insurance Group. The Board granted a petition for reconsideration and affirmed a prior order regarding sanctions and costs. Specifically, Chubb Insurance Group, administered by Gallagher Bassett Services, Inc., was ordered to pay an additional $395 for attorneys' fees related to a petition for fees, less any credit for prior payments.

WORKERS' COMPENSATION APPEALS BOARDSOUTH HILLS ACADEMYCHURCH MUTUAL INSURANCE COMPANYSECURITY NATIONAL INSURANCE COMPANYAMTRUST NORTH AMERICACRESCENT HOTELS & RESORTSLLCCHUBB INSURANCE GROUPGALLAGHER BASSETT SERVICESINC.
References
0
Case No. MISSING
Regular Panel Decision

Northbrook Excess & Surplus Insurance v. Chubb Group of Insurance Companies

This declaratory judgment action addresses the hierarchy of excess insurance policies in a situation where one policy is primary for owned vehicles but excess for non-owned, and the second is an umbrella policy covering multiple risks. The case stems from an accident involving a rented van, which led to a $650,000 settlement. After the primary insurer paid $500,000, Chubb Group of Insurance Companies and Northbrook Excess and Surplus Insurance Co. each contributed $75,000, pending a determination of their respective excess coverage obligations. The Supreme Court initially ruled for ratable contribution. However, citing State Farm Fire & Cas. Co. v LiMauro, the appellate court reversed, holding that Northbrook's umbrella policy constitutes a final tier of coverage, not required to contribute ratably with Chubb's excess policy. Consequently, summary judgment was granted to Northbrook, entitling it to a $75,000 reimbursement from Chubb.

Excess InsuranceUmbrella InsuranceDeclaratory JudgmentInsurance Policy InterpretationInsurance Coverage DisputeAutomobile Liability InsuranceNon-Owned VehicleRatable ContributionFinal Tier CoverageSummary Judgment
References
2
Case No. ADJ2109115; ADJ3790194; ADJ4103411
Regular
Aug 01, 2013

LETICIA BENAVIDES vs. BON APPETIT DANISH; MACY'S; CHUBB GROUP OF INSURANCE CO.

The Workers' Compensation Appeals Board denied the applicant's petition for reconsideration. The applicant sought penalties and attorney fees for the late payment of a Compromise and Release (C&R) settlement, alleging Chubb Group failed to make timely and correct payment. The Board found that the delay was due to a single instance of human error involving an incorrect address on the C&R, which was promptly corrected upon discovery. The applicant also contributed to the delay by not notifying Chubb of the non-receipt of payment for over three months. Therefore, the Board concluded there was no unreasonable delay justifying penalties.

Workers Compensation Appeals BoardPetition for ReconsiderationDeniedWCJ ReportDefective VerificationCured VerificationSupplemental PetitionCompromise and ReleaseLate PaymentChubb Group
References
3
Case No. 2024-50-2711
Regular Panel Decision
Feb 20, 2026

Lusk v. Portopiccolo Group LLC, dba The Portopiccolo Group

This interlocutory appeal concerns an employer's denial of medical treatment for an employee's work-related injuries. Employee Cheryl Lusk, injured by a resident at Portopiccolo Group, LLC, was recommended for cervical spine surgery by her authorized treating physician, Dr. John Burleson. The employer denied the surgery based on a utilization review report, which was upheld by the Bureau's Medical Director. The trial court, however, ordered the employer to provide the surgery, relying on the presumption of medical necessity for treatment recommended by an authorized physician. The Appeals Board affirmed the trial court's decision, concluding that the employer failed to rebut this presumption, and remanded the case for further proceedings.

Workers' CompensationMedical Treatment DenialUtilization ReviewSurgical AuthorizationPresumption of Medical NecessityEmployer AppealCervical Spine InjuryACDF SurgeryAuthorized Treating PhysicianBurden of Proof
References
8
Case No. MISSING
Regular Panel Decision

Dewan v. Blue Man Group Limited Partnership

Plaintiff Brian Dewan, a musician, sued the Blue Man Group entities and individuals, seeking a declaration of co-authorship for musical compositions used in their "Blue Man Group: Tubes" performance and damages for state law claims. Dewan claimed he collaborated with the defendants in composing music for the show and was repeatedly assured of his co-authorship rights and that an agreement would be formalized, but it never materialized. Defendants moved to dismiss, arguing the co-authorship claim under the Copyright Act was time-barred. The court found that Dewan's equitable estoppel argument was unreasonable after late 1993 or 1994, as he had sufficient notice that a lawsuit was necessary. Consequently, the court dismissed the federal co-authorship claim due to the expiration of the statute of limitations and declined to exercise supplemental jurisdiction over the remaining state law claims.

Copyright ActCo-authorshipStatute of LimitationsEquitable EstoppelMotion to DismissFederal JurisdictionState Law ClaimsMusical CompositionsCollaborationDeclaratory Judgment
References
11
Case No. 06 Civ. 0822(RJH)
Regular Panel Decision

Vanamringe v. Royal Group Technologies Ltd.

This Memorandum Opinion and Order addresses two consolidated securities fraud actions against Royal Group Technologies Limited and its officers and directors. The plaintiffs, known as the 'Snow Group', allege a fraudulent scheme involving false and misleading statements to inflate Royal Group's stock price, violating Sections 10(b) and 20(a) of the Exchange Act. The Court consolidated the two actions, Vanamringe v. Royal Group Technologies Limited and Messinger v. Royal Group Technologies Limited, under the caption In re Royal Group Technologies Securities Litigation. The Snow Group's motion for appointment as lead plaintiff was granted, as they demonstrated the largest financial interest and satisfied Rule 23 requirements for typicality and adequacy. The Court also approved the Snow Group's selection of Lerach Coughlin Stoia Geller Rudman & Robbins LLP and Labaton Sucharow & Rudoff LLP as co-lead counsel for the class.

Securities FraudClass ActionLead PlaintiffConsolidationPSLRAFederal Rules of Civil Procedure Rule 23Corporate FraudStock ManipulationInvestor ProtectionExchange Act
References
8
Case No. 01-07-00808-CV
Regular Panel Decision
Nov 20, 2008

the City of Houston v. Southern Electrical Services, Inc., as Assignee of the Morganti Group, Inc. and the Morganti Group, Inc.

The City of Houston appealed the trial court's denial of its plea to the jurisdiction in a breach of contract suit filed by Southern Electrical Services, Inc. (SES) and The Morganti Group, Inc. The appellees claimed the City breached the contract by providing incorrect prevailing wage rates for a construction project. The City argued that SES and Morganti failed to allege facts sufficient to waive governmental immunity under the Texas Local Government Code. The Court of Appeals, First District of Texas, affirmed the trial court's order, concluding that SES alleged sufficient facts to qualify for the statutory waiver of sovereign immunity for breach of contract.

Governmental ImmunityBreach of ContractPlea to the JurisdictionPrevailing Wage RatesTexas Local Government CodeSovereign Immunity WaiverContract LawPublic Works ProjectAppellate ReviewStatutory Interpretation
References
9
Case No. ADJ8589789
Regular
Jun 05, 2014

ANTONIA GARCIA vs. GOGLANIAN BAKERIES, CHUBB GROUP OF INSURANCE COMPANIES

The Workers' Compensation Appeals Board (WCAB) dismissed Antonia Garcia's Petition for Reconsideration against Goglanian Bakeries and Chubb Group of Insurance Companies. The dismissal was based on the petition's failure to meet the verification requirement of Labor Code section 5902. Even if it had been verified, the WCAB would have denied the petition on its merits, adopting the reasoning of the workers' compensation judge.

Petition for ReconsiderationVerifiedLabor Code section 5902DismissalWorkers' Compensation Appeals BoardAdministrative Law JudgeReport and RecommendationVerified PetitionDenied on MeritsWCJ
References
2
Case No. 14-15-01031-CV
Regular Panel Decision
Jul 20, 2017

Heather Tenini Kuentz, Individually, as Personal Representative of the Estate of Robert Michael Kuentz, and as Next Friend of XXXXX XXXXXXX XXXXXX, a Minor, Larry Michael Robert Kuentz and Sandra Kuentz v. Cole Systems Group, Inc. D/B/A the Cole Group

Robert Kuentz, a sales manager, was fatally shot by a salesman, Keith Grimmett, who had been rehired by Mac Haik Chevrolet. Kuentz's family sued Cole Systems Group, an employment screening company, alleging negligence in performing Grimmett's pre-employment background check. The trial court granted summary judgment for Cole, which the appellate court affirmed. The appellate court ruled that Cole's duty was limited to the specific services agreed upon with Mac Haik and did not include a broader investigative or disclosure duty for information outside their contractual scope, such as civil or family court records. The court found no evidence that Cole failed to perform the contracted services or that Mac Haik relied on Cole for additional, uncontracted services.

NegligenceEmployment ScreeningBackground CheckDuty of CareSummary JudgmentTort LawThird-Party LiabilityForeseeabilityWrongful DeathAppellate Review
References
19
Case No. ADJ7915283
Regular
Nov 01, 2013

GUILLERMO LEMUS vs. G & K MANAGEMENT, INC., CHUBB INSURANCE GROUP, GALLAGHER BASSETT SERVICES, INC.

This case involves an applicant, Guillermo Lemus, and defendants G & K Management, Inc., and Chubb Insurance Group. The Workers' Compensation Appeals Board (WCAB) issued an order dismissing a Petition for Reconsideration filed in this matter. The WCAB adopted the reasoning of the workers' compensation administrative law judge, noting the petition was skeletal and unverified. Even on the merits, the petition would have been denied based on the WCJ's report.

Petition for ReconsiderationWCABAdministrative Law JudgeLien ClaimantUnverifiedSkeletalDismissalChubb Insurance GroupGallagher Bassett ServicesG&K Management
References
0
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