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

Case No. MISSING
Regular Panel Decision

Employers Insurance v. General Accident, Fire & Life Assurance Corp.

Employers Insurance of Wausau (Wausau) sought summary judgment for 50% reimbursement of a $500,000 settlement and defense costs. The settlement stemmed from an underlying personal injury action where Frank Rayno, an employee of Sage Garage, was injured on a construction site in 1976. Wausau provided workers' compensation and employer's liability insurance to Sage Garage, while General Accident provided general liability coverage. Wausau paid the full settlement and then pursued General Accident for contribution. General Accident argued for a pro rata contribution based on policy limits. The court granted Wausau's motion for summary judgment, ruling that both insurers should contribute equally up to the limit of the smaller policy, which was General Accident's $500,000 policy, meaning General Accident owed $250,000. The defendants' cross-motion was denied.

Insurance disputeSummary judgmentDeclaratory judgmentContribution among insurersReimbursementPolicy limitsEmployer's liability insuranceGeneral liability insuranceWorkers' compensationPro rata contribution
References
0
Case No. 01-19-00852-CV
Regular Panel Decision
Sep 21, 2021

National Union Fire Insurance Company of Pittsburgh, PA v. Exxon Mobil Corporation

This case involves two related appeals concerning insurance coverage for bodily injury claims against Exxon Mobil Corporation by its contractor's employees, Kevin Roberts and Arturo Munoz. National Union Fire Insurance Company of Pittsburgh, Pa. challenged a trial court's summary judgment in favor of Exxon and Starr Indemnity and Liability Insurance Company, arguing its umbrella policy did not provide coverage beyond its CGL policy, as dictated by the Exxon-Savage Contract. Exxon also challenged a summary judgment favoring Starr. The appeals court reversed the judgment against National Union, finding that 'Commercial General Liability insurance' in the contract referred only to primary coverage, not umbrella or excess policies. Consequently, Exxon was not entitled to coverage under National Union's umbrella policy. The court affirmed the summary judgment in favor of Starr, as its bumbershoot policy was also considered an umbrella policy. The case was remanded for reconsideration of attorney's fees and costs.

Insurance Policy InterpretationCommercial General LiabilityUmbrella Liability InsuranceExcess Liability InsuranceAdditional Insured EndorsementSummary Judgment ReviewBreach of ContractDeclaratory JudgmentAppellate ProcedurePersonal Injury Claims
References
34
Case No. MISSING
Regular Panel Decision

Pesta v. City of Johnstown

This appeal concerns the applicability of the antisubrogation rule. Plaintiff, an employee of Peter Luizzi & Brothers Contracting (Luizzi), suffered severe injuries in a construction accident involving a Luizzi dump truck. Plaintiff sued defendant, who then filed a third-party action against Luizzi for common-law indemnification. The Supreme Court initially ruled defendant was entitled to indemnification for damages exceeding Luizzi's existing insurance policies. Upon reargument, the court granted defendant's motion in full, concluding the antisubrogation rule did not apply because Luizzi's commercial general liability, commercial automobile, and commercial liability umbrella policies had applicable exclusions, and the owners and contractors protective liability (OCP) policy named only the defendant as an insured. Luizzi appealed this decision. The appellate court affirmed, finding that the dump truck was an 'auto' under the CGL policy's exclusion, the co-employee exclusion in the automobile policy was valid, thus the umbrella policy was not implicated, and the antisubrogation rule was inapplicable to the OCP policy as it only insured the defendant.

AntisubrogationInsurance ExclusionIndemnificationSummary JudgmentWorkers' CompensationCommercial General LiabilityCommercial Automobile PolicyUmbrella PolicyOCP PolicyAppellate Review
References
9
Case No. MISSING
Regular Panel Decision

Zurich General Accident & Liability Insurance Co. v. Holmes

This is an appeal in a workmen's compensation case from a District Court judgment in Jefferson County, Texas. The appellant, Zurich General Accident & Liability Insurance Company, Ltd., appealed a judgment for the injured employee, Holmes, regarding the nature and extent of his injury and wage rate. The jury found Holmes suffered a 17.5% partial permanent loss of his right leg's use due to an injury in July 1952 while working for Pure Oil Company. The trial court set his wage rate at $90 per week, leading to a compensation award of $9.45 per week for 200 weeks, less $125 already paid. The appellate court affirmed the trial court's judgment, but reformed it to credit the appellant for the $125 already paid to the appellee.

Wage Rate CalculationPartial Permanent DisabilityLeg Injury CompensationInsurance Carrier AppealJudicial Notice of Employment ConditionsStatutory Wage Computation (Article 8309)Evidence SufficiencyMotion for Instructed VerdictCredit for Advance PaymentsAppellate Judgment Reformation
References
6
Case No. 10-86-161-CV
Regular Panel Decision
Aug 06, 1987

Jones v. Houston General Ins. Co.

Eddie Jones, an employee of Hutchins Grass Company, died in the course of employment on September 14, 1977. His beneficiaries sought death benefits under the Texas Worker's Compensation Act from Houston General Insurance Company, which had issued an assigned-risk policy to Hutchins. The carrier cancelled the policy on June 22, 1977, due to the employer's failure to pay interim premiums and file payroll reports. The trial court issued a take-nothing judgment in favor of Houston General, finding the policy was cancelled prior to Jones' death. On appeal, the beneficiaries contended the cancellation was ineffective, arguing only the Assigned Risk Pool could cancel the policy. The Court of Appeals of Texas, Waco, affirmed the judgment, holding that the carrier had the authority to cancel the assigned-risk policy without prior directive from the Assigned Risk Pool, consistent with the policy's terms and statutory interpretation.

Insurance Policy CancellationAssigned Risk PlanDeath Benefits ClaimWorker's Compensation ActStatutory InterpretationPremium Non-PaymentEmployer LiabilityJudicial ReviewTexas LawAppellate Procedure
References
9
Case No. MISSING
Regular Panel Decision

American Motorists Insurance Co. v. Occidental Chemical Corp.

Houston Scale Company, Inc. purchased a comprehensive general liability (CGL) policy and a commercial catastrophe liability policy from American Motorists Insurance Company. Houston Scale failed to name Occidental Chemical Corporation as an additional insured on the CGL policy, despite a contractual obligation. When a personal injury suit was filed against Occidental, it sought coverage under the commercial catastrophe policy, arguing it qualified as an insured due to the contractual obligation. The trial court granted summary judgment for Occidental, awarding damages and attorney's fees. American Motorists appealed, challenging Occidental's status as an insured under the catastrophe policy and the award of attorney's fees. The appellate court affirmed the trial court's judgment, holding that Occidental was indeed an insured under the replacement CGL coverage provisions of the commercial catastrophe policy and that attorney's fees were properly awarded.

Insurance LawCGL PolicyCommercial Catastrophe PolicyAdditional InsuredContractual ObligationSummary JudgmentAttorney's FeesBreach of ContractExcess CoverageReplacement Coverage
References
15
Case No. 2020 NY Slip Op 07851
Regular Panel Decision
Dec 23, 2020

Bodlovic v. Giannoutsos

Miodrag Bodlovic, a plaintiff, sustained personal injuries while working for Gigi Salon & Spa due to a malfunctioning rollup gate. He and his wife sued the premises owners, Frank Giannoutsos, Paraskevi Giannoutsos, and Vasiliki Giannoutsos, alleging negligence. The Giannoutsos defendants, named as additional insureds on Gigi Salon's commercial general liability policy with United States Liability Insurance Company (USLIC), sought a declaration that USLIC was obligated to defend and indemnify them. USLIC moved for summary judgment, arguing a bodily injury exclusion in its policy precluded coverage. However, the Supreme Court, Queens County, denied this motion, finding an exception to the exclusion for liability assumed under an 'insured contract,' which in this case was the lease agreement between Gigi Salon and the Giannoutsos defendants. The Appellate Division, Second Department, affirmed the Supreme Court's order, concluding that USLIC failed to demonstrate, prima facie, that the defendants were not entitled to coverage.

Insurance policyAdditional insuredSummary judgmentBodily injury exclusionInsured contractLease agreementIndemnificationAppellate reviewCoverage disputePremises liability
References
10
Case No. MISSING
Regular Panel Decision

Romano v. Whitehall Properties

An employee of Sorbara Construction Company was injured at a construction site owned by Whitehall Properties, LLC. The employee received workers' compensation benefits from Travelers Indemnity Insurance Company of America, Sorbara's carrier. The employee also filed a negligence action against Whitehall and the general contractor, Kreisler Borg Florman General Construction Co., Inc. This negligence action was settled, with Travelers contributing under a general liability policy. Whitehall and Kreisler appealed a Supreme Court order denying their motion to extinguish Travelers' workers' compensation lien against the settlement. The appellate court affirmed, ruling that the anti-subrogation rule did not apply because Travelers' workers' compensation obligation arose from a separate policy issued to Sorbara, not the general liability policy covering Whitehall and Kreisler, thus allowing Travelers to assert its lien.

Workers' Compensation LienAnti-Subrogation RuleGeneral Liability PolicyPersonal Injury DamagesConstruction AccidentEmployer NegligenceInsurance CarrierSettlement AgreementAppellate DecisionThird-Party Action
References
6
Case No. MISSING
Regular Panel Decision

Hartford Accident & Indemnity Co. v. Commercial Union Insurance

This case involves a dispute between two insurance companies, Hartford Accident and Indemnity Company (excess insurer) and Commercial Union Insurance Company (primary insurer), concerning liability for an injury claim. Michael Jutt, an employee of Minuteman Press International, Inc., was injured while on a Minuteman-owned boat. Commercial Union, the primary insurer, denied coverage and refused to defend Minuteman, leading Hartford, the excess insurer, to provide defense and settle Jutt's claim for $135,000. Hartford subsequently sued Commercial Union for breach of fiduciary duty. The District Court affirmed Hartford's standing to sue, recognizing a direct fiduciary duty owed by a primary insurer to an excess insurer, and found that the "paid employees" exclusion in Commercial Union's policy was ambiguous. Consequently, the Court ruled in favor of Hartford, ordering Commercial Union to pay $135,000 plus interest.

Insurance LawExcess InsurancePrimary InsuranceFiduciary DutyEquitable SubrogationPolicy ExclusionAmbiguous Contract TermDeclaratory Judgment ActionStanding to SueMarine Insurance
References
5
Case No. 03-93-00282-CV
Regular Panel Decision
Nov 01, 1995

Leslie Vandewater, Individually and as Next Friend of Jordan Vandewater, a Minor v. American General Fire and Casualty Company

Leslie Vandewater, individually and as next friend of her minor son, Jordan, appealed a summary judgment in a suit for declaratory relief brought by American General Fire and Casualty Company. Jordan contracted a virus in utero from his mother, Leslie, who was employed by Vandewater Construction Company, resulting in his mental retardation. The core issue was the applicable policy limit under an 'Employers Liability Insurance' section of American General's policy. Leslie and Jordan contended a $500,000 limit should apply, arguing Jordan was not an employee. However, the trial court determined and the appellate court affirmed that the $100,000 limit specified for bodily injury by disease to any one employee unambiguously applied, extending to consequential bodily injuries sustained by an injured employee's child.

Insurance PolicyPolicy LimitsWorkers' CompensationEmployers' LiabilityConsequential Bodily InjuryDeclaratory JudgmentSummary JudgmentPolicy InterpretationContract LawMinor's Claim
References
17
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