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

Case No. ADJ7437756
Regular
Mar 23, 2012

Antonio Parvool vs. TONY'S FOOD SERVICE, TRAVELERS INDEMNITY OF CONNECTICUT

The Workers' Compensation Appeals Board granted reconsideration, finding that applicant Antonio Parvool sustained an industrial injury while employed as a chef's assistant and traveling for his employer. The Board overturned the original finding that the applicant's dive into a pool at an employer-provided hotel was not work-related, applying the "commercial traveler rule." This rule presumes an employee is acting within the scope of employment during business travel, including activities reasonably necessary for comfort. The Board clarified that Labor Code section 3600(a)(9) regarding recreational activities does not apply to commercial travelers.

Commercial traveler ruleIndustrial injuryCourse of employmentReconsiderationFindings and OrdersLabor Code section 3600(a)(9)Reasonable expectancyImpliedly requiredWCJOff-duty recreational activity
References
11
Case No. MISSING
Regular Panel Decision

Cephalon, Inc. v. Travelers Companies, Inc.

Plaintiff Cephalon, Inc. initiated a declaratory judgment action against The Travelers Companies, Inc. and its four subsidiaries in the Southern District of New York. Cephalon sought a declaration that its off-label promotion of the drug Actiq did not violate the FDCA and caused no injury to Travelers. This suit was filed after Travelers, a workers' compensation insurer, sent pre-suit settlement demands to Cephalon, accusing it of causing damages through off-label drug promotion. Travelers moved to dismiss or transfer the case. The court granted Travelers' motion to dismiss, ruling that Cephalon's declaratory action was improperly anticipatory, having been filed in direct response to Travelers' specific threat of litigation and impending deadlines.

Declaratory JudgmentImproperly AnticipatoryFirst-Filed RuleMotion to DismissFederal Rule of Civil Procedure 12(b)(6)Off-Label Drug PromotionFood, Drug and Cosmetics ActInsurance DisputeWorkers' CompensationForum Selection
References
19
Case No. MISSING
Regular Panel Decision

Travelers Insurance v. Nory Construction Co.

Plaintiff Travelers Insurance Company initiated a subrogation action against Nory Construction Co., Inc. to recover over $3.5 million paid to satisfy a judgment against its insured, the State of New York, following a construction accident. Travelers sought common-law indemnification, arguing Nory was entirely at fault, including amounts paid beyond its policy limits. Nory countered that Travelers could not recover voluntary payments, and the claim was barred by the antisubrogation rule and untimely disclaimer. The court denied Travelers' motion for summary judgment due to insufficient evidence regarding Nory's sole fault. Ultimately, the court granted Nory's motion for summary judgment, concluding that Travelers' overpayment, made without legal compulsion or Nory's request, constituted a voluntary payment and was therefore not recoverable under equitable subrogation principles.

SubrogationIndemnificationInsurance Policy LimitsAntisubrogation RuleVoluntary Payment DoctrineSummary Judgment MotionConstruction LawWorkers' Compensation InsuranceCommercial General LiabilityUmbrella Policy
References
48
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. MISSING
Regular Panel Decision

Pecker Iron Works of New York, Inc. v. Traveler's Insurance

This case involves a dispute between Pecker Iron Works and Travelers Indemnity Company of Connecticut concerning the primary versus excess coverage obligations of two liability insurance carriers. Pecker, designated as an 'additional insured' under Upfront Enterprises' policy with Travelers, sought primary coverage after an Upfront worker was injured on a construction site. Travelers contended its policy provided only excess coverage for additional insureds unless explicitly designated as primary in a written contract. The Supreme Court initially agreed with Travelers, but the Appellate Division reversed, holding that coverage for additional insureds is presumed primary unless unambiguously stated otherwise. The Court of Appeals affirmed the Appellate Division's decision, concluding that Pecker was entitled to primary coverage.

Insurance CoverageAdditional InsuredPrimary CoverageExcess CoverageSubcontractor AgreementDeclaratory JudgmentContract InterpretationLiability InsuranceConstruction ProjectAppellate Review
References
4
Case No. MISSING
Regular Panel Decision
Feb 04, 1999

Chase Manhattan Bank, N. A. v. Travelers Group, Inc.

The Supreme Court, New York County, granted plaintiffs' motion for summary judgment, compelling The Travelers Group to indemnify plaintiffs for a $2.3 million judgment in a personal injury action, and denied Travelers' cross-motion. The Travelers Group had issued a workers' compensation policy to FTJ Environmental, Inc., whose employees were injured while working in New York City. The policy's coverage was explicitly conditioned on the work in New York being necessary or incidental to FTJ's work in New Jersey, which was listed as the coverage state. The appellate court found no evidence in the record to support this condition and noted that the policy limit was $100,000 per accident, not $2.3 million. Consequently, the appellate court modified the order, denying plaintiffs' motion for summary judgment.

Summary JudgmentIndemnificationWorkers' Compensation PolicyEmployers Liability PolicyPolicy CoverageLabor Law § 240Burden of ProofInsurance Policy LimitsAppellate DecisionPersonal Injury
References
1
Case No. ADJ2828753 (MON 0248336) ADJ1706360 (MON 0247675)
Regular
Jun 19, 2012

MICHAEL LEZINE vs. LOS ANGELES COUNTY METROPOLITAN TRANSPORTATION AUTHORITY, THE TRAVELERS INSURANCE COMPANY, CONSTITUTION STATE SERVICE COMPANY

This case involves Travelers Insurance seeking reconsideration of two separate Workers' Compensation Appeals Board (WCAB) findings. The WCJ initially found applicant sustained industrial injuries resulting in permanent disability and need for medical treatment. However, the WCJ later rescinded the decision for one case (ADJ2828753) and Travelers withdrew its petition for the other (ADJ1706360). Consequently, as there are no outstanding issues for reconsideration, the WCAB dismissed Travelers' Petition for Reconsideration.

Workers' Compensation Appeals BoardMichael LezineLos Angeles County Metropolitan Transportation AuthorityTravelers Insurance CompanyConstitution State Service CompanyADJ2828753ADJ1706360cumulative injuryhypertensionpermanent disability
References
0
Case No. 2017 NY Slip Op 04009 [150 AD3d 1507]
Regular Panel Decision
May 18, 2017

Matter of Jie Cao v. Five Star Travel of NY Inc.

Claimant, a bus driver, was involved in a 2007 accident and successfully applied for workers' compensation benefits, naming "Five Stars Travel Bus Inc." as his employer. Five Star Travel of NY Inc. (Five Star) did not appear after being served, leading to a WCLJ finding it liable for awards and assessments. After subsequent awards and medical treatment authorizations, a settlement was approved in 2013. In May 2015, Five Star sought to reopen the claim and challenge the prior decisions and settlement, but the Workers' Compensation Board denied the application due to untimely submission of new material evidence and the non-reviewable nature of an approved waiver agreement. The Appellate Division affirmed the Board's decision.

Workers' CompensationBus AccidentUninsured EmployerClaim ReopeningSettlement AgreementBoard ReviewAppellate DivisionTimelinessContinuing JurisdictionDue Process
References
6
Case No. 2017 NY Slip Op 04008 [150 AD3d 1505]
Regular Panel Decision
May 18, 2017

Claim of Jie Cao v. Five Star Travel of NY Inc.

Norman Lan Chen, a bus driver, was involved in a 2007 bus accident. He successfully applied for workers' compensation benefits, and the Workers' Compensation Board found Five Star Travel of NY Inc. (his employer) to be uninsured and liable for awards. A settlement agreement was approved by the Board in October 2011. In May 2015, Five Star Travel of NY Inc. sought to reopen the claim and revisit the settlement approval, but the Board denied the application. The Appellate Division, Third Department, affirmed the Board's decision, finding that no material new evidence was presented and the application was untimely. The court also held that the Board was correct in declining to revisit the previously approved Workers' Compensation Law § 32 settlement agreement.

Workers' Compensation BoardAppealClaim ReopeningSettlement AgreementUninsured EmployerTimelinessJudicial ReviewAppellate DivisionBus Accident
References
6
Case No. ADJ1607814 (AHM 0118602) ADJ540204 (LBO 0344448)
Regular
Aug 27, 2009

JANET LIPSON vs. DAVID'S BRIDAL, THE HARTFORD INSURANCE COMPANY, NATIONAL FIRE & MARINE/AMERICAN COMMERCIAL CLAIMS ADMINISTRATION, TRAVELERS INSURANCE COMPANY

The Appeals Board affirmed the arbitrator's decision denying Hartford's petition for contribution. Hartford sought reimbursement from Travelers and ACCA for bilateral upper extremity injuries sustained by the applicant, Janet Lipson, while employed by David's Bridal. The arbitrator found insufficient evidence to establish a cumulative trauma injury beyond the period insured by Hartford, as Travelers' coverage ended before Lipson's employment and ACCA's coverage began later. The Board adopted the arbitrator's reasoning that medical reports lacked sufficient analysis to define a second cumulative trauma period for which other insurers would be liable.

Workers' Compensation Appeals BoardReconsiderationContributionStipulated Findings and AwardBilateral Upper Extremity InjuryCumulative TraumaAgreed Medical EvaluatorTreating PhysicianApplication for Adjudication of ClaimWage Statement
References
0
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