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

Case No. 03 Civ. 0332(AKH)
Regular Panel Decision
Oct 29, 2004

In Re September 11th Liability Insurance Coverage Cases

This opinion and order addresses two Rule 12(c) motions regarding insurance coverage for the World Trade Center properties following the September 11, 2001, attacks. The Port Authority of New York and New Jersey sought a declaration that it is an "Additional Insured" under Zurich American Insurance Company's policies, while World Trade Center Properties LLC (WTCP) sought a declaration that Zurich is obligated to cover defense costs. The court, presided over by District Judge Hellerstein, denied both motions. It found ambiguity in the binder regarding the Port Authority's "Additional Insured" status, stating that the issue was premature without further discovery. Furthermore, the court held that New York Insurance Regulation 107 does not require rewriting Zurich's binder and policies to include defense costs, considering the unique circumstances, the sophistication of the insured, and the fact that Zurich explicitly excluded defense costs, which Silverstein (WTCP's affiliate) accepted after failing to secure conventional coverage. The court also affirmed supplemental jurisdiction over the insurance claims due to their close relation to the underlying September 11th liability cases.

Insurance CoverageSeptember 11 AttacksWorld Trade CenterRule 12(c) MotionDeclaratory ReliefAdditional Insured StatusDefense CostsInsurance BinderNew York Insurance LawRegulation 107
References
48
Case No. ADJ744923 (ANA 0385182)
Regular
Jul 22, 2011

CHARLES BUFFINGTON III vs. FACTORY MUTUAL, INFRARED TESTING, INC., LIBERTY MUTUAL INSURANCE COMPANY, UNINSURED EMPLOYERS BENEFITS TRUST FUND

Factory Mutual seeks reconsideration of a workers' compensation decision finding Liberty Mutual provided coverage for Infrared Testing, Inc. during the applicant's injury period. Factory admits it sold its interest in Infrared before the cumulative injury period, arguing Liberty's coverage stipulation was a mistake. The Board dismissed Factory's petition, finding Factory lacks standing as it had no interest in the employer after August 2, 2000. The Board also indicated it would have denied the petition on the merits due to Liberty's stipulation and the elapsed premium collection period.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrdersStipulationCoverage disputeMistake in coverageSale of interestUninsured Employers Benefits Trust FundStandingAggrieved party
References
0
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
Case No. MISSING
Regular Panel Decision

McLaughlin v. Midrox Insurance

This case involves an appeal concerning an insurance coverage dispute. Plaintiffs sought to compel Midrox Insurance Company to indemnify the Blodgett Brothers Partnerships for a $1 million judgment in an underlying personal injury action. The accident involved a motorcycle operated by plaintiff Charles R. McLaughlin and a pickup truck driven by Ronald Blodgett. Midrox had disclaimed coverage, arguing the accident occurred off insured premises and involved a registered vehicle. The court affirmed the lower court's decision, ruling that the farmowner's policy did provide coverage. The court determined that public roadways used for transporting materials between farm parcels could be considered 'insured premises' and that the pickup truck's agricultural registration did not negate coverage given its exclusive use for farming purposes.

Personal InjuryFarmowner's InsuranceInsurance CoverageAgricultural TruckPolicy InterpretationOff-Premises AccidentPublic RoadwaysSummary JudgmentIndemnificationVehicle and Traffic Law
References
5
Case No. MISSING
Regular Panel Decision

In re the Liquidation of Midland Insurance

Policyholders New York Dock Railway (NYDR) and Brooklyn Eastern District Terminal (BEDT), joined by claimants Buividas and Romacho, moved to confirm a referee's report that found coverage for their claims by the Stock Workers' Compensation Security Fund. The Superintendent of Insurance, as liquidator of Midland Insurance Company, cross-moved to disaffirm the report, arguing against Security Fund coverage based on his interpretation of relevant statutes. The court reviewed the referee's decision, finding it erroneous due to a misinterpretation of legislative history and intent regarding security fund coverage limitations, particularly concerning Chapter 801 amendments. Upholding the Superintendent's rational interpretation, the court denied the motion to confirm and granted the cross-motion to disaffirm, affirming the denial of security fund coverage.

Workers' Compensation Security FundInsurance Coverage DisputeMidland Insurance Company LiquidationFederal Employers' Liability ActJones ActLongshoremen's and Harbor Workers' Compensation ActStatutory InterpretationLegislative HistoryThird-Party IndemnificationEmployer's Liability
References
6
Case No. MISSING
Regular Panel Decision

U. P. Iron Works v. Investors Insurance

Plaintiff insured brought a declaratory judgment action against their insurer, who issued both workers' compensation and general liability policies. The dispute arose after a partner was injured, leading to a third-party products liability action against the partnership. The insurer disclaimed coverage, citing lack of coverage for a direct suit by a partner and late notice of the accident. The court found that coverage existed for the third-party claim, extending it to a partner similar to an employee. Furthermore, the court determined that the notice provided by the insured, though three years after the accident, was not unreasonably late given the complexities involved. Consequently, the court declared the policy to be in full force and effect for the accident.

Declaratory JudgmentInsurance CoverageWorkers' Compensation PolicyGeneral Liability PolicyThird-Party ClaimPartner InjuryEmployee ExclusionLate Notice DisclaimerDuty to DefendSummary Judgment Motion
References
2
Case No. MISSING
Regular Panel Decision

Hayden v. S & W Meat & Poultry

Claimant, a partner in S & W Meat & Poultry, sustained a serious injury. A workers' compensation claim was filed, but the carrier contested coverage, arguing that claimant, as a partner, had not formally elected coverage under Workers' Compensation Law § 54 (8). The Workers' Compensation Board applied estoppel, finding the carrier failed to advise the employer of the election requirement. On appeal, the court reversed this decision, holding that the employer's insurance broker, the Fear agency, was notified of the lack of coverage, and this knowledge is imputed to the employer. The court found insufficient evidence for estoppel and remitted the matter to the Board for further proceedings.

Workers' CompensationEstoppelInsurance CoveragePartnershipAgent LiabilityImputed KnowledgePremium RefundAppellate ReviewRemittalWorkers' Compensation Law § 54 (8)
References
5
Case No. MISSING
Regular Panel Decision

Claim of Cerbasi v. County Metal & Glass, Inc.

A claimant injured their left arm while working at a New York construction site for a New Jersey employer insured by New Jersey Manufacturers Insurance Company (NJMIC). A dispute arose regarding coverage, with the Workers’ Compensation Law Judge and Board determining the policy covered the accident because New York was not an explicitly excluded state and NJMIC’s attempt to amend the policy was ineffective. NJMIC appealed, arguing the Board erred in its coverage finding and that Workers’ Compensation Law § 54 (5) notice requirements did not apply to partial cancellations. The Appellate Division affirmed, finding the Board's determination on coverage implicit and that NJMIC failed to demonstrate an effective exclusion or proper cancellation under Workers' Compensation Law § 54 (5). The court also noted NJMIC's argument regarding partial cancellation was unpreserved.

Workers' CompensationInsurance CoveragePolicy ExclusionNew York LawNew Jersey BusinessStatutory ComplianceCancellation NoticeAppellate ReviewJurisdictionLeft Arm Injury
References
9
Case No. MISSING
Regular Panel Decision

In Re Texaco Inc.

Texaco Inc. and its two subsidiaries, Texaco Capital Inc. and Texaco Capital N.V., filed for Chapter 11 bankruptcy. Texaco sought to extend the exclusive periods for filing a reorganization plan, citing the massive size of the case, over 300,000 creditors, and the pending appeal of a $10.3 billion judgment against it by Pennzoil Company. Pennzoil, a leading general unsecured creditor, moved to reduce these exclusivity periods to propose its own creditor's plan. The court, presided over by Bankruptcy Judge Howard Schwartzberg, considered the unprecedented size and complexity of Texaco's bankruptcy case, which is the largest ever filed in the U.S., and the unresolved multi-billion dollar Pennzoil judgment. The court found that Texaco had established sufficient cause for an extension, while Pennzoil failed to demonstrate cause for reduction. Consequently, Texaco's motion to extend the exclusivity periods by another 120 and 180 days was granted, and Pennzoil's motion to shorten them was denied.

BankruptcyChapter 11Exclusivity PeriodPlan of ReorganizationCorporate DebtorsComplex LitigationDebtor-Creditor DisputeJudgment AppealSouthern District of New YorkCorporate Restructuring
References
12
Case No. ADJ1817205 (RIV 0076837) ADJ2824273 (RIV 0076838)
Regular
Jul 02, 2014

SONNY LOVELESS vs. NEWPORT FARMS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, ZURICH AMERICAN INSURANCE CO., VIRGINIA SURETY INSURANCE COMPANY

This case involves a dispute over reimbursement for workers' compensation benefits paid by CIGA. The Appeals Board affirmed an arbitrator's decision granting CIGA full reimbursement from Virginia Surety and Zurich for benefits paid to the applicant. Virginia Surety's arguments that the cumulative trauma periods should be reevaluated and that CIGA was liable for the first period were rejected. The Board found Virginia Surety is bound by prior stipulations establishing two cumulative trauma periods, making its coverage "other insurance" under Insurance Code § 1063.1(c)(9) and thus excluding CIGA's liability for those benefits.

Workers' Compensation Appeals BoardSonny LovelessNewport FarmsCalifornia Insurance Guarantee Association (CIGA)Superior NationalZurich American Insurance Co.Virginia Surety Insurance Companycumulative traumastipulated awardreimbursement
References
4
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