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Case Law Database

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. MISSING
Regular Panel Decision

O'Keefe v. General Accident Insurance

Plaintiff Violet O'Keefe initiated an action against General Accident Insurance Company, alleging disparate treatment and retaliation based on age and sex, violating Title VII, ADEA, and New York Human Rights Law. O'Keefe claimed a discriminatory work environment and unlawful termination following her refusal of a proposed job transfer. The defendant argued O'Keefe's performance was poor and the transfer was a lateral move. The District Court denied the defendant's motion for summary judgment regarding the federal discrimination and retaliation claims, finding a genuine issue of material fact existed as to whether General Accident's reasons for termination were pretextual. However, the Court granted summary judgment for the defendant on the state law claims, declining to exercise pendent jurisdiction.

DiscriminationAge DiscriminationSex DiscriminationTitle VIIADEARetaliationSummary JudgmentEmployment LawPretextPrima Facie Case
References
19
Case No. MISSING
Regular Panel Decision

Bach v. Millard Fillmore Health Systems, Inc.

This case addresses the applicability of the Omnibus Workers’ Compensation Reform Act of 1996 to a third-party action. The plaintiff was injured in July 1996, prior to the Act’s effective date of September 10, 1996. However, the subsequent third-party lawsuit against the employer, Amherst Acoustical, Inc., was initiated in November 1997, after the Act became law. The court examined whether the accident date or the lawsuit commencement date should dictate the application of the new legislation. Relying on the Court of Appeals' clear directive in Majewski v Broadalbin-Perth Cent. School Dist., the court ruled that irrespective of the accident date, a prospective application of the law to actions filed after the effective date requires dismissal of the third-party claim.

Workers' CompensationThird-Party ClaimStatutory InterpretationLegislative IntentProspective ApplicationMajewski RuleDismissalNew York LawOmnibus Workers' Compensation Reform ActTort Law
References
1
Case No. MISSING
Regular Panel Decision

Claim of Krausa v. Totales Debevoise Corp.

Walter Krausa's 1994 claim for silicosis was established, leading to his classification as permanently totally disabled, and his workers' compensation carrier, the State Insurance Fund, became eligible for reimbursement from the Special Disability Fund. After Krausa's death in 2007, his widow filed for death benefits, which were awarded by a Workers’ Compensation Law Judge, who simultaneously discharged the Special Disability Fund from liability. The carrier appealed this decision, seeking continued reimbursement, but the Workers’ Compensation Board denied their request. This appellate court reversed the Board's decision, clarifying that the statutory language regarding the "date of accident or date of disablement" refers to the original disablement date of September 24, 1992, not the date of death, and that death is considered a consequence of the original injury, not a new accident. Therefore, the court concluded that the carrier was indeed entitled to reimbursement from the Special Disability Fund.

Workers' CompensationSilicosisOccupational DiseaseSpecial Disability FundReimbursementDeath BenefitsStatutory InterpretationDate of DisablementDate of AccidentAppellate Review
References
13
Case No. MISSING
Regular Panel Decision
Dec 09, 2009

Claim of Klamka v. Consolidated Edison Co. of New York, Inc.

Claimant sought workers' compensation benefits for a back injury sustained while lifting manhole covers during the course of employment. The self-insured employer and its claims administrator controverted the claim. A Workers' Compensation Law Judge credited claimant's testimony, and the Workers' Compensation Board found a work-related injury, modifying the date of accident to March 30, 2008. The employer appealed this decision. The court affirmed the Board's decision, finding substantial evidence for both the work-related injury and the accident date, noting that the precise date of injury was not dispositive.

Workers' CompensationBack InjuryWork-Related InjuryAccident Date DisputeSubstantial EvidenceCredibility DeterminationsMedical EvidenceMRI FindingsAppellate ReviewEmployer Appeal
References
4
Case No. MISSING
Regular Panel Decision
Jun 30, 1992

National General Insurance v. Hartford Accident & Indemnity Co.

This case concerns a declaratory judgment action regarding insurance coverage following a fatal airplane crash. Warren Geddes, president of American Investor Services, Inc. (AIS), was piloting a plane carrying Gary Conway, an AIS employee, when it crashed, killing both. National General Insurance Company, insurer of the plane owner, sought for Hartford Accident and Indemnity Company, AIS's workers' compensation insurer, to defend and indemnify AIS and Geddes' Estate in a wrongful death action. Hartford denied coverage for Geddes' Estate, arguing he was not a named or additional insured under their policy. The court modified the initial judgment, declaring that Hartford has no duty to defend or indemnify the Estate of Geddes, while otherwise affirming the judgment.

Insurance CoverageDeclaratory JudgmentWrongful DeathDuty to DefendDuty to IndemnifyNamed InsuredAdditional InsuredWorkers' Compensation PolicyAirplane CrashEstate Liability
References
5
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

Hartford Accident & Indemnity Co. v. Coastal Dry Dock & Repair Corp.

This case concerns an appeal by Hartford Accident and Indemnity Co. (insurer) against Coastal Dry Dock and Repair Corp. (insured) regarding unpaid retrospective premiums on a workers' compensation policy. The insurer sought to recover additional premiums calculated based on the insured's loss record, as stipulated by a 'Retrospective Premium Endorsement.' The defendant raised multiple defenses and counterclaims, alleging improper calculations, misrepresentation, and mishandling of claims. The Supreme Court initially denied the plaintiff's motion for summary judgment. However, the Appellate Division reversed this decision, ruling that the defendant's opposition, primarily an attorney's affidavit lacking personal knowledge, was insufficient to raise a genuine issue of material fact. The court found the defendant's defenses and counterclaims legally insufficient, affirming the insurer's contractual right to negotiate and settle claims.

Workers' Compensation PolicyRetrospective PremiumSummary JudgmentContract DisputeInsurance LawAppellate ReviewAffidavit SufficiencyEvidentiary FactsClaims SettlementPolicy Interpretation
References
6
Case No. MISSING
Regular Panel Decision

In Re Lawrence United Corp.

The Monroe Group, Inc. (Monroe) sought to compel General Accident Insurance Company of America (General Accident) to release commissions owed from a court-approved sale of the Debtor's assets. The Debtor, a former agent for General Accident, filed for Chapter 11 bankruptcy, and its Rochester office assets were sold to Monroe 'free and clear of all liens and other interests.' General Accident withheld commissions, arguing a right of recoupment for prepetition premiums owed by the Debtor, which it contended was not an 'interest' extinguished by the sale order. The court determined it had 'core' jurisdiction over the dispute, finding that General Accident's alleged right of recoupment was not an 'interest' under 11 U.S.C. § 363(f) and could not be asserted against postpetition commissions to recover prepetition premiums. Consequently, the court granted Monroe's motion, compelling General Accident to release the commissions.

Bankruptcy Court JurisdictionChapter 11 BankruptcyAsset SalesRecoupment RightsInsurance CommissionsDebtor-in-PossessionSecured ClaimsUnsecured ClaimsSale Free and Clear of InterestsPostpetition vs. Prepetition Debts
References
19
Case No. MISSING
Regular Panel Decision

Claim of Zygler v. Tenzer Coat Co.

An employer and carrier appealed a disability award granted to a claimant who suffered a cerebral vascular episode after an oral quarrel with his foreman over work distribution. The Workers' Compensation Board had previously determined this constituted an accident, reversing a Referee's finding of no accident. The court, however, found that an argument without physical violence, even if it leads to a vascular incident, does not constitute an accident within the meaning of the Workmen’s Compensation Law, especially when such arguments are common in piece work environments. Citing relevant precedents involving similar emotional strain without physical exertion leading to heart attacks or vascular incidents, the court concluded that a finding of accident could not be sustained. Consequently, the award was reversed, and the claim was dismissed, with costs awarded to the appellants against the Workmen’s Compensation Board.

Workers' CompensationAccident DefinitionCerebral Vascular EpisodeEmotional StrainOral QuarrelDisability AwardEmployer LiabilityCarrier LiabilityPiece WorkPre-existing Condition
References
3
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