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

Case No. 00-80050A
Regular Panel Decision
May 23, 2000

Victory Markets, Inc. v. NYS Unemployment Insurance (In Re Victory Markets Inc.)

Victory Markets, Inc. (VMI) and Victory Markets, LLC (LLC) initiated an adversary proceeding against the New York State Unemployment Insurance Division of the Department of Labor, challenging the Department's transfer of VMI's unemployment insurance tax experience rating to new owners following VMI's Chapter 11 reorganization. VMI argued this transfer violated its reorganization plan and negatively impacted funds available for creditors. The Department moved to dismiss for lack of subject matter jurisdiction, contending the dispute involved non-debtor parties and state law, and was furthermore precluded by the Tax Injunction Act. The Bankruptcy Court, presided over by Chief Judge STEPHEN D. GERLING, granted the Department's motion, finding it lacked jurisdiction under 'arising in,' 'arising under,' or 'related to' doctrines, as the matter concerned a state agency's application of state law against non-debtors with a remote connection to the bankruptcy estate. The court also emphasized the availability of a plain, speedy, and efficient remedy in state courts, which barred federal intervention.

BankruptcySubject Matter JurisdictionTax Injunction ActNew York Labor LawUnemployment Insurance TaxChapter 11 ReorganizationAdversary ProceedingState Tax DisputeNon-Debtor PartiesExperience Rating Transfer
References
20
Case No. 2016 NY Slip Op 03815 [139 AD3d 497]
Regular Panel Decision
May 12, 2016

Mt. Hawley Insurance v. American States Insurance

Mt. Hawley Insurance Company and other plaintiffs, Chatsworth Builders, LLC and 537 West 27th Street Owners, LLC, initiated a declaratory judgment action against J&R Glassworks, Inc. for breach of its obligation to procure insurance related to a construction project. J&R Glassworks, Inc. failed to respond to the complaint, leading to a default judgment. J&R's subsequent motion to vacate this default judgment was denied by the Supreme Court, New York County. The Appellate Division, First Department, affirmed the denial, clarifying that the default judgment was limited solely to the claim regarding the breach of the obligation to procure insurance, as agreements to indemnify are distinct from agreements to procure insurance.

Default JudgmentVacate DefaultInsurance ObligationBreach of ContractContractual IndemnificationProcure InsuranceAppellate ReviewConstruction ProjectSubcontractorDeclaratory Judgment
References
3
Case No. Motions Nos. 5 and 7
Regular Panel Decision
Jul 27, 1978

Rachlin v. Lewis

This case consolidates two CPLR article 78 proceedings challenging the Insurance Department's regulations on attorneys' fees in no-fault automobile insurance disputes and the constitutionality of certain sections of the Insurance Law. The petitioners sought to rescind 11 NYCRR 65.16 and declare Insurance Law section 671 et seq. unconstitutional. The court ruled that sections 11 NYCRR 65.16 (c) (7) (ix), which prohibited attorneys from charging clients fees in excess of insurer-paid fees, and 11 NYCRR 65.16 (c) (7) (vii), concerning the regulation of disbursements, were invalid as they exceeded the scope of the enabling legislation. However, the court upheld the general fee schedule, finding a rational basis for its establishment by the Insurance Department.

Attorney's FeesNo-Fault InsuranceInsurance LawRegulatory ChallengeCPLR Article 78Administrative LawConstitutional LawDisbursementsArbitrationAutomobile Insurance
References
6
Case No. 2017 NY Slip Op 04774 [151 AD3d 504]
Regular Panel Decision
Jun 13, 2017

Nationwide Mutual Insurance Co. v. U.S. Underwriters Insurance Co.

This case concerns an insurance coverage dispute where Nationwide Mutual Insurance Company and Artimus Construction Corp., Inc., as subrogees, sought coverage from U.S. Underwriters Insurance Company. The Appellate Division, First Department, affirmed the lower court's decision to dismiss the complaint. The court found that the plaintiffs were collaterally estopped from relitigating insurance coverage issues because these matters had been decided in a prior declaratory judgment action. The majority concluded that Nationwide's subrogor, Artimus, and Artimus's subrogor, Armadillo, had a full and fair opportunity to litigate the coverage issues previously. Furthermore, the court held that the doctrine of res judicata also barred the claims, applying a transactional analysis which dictates that all claims arising from the same transaction that could have been raised in prior litigation are precluded.

Insurance CoverageSubrogationCollateral EstoppelRes JudicataAppellate ReviewDeclaratory JudgmentPersonal Injury ActionEmployer Liability ExclusionLate Notice of ClaimPrivity
References
12
Case No. MISSING
Regular Panel Decision

Nationwide Insurance v. Empire Insurance Group

This case concerns a dispute over insurance coverage. Marcos Ramirez was injured while working for Fortuna Construction, Inc. at premises owned by 11194 Owners Corp. Fortuna had subcontracted work from Total Structural Concepts, Inc. and agreed to add Total Structural as an additional insured on its general liability policy with Empire Insurance Group and Allcity Insurance Company. Ramirez sued 11194 Owners Corp. and Total Structural. Total Structural then commenced a third-party action against Fortuna. Nationwide Insurance Company, as Total Structural's insurer and subrogee, initiated a declaratory judgment action against Empire and Allcity after discovering Total Structural was an additional insured on their policy, demanding coverage for the Ramirez action. The Supreme Court granted Nationwide's motion for summary judgment, but the appellate court reversed, finding that Total Structural failed to provide timely notice of the Ramirez action to Empire and Allcity as required by the policy. The court emphasized that timely notice is a condition precedent to recovery and that lack of diligent effort to ascertain coverage vitiates the policy. Consequently, the appellate court granted Empire and Allcity's cross-motion, declaring they are not obligated to defend or indemnify Nationwide/Total Structural.

Insurance CoverageTimely NoticeCondition PrecedentDeclaratory JudgmentAdditional InsuredSubrogationSummary JudgmentBreach of ContractPersonal InjuryGeneral Liability Policy
References
8
Case No. MISSING
Regular Panel Decision
May 08, 2003

Allianz Underwriters Insurance v. Landmark Insurance

This case involves an appeal by Allianz Underwriters Insurance Company, an excess liability insurer, against the law firm Underberg & Kessler, LLP. Allianz alleged that Underberg, retained by the primary insurer General Star Indemnity Corporation to represent their mutual insured Dunlop Tire Corporation in an underlying wrongful death action, breached its fiduciary duty and committed professional negligence. Allianz claimed Underberg failed to initiate a third-party action against Nicholson & Hall, Dunlop's employer (also insured by General Star), to protect General Star's interests over Dunlop's and Allianz's. The Supreme Court initially dismissed Allianz's complaint against Underberg. However, the Appellate Division, First Department, reversed this decision, holding that Allianz could pursue its claim against Underberg based on principles of equitable subrogation and a "near privity" relationship, thereby reinstating the complaint.

Equitable SubrogationLegal MalpracticeProfessional NegligenceExcess InsurancePrimary InsuranceFiduciary DutyNear PrivityDismissal ReversalAppellate ReviewIndemnification Clause
References
15
Case No. MISSING
Regular Panel Decision

Transcontinental Insurance v. State Insurance Fund

This case involves a dispute between two insurers, Transcontinental Insurance Company (plaintiff) and State Insurance Fund (defendant), regarding their contribution to the defense and settlement of an underlying personal injury action. Transcontinental, which insured the contractor Master, sought a declaration that State Insurance Fund, Master's workers' compensation insurer, should contribute as a co-insurer for expenses incurred defending and settling the action on behalf of NYPA. The Supreme Court dismissed the complaint, applying the antisubrogation rule. The Appellate Division modified the judgment, vacating the dismissal but affirming the application of the antisubrogation rule, declaring that State Insurance Fund is not obligated to reimburse Transcontinental for the expenses.

Insurance DisputeAntisubrogation RuleDeclaratory JudgmentCommercial General Liability PolicyWorkers' Compensation InsuranceIndemnificationCo-insurancePersonal Injury ActionAppellate ReviewContractual Obligation
References
5
Case No. 2008 NY Slip Op 30920(U)
Regular Panel Decision
Mar 31, 2008

Silverite Construction Co. v. One Beacon Insurance

Plaintiffs Silverite Construction Company, Inc. and the New York City Department of Environmental Protection's motion for summary judgment was denied, and defendant One Beacon Insurance Company's motion for summary judgment was granted and affirmed. The court rejected plaintiffs' excuse for their 2 1/2-month late notice of a worker's injury, citing evidence such as the worker's removal by ambulance, an accident report, missed work, limited duties upon return, and a filed notice of claim. One Beacon's disclaimer was deemed timely following a brief investigation into the plaintiffs' status as additional insureds. This decision highlights the necessity of timely notification in insurance claims, irrespective of the perceived likelihood of a claim.

Summary JudgmentInsurance LawLate NoticeWorker InjuryAdditional InsuredDisclaimerAppellate ReviewConstruction SiteAccident ReportTimely Notice
References
1
Case No. CA 11-00156
Regular Panel Decision
Jun 17, 2011

MERCHANTS MUTUAL INSURANCE COMPANY v. NEW YORK STATE INSURANCE FUND

Plaintiff, Merchants Mutual Insurance Company, initiated an action against New York State Insurance Fund to recover funds related to an underlying wrongful death lawsuit. The core issue was the defendant's obligation to indemnify Jerrick Waterproofing Co., Inc. for a construction accident. The Supreme Court granted summary judgment to the plaintiff, which the defendant appealed. The Appellate Division, Fourth Judicial Department, affirmed the lower court's decision, ruling that the defendant was indeed obligated to provide unlimited coverage to Jerrick Waterproofing, despite a policy exclusion, as a common-law right to indemnity existed. Consequently, the plaintiff's excess coverage was not triggered.

Insurance disputeWorkers' CompensationIndemnificationExcess coverageSummary judgmentAppellate reviewNew York lawEmployer liabilityPolicy exclusionCommon-law indemnity
References
4
Case No. 2014 NY Slip Op 08848 [123 AD3d 933]
Regular Panel Decision
Dec 17, 2014

Public Service Mutual Insurance v. Fiduciary Insurance Co. of America

This case involves an appeal by Fiduciary Insurance Company of America (appellant) from an order and judgment confirming an arbitration award in favor of Public Service Mutual Insurance Company (respondent), as subrogee of Peter Daversa. The Supreme Court, Queens County, granted the petition to confirm and denied Fiduciary's cross-petition to vacate the arbitration award. The Appellate Division, Second Department, dismissed the appeal from the intermediate order, finding it merged into the judgment, and affirmed the judgment. The court applied closer judicial scrutiny to the compulsory arbitration award, determining that the arbitrator's decision had ample evidentiary support and was not arbitrary or capricious. The appellant's contentions regarding proximate cause, burden of proof, and prejudgment interest were found to be without merit.

Arbitration Award ConfirmationInsurance SubrogationAppellate ReviewJudicial ScrutinyEvidentiary SupportArbitrator's DeterminationProximate CausationBurden of ProofPrejudgment InterestCPLR Article 75 Proceeding
References
8
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