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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
Jan 03, 2000

Fireman's Fund Insurance v. Newark Insurance

This case concerns an appeal regarding an insurance coverage dispute. The Supreme Court, New York County, declared in favor of plaintiff insurer Fireman's, requiring defendant-appellant insurer Reliance to defend and indemnify Fireman's insured, Fisher, in an underlying personal injury action. The injury occurred at a construction site where Fisher was the general contractor and Reliance's insured, Consultants, was a subcontractor. The court affirmed the decision, finding that Fisher, as an additional insured on Reliance's policy, was entitled to the same coverage as Consultants, without a specific limitation for Consultants' negligence. The ruling also noted that General Obligations Law § 5-322.1 (1) does not affect the validity of insurance contracts, even while voiding agreements to indemnify negligent parties against their own negligence.

insurance coverageadditional insuredindemnificationduty to defendpersonal injuryconstruction liabilitysubcontractorgeneral contractorinsurance policy interpretationappellate review
References
3
Case No. MISSING
Regular Panel Decision

Hutchinson v. Lansing Conduit Corp.

Claimant asserted a work-related hearing loss in both ears and filed a workers’ compensation claim. An investigation revealed that Reliance National Insurance Company provided workers’ compensation insurance to the employer from January to July 1996. The Workers’ Compensation Board determined the date of disablement was March 13, 1996, making Reliance the responsible carrier. Reliance and the employer appealed, claiming an exclusion limited the policy's applicability to the claim. The Board's finding was affirmed as Reliance failed to produce a copy of the policy to substantiate their claim, despite being directed multiple times.

Hearing LossWorkers' CompensationInsurance CoverageDate of DisablementPolicy ExclusionBurden of ProofAppellate DivisionAffirmationResponsible CarrierEmployer Liability
References
3
Case No. MISSING
Regular Panel Decision
Oct 11, 1995

International Rescue Committee v. Reliance Insurance

The International Rescue Committee (IRC) sued Reliance Insurance Company for breach of contract after Reliance denied a workers' compensation claim for an employee injured by a landmine in Somalia, citing a policy exclusion for injuries arising from war or civil unrest. The IRC's motion for summary judgment was denied by the IAS Court, which the Supreme Court, New York County, affirmed. The affirmation was based on the need for further discovery by Reliance regarding the conditions in Somalia and the existence of factual issues concerning whether the employee's injury arose from civil war, rebellion, or insurrection, as specified in the exclusion clause.

Insurance CoverageWorkers' CompensationPolicy ExclusionSummary Judgment MotionDiscovery NeedsFactual DisputeCivil War ClauseInternational IncidentLandmine InjuryBreach of Insurance Contract
References
2
Case No. ANA 352921
Regular
Oct 02, 2007

STEPHEN GRIFFIS vs. ORANGE COUNTY FIRE AUTHORITY, CIGA on behalf of RELIANCE NATIONAL INSURANCE COMPANY, in liquidation, AIG CLAIMS SERVICES

The Workers' Compensation Appeals Board (WCAB) reconsidered a decision regarding an applicant's cumulative trauma injury to May 12, 1997. The WCAB found that AIG, as "other insurance," is liable for all benefits awarded after Reliance National Insurance Company (Reliance) became insolvent on October 3, 2001. Consequently, the California Insurance Guarantee Association (CIGA) is entitled to reimbursement from AIG for all benefits CIGA paid after Reliance's liquidation.

CIGAReliance National InsuranceAIG Claims Servicescumulative traumabilateral hearing lossstipulated awardliquidationreimbursementother insurancecovered claim
References
7
Case No. MISSING
Regular Panel Decision
Feb 23, 2007

Yale Club of New York City, Inc. v. Reliance Insurance

The case addresses whether a letter received by an insured, the Yale Club of New York, constituted a "claim" under a claims-made insurance policy issued by Reliance Insurance Company, where the term "claim" was undefined. The letter, sent by an attorney representing employees, sought information regarding alleged deprivation of tips and bonuses but did not demand payment or explicitly threaten legal action. Reliance disclaimed coverage for a subsequent lawsuit, arguing the letter was a claim made before its policy commenced. The Supreme Court affirmed a Referee's report, which found the letter to be a mere request for information, not a claim. The appellate court upheld this decision, emphasizing that ambiguities in insurance contracts must be construed against the insurer, and the letter's content was insufficient to qualify as a "claim" at the time of its receipt, thus requiring Reliance to cover the loss.

Claims-made policyInsurance coveragePolicy interpretationContract ambiguityContra proferentemNotice of claimDefinition of "claim"Directors and officers liabilityEmployee claimsLiquidation Bureau
References
18
Case No. ADJ4618855 (VNO 0403261) ADJ181556 (VNO 0501021)
Regular
Jun 18, 2013

CYNTHIA WILLIAMS, vs. FORD MEEHAN INSURANCE; CIGA and its servicing facility, SEDGWICK CMS FOR RELIANCE INSURANCE COMPANY, in liquidation; MULLIN CONSULTING; FARMERS INSURANCE & EVEREST NATIONAL INSURANCE COMPANY,

The Workers' Compensation Appeals Board (WCAB) denied CIGA's petition for reconsideration, upholding the finding that CIGA, as administrator for Reliance Insurance, is solely liable for the applicant's injuries sustained between November 2, 1998, and July 19, 1999. The WCAB adopted the judge's report which found that the applicant's subsequent employment did not contribute to her disability. The decision was based on extensive medical evidence and the judge's determination of credibility regarding the applicant's testimony and the Agreed Medical Examiner's reports. CIGA's arguments regarding reliance on specific medical opinions and the admission of evidence were rejected by the WCAB.

CIGAReconsiderationWCJAgreed Medical ExaminerAMEContinuous TraumaReliance InsuranceSedgwick CMSDr. FriedmanDr. Mandel
References
0
Case No. ADJ4415679 (OAK 0259031) ADJ2701101 (WCK0050594)
Regular
May 10, 2010

Stanley Sanders vs. REMEDY INTELLIGENT STAFFING, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for RELIANCE NATIONAL INSURANCE COMPANY, OREGON STEEL MILLS, INC. dba NAPA PIPE

The Workers' Compensation Appeals Board reversed a judge's decision, ruling that Napa Pipe, a self-insured special employer, is liable for applicant Stanley Sanders' workers' compensation benefits. Despite an agreement between the general employer (Remedy Temp) and Napa Pipe attempting to limit liability to Remedy Temp's insurer (Reliance), Napa Pipe's joint and several liability as a special employer cannot be contractually eliminated. Because Napa Pipe's self-insurance was not excluded for special employees and constitutes "other insurance" under Insurance Code § 1063.1(c)(9), CIGA is relieved of its obligation to provide benefits following Reliance's insolvency. Therefore, Napa Pipe must now provide all workers' compensation benefits and administer the claim.

Workers' Compensation Appeals BoardStanley SandersRemedy Intelligent StaffingCalifornia Insurance Guarantee AssociationReliance National Insurance CompanyOregon Steel MillsNapa PipeADJ4415679ADJ2701101Opinion and Decision After Reconsideration
References
24
Case No. MISSING
Regular Panel Decision
Aug 09, 2004

In re Fifth Judicial District Asbestos Litigation

In this case, 23 plaintiffs sued Metropolitan Life Insurance Company for civil conspiracy and fraud, alleging the company withheld and misrepresented information about the dangers of asbestos from studies conducted in the 1920s and 1930s. Plaintiffs claimed this prevented them from making informed decisions about asbestos exposure. Metropolitan Life moved for summary judgment, arguing a lack of duty, reliance, and causation. The court determined that while civil conspiracy is not an independent tort in New York, it considered the underlying claim of fraud. The court found that the plaintiffs failed to provide any admissible evidence demonstrating justifiable detrimental reliance on the alleged misrepresentations or nondisclosures, particularly given the existing scientific literature on asbestos dangers at the time. Consequently, the defendant's motion for summary judgment was granted.

Civil ConspiracyFraudAsbestos ExposureSummary JudgmentMedical MisrepresentationCorporate LiabilityProduct SafetyPublic Health LitigationJustifiable RelianceToxic Tort
References
27
Case No. MISSING
Regular Panel Decision

Reliance Insurance v. Garsart Building Corp.

This case concerns an appeal from a judgment involving insurance coverage disputes. The Supreme Court of Rockland County declared that Reliance Insurance Company of New York properly disclaimed coverage under its general liability policy issued to Garsart Building Corp. and was not required to defend or indemnify Garsart in an underlying personal injury action. The court also ruled that Planet Insurance Company was not obligated to defend or indemnify Garsart under its workers' compensation policy. Appellants J and J Associates, Louis C. Pell, County of Rockland Industrial Development Authority, and Garsart Building Corp. appealed this judgment. The appellate court affirmed the judgment, finding the appellants failed to provide a valid excuse for not complying with notice requirements and that Horace Hall was an independent contractor, not an employee of Garsart.

Insurance CoverageDisclaimer of CoverageNotice RequirementsIndependent ContractorEmployers' LiabilityAppellate AffirmanceDeclaratory JudgmentPersonal Injury LitigationPolicy InterpretationInsurance Disputes
References
7
Case No. MISSING
Regular Panel Decision

Reliance Insurance v. Certain Member Companies

Plaintiffs Reliance Insurance Company and New York Marine & General Insurance Company commenced this action seeking a declaratory judgment to void a reinsurance binder ab initio. Defendants, Certain Member Companies of the Institute of London Underwriters, issued this binder covering plywood cargo. A cargo fire on the vessel SAMICK NORDIC destroyed the plywood, leading to a dispute over a $2,043,740.24 reinsurance coverage. Plaintiffs argued they were misled by brokers into believing the reassured was retaining a portion of the risk, a customary practice, whereas the London Underwriters had ceded 100% of the FPA risk. The court found that plaintiffs reasonably believed in retention and were indeed misled by the brokers' actions and omissions, constituting a violation of the duty of uberrimae fidei, or utmost good faith. Consequently, the court entered judgment in favor of the plaintiffs, declaring the reinsurance binder void ab initio and dismissing the defendants' counterclaim.

Reinsurance disputeMarine insuranceDeclaratory judgmentUberrimae fideiBroker misleadingDuty to discloseFPA riskCargo insuranceContract void ab initioGood faith in insurance
References
10
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