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

Case No. CA 10-00545
Regular Panel Decision
Feb 10, 2011

HAHN AUTOMOTIVE WAREHOUSE, INC. v. AMERICAN ZURICH INSURANCE COMPANY

Hahn Automotive Warehouse, Inc. (plaintiff) initiated a breach of contract action against American Zurich Insurance Company and Zurich American Insurance Company (defendants), contending that bills issued under insurance contracts were time-barred. Defendants counterclaimed for damages stemming from plaintiff's alleged breach of these contracts. The Supreme Court partially granted plaintiff's cross-motion, deeming counterclaims for debts arising over six years prior as time-barred. Concurrently, it permitted defendants to utilize a $400,000 letter of credit to satisfy any outstanding debt, including those deemed time-barred. On appeal, the Appellate Division affirmed the use of the letter of credit for time-barred debts, reasoning that the statute of limitations only bars the remedy, not the underlying obligation. The court also affirmed that defendants' counterclaims for debts over six years old were time-barred, as the right to demand payment accrued earlier. Finally, the court modified the order to dismiss plaintiff's second through fourth causes of action. A dissenting opinion argued that the counterclaims were not time-barred, asserting that the cause of action accrued upon demand and refusal of payment, not merely when the right to demand payment existed.

Breach of contractInsurance contractsStatute of limitationsLetter of creditSummary judgmentAppellate reviewContract interpretationTime-barred claimsAccrual of cause of actionRetrospective premiums
References
23
Case No. MISSING
Regular Panel Decision

Hakim v. Armstrong Rubber Co.

Joseph Hakim initiated a negligence action seeking damages for personal injuries after a forklift tire he was changing exploded. He alleged that Armstrong Rubber Company negligently designed and manufactured the tire, Firestone Tire & Rubber Company negligently designed and manufactured the wheel rim, and Clark Equipment Company negligently manufactured and failed to inspect the forklift. Armstrong and Firestone successfully moved for summary judgment by presenting evidence that they did not manufacture the specific tire or rim involved, which Hakim failed to rebut with sufficient evidence. Conversely, Clark Equipment Company's motion for summary judgment was denied due to its failure to provide any evidence disproving its involvement in the forklift's manufacture or inspection.

Forklift accidentTire explosionProduct liabilitySummary judgmentNegligenceManufacturing defectDesign defectInspection failureHearsay evidencePrima facie case
References
2
Case No. ADJ3310545
Regular
Dec 07, 2017

LANCE GOODWIN vs. EDW APFFELS COMPANY, INC., PACIFIC COMPENSATION INSURANCE COMPANY

This case involves an award of additional attorney's fees under Labor Code § 5801. The Second District Court of Appeal previously remanded the matter for such an award after denying the defendant's Petition for Writ of Review. Applicant's counsel and the defendant stipulated to reasonable attorney's fees of $8,000.00 for services rendered in responding to the petition. The Board found the stipulated amount reasonable and issued the award to the applicant's law firm.

Writ of ReviewAttorney's FeesLabor Code § 5801RemandStipulationAppellate Attorney's FeesWorkers' Compensation Appeals BoardPacific Compensation Insurance CompanyEDW APFFELS COMPANYINC.
References
1
Case No. MISSING
Regular Panel Decision

Homestead Village Assoc., L.P. v. Diamond State Insurance

Plaintiff Homestead Village Associates, LP sued its insurers, Diamond State Insurance Company and Chubb Insurance Company of New Jersey, seeking a declaratory judgment regarding their duty to defend and indemnify Homestead in a personal injury action. Homestead also sued its insurance broker, Capacity Coverage Company of New Jersey, for breach of contract and negligence due to late notification of the accident. All parties cross-moved for summary judgment. The court granted Diamond's motion, finding Homestead's 16-month delay in notification unreasonable. Chubb's motion was granted in part and denied in part, as the court found late notice from Homestead, but a factual dispute remained regarding Chubb's timely disclaimer. The court also clarified that Chubb's excess policy would not 'drop down' to cover primary obligations and it had no duty to defend. Homestead's and Capacity's cross-motions for summary judgment were denied, with factual disputes remaining regarding a special relationship and Capacity's knowledge of the accident's seriousness.

Insurance Coverage DisputeDeclaratory JudgmentSummary Judgment MotionLate Notice DefenseExcess Insurance PolicyInsurance Broker LiabilityBreach of ContractNegligence ClaimChoice of LawNew York Insurance Law
References
41
Case No. ADJ1526910 (LAO 0881311) ADJ1183697 (LAO 0881312)
Regular
Apr 14, 2017

MARGARITA GIUSTRA vs. PRIMARY PROVIDER MANAGEMENT, NATIONAL LIABILITY AND FIRE INSURANCE COMPANY, DELOS INSURANCE COMPANY

The Workers' Compensation Appeals Board denied Delos Insurance Company's petition for reconsideration. The Board adopted the arbitrator's report, which found that a prior Compromise and Release agreement between the applicant and Delos Insurance Company only settled a specific injury, not the continuous trauma claim. This decision allowed National Liability and Fire Insurance Company's petition for contribution against Delos Insurance Company for a portion of benefits paid for the continuous trauma injury. The arbitrator also determined that prior conflicting judicial decisions did not bar Delos Insurance Company from being joined in the contribution proceedings.

Workers Compensation Appeals BoardMargarita GiustraPrimary Provider ManagementNational Liability and Fire Insurance CompanyDelos Insurance CompanyADJ1526910ADJ1183697Petition for ReconsiderationArbitrator's ReportCompromise and Release
References
7
Case No. MISSING
Regular Panel Decision
May 12, 1995

Wausau Underwriters Insurance v. Continental Casualty Co.

This case addresses a dispute between Wausau Underwriters Insurance Company (Wausau) and Continental Casualty Company (Continental), along with The Hartford Insurance Group. Wausau, as the employer's liability carrier for H. Sand & Company, successfully argued that a third-party action by Slattery-Argrett, subrogor of Continental, against H. Sand & Company, constituted an impermissible subrogation claim by an insurer against its own insured. The underlying matter involved a personal injury sustained by an employee of H. Sand & Company. Continental had initially disclaimed coverage for Sand in the third-party action. The Supreme Court granted Wausau's motion for summary judgment, declaring the subrogation action a violation of public policy and awarding Wausau damages. The appellate court affirmed this judgment, distinguishing the present case from prior rulings like *North Star Reins. Corp. v Continental Ins. Co.*, and emphasizing the distinction between claims for indemnification and contribution within insurance policy exclusions.

Subrogation ClaimInsurance Coverage DisputeIndemnification vs. ContributionPublic Policy in InsuranceSummary JudgmentEmployer LiabilityGeneral Liability InsuranceExcess Liability InsuranceConstruction AccidentWorkers' Compensation Carrier
References
9
Case No. MISSING
Regular Panel Decision

Tozzi v. Long Island Railroad

Fred Tozzi, an employee of L & L Painting Company, Inc., was injured on the job in 1989, leading to a primary action against Long Island Railroad Company and a third-party action by the Railroad against L & L. Subsequently, L & L commenced a fourth-party action against its insurer, Commerce and Indemnity Insurance Company (C & I), seeking defense and indemnification under its commercial general liability policy. L & L moved for summary judgment, arguing the policy was ambiguous and regulatory estoppel applied, while C & I cross-moved to dismiss, citing an employee bodily injury exclusion. The court declined to apply regulatory estoppel due to the limited nature of New York's regulatory approval process for the insurance endorsement. However, the court found an ambiguity in the policy when considering the "Notice of Occurrence" endorsement alongside the exclusion. Construing this ambiguity in favor of the insured, the court granted L & L's motion for summary judgment, mandating C & I to defend and indemnify L & L, but also declared that L & L owed common-law and contractual indemnification to the Long Island Railroad Company.

Insurance policy interpretationCommercial General Liability (CGL)Employee bodily injury exclusionContractual indemnificationDuty to defendDuty to indemnifyRegulatory estoppelJudicial estoppelSummary judgmentAmbiguity in contract
References
45
Case No. CA 12-01554
Regular Panel Decision
Apr 26, 2013

SMITH, PAUL J. v. NESTLE PURINA PETCARE COMPANY

Paul J. Smith, a plaintiff, sued Nestle Purina Petcare Company (Nestle) for injuries sustained after slipping and falling in a grain silo during a construction project. Nestle then initiated a third-party action against E.E. Austin & Son, Inc. (Austin), Smith's employer. The Supreme Court denied motions for summary judgment from Nestle and Austin. On appeal, the Appellate Division modified the order, granting summary judgment to Nestle and Austin on Labor Law § 240 (1) and most of § 241 (6) claims, finding the injury unrelated to ladder use and certain regulations inapplicable. However, the court affirmed the denial of summary judgment on the Labor Law § 241 (6) claim based on 12 NYCRR 23-1.7 (e) (2), the Labor Law § 200/common-law negligence claims, and the contractual indemnification claim between Nestle and Austin due to unresolved factual issues regarding Nestle's negligence.

Labor LawWorkplace InjuryConstruction AccidentSummary JudgmentContractual IndemnificationAppellate DivisionPremises LiabilityNegligenceSlip and FallGrain Silo
References
24
Case No. MISSING
Regular Panel Decision

International Union of Electrical & Machine Workers v. General Electric Co.

This case involves a dispute between the International Union of Electrical Radio and Machine Workers (Union) and General Electric Company (Company), and Metropolitan Life Insurance Company, concerning a 1966 Pension and Insurance Agreement and its incorporated Insurance Plan. The Union alleged the Company wrongfully rejected sickness and accident claims filed during a strike and, alternatively, sought reimbursement for employee contributions for coverage not provided during the strike. The central issue was the interpretation of clauses governing sickness and accident benefits during voluntary strike absences. The Court found that the Company properly rejected claims for benefits arising more than 31 days into the strike, dismissing the Union's first claim. However, the Court ruled that employees are entitled to reimbursement for the portion of their contributions related to sickness and accident coverage not afforded during the strike, and ordered an assessment of damages if parties cannot agree on the amount.

labour lawcollective bargaining agreementinsurance plansickness and accident benefitsstrikeemployee contributionscontract interpretationunjust enrichmentdamagesfederal court
References
6
Case No. MISSING
Regular Panel Decision

CHARLES F. EVANS CO., INC. v. Zurich Ins. Co.

Plaintiff Charles F. Evans Company, an insured, sought a declaration that defendant Zurich Insurance Company must defend it in an underlying action. This underlying action involved Damon G. Douglas Company, a general contractor, who subcontracted roofing work to Evans for a BASF Corporation building. BASF counterclaimed against Douglas for improperly installed and leaking roofing, leading Douglas to bring a third-party action against Evans for indemnity and contribution. BASF's counterclaim alleged bodily injuries to its employees due to slip-and-falls from the leaking roof, resulting in lost-time and workers' compensation claims. The court found that the insurance policy, covering damages for 'bodily injury,' was at least ambiguous regarding these claims and thus must be construed against the insurer, triggering Zurich's duty to defend Evans. The court also rejected Zurich's argument that the slip-and-falls were not 'occurrences' (accidents) under the policy.

Duty to DefendInsurance CoverageBodily InjurySlip and FallConstruction ContractRoofing DefectWorkers' Compensation ClaimsPolicy AmbiguityThird-Party ActionIndemnity
References
3
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