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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
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

Fulton Boiler Works, Inc. v. American Motorists Insurance

Fulton Boiler Works, Inc., filed an action against several insurance companies regarding defense and indemnification for thousands of asbestos claims. The court addressed multiple pending motions for summary judgment, focusing on the proper allocation of indemnity costs among the liable parties, Fulton's obligation for uninsured years, the applicability of equitable estoppel against insurers, and Travelers' specific obligations concerning notice of claims and disclaimers. The court ruled that a pro rata allocation of indemnity costs is appropriate, with Fulton liable for periods it was uninsured. Equitable estoppel was deemed inapplicable to bar insurers from seeking contribution, and Travelers was found to have received proper notice for many claims and is barred from disclaiming coverage due to untimely disclaimers. This order, along with a previous one, sets the 'ground rules' for resolving past, pending, and future asbestos claims.

Asbestos LiabilityInsurance Coverage DisputeIndemnity AllocationSummary JudgmentEquitable EstoppelNotice ProvisionsDisclaimer of CoveragePro Rata AllocationInjury-in-factComprehensive General Liability Policy
References
23
Case No. MISSING
Regular Panel Decision

Wausau Business Insurance v. Horizon Administrative Services LLC

Wausau Business Insurance Company sued multiple defendants, including Horizon Administrative Services LLC, alleging failure to pay outstanding premiums for two Workers Compensation and Employers Liability Insurance policies. Defendants counterclaimed and asserted an affirmative defense, arguing that Wausau's negligent handling of workers' compensation claims increased their policy premiums. Wausau moved to dismiss the counterclaim and strike the affirmative defense, contending they are not cognizable under New York law. Defendants conceded this for New York but argued Pennsylvania and Delaware law should apply. The court applied New York's choice of law analysis, determining that New York law should govern all defendants and policies due to the majority of insureds and the first named insured being in New York, and policies being issued there. Consequently, the court granted Wausau's motion, dismissing the defendants' counterclaim and striking their affirmative defense.

Choice of LawFederal Rules of Civil ProcedureMotion to DismissAffirmative DefenseWorkers' Compensation InsuranceInsurance Policy PremiumsNegligent Claims HandlingNew York LawPennsylvania LawDelaware Law
References
25
Case No. MISSING
Regular Panel Decision

Wausau Business Insurance v. Sentosa Care LLC

Wausau Business Insurance Co. sued Sentosa Care LLC and numerous other entities for breach of contract, specifically non-payment of retrospective premiums for workers’ compensation and employer liability policies. Defendants challenged the contracts' validity, asserting illegality due to a lack of common ownership among combined insureds, and contested Wausau's methods for calculating unpaid premiums and damages. The Court denied Defendants' motion for reconsideration of diversity jurisdiction and their cross-motion for summary judgment. It found the insurance policies to be valid and enforceable, Wausau to have fully performed its obligations, and Defendants to have breached the agreements by failing to pay the outstanding balances. The Court granted Wausau's motion for summary judgment, rejecting the illegality argument and affirming Wausau's damage calculations, awarding over $6.7 million plus interest to the plaintiff.

Workers' Compensation InsuranceBreach of ContractSummary JudgmentInsurance Policy DisputeRetrospective PremiumsCorporate GroupingEmployer Liability PoliciesDamages CalculationContract EnforceabilityFederal Court Litigation
References
16
Case No. MISSING
Regular Panel Decision
Feb 18, 1972

Claim of McGee v. Allstate Insurance

The claimant's husband, a District Sales Manager for Allstate Insurance Company, died in a car accident on September 30, 1970, after attending a sales meeting and continuing business discussions at bars. Although his home was in Utica, the accident occurred en route from Rome. The Workmen’s Compensation Board found the decedent was an outside worker and in the course of his employment at the time of death, awarding death benefits to the claimant. The employer and its insurance carrier appealed this decision. The appellate court affirmed the board's decision, ruling that social activities connected with and incidental to an employer’s business are considered part of employment and that the decedent had not deviated from his employment.

Death BenefitsCourse of EmploymentOutside WorkerSales MeetingBusiness DiscussionCar AccidentDeviation from EmploymentAppellate ReviewAffirmation
References
3
Case No. MISSING
Regular Panel Decision

Wausau Underwriters Insurance v. Old Republic General Insurance

This case addresses a dispute between Wausau Underwriters Insurance Company and Old Republic General Insurance Company concerning their respective obligations to defend and indemnify the "Broadway Defendants" in an underlying personal injury lawsuit. Wausau, providing coverage to the Broadway Defendants, sought a declaratory judgment that Old Republic, as the insurer for construction manager McGowan Builders Inc., was required to provide coverage as the Broadway Defendants were additional insureds. The Court, applying New York law, determined that the injury sustained by a potential subcontractor's employee on the construction site arose from McGowan's "ongoing operations," thus triggering Old Republic's duty to both defend and indemnify. Furthermore, the Court rejected Old Republic's defense of untimely notice, finding no material prejudice to its ability to investigate or defend the claim. Consequently, Wausau's motion for summary judgment was granted, ordering Old Republic to fulfill its defense and indemnification duties and reimburse Wausau for its costs and interest.

Insurance DisputeDeclaratory JudgmentSummary JudgmentDuty to DefendDuty to IndemnifyAdditional InsuredOngoing OperationsConstruction Site InjuryNew York LawLate Notice Defense
References
40
Case No. ADJ4482163 (VNO 0264880)
Regular
Apr 05, 2010

CHARLES THOMPSON vs. LOCKHEED MARTIN, Employers Mutual of Wausau Insurance Company

The Workers' Compensation Appeals Board granted Wausau's petition for reconsideration to correct a coverage date error, finding Wausau's insurance coverage ended before the applicant's last year of injurious exposure. Consequently, Wausau was dismissed as a party defendant, and Lockheed Martin, self-insured and administered by Helmsman, was found solely liable for benefits. Helmsman's petition for reconsideration was denied due to its inadequacy and failure to comply with procedural rules. The original award of 83% permanent disability and need for future medical care was otherwise affirmed.

Workers' Compensation Appeals BoardLockheed MartinHelmsman Management ServicesEmployers Mutual of Wausau Insurance Companyindustrial injurypsychelungsneurologic systemcognitive dysfunctionpermanent disability
References
1
Case No. MISSING
Regular Panel Decision

Continental Insurance v. State

Thomas Murray, an executive officer and co-owner of T & T Murray Company, Inc., sustained severe injuries while working, having previously elected to be excluded from Workers’ Compensation coverage under Workers’ Compensation Law § 54 (6). Following a successful lawsuit against the general contractor, Concept Construction Corp., and subsequent indemnification from T & T, Concept's liability carrier, Continental Insurance Company, sought coverage from T & T's insurer, State Insurance Fund. The State Fund denied the claim, asserting the exclusion applied to both Workers’ Compensation and Employers’ Liability coverage. The Court of Appeals affirmed the denial, ruling that the two types of coverage are inextricably linked, and the election to exclude executive officers from Workers’ Compensation coverage also eliminates Employers’ Liability coverage for injuries to those officers.

Workers' Compensation Law § 54(6)Employers' Liability CoverageExecutive Officer ExclusionCorporate OfficersStock OwnershipInsurance Policy InterpretationThird-Party IndemnificationSubrogation ClaimStatutory InterpretationNew York Court of Appeals
References
6
Case No. MISSING
Regular Panel Decision

Perfect Dental, PLLC v. Allstate Insurance

In this consolidated action, plaintiffs Perfect Dental Care, P.C., Zodiac Dental, PLLC, and Smooth Dental PLLC (Dental PCs) sought unpaid insurance claims from Allstate Insurance Company and State Farm Mutual Automobile Insurance Company (Insurers). The Insurers countersued alleging insurance fraud and unjust enrichment, and initiated a third-party action against various individuals and entities. The Insurers moved for partial summary judgment, seeking a declaratory judgment that Dental PCs could not recover for services provided by dentists and physical therapists, and for summary judgment on their fraud and unjust enrichment counterclaims. The court denied summary judgment concerning dentists' services, finding a triable issue of fact regarding their employment status. However, it granted summary judgment for the Insurers regarding physical therapy services, as Dental PCs conceded these services were provided by non-employees. Consequently, the court also denied summary judgment on the fraud and unjust enrichment claims, as their resolution depended on the unresolved employment status of the dentists.

Insurance ClaimsHealthcare ServicesContract LawSummary JudgmentProfessional CorporationsIndependent ContractorsEmployment LawFraud AllegationsUnjust EnrichmentDeclaratory Judgment
References
17
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