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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
Jan 13, 1995

National Union Fire Insurance Co. of Pittsburgh, PA v. State Insurance Fund

Plaintiff National Union Fire Insurance Company of Pittsburgh, PA (National Union) initiated a declaratory judgment action against The State Insurance Fund (SIF) to recover defense and settlement costs. These costs were expended on behalf of Regional Scaffolding and Hoisting Co., Inc., a mutually insured party in an underlying personal injury action. The Supreme Court initially denied National Union's motion for summary judgment and ruled in favor of SIF. However, the appellate court reversed this decision, concluding that the antisubrogation rule did not apply in this context. Consequently, it determined that National Union and SIF were co-insurers for Regional Scaffolding's common-law liability. The court granted National Union's motion for summary judgment in part, declaring SIF's duty to reimburse National Union for one-half of the reasonable settlement and defense costs, and remanded for a trial to ascertain these amounts.

Antisubrogation RuleDeclaratory JudgmentSummary JudgmentInsurance Coverage DisputeCo-Insurer LiabilityDefense Costs ReimbursementSettlement CostsEmployer's LiabilityComprehensive General LiabilityThird-Party Action
References
8
Case No. MISSING
Regular Panel Decision

Everest National Insurance Co. v. Texas Workers' Compensation Commission

Everest National Insurance Company, an insurance carrier, sought reimbursement from the Subsequent Injury Fund for overpaid workers' compensation benefits. These overpayments occurred between a hearing officer's decision and an appeals panel decision, a period the Fund characterized as a 'reimbursement gap.' After the Fund denied a portion of the reimbursement, Everest filed a declaratory judgment suit in district court. The district court dismissed the suit, citing a lack of subject-matter jurisdiction due to Everest's alleged failure to exhaust administrative remedies. On appeal, the Court reversed the district court's judgment, holding that Everest was authorized to bring a direct suit for declaratory relief under the UDJA and was not required to exhaust administrative remedies as none were available, remanding the cause for consideration on the merits.

Workers' CompensationInsurance ReimbursementDeclaratory JudgmentAdministrative Procedure ActUniform Declaratory Judgments ActSubsequent Injury FundExhaustion of Administrative RemediesJurisdictionStatutory InterpretationAppellate Review
References
7
Case No. AHM 90917 AHM 90918
Regular
Jul 11, 2007

ANGEL SOSA vs. D.W. FOODS, EVEREST NATIONAL INSURANCE COMPANY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, VILLANOVA INSURANCE

This case concerns a dispute over reimbursement between an insurer, Everest, and the California Insurance Guarantee Association (CIGA), which is handling claims for a liquidated insurer, Villanova. The Board denied Everest's petition, upholding a prior award for reimbursement from Everest to CIGA. However, the Board granted CIGA's petition to amend the award to include Villanova Insurance as a party defendant.

CIGAEverest National Insurance CompanyVillanova Insuranceliquidationreconsiderationreimbursementbill review chargesjoint and several liabilitycumulative traumadenied due process
References
0
Case No. 2015 NY Slip Op 07554 [132 AD3d 500]
Regular Panel Decision
Oct 15, 2015

Bridge Street Contracting Inc. v. Everest National Insurance

This case addresses an insurer's disclaimer of coverage due to late notice of claims. The Appellate Division, First Department, modified a lower court order, declaring that Everest National Insurance Company has no duty to defend or indemnify Bridge Street Contracting Inc. in the underlying action. The court ruled that Everest properly disclaimed coverage without needing to demonstrate prejudice, as it was not participating in the defense when Bridge Street was served with the claims. Arguments regarding waiver of the late notice defense and antisubrogation were rejected. CastlePoint Insurance Company's motion to intervene was also denied as academic.

Insurance CoverageLate NoticeDisclaimer of CoverageSummary JudgmentDuty to DefendDuty to IndemnifyAntisubrogationInterventionAppellate DivisionContract Law
References
4
Case No. 04-25-00040-CV
Regular Panel Decision
Nov 26, 2025

Enrique Cantu and Bridgefield Casualty Insurance Company v. Javier A. Libson, Nosbil, Inc., Jose Luis Ramirez, Utica National Insurance Group, Utica National Insurance Company of Texas, Utica Mutual Insurance Company, and Republic Franklin Insurance Company

Appellants Enrique Cantu and Bridgefield Casualty Insurance Company appealed a no-evidence summary judgment. Cantu's claims of negligence per se, negligent hiring, training, retention, and negligent entrustment were affirmed. However, the summary judgment for Cantu's ordinary negligence claims was reversed and remanded. Additionally, the judgment favoring the insurance defendants (Utica National Insurance Group, Utica National Insurance Company of Texas, Utica Mutual Insurance Company, and Republic Franklin Insurance Company) was also reversed, as their motion for summary judgment was not properly heard. The case involved a collision between Cantu and Jose Luis Ramirez, an employee of Nosbil, Inc., in foggy conditions, leading to Cantu suing for negligence and insurance claims.

NegligenceAutomobile AccidentSummary JudgmentAppellate ReviewProximate CauseDuty of CareBreach of DutyCausationInsurance ClaimsVicarious Liability
References
36
Case No. MISSING
Regular Panel Decision

National Western Life Insurance Co. v. Rowe

National Western Life Insurance Co. appealed a trial court's order certifying a class action initiated by Ella Mae Rowe. The dispute centers on child riders in life insurance policies, specifically National's alleged practice of continuing to collect premiums after coverage terminates when a child reaches twenty-five, and its failure to refund these unearned premiums. Rowe accused National of breach of contract, fraud, negligent misrepresentation, unjust enrichment, and violations of consumer protection laws. National challenged the class certification on grounds including the trial plan's impact on burden of proof, statute of limitations, commonality, and choice of law, as well as the admission of expert testimony and allocation of discovery costs. The appellate court affirmed the trial court's order, finding no abuse of discretion in the certification or the handling of related procedural issues.

Class actionLife insuranceChild ridersPremium refundsBreach of contractFraudNegligent misrepresentationUnjust enrichmentDeceptive Trade PracticesTexas Insurance Code
References
41
Case No. MISSING
Regular Panel Decision

National Union Fire Insurance Co. v. Valdez

This original mandamus action, brought by National Union Fire Insurance Co., challenges a trial court's order compelling the production of its attorney's entire litigation files from a prior, related workers' compensation case. Jimmy Ray Haynes, the injured employee, had prevailed in the compensation case and subsequently filed a bad faith insurance claim against National Union. In the bad faith case, Haynes sought discovery of all records from National Union's former law firm, Hirsch, Glover, Robinson & Sheiness, related to the compensation case. National Union objected, asserting attorney-client and work-product privileges. The Supreme Court of Texas held that a request for an attorney's entire file is objectionable under the work-product exemption because it inherently reveals the attorney's mental processes and trial strategy. The Court further determined that National Union had not waived its privileges through offensive use, as it was not seeking affirmative relief and had removed reliance on its attorney's testimony. Consequently, the Supreme Court conditionally granted the writ of mandamus, directing the trial court to vacate its order for file production.

MandamusDiscoveryAttorney Work ProductAttorney-Client PrivilegeBad Faith InsuranceWorkers' Compensation LawPrivilege WaiverTrial StrategyLitigation FilesSubpoena Duces Tecum
References
11
Case No. MISSING
Regular Panel Decision
Feb 28, 1991

North River Insurance v. United National Insurance

This appellate decision addresses the apportionment of liability between North River Insurance Co. and United National Insurance Company arising from a settlement for an injured employee. The court clarified that North River, as the workers' compensation carrier, is solely responsible for its waived lien, reversing a lower court's finding. It further determined that both insurers' "other insurance" clauses called for pro rata contribution, not equal shares, for the $588,245 settlement payment and defense costs. The court calculated specific shares for each insurer and ruled that North River is entitled to interest from the original payment date in 1982. The Supreme Court's order was thus modified to reflect these findings.

Insurance disputePro rata contributionEquitable apportionmentWorkers' compensation lienDefense costsOther insurance clausesSettlement apportionmentInterest calculationAppellate decisionInsurer liability
References
10
Case No. MISSING
Regular Panel Decision

National Union Fire Insurance Co. of Pittsburgh v. American Re-Insurance Co.

The case revolves around a dispute between National Union Fire Insurance Company and American Re-Insurance Company regarding a pollution exclusion clause in a reinsurance policy. National Union sought reimbursement from American Re after settling claims where employees were exposed to metalworking fluids. American Re denied coverage, arguing its pollution exclusion applied. The court, applying Ohio law, found American Re's pollution exclusion ambiguous due to its broad language and its intended purpose of covering environmental contamination. Consequently, American Re's motion for summary judgment was denied, and National Union's motion to strike American Re's defense was granted, requiring American Re to "follow the fortunes" of National Union.

ReinsurancePollution Exclusion ClauseContract InterpretationFollow the Fortunes DoctrineSummary JudgmentInsurance CoverageAmbiguity in ContractsOhio State LawDiversity JurisdictionIndustrial Contamination
References
31
Case No. ADJ7539480
Regular
Sep 20, 2011

GARY KREFT vs. CELESTRON, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, COMPWEST INSURANCE COMPANY, HARTFORD INSURANCE COMPANY, AMERICAN CLAIMS MANAGEMENT, STATE COMPENSATION INSURANCE FUND, Everest National Insurance Co.

This case concerns a cumulative injury claim where the Workers' Compensation Appeals Board (WCAB) granted Everest National Insurance Co.'s Petition for Removal. The WCAB amended a prior order joining Everest and other carriers, clarifying that Labor Code section 5500.5(a) limits liability for cumulative injuries to employers/insurers covering the year immediately preceding the date of injury or last exposure. As the date of injury/exposure was not yet determined and appeared to be the last day of employment, only the carriers covering that final year (CompWest and Hartford) were ordered joined. Everest was removed as a party defendant pending further determination.

Petition for RemovalLabor Code section 5500.5(a)cumulative injurylast injurious exposurejoinder of partiesWorkers' Compensation Appeals Boarddate of injuryrepetitive job dutiesCalifornia Insurance Guarantee AssociationCIGA
References
1
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