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

Case No. B167017
Significant
Nov 18, 2004

General Casualty Insurance and Regent Insurance, Joseph A. Lane, American Home Assurance Company vs. Workers' Compensation Appeals Board and California Insurance Guarantee Association

The court has requested responses from the Workers' Compensation Insurance Rating Bureau (WCIRB) and the California Insurance Commissioner regarding the exclusion of special employees from a special employer's workers' compensation policy, specifically questioning the use and requirements of Form No. 11 for this purpose.

WCIRBForm No. 11limiting endorsementsrestricting endorsementsspecial employeesgeneral employerstemporary employeesleased employeesInsurance CommissionerCalifornia Code of Regulations
References
1
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

Continental Casualty Co. v. Employers Insurance

Plaintiff insurance companies, Continental Insurance Co. and American Casualty Co. (CNA), initiated a declaratory judgment action seeking a declaration that they have no duty to indemnify Robert A. Keasbey Co. (Keasbey) for asbestos-related claims, arguing that all claims fall under exhausted products hazard/completed operations coverage. The defendant class of asbestos claimants sought coverage under a new 'operations' theory not subject to aggregate limits. The trial court ruled in favor of the claimants, but the appellate court reversed. The appellate court found that equitable affirmative defenses like laches applied against the claimants, who stood in Keasbey’s shoes. It further determined that coverage is triggered by 'injury-in-fact' rather than mere exposure to asbestos, and that the aggregate limits of the primary and excess policies were exhausted, thus absolving CNA of further indemnity obligations.

AsbestosInsurance Coverage DisputeDeclaratory JudgmentProducts HazardCompleted OperationsOperations CoverageAggregate LimitsExcess InsuranceBodily InjuryInjury-in-Fact
References
29
Case No. ADJ1888124 (SAL 0111884) ADJ3322590 (SAL 0079903)
Regular
Oct 20, 2016

MARIA NUNEZ vs. MANN PACKING COMPANY, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION For FREMONT COMPENSATION INSURANCE COMPANY, In Liquidation; STATE OF CALIFORNIA

This case concerns the California Insurance Guarantee Association's (CIGA) liability for an applicant's workers' compensation claims after Fremont Compensation Insurance Company became insolvent. CIGA argued it should be relieved of liability because the State of California, as the applicant's employer through IHSS, constituted "other insurance" under Insurance Code Section 1063.1. The Appeals Board affirmed the WCJ's decision, holding that the State of California does not qualify as "other insurance" under the relevant statutes. This distinction is based on the State not being required to obtain workers' compensation insurance or a certificate of self-insurance like private or other public employers.

CIGAFremont Compensation Insurance Companyliquidationlegally uninsuredother insuranceInsurance Code Section 1063.1covered claimsIn-Home Supportive Services (IHSS)statutory limitationsself-insurance
References
5
Case No. MON 0271251 MON 0271252 MON 0271253
Regular
Jan 09, 2008

CONSUELO AMADOR vs. JIMWAY, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for FREMONT INDEMNITY INSURANCE COMPANY, in liquidation, by CAMBRIDGE INTEGRATED SERVICES, STATE COMPENSATION INSURANCE FUND

This case concerns liability for an applicant's cumulative trauma injury where both Fremont Indemnity (represented by CIGA) and the State Compensation Insurance Fund (SCIF) provided coverage. The Workers' Compensation Appeals Board reversed an arbitrator's decision, finding that SCIF, as a solvent insurer jointly and severally liable for the injury, constitutes "other insurance." Therefore, under Insurance Code section 1063.1(c)(9), CIGA is not liable for the applicant's cumulative trauma injury.

CIGAFremont IndemnitySCIFcumulative traumajoint and several liabilitycovered claimother insuranceInsolvencyLabor Code section 5500.5Insurance Code section 1063.1(c)(9)
References
12
Case No. 2021 NY Slip Op 00606 [191 AD3d 1074]
Regular Panel Decision
Feb 04, 2021

Matter of Pisarski v. Accurate Plumbing & Heating Co.

Claimant Michael Pisarski established a workers' compensation claim for occupational bilateral knee and shoulder injuries after retiring as a union plumber. The Workers' Compensation Board ultimately set the date of disablement as July 12, 2016, and a Worker's Compensation Law Judge ruled Norguard Insurance Company, which covered the employer during Pisarski's last employment, was the liable carrier, as no active policy was found on the disablement date. Norguard appealed, distinguishing its case from Matter of Cammarata, where the employer had ceased business. The Appellate Division, Third Department, found that the Board erred by not determining the business status of Accurate Plumbing and Heating Co. on the date of disablement. This determination is crucial to establish whether Accurate Plumbing was required to maintain an insurance policy or if the Uninsured Employers Fund should be responsible. Consequently, the court reversed the Board's decision and remitted the matter for further proceedings.

Workers' CompensationOccupational DiseaseDate of DisablementInsurance Carrier LiabilityUninsured Employers FundAppellate ReviewRemittalBusiness Status DeterminationPolicy CoverageKnee Injury
References
6
Case No. 2015 NY Slip Op 06582 [131 AD3d 598]
Regular Panel Decision
Aug 19, 2015

Tully Construction Co. v. Illinois National Insurance

Tully Construction Co., Inc. (Tully) and Zurich American Insurance Company (Zurich) appealed an order and judgment of the Supreme Court, Queens County. The Supreme Court denied their separate motions for summary judgment on the complaint and granted Illinois National Insurance Company's (Illinois) cross-motion for summary judgment. The dispute centered on Illinois's obligation to indemnify Tully under a commercial umbrella liability insurance policy, which was contingent upon the exhaustion of underlying insurance. The Supreme Court found that Zurich's Workers Compensation and Employers Liability policy had an unlimited liability provision. As a result, the excess coverage of Illinois's umbrella policy was never triggered. The Appellate Division affirmed the order and judgment, declaring that Illinois had no obligation to indemnify Tully and that Zurich must reimburse Illinois for $2,500,000.

Insurance coverage disputeUmbrella liability insuranceWorkers' Compensation policyEmployers Liability policySummary judgment motionIndemnification obligationPolicy exhaustionExcess coverage triggerPrimary insurer vs. excess insurerAppellate Division Second Department
References
7
Case No. 2025 NY Slip Op 04576 [241 AD3d 563]
Regular Panel Decision
Aug 06, 2025

New York Bus Operators Compensation Trust v. American Home Assur. Co.

The New York Bus Operators Compensation Trust (NYBOCT), a self-insured entity, brought an action against its excess-of-loss insurer, American Home Assurance Co., alleging breach of contract and seeking declaratory relief. This dispute arose after American Home denied coverage for a workers' compensation claim due to untimely notice. The Supreme Court granted American Home's motion to dismiss the complaint as time-barred, which NYBOCT appealed. The Appellate Division affirmed the Supreme Court's decision, ruling that the six-year statute of limitations for breach of contract began when American Home disclaimed coverage on May 18, 2012, making NYBOCT's 2020 lawsuit untimely. The court rejected arguments related to the continuing-wrong doctrine and estoppel.

Limitation of ActionsBreach of ContractInsurance ContractDisclaimer of CoverageStatute of LimitationsWorkers' CompensationExcess-of-Loss PolicySelf-Insured TrustUntimely NoticeAppellate Review
References
29
Case No. GRO 0022416
Regular
Mar 24, 2008

GERALD RICE vs. ALASCO RUBBER & PLASTICS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, CAMBRIDGE INTEGRATED SERVICES GROUP, FREMONT COMPENSATION INSURANCE COMPANY, NATIONAL SURETY/FIREMAN'S FUND

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior decision. The Board found that the California Insurance Guarantee Association (CIGA) is solely liable for the applicant's industrial injury benefits. This is because the insolvent insurer, Fremont Compensation Insurance Company, was the only insurer on the risk during the one-year period preceding the applicant's cumulative trauma injury.

WORKERS' COMPENSATION APPEALS BOARDCIGAFREMONT COMPENSATION INSURANCE COMPANYINSOLVENCYLIQUIDATIONCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONNATIONAL SURETY/FIREMAN'S FUNDALASCO RUBBER & PLASTICSLABOR CODE SECTION 5500.5CUMULATIVE TRAUMA INJURY
References
1
Case No. OAK 293546, OAK 295646 OAK 295645, OAK 322365
Regular
Aug 22, 2008

LAURA BERRY vs. GOLDEN RAIN FOUNDATION, AMERICAN HOME ASSURANCE CO., AIG CLAIM SERVICES, ROSSMOOR MEDICAL CENTER, STATE COMPENSATION INSURANCE FUND

The Board denied American Home Assurance Co.'s petition and granted State Compensation Insurance Fund's petition for reconsideration, affirming the June 5, 2008 Findings, Award and Order, except for the employer's identity, which was deferred for further proceedings.

Workers' Compensation Appeals BoardPetition for ReconsiderationCumulative TraumaTemporary DisabilityPermanent and StationaryBanker for AwardEmployer IdentificationSeparate EntitiesDevelop the RecordFindings Award and Order
References
1
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