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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

Commercial Risk Reinsurance Co. v. Security Insurance

Petitioners Commercial Risk Reinsurance Company Limited and Commercial Risk Re-Insurance Company (collectively “Commercial Risk”) initiated an action to vacate an arbitration award obtained by respondent Security Insurance Company of Hartford (“Security”). Security subsequently cross-moved to confirm the Award. The District Court denied Commercial Risk’s motion to vacate and granted Security’s motion to confirm the Award, finding that Commercial Risk failed to establish sufficient grounds for misconduct by the arbitrators. Commercial Risk then sought reconsideration of this order, arguing improper exclusion of a witness and documents related to damages. The Court denied the motion for reconsideration, reaffirming its original decision and emphasizing the broad discretion granted to arbitrators in procedural matters, particularly given the "Honorable Engagement" clause in the parties' agreement.

ArbitrationReinsurance ContractsVacatur of Arbitration AwardConfirmation of Arbitration AwardMotion for ReconsiderationFederal Arbitration ActInternational ArbitrationEvidentiary RulingsJudicial ReviewArbitrator Discretion
References
27
Case No. MISSING
Regular Panel Decision

474431 Associates v. AXA Global Risks US Insurance

This case involves an appeal by Allcity Insurance Company in a consolidated action seeking a declaratory judgment regarding co-insurance liability between Allcity and AXA Global Risks US Insurance Company. The dispute arose from an underlying action where an injured worker obtained a judgment against a property owner, which was satisfied by the owner's insurer, AIG. AIG then sought reimbursement from the worker's employer's carriers, Allcity (worker's compensation) and AXA (general liability). The Supreme Court initially favored AXA, but the appellate court reversed, holding that AXA's disclaimer of coverage was untimely under Insurance Law § 3420 (d). The matter was remitted to declare AXA a co-insurer with Allcity.

Insurance Law § 3420 (d)Disclaimer of CoverageTimely Notice RequirementCo-Insurance DisputeGeneral Liability InsuranceWorker's Compensation InsuranceSummary Judgment MotionAppellate Court DecisionDeclaratory ReliefPolicy Exclusion
References
6
Case No. MISSING
Regular Panel Decision

New York State Workers' Compensation Board v. Consolidated Risk Services, Inc.

The New York State Workers’ Compensation Board, acting as a governmental agency and successor in interest to several insolvent workers' compensation self-insured trusts, commenced an action against a third-party administrator (Consolidated Risk Services, Inc.), its employees, related corporate entities, insurance brokers (including Hickey-Finn & Co., Inc.), former trustees of one of the trusts (RITNY), and an actuarial firm (Regnier Consulting Group, Inc.). The plaintiff alleged misconduct and malfeasance by the defendants led to trust insolvencies and sought to recover accumulated deficits. The case involves cross appeals challenging the Supreme Court’s partial dismissal of the complaint, specifically concerning the timeliness of claims for breach of fiduciary duty, fraud, fraudulent inducement, breach of contract, and common-law indemnification, applying the repudiation and discovery rules for statute of limitations. The Appellate Division modified the Supreme Court's order by dismissing specific claims against Hickey-Finn & Co., Inc., broadening the temporal scope of breach of fiduciary duty claims against other defendants, and reinstating common-law indemnification claims against several RITNY trustees, affirming the order as modified and remitting the case.

Workers' CompensationBreach of Fiduciary DutyFraudFraudulent InducementBreach of ContractCommon-Law IndemnificationStatute of LimitationsRepudiation RuleDiscovery RuleTrust Insolvency
References
27
Case No. 2017 NY Slip Op 27428
Regular Panel Decision
Dec 14, 2017

New York State Workers' Compensation Bd. v. Compensation Risk Mgrs., LLC

This action was brought by the New York State Workers' Compensation Board (WCB), as an assignee of former members of the Healthcare Industry Trust of New York (HITNY), against Compensation Risk Managers, LLC (CRM), HITNY trustees, and auditing firm UHY LLP. The WCB alleged mismanagement, breach of fiduciary duty, and negligent auditing, leading to the Trust's insolvency. Defendants moved to dismiss on grounds of standing, statute of limitations, and pleading particularity. The court dismissed certain derivative claims and negligent misrepresentation claims against some trustees due to standing issues and statute of limitations. All claims against UHY LLP were dismissed for lack of a near-privity relationship or prior precedent. An implied indemnity claim against the trustees was sustained. The WCB's cross-motion to consolidate related actions was denied.

Workers' Compensation LawGroup Self-Insured Trust (GSIT)Fiduciary DutyNegligenceNegligent MisrepresentationStatute of LimitationsStandingDerivative ActionImplied IndemnityAuditing Firm Liability
References
46
Case No. 2017 NY Slip Op 04184 [150 AD3d 1589]
Regular Panel Decision
May 25, 2017

New York State Workers' Compensation Board v. Program Risk Management, Inc.

The New York State Workers' Compensation Board, acting as administrator and successor to the Community Residence Insurance Savings Plan, initiated legal action against various entities and individuals after the trust became severely underfunded. Defendants include Program Risk Management, Inc. (administrator), PRM Claims Services, Inc. (claims administrator), individual officers of PRM, the Board of Trustees, and Thomas Gosdeck (trust counsel). The plaintiff sought damages for claims such as breach of contract, breach of fiduciary duty, and legal malpractice. The Supreme Court's order partially dismissed some claims and denied others. On cross-appeal, the Appellate Division, Third Department, modified the Supreme Court's order, notably reversing the dismissal of several breach of fiduciary duty claims and common-law indemnification against PRMCS, while affirming denials of motions to dismiss breach of contract, legal malpractice, and unjust enrichment claims. The court's decision was influenced by recent rulings in State of N.Y. Workers' Compensation Bd. v Wang.

Workers' Compensation LawGroup Self-Insured TrustBreach of ContractBreach of Fiduciary DutyLegal MalpracticeUnjust EnrichmentStatute of LimitationsEquitable EstoppelAlter Ego LiabilityCommon-Law Indemnification
References
20
Case No. ADJ361974
Regular
Feb 11, 2013

ANA VELASQUEZ vs. AMERICAN BUILDING MAINTENANCE

The Workers' Compensation Appeals Board (WCAB) granted reconsideration of a $1,000 sanction against applicant's attorney, Peter T. Brown, and his firm. The original sanction was for violating rules regarding supervision of non-attorney employees and requiring specific written authorization for settlement documents. The WCAB found Brown's conduct, including alleged misrepresentations and failure to adequately supervise his employee's submission of a compromise and release without full disclosure, warranted an increased sanction. The WCAB is now considering imposing a sanction of up to $2,500 and has given Brown an opportunity to show cause why this increase is not warranted.

Workers' Compensation Appeals BoardSanctionsPetition for ReconsiderationFindings and OrderAdministrative Law JudgeCompromise and ReleaseSupervisionWritten AuthorizationCumulative TraumaGood Faith Negotiation
References
0
Case No. ADJ6610233
Regular
Nov 18, 2014

WILLIAM WILLIAMS (Deceased) vs. STATE OF CALIFORNIA, CDCR - PLEASANT VALLEY STATE PRISON, Legally Uninsured; STATE COMPENSATION INSURANCE FUND/STATE CONTRACT SERVICES, Adjusting Agency

This case concerns a deceased correctional officer whose dependent sons were awarded death benefits. The Appeals Board denied reconsideration of its prior order requiring an offset for a CalPERS special death benefit received by the decedent's widow, deeming it consistent with precedent and statutory intent. The Board also issued a notice of intention to disallow the applicant's attorney's requested fee increase due to non-compliance with a rule regarding notice to the client of adverse interests. Compliance with this rule is required for the fee increase to be considered by the trial judge.

CalPERSspecial death benefitoffsetdeath benefitsdependent childrenattorney's feesWCAB Rule 10778adverse interestindependent counselPetiton for Reconsideration
References
4
Case No. ADJ7825337, ADJ7825332
Regular
Sep 04, 2014

JENNIFER MELVILLE vs. XEROX CORPORATION, JEFFREY S. SCHWARTZ, SPECIALTY RISK

This case concerns Jennifer Melville's appeal of a Workers' Compensation Appeals Board (WCAB) decision regarding her industrial injuries with Xerox Corporation. The applicant sought compensation for neck, lumbar spine, and headache injuries, but her claims for shoulder, upper extremity, knee, thoracic outlet syndrome (TOS), internal, and sleep disorders were disputed. While the WCJ found 31% permanent disability for neck, spine, and headaches, the applicant appealed issues including a 15% permanent disability increase, a job displacement voucher, and the denial of TOS compensation. The WCAB deferred the decision on the 15% increase due to insufficient evidence and affirmed the WCJ's findings on other issues, with one commissioner dissenting on the TOS causation.

Thoracic Outlet SyndromeAgreed Medical ExaminerCumulative TraumaPermanent DisabilityTemporary DisabilityLabor Code section 4658(d)(2)Supplemental Job Displacement VoucherLabor Code section 4658.5Credit for Disability PaymentsIndustrial Causation
References
1
Case No. ADJ1950726 (MON 0361748), ADJ6963803, ADJ7198723
Regular
Mar 20, 2012

DANA BURREL vs. LONG BEACH UNIFIED SCHOOL DISTRICT, TRISTAR RISK MANAGEMENT

In three workers' compensation cases, the applicant sustained industrial injuries to her upper extremities on May 21, 2006, March 11, 2008, and July 28, 2008. The Appeals Board granted reconsideration to review the application of Labor Code section 4658(d)(2), which mandates a 15% increase in permanent disability payments when an employer fails to offer suitable work within 60 days of an injury becoming permanent and stationary. The employer stipulated to providing some medical treatment and returning the applicant to work, but failed to offer regular, modified, or alternative work for 12 months post-injury. The Board found the employer's contention of denial unsubstantiated by evidence and, following *Bontempo v. Workers' Comp. Appeals Bd.*, ruled that the 15% increase applies to all three cases.

Labor Code section 4658(d)(2)permanent disability increaseindustrial injuryright upper extremityright handright wristright shoulderright armleft wristleft hand
References
4
Case No. ADJ700838 (SRO 0096054) ADJ414827 (SRO 0096056) ADJ178893 (SRO 0096055)
Regular
Mar 21, 2019

Margaret Knapp vs. Department of Social Services, In-Home Supportive Services, York Risk Services Group, Inc.

This case concerns a workers' compensation claimant seeking increased benefits for new and further permanent disability stemming from three prior back/spine injuries. The Appeals Board ultimately modified the original judge's award, finding the claimant's combined industrial disability after reopening is 52% after apportioning 30% to non-industrial factors. This results in a revised total permanent disability award of $47,982.50, with credit for prior payments. The Board also increased the attorney's fee to 15% of the new and additional benefits due to the complexity of the case.

SB 899apportionmentnew and further disabilitycumulative injurypermanent disabilitystipulated awardagreed medical evaluatorvocational rehabilitationmedical treatmentindustrial injury
References
9
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