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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

Home Indemnity Co. v. Castel Construction Inc.

The Home Indemnity Company sought to recover unpaid workers’ compensation and general accident insurance premiums from Castel Construction, Inc., after the primary obligor, Gemelli Realty Corp., declared bankruptcy. Castel Construction, Inc., though a named insured, argued it had no direct relationship with the broker or plaintiff and claimed it derived no benefit from the policies. However, the court found Castel Construction, Inc. expressly liable under the insurance contract for the earned premiums. The decision highlighted the benefits Castel Construction, Inc. received as a named insured, including compliance with Workers’ Compensation Law § 50, and distinguished its situation from a prior case where the defendant was not explicitly named. Ultimately, judgment was rendered in favor of the Home Indemnity Company for the outstanding premiums.

Insurance PremiumsWorkers' Compensation CoverageGeneral Accident CoverageContractual LiabilityNamed InsuredSubcontractor LiabilityCorporate BankruptcyConstruction LawNew York Supreme CourtInsurance Broker
References
3
Case No. 80-3008, 81-1497
Regular Panel Decision

Hartley v. Peter Kiewit Sons' Co.

Plaintiff James Hartley sustained personal injuries while employed by Peter Kiewit Sons' Co. during bridge construction in Troy, New York. He filed two consolidated actions: one against Kiewit under the Jones Act for bodily injury and loss of earnings, and another against Home Indemnity Company, Kiewit's workers' compensation insurer, alleging denial of LHWCA benefits after receiving New York State benefits. Defendants moved for summary judgment, arguing Hartley's injury was covered by neither the Jones Act nor LHWCA. The court granted summary judgment for Home Indemnity, dismissing the LHWCA claim based on precedents that Hartley's construction activities were not considered "maritime employment" under the Act. However, the court denied Kiewit's motion to dismiss the Jones Act claim, finding a sufficient evidentiary basis for Hartley to potentially qualify as a "seaman," thus allowing that claim to proceed to trial.

Jones ActLongshoremen's and Harbor Workers' Compensation Act (LHWCA)Maritime EmploymentSeaman StatusSummary Judgment MotionPersonal InjuryBridge ConstructionNavigable WatersVesselDockworker
References
18
Case No. MISSING
Regular Panel Decision
Feb 22, 1984

Barnhardt v. Hudson Valley District Council of Carpenters Benefit Funds

The plaintiff, injured in May 1978 during maintenance work, was denied workers' compensation due to the absence of an employer-employee relationship. Subsequently, he sought reimbursement for medical expenses from the Hudson Valley District Council of Carpenters Benefit Funds (Benefit Funds) through a union insurance policy. Continental Assurance Company (Continental), Benefit Funds' insurer, rejected the claim, citing an employment-related injury exclusion in the policy. The plaintiff then initiated an action against Benefit Funds, which in turn filed a third-party action against Continental seeking indemnification. Continental's motion for summary judgment, asserting the exclusion, was denied by the County Court. The appellate court affirmed this denial, ruling that the exclusionary language was ambiguous and applied only in cases where a clear employer-employee relationship existed, a fact still to be determined.

Insurance Policy InterpretationEmployment StatusWorkers' Compensation ExclusionSummary Judgment MotionContractual AmbiguityGroup Health InsuranceMedical Expense ReimbursementThird-Party ActionAppellate ReviewEmployer-Employee Relationship
References
10
Case No. MISSING
Regular Panel Decision

Cook v. Pension Benefit Guarantee Corp.

The Trustees of the Local 852 General Warehouseman’s Union Pension Fund sued the Pension Benefit Guarantee Corporation (PBGC) seeking reimbursement for pension benefits paid to retirees of two closed warehouses. The Fund argued for recovery based on equitable estoppel, asserting detrimental reliance on an initial PBGC determination that it would guarantee these benefits. The PBGC moved for summary judgment, contending that estoppel against a federal agency requires a showing of affirmative misconduct or manifest injustice. The Court found no evidence of affirmative misconduct by the PBGC and concluded that its change in determination, made to conform with Congressional intent, did not constitute manifest injustice. Consequently, the Court granted the PBGC's motion for summary judgment, ruling that equitable estoppel was inapplicable.

Equitable EstoppelFederal Agency EstoppelSummary JudgmentERISAPension BenefitsMulti-employer PlanPension Benefit Guarantee Corporation (PBGC)Affirmative MisconductManifest InjusticeDetrimental Reliance
References
10
Case No. MISSING
Regular Panel Decision

Jeffries v. Pension Trust Fund of the Pension, Hospitalization & Benefit Plan of the Electrical Industry

Plaintiff Claude Jeffries, a retired electrician, sued the Pension Trust Fund of the Electrical Industry under ERISA, seeking to include pension credits from 1969-1975 in his current benefits. He alleged the Plan should have declared a partial termination during a 1975-1979 New York recession, which would have vested his benefits. The defendant moved to dismiss the complaint, arguing lack of standing and statute of limitations, while plaintiff moved for class certification for similarly affected members. The court denied the defendant's motion to dismiss the claim for benefits, finding it timely, but granted dismissal for the breach of fiduciary duty claim as time-barred. The plaintiff's motion for class certification was denied due to insufficient evidence for numerosity, with leave to refile after discovery.

ERISAPension BenefitsClass CertificationMotion to DismissStatute of LimitationsFiduciary DutyPartial TerminationBenefit ForfeitureUnemploymentLabor Union
References
15
Case No. MISSING
Regular Panel Decision

Carminucci v. Pepsico, Inc.

The intervener plaintiff Madrone Excavating Company, Inc., by its subrogee ITT Hartford Accident Indemnity Company appealed an order from the Supreme Court, Westchester County. The original order determined that New York Workers’ Compensation Law applied, denying full reimbursement to ITT Hartford for benefits paid to Mark T. Carminucci and compelling ITT Hartford to pay a pro rata share of litigation expenses. The appellate court reversed, ruling that Connecticut law applies because benefits were paid under Connecticut's Workers’ Compensation Act. Under Connecticut law, ITT Hartford, as subrogee, is entitled to full reimbursement of both past and the present value of future workers’ compensation benefits. The court further held that ITT Hartford is not required to share litigation expenses on a pro rata basis. The case was remitted to the Supreme Court for a hearing to determine the total reimbursement amount.

Workers' CompensationSubrogationReimbursementChoice of LawConnecticut LawNew York LawPersonal InjuryMotor Vehicle AccidentAppellate ReviewLitigation Expenses
References
5
Case No. MISSING
Regular Panel Decision
Jan 15, 1988

Pension Benefit Guaranty Corp. v. LTV Corp.

David H. Miller and William W. Shaffer ("Miller and Shaffer") moved to intervene individually and as representatives of participants in the Jones & Laughlin Retirement Plan in an action filed by the Pension Benefit Guaranty Corporation (PBGC) against LTV Corporation and LTV Steel Company ("LTV"). LTV did not object to individual intervention but opposed class action intervention, arguing it would delay the PBGC action. The court granted the motion, allowing Miller and Shaffer to intervene both individually and as class representatives. The decision emphasized that Miller and Shaffer met the minimal burden of showing that PBGC's representation might be inadequate, as their interests, seeking full plan benefits, could diverge from PBGC's role as plan administrator. This opinion allows the class action to proceed under Rule 23(e), preventing dismissal or compromise without court approval.

InterventionERISAPension PlansBankruptcyClass ActionRule 24Rule 23(e)Adequate RepresentationPlan TerminationRestoration
References
6
Case No. ADJ329334 (OAK 0311178), ADJ2064025 (OAK 0318666)
Regular
Feb 22, 2013

Vilma Ruiz vs. Margaret O'Leary, California Insurance Guarantee Association, for Fremont Indemnity Company, Republic Indemnity Company

The California Workers' Compensation Appeals Board rescinded a prior award finding Republic Indemnity liable for applicant's cumulative injury. The Board ruled that the applicant's compromise and release agreement with Republic barred further claims against them, and that CIGA was not liable because other insurance (Republic) was available. The Board also determined that the applicant's specific injury claim caused no temporary disability, permanent disability, or need for future medical treatment. Consequently, the applicant was awarded no further benefits in either case.

Workers' Compensation Appeals BoardCalifornia Insurance Guarantee AssociationFremont Indemnity CompanyRepublic Indemnity Companycumulative injuryspecific injurycompromise and releaseinsolvent carriercovered claimsother insurance
References
18
Case No. ADJ2549830 (LAO 0657500)
Regular
Apr 04, 2011

ANTHONY WELCH vs. SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) sought reconsideration of a WCJ award that included a $29,000 lump-sum attorney fee. The SIBTF argued this violated Labor Code section 5100.5, which prohibits commutation of SIBTF benefits for attorney fees. The Appeals Board granted reconsideration, finding the attorney's unilateral addition of the lump sum to stipulations unacceptable. The Board amended the award to provide the attorney a fee of 15% of each weekly indemnity payment, affirming the remainder of the award.

Subsequent Injuries Benefits Trust FundPetition for ReconsiderationAttorney FeesLabor Code Section 5100.5CommutationStipulations with Request for AwardUnilateral AlterationWCJ AwardPermanent Disability IndemnityLife Pension Indemnity
References
1
Case No. 2021 NY Slip Op 04070
Regular Panel Decision
Jun 24, 2021

Matter of Cisnero v. Independent Livery Driver Benefit Fund

Claimant Jeffrey Cisnero, an independent livery driver, sustained injuries when he was shot during a dispatch. He filed a claim for workers' compensation benefits, which was initially disallowed by a WCLJ but later reversed by the Workers' Compensation Board, finding coverage through the Independent Livery Driver Benefit Fund (ILDBF). The carrier appealed, arguing misinterpretation of the relevant statutes, particularly Executive Law § 160-ddd (1). The Appellate Division, Third Department, affirmed the Board's decision, determining that Cisnero's injuries arose out of and in the course of providing covered services as an independent livery driver dispatched by an ILDBF member. The court found that the vehicle's attenuated affiliation with the New York Black Car Operators' Injury Compensation Fund, Inc. did not alter ILDBF's liability.

Workers' CompensationLivery DriverIndependent ContractorBenefit FundAccidental InjuryCourse of EmploymentStatutory InterpretationExecutive LawWorkers' Compensation LawAppellate Review
References
3
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