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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
Oct 15, 1979

In re the General Assignment for the Benefit of Creditors of Am-Lon Knit Goods Finishing Corp.

This proceeding involved an assignee for the benefit of creditors seeking judicial determination of priority among various creditor claims. The claims included those from the Federal Government, preferred wage claims, the New York State Tax Commission for income withholding taxes, the Industrial Commissioner for unemployment insurance contributions, the Director of Finance of the City of New York for various city taxes, and two insurance companies for workers' compensation insurance premiums. The court reconsidered an earlier decision and clarified that Labor Law § 574 is applicable and controlling in this context, establishing parity between New York State and City tax claims. Consequently, these tax claims were granted priority over the workers' compensation insurance premiums. The decision also distinguishes insolvency proceedings from decedent's estate cases, which are governed by SCPA 1811.

InsolvencyCreditor PriorityTax ClaimsUnemployment InsuranceWorkers' CompensationAssignee for Benefit of CreditorsState TaxesCity TaxesLabor LawSCPA
References
14
Case No. ADJ2279830 (LBO 0290929) ADJ3851198 (LBO 0362934)
Regular
Sep 05, 2008

SUSAN ORTLOFF vs. ANAHEIM GENERAL HOSPITAL, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for FREMONT COMPENSATION, ARGONAUT INSURANCE COMPANY

The Workers' Compensation Appeals Board granted CIGA's reconsideration, affirming the denial of contribution for Fremont's pre-insolvency benefits due to untimeliness under Labor Code §5500.5(e). However, the Board reversed the denial of CIGA's reimbursement claim for post-insolvency benefits, finding that Argonaut provided "other insurance" and is therefore liable for reimbursement. The Board ordered Argonaut to reimburse CIGA for benefits paid after Fremont's insolvency.

CIGAFremont CompensationArgonaut Insurancecontributionreimbursementinsolvencycumulative traumastipulated awardstatute of limitationsLabor Code 5500.5(e)
References
11
Case No. MISSING
Regular Panel Decision

Claim of Scheib v. Milton Herman Management

Claimant, injured in the course of employment, received monetary awards. The employer's carrier, Cosmopolitan Mutual Insurance Company, became insolvent, leading to the State Superintendent of Insurance being appointed as liquidator. When the Superintendent defaulted on weekly payments, a penalty was imposed. The Workers’ Compensation Board affirmed this penalty, stating that carrier insolvency does not exempt liquidators from penalties. The court affirmed this decision, holding that the Superintendent assumes the same rights and duties as the insolvent carrier and is thus liable for late payment penalties from the Mutual Workers’ Compensation Security Fund.

Penalties for Late PaymentInsolvent Insurance CarrierSuperintendent of InsuranceLiquidator ResponsibilitiesMutual Workers’ Compensation Security FundStatutory InterpretationAppellate ReviewEmployer LiabilityCompensation Benefits
References
0
Case No. ADJ937954 (POM 0254711)
Regular
Aug 18, 2010

ANGELITA (ANGIE) FERNANDEZ vs. OAK TREE RACING ASSOCIATION, LOS ANGELES TURF CLUB, CADDIE SERVICES, INCORPORATED, CIGA by its servicing agent CAMBRIDGE INTEGRATED SERVICES for LEGION INSURANCE, in liquidation, CRAWFORD & COMPANY on behalf of ZURICH INSURANCE

This case involved an applicant claiming industrial injury to her shoulders and upper extremities. A prior insurer, Legion Insurance, erroneously paid benefits through its administrator, REM, before its insolvency. The Workers' Compensation Appeals Board denied reconsideration of the arbitrator's decision, which held Zurich Insurance (adjusted by Crawford & Company) liable for reimbursement to CIGA. This is because Zurich provided "other insurance" for a portion of the cumulative trauma injury, making it solely responsible for benefits where both an insolvent and solvent insurer would be liable. The Board found CIGA could recover pre-insolvency and mistaken payments, and Zurich's due process claims were unpersuasive.

CIGAZurich InsuranceCrawford & CompanyOak Tree Racing AssociationLegion InsuranceFremont Indemnitycumulative traumainsolvent insurersolvent insurerreimbursement
References
8
Case No. ADJ1034828
Regular
Jan 19, 2000

KELLY JOLLY vs. INPUT 1; CIGA administered by its servicing facility CAMBRIDGE INTEGRATED SERVICES GROUP, INC. for FREMONT COMPENSATION INSURANCE COMPANY; In liquidation; GRANITE STATE INSURANCE COMPANY, by AIG; STATE COMPENSATION INSURANCE FUND; AMERICAN SAFETY CASUALTY, by GALALGHER BASSETT

The Workers' Compensation Appeals Board denied reconsideration in this case. The Board adopted the arbitrator's report, which explained their prior holding. This holding established that CIGA is entitled to pre-litigation benefits from an insolvent carrier but must remit those proceeds to the insolvent carrier's trustee. Therefore, the petition for reconsideration was denied.

CIGAReconsideration DeniedInsolvent CarrierTrusteePre-litigation BenefitsLiquidated Insurance CompanyServicing FacilityWorkers' Compensation Appeals BoardArbitrator ReportAdjudication
References
0
Case No. ADJ244571 (VEN 0110022) ADJ3315572 (VEN 0110023) ADJ3817980 (OXN 0145232) ADJ2004405 (OXN 0145234) ADJ4239471 (OXN 0145235)
Regular
Jan 19, 2010

DIANA HARDMAN vs. COMMUNITY MEMORIAL HOSPITAL, AIG DOMESTIC CLAIMS, INC./CHARTIS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, BROADSPIRE, CALIFORNIA COMPENSATION INSURANCE COMPANY, FREMONT COMPENSATION INSURANCE COMPANY, American Home Assurance

This case involves five workers' compensation claims by applicant Diana Hardman against Community Memorial Hospital, with American Home Assurance (AIG) as a defendant insurer. AIG seeks reconsideration of the WCJ's findings, arguing it should only be liable for permanent disability directly arising from injuries covered by its policies, not those covered by insolvent insurers now handled by CIGA. The Appeals Board granted reconsideration, rescinded the WCJ's decisions, and returned the matter for further proceedings. Key issues include the admissibility of a deposition, the apportionment of permanent disability based on recent appellate decisions, and clarification of liability for injuries that occurred during periods covered by multiple insurers, including insolvent ones.

Workers' Compensation Appeals BoardDiana HardmanCommunity Memorial HospitalAIG Domestic ClaimsCalifornia Insurance Guarantee AssociationBroads PireCalifornia Compensation Insurance CompanyFremont Compensation Insurance CompanyOpinion and Order Granting ReconsiderationDecision After Reconsideration
References
8
Case No. ADJ 4359672 (VNO 0478019)
Regular
Apr 08, 2016

JORGE OROZCO vs. MARRIOTT DOWNTOWN LOS ANGELES/INTERSTATE HOTELS AND RESORTS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for AMERICAN PROTECTION INSURANCE COMPANY, ZURICH NORTH AMERICA, CENTURY PLAZA HOTEL

This case concerns the California Insurance Guarantee Association's (CIGA) liability for an insolvent insurer's obligations under a workers' compensation settlement. The applicant settled a cumulative trauma injury claim, and the settlement agreement apportioned liability for remaining lien claims among insurers, including American Protection Company. After American Protection Company became insolvent, CIGA stepped in, but sought dismissal, arguing its liability was not joint and several and no "other insurance" existed. The Board affirmed the dismissal of CIGA, holding that the original joint and several nature of the insurers' liability, as established by case law and the settlement, means Zurich North America's remaining liability constitutes "other insurance" relieving CIGA.

CIGAAmerican Protection Insurance CompanyMarriott Downtown Los AngelesInterstate Hotels and ResortsZurich North AmericaCentury Plaza HotelBroadspireSedgwick Claims Management ServicesCompromise and Release Agreementcumulative trauma
References
4
Case No. ADJ1643143 (SRO 0122410)
Regular
May 25, 2010

JUAN ESCUTIA vs. NICK LERAS WATER TRUCKS, et al.

The Workers' Compensation Appeals Board affirmed a prior decision holding the State Compensation Insurance Fund (SCIF) liable for reimbursement to the California Insurance Guarantee Association (CIGA). CIGA, adjusting claims for an insolvent insurer, sought reimbursement for various administrative expenses, including bill review, court reporter fees, and opposing counsel fees incurred while administering an injured worker's claim. The Board found these costs, particularly bill review expenses, were part of "incurred losses" under the California Workers' Compensation Uniform Statistical Reporting Plan and thus reimbursable. This decision establishes that CIGA can recover such administrative costs from a solvent insurer when adjusting claims for an insolvent carrier.

CIGASCIFBill ReviewIncurred LossesLoss Adjustment ExpensesInsurance Code Section 1063.1(c)(9)Labor Code Section 5500.5(e)California Workers' Compensation Uniform Statistical Reporting PlanReconsiderationFindings and Orders
References
7
Case No. MISSING
Regular Panel Decision

In re Headlee Management Corp.

This memorandum decision addresses a Chapter 7 trustee's motion to disgorge interim Chapter 11 professional fees. The trustee sought disgorgement due to the administrative insolvency of the Chapter 7 estate, which would prevent pro rata distribution to Chapter 11 administrative claimants if interim payments were retained. Chief United States Bankruptcy Judge Cecelia G. Morris denied the motion. The court concluded that the Bankruptcy Code, specifically §§ 726(b) and 330(a)(5), does not provide statutory authority to compel disgorgement of interim fees solely based on administrative insolvency upon conversion. It further determined that § 105(a) cannot be used to create such a remedy when the Code already provides specific provisions for fee recovery.

BankruptcyChapter 7Chapter 11Professional FeesDisgorgementAdministrative InsolvencyInterim FeesConverted CaseBankruptcy Code Section 726(b)Bankruptcy Code Section 330(a)(5)
References
25
Case No. MISSING
Regular Panel Decision

In re the Liquidation of Consolidated Mutual Insurance

The case concerns Arcade Cleaning Contractors, Inc.'s claim against the New York State Property and Liability Insurance Security Fund for reimbursement of a $1,500 payment made in a settlement. Arcade sought indemnification from its insolvent liability insurer, Consolidated Mutual Insurance Company, for a claim arising from an employee's injury. The Superintendent of Insurance determined that the Security Fund, established by Insurance Law § 334, does not cover an insured's claim against its insolvent liability insurer resulting from contractual or common-law liability to indemnify a third party for employee injury. The Supreme Court initially allowed Arcade's claim, but the Appellate Division reversed, upholding the Superintendent's determination. The Court of Appeals affirmed the Appellate Division's order, finding the Superintendent's interpretation to be neither contrary to statute nor unreasonable, given the exclusion of workers' compensation and employer's liability insurance (defined in Insurance Law § 46 subdivision 15) from the Security Fund's coverage.

Insurance LawWorkers' CompensationInsolvencySecurity FundIndemnificationThird-Party ClaimsStatutory InterpretationEmployer's LiabilityContractual LiabilitySuperintendent of Insurance Authority
References
15
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