CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. 2016 NY Slip Op 04185
Regular Panel Decision
Jun 01, 2016

Mecca Contracting, Inc. v. Scottsdale Insurance

Mecca Contracting, Inc., a general contractor, sought a declaratory judgment against Scottsdale Insurance Company after Scottsdale disclaimed coverage for an underlying personal injury action. Mecca, designated as an additional insured under a policy issued by Scottsdale to subcontractor Salcora Construction Corp., sought defense and indemnity, arguing the Scottsdale policy was primary. The Supreme Court granted summary judgment to Mecca, a decision affirmed by the Appellate Division, Second Department. The Appellate Division found Mecca was entitled to the declaration that Scottsdale was obligated to defend and indemnify it, and that the Scottsdale policy was primary, based on the contract between Mecca and Salcora and the 'Blanket Additional Insured Endorsement.' The matter was remitted to the Supreme Court, Kings County, for the entry of a formal judgment.

Insurance CoverageDeclaratory JudgmentAdditional Insured EndorsementPrimary CoverageGeneral Contractor LiabilitySubcontractor AgreementConstruction LawIndemnityDefense ObligationBreach of Contract
References
6
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. 03-17-0081-CV
Regular Panel Decision
Dec 29, 2017

PHI Air Medical, LLC v. Texas Mutual Insurance Company, Hartford Underwriters Insurance Company, TASB Risk Management Fund, Transportation Insurance Company, Truck Insurance Exchange, Twin City Fire Insurance Company, Valley Forge Insurance Company

This letter serves as a reply from Insurer Appellees Texas Mutual Insurance Company, et al. to the Third District Court of Appeals. It addresses arguments made by PHI Air Medical, LLC regarding the definition of the 'business of insurance' under the McCarran-Ferguson Act, particularly concerning payments made to third parties versus directly to insureds. The Insurers contend that PHI's proposed distinction lacks common sense and is contrary to established Supreme Court authority, citing cases such as U.S. Treasury v. Fabe. They argue that the actual performance of an insurance contract, including paying medical benefits to providers, is an essential part of the 'business of insurance' and that state laws prescribing contract terms directly regulate this business. The letter concludes by asserting that PHI’s arguments are inconsistent with both the practical workings of insurance and Supreme Court precedent.

McCarran-Ferguson ActBusiness of InsuranceThird-Party PaymentsInsurance Contract PerformanceWorkers' Compensation LawSupreme Court PrecedentAppellate ReviewTexas Workers' CompensationStatutory InterpretationInsurance Regulation
References
4
Case No. MISSING
Regular Panel Decision

GuideOne Specialty Insurance v. Admiral Insurance

This case involves an insurance coverage dispute where Weingarten Custom Homes (WCH) contracted with Torah Academy for construction, designating Torah Academy as an additional insured under WCH's liability policy with Admiral Insurance Company. The Admiral policy had lower coverage limits ($1,000,000) than required by the contract ($2,000,000/$5,000,000), with GuideOne Specialty Insurance Company providing secondary and excess coverage to Torah Academy. After a construction worker's injury led to a $1,225,000 settlement, Admiral paid $1,000,000, and GuideOne paid $225,000. GuideOne then sued Admiral to recover its payment, arguing that a letter signed by Admiral's claims superintendent effectively modified Admiral's policy to higher limits. The appellate court reversed the Supreme Court's decision, ruling that the letter did not constitute a valid policy endorsement and that the policy's unambiguous terms could not be altered by extrinsic evidence, thereby granting Admiral's motion to dismiss GuideOne's complaint.

Insurance Policy DisputeContract InterpretationLiability InsuranceAdditional InsuredPolicy LimitsMotion to DismissAppellate ReversalDocumentary EvidenceExtrinsic Evidence RulePolicy Amendment
References
12
Case No. 3-94-122-CV
Regular Panel Decision
Jan 18, 1995

Texas Workers' Compensation Insurance Facility v. State Board of Insurance, Aetna Casualty & Surety Company, Hartford Accident & Indemnity Company, Houston General Insurance Company, Liberty Mutual Fire Insurance Company, United States Fire Insurance Company

The Texas Workers' Compensation Insurance Facility (Facility) appealed a district court judgment that affirmed an order by the State Board of Insurance. The Board had ordered the Facility to indemnify several servicing companies for legal expenses incurred in litigation brought by Standard Financial Indemnity Company (SFIC). The Facility argued that Article 5.76-2, section 2.05(i) of the Texas Insurance Code, which states the Facility 'may not indemnify the servicing companies,' terminated the servicing companies' right to indemnification. The appellate court affirmed the trial court's judgment, holding that the servicing companies had a vested contractual right to indemnification which arose when they entered into servicing company agreements, and that section 2.05(i) could not be applied retroactively to impair these vested rights. The court found that the law existing at the time the contracts were made, which included the Facility's bylaws allowing for indemnification, was incorporated into the agreements.

Workers' CompensationInsurance LawContractual RightsVested RightsRetroactive Application of LawIndemnificationStatutory InterpretationAdministrative LawAppellate ReviewTexas Insurance Code
References
32
Case No. 03-04-00105-CV
Regular Panel Decision
Mar 03, 2006

Liberty Mutual Insurance Company, Liberty Mutual Fire Insurance Company, and Liberty Insurance Corporation v. Texas Department of Insurance and Jose Montemayor, as Commissioner of Insurance Amber, Inc., Champagne-Webber, Inc. Churchill Truck Lines, Inc. And Royal Seating Corp.

Liberty Mutual Insurance Company and its affiliates appealed a district court judgment requiring them to issue rebates to workers' compensation policyholders for 1991 and 1992 surpluses. The appellants argued that a rule from the Texas Department of Insurance, which mandated these pass-throughs, unconstitutionally impaired their contractual rights, deprived them of property without due process, and constituted an impermissible retroactive law. The appeals court affirmed the district court's decision, finding that the Department's rule was a valid exercise of legislative power, served a legitimate public purpose by preventing insurers from retaining unforeseen windfalls, and did not violate constitutional prohibitions regarding retroactive legislation, contract impairment, or due process rights.

Insurance LawWorkers' Compensation InsuranceRetrospective Rating PlanInsurance RegulationConstitutional ChallengesContractual ObligationsDue ProcessRetroactive LegislationAppellate Court DecisionTexas Department of Insurance
References
35
Case No. MISSING
Regular Panel Decision
Jun 18, 1992

Shelton Insurance Agency v. St. Paul Mercury Insurance Co.

This case involves an appeal by Shelton Insurance Agency and John M. Roberts against St. Paul Mercury Insurance Company regarding the alleged mishandling of an insurance claim. Shelton Agency initially sued St. Paul for violations of the DTPA, Texas Insurance Code, breach of contract, and breach of the duty of good faith and fair dealing after St. Paul denied coverage to its customer, Frio Drilling Company. A jury found in favor of Shelton Agency, awarding actual and exemplary damages, but the trial court granted St. Paul's motion for judgment n.o.v. The appellate court affirmed the trial court's judgment on the DTPA, insurance code, breach of good faith, and punitive damages claims. However, it reversed and rendered the judgment on the breach of contract claim, ruling that Shelton Agency was entitled to recover $34,000 for premiums it wrote off.

Insurance LawAgency LiabilityBreach of ContractGood Faith and Fair DealingDTPATexas Insurance CodeDenial of CoverageInsurance Bad FaithPunitive DamagesJudgment N.O.V.
References
30
Case No. 6:09-CV-853
Regular Panel Decision

Utica Mutual Insurance Co. v. Fireman's Fund Insurance Co.

This case details a dispute between Utica Mutual Insurance Company (Utica) and Fireman’s Fund Insurance Company (FFIC) concerning reinsurance contracts, with Utica seeking substantial damages for alleged breach of contract and bad faith. FFIC counterclaimed for rescission of the reinsurance agreements. A central contention revolves around whether Utica's primary liability policies issued to Goulds from 1966-1972 contained aggregate limits for bodily injury, a condition critical to triggering FFIC's reinsurance obligations. The court dismissed Utica's bad faith claim (Count II) and its request for declaratory relief (Count III) but denied all other motions for summary judgment by both parties, including those regarding the 'follow the settlement' doctrine, FFIC's rescission counterclaim, and the timeliness of notice. Consequently, the core breach of contract claim (Count I) and FFIC's counterclaims for rescission are slated to proceed to trial.

Reinsurance DisputeBreach of ContractSummary JudgmentFollow the Settlement DoctrineAggregate LimitsBad Faith ClaimRescissionNotice of ClaimInsurance LawAsbestos Claims
References
56
Case No. 03-15-00314-CV
Regular Panel Decision
Aug 07, 2015

California Insurance Guarantee Association, Oklahoma Property and Casualty Insurance Guaranty Association, and Texas Property and Casualty Insurance Guaranty Association v. Hill Brothers Transportation, Inc.

The appellants, California Insurance Guarantee Association (CIGA), Oklahoma Property and Casualty Insurance Guaranty Association (OPCIGA), and Texas Property and Casualty Insurance Guaranty Association (TPCIGA), collectively "Guaranty Associations," are appealing a summary judgment granted in favor of the appellee, Hill Brothers Transportation, Inc. ("Hill Bros."). The suit was filed on March 31, 2009, alleging Hill Bros. failed to reimburse the Guaranty Associations for payments of workers' compensation benefits and claim handling expenses within the deductible limits of a policy issued by the insolvent Legion Insurance Company ("Legion"). The District Court granted summary judgment to Hill Bros. based on the statute of limitations, ruling that the cause of action accrued on April 1, 2002. The Guaranty Associations argue that the accrual date is incorrect, as their statutory obligations had not been triggered, payments had not been made, and demand for reimbursement had not occurred by that date. They also contend that their compliance with Pennsylvania law (the "Pennsylvania Act") in seeking reimbursement through Legion in Liquidation constitutes a mitigating circumstance for any delay, making reasonableness a fact question. Furthermore, they assert the policy was a continuing contract, and the statute of limitations should not have accrued until full performance on April 28, 2009. Alternatively, they argue that claims for deductible payments made within four years of filing suit (March 31, 2005) are not barred.

Workers' CompensationInsurance Guaranty AssociationStatute of LimitationsBreach of ContractDeductible ReimbursementInsolvencyInsurance PolicyContinuing ContractPennsylvania ActTravis County
References
21
Case No. 03-04-00050-CV
Regular Panel Decision
Jul 29, 2004

Al Boenker Insurance Agency, Inc. v. the Texas FAIR Plan Association The Texas Department of Insurance And Jose Montemayor, Commissioner of Insurance

Appellant Al Boenker Insurance Agency, Inc. appealed a summary judgment ruling in favor of the Texas FAIR Plan Association (FAIR Plan). Al Boenker had challenged a bulletin issued by FAIR Plan, which restricted fees insurance agencies could charge for homeowners insurance applications and allowed for termination of agencies violating the contract. Al Boenker argued that FAIR Plan violated the separation-of-powers doctrine and exceeded its statutory authority. The Court of Appeals affirmed the district court's judgment, concluding that FAIR Plan is not a state agency subject to the Texas Administrative Procedure Act's rulemaking provisions and acted within its authority derived from the FAIR Plan Act and its Plan of Operation by contractually limiting agent compensation and establishing conditions for agent termination.

Administrative LawInsurance LawContract LawSummary JudgmentDeclaratory JudgmentInjunctionAgency AuthoritySeparation of PowersStatutory ConstructionTexas Court of Appeals
References
16
Showing 1-10 of 18,232 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational