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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

Long v. Liberty Mutual Insurance

A claimant, a member of the Buffalo Destroyers football team, was injured and filed a workers' compensation claim with Liberty Mutual Insurance Company. Liberty Mutual denied coverage, arguing the claimant was not an employee of its insured, Source One Group, and that the policy could not cover a New York entity. The Workers' Compensation Board initially found the claimant a dual employee, then a special employee of the Destroyers and a general employee of Source One, entitling him to coverage. The court determined that while the claimant was not a de facto employee of Source One, Liberty Mutual was estopped from denying coverage due to its conduct, including issuing a certificate of insurance and accepting premiums. Therefore, the court affirmed the Board's decision, holding Liberty Mutual responsible for the claimant's workers' compensation benefits.

Insurance Coverage DisputeEmployer LiabilityProfessional Employee OrganizationSpecial Employment DoctrineEstoppel in InsuranceAssigned-Risk Insurance PolicySports Athlete InjuryAppellate DecisionPayroll Audit DisputeCertificate of Insurance Validity
References
11
Case No. MISSING
Regular Panel Decision

Big Yank Corp. v. Liberty Mutual Fire Insurance (In Re Water Valley Finishing, Inc.)

This case is an appeal from an adversary proceeding in the United States Bankruptcy Court for the Southern District of New York. The Bankruptcy Court ruled that a Kentucky district court's award of sanctions against Big Yank Corporation, in the form of attorney's fees, was discharged in bankruptcy under 11 U.S.C. § 1141(d)(1). Liberty Mutual Fire Insurance Company, the appellant, challenged this ruling, arguing the claim did not arise until after the confirmation of Big Yank's reorganization plan. The District Court affirmed the Bankruptcy Court's decision, finding that the possibility of the sanctions claim was within the contemplation of the parties prior to the bankruptcy petition and plan confirmation, thus making it a pre-petition claim discharged by the plan.

Bankruptcy AppealSanctions DischargeAttorney's FeesChapter 11 ReorganizationClaim AccrualPre-petition ClaimContingent ClaimUnmatured ClaimBad Faith LitigationFederal Bankruptcy Law
References
20
Case No. MISSING
Regular Panel Decision
Jan 22, 2007

Liberty Mutual Insurance v. Insurance Co. of Pennsylvania

This case concerns an appeal regarding an insurance dispute between Liberty Mutual (excess insurer) and AIG (primary insurer) over a $1.5 million settlement payment in a personal injury action. The underlying action involved an employee of General Industrial Service Corporation, a subcontractor, suing the project's owner and construction manager under the Labor Law. AIG, General's primary insurer, had refused to participate in the defense or settlement. The Supreme Court's order, which limited plaintiff's recovery to $500,000, was modified on appeal. The appellate court increased AIG's potential liability limit to $1,000,000, pending a determination of whether the employee sustained a 'grave injury' under Workers' Compensation Law § 11. The court affirmed that AIG, as a primary insurer, must exhaust its coverage before Liberty's excess coverage is implicated and is not entitled to apportionment with the excess insurer.

Insurance Coverage DisputeExcess InsurancePrimary InsuranceIndemnificationSubrogationWorkers' Compensation LawGrave InjurySummary JudgmentPolicy LimitsApportionment of Liability
References
6
Case No. MISSING
Regular Panel Decision

Pellerin v. Nationwide Mutual Fire Insurance

Plaintiff Patrick Pellerin filed an action seeking a declaration that defendant Nationwide Mutual Fire Insurance Company is obligated to defend him and his son, Shawn Pellerin, in an underlying personal injury lawsuit. Nationwide moved for summary judgment, arguing the Pellerins failed to provide timely notice of the incident as required by their homeowner's insurance policy. The Pellerins cross-moved for summary judgment, asserting sufficient notice and the inapplicability of an intentional act exclusion. The court denied Nationwide's motion and granted the Pellerins' cross-motion, ruling that the notice given was reasonable as a matter of law and Nationwide failed to establish a genuine issue regarding the intentional act exclusion. Consequently, Nationwide was ordered to defend and indemnify the Pellerins in the underlying lawsuit.

Summary JudgmentInsurance CoverageNotice RequirementsIntentional Act ExclusionHomeowners PolicyDuty to DefendDuty to IndemnifyPersonal InjuryDeclaratory JudgmentNew York Law
References
7
Case No. CA 13-00513
Regular Panel Decision
May 09, 2014

DRYDEN MUTUAL INSURANCE COMPANY v. GOESSL, STANLEY

Plaintiff Dryden Mutual Insurance Company initiated an action seeking a declaration that it was not obligated to defend or indemnify Stanley Goessl in an underlying tort action, which arose from a fire during plumbing work. Defendants AP Daino & Plumbing, Inc. and its insurer, The Main Street America Group, also denied coverage for Goessl. The Supreme Court initially ruled in favor of Dryden Mutual and against Main Street America Group. However, the Appellate Division reversed this judgment, declaring that Dryden Mutual is obligated to defend and indemnify Goessl and reimburse his attorney's fees, based on his status as a sole proprietor insured by them. Conversely, The Main Street America Group was found to have no duty to defend or indemnify Goessl, as he was deemed an independent contractor, not an employee of AP Daino, according to their policy's plain meaning and their business arrangement. Sconiers, J., dissented, arguing that the trial court's finding of Goessl as an employee should have been upheld.

Insurance coverage disputeBusiness liabilityIndependent contractor classificationEmployee statusDuty to indemnifyDuty to defendSubcontracting agreementDeclaratory judgment actionAppellate review of judgmentContract interpretation
References
22
Case No. MISSING
Regular Panel Decision

Insurance Corp. of New York v. United States Fire Insurance

This case concerns a dispute between a primary insurer, The Insurance Corporation of New York, and an excess insurer, United States Fire Insurance Company (US Fire), regarding the timeliness of claim notice and US Fire's subsequent disclaimer. The motion court initially denied US Fire's cross-motion for summary judgment, deeming its disclaimer untimely. However, the appellate court determined that US Fire received proper notice on April 20, 2006, not March 16, 2006, making its disclaimers, issued eight days later, timely as a matter of law. Consequently, the appellate court reversed the lower court's decision, granting US Fire's cross-motion for summary judgment and dismissing the complaint against it. Additionally, an appeal from a separate order regarding US Fire's request to rescind an insurance policy was dismissed as abandoned.

Insurance PolicyExcess InsurancePrimary InsuranceTimely NoticeDisclaimer of CoverageSummary JudgmentAppellate ReviewClaim NotificationInsurance ContractLiability Insurance
References
9
Case No. ADJ3388315 (SBR 0294441) ADJ683842 (SBR 0340933)
Regular
Jul 22, 2014

Marvin Camacho vs. Western Metal Lathe, Sompo Japan Insurance Company, Broadspire, Remedy Temp, Reliance National, California Insurance Guarantee Association, Williams Furnace Company, St. Paul Fire & Marine, Kimco Staffing, Liberty Mutual Insurance

The Workers' Compensation Appeals Board denied Williams Furnace Company's petition for reconsideration and granted Sompo Japan Insurance Company's petition. The Board affirmed the original award for Marvin Camacho's neck and back injuries sustained while employed by Remedy Temp and Western Metal Lathe, as well as prior injuries to his cervical and lumbar spine from Williams Furnace Company. Issues of temporary total disability, additional attorney's fees, and other matters were deferred for further development at the trial level. Liberty Mutual Insurance, carrier for Kimco Staffing, was dismissed from the case.

WORKERS' COMPENSATION APPEALS BOARDWESTERN METAL LATHESOMPO JAPAN INSURANCE COMPANYBROADSPIREREMEDY TEMPRELIANCE NATIONALCALIFORNIA INSURANCE GUARANTEE ASSOCIATIONWILLIAMS FURNACE COMPANYST. PAUL FIRE & MARINEKIMCO STAFFING
References
0
Case No. 2017 NY Slip Op 04774 [151 AD3d 504]
Regular Panel Decision
Jun 13, 2017

Nationwide Mutual Insurance Co. v. U.S. Underwriters Insurance Co.

This case concerns an insurance coverage dispute where Nationwide Mutual Insurance Company and Artimus Construction Corp., Inc., as subrogees, sought coverage from U.S. Underwriters Insurance Company. The Appellate Division, First Department, affirmed the lower court's decision to dismiss the complaint. The court found that the plaintiffs were collaterally estopped from relitigating insurance coverage issues because these matters had been decided in a prior declaratory judgment action. The majority concluded that Nationwide's subrogor, Artimus, and Artimus's subrogor, Armadillo, had a full and fair opportunity to litigate the coverage issues previously. Furthermore, the court held that the doctrine of res judicata also barred the claims, applying a transactional analysis which dictates that all claims arising from the same transaction that could have been raised in prior litigation are precluded.

Insurance CoverageSubrogationCollateral EstoppelRes JudicataAppellate ReviewDeclaratory JudgmentPersonal Injury ActionEmployer Liability ExclusionLate Notice of ClaimPrivity
References
12
Case No. MISSING
Regular Panel Decision
Jan 13, 1995

National Union Fire Insurance Co. of Pittsburgh, PA v. State Insurance Fund

Plaintiff National Union Fire Insurance Company of Pittsburgh, PA (National Union) initiated a declaratory judgment action against The State Insurance Fund (SIF) to recover defense and settlement costs. These costs were expended on behalf of Regional Scaffolding and Hoisting Co., Inc., a mutually insured party in an underlying personal injury action. The Supreme Court initially denied National Union's motion for summary judgment and ruled in favor of SIF. However, the appellate court reversed this decision, concluding that the antisubrogation rule did not apply in this context. Consequently, it determined that National Union and SIF were co-insurers for Regional Scaffolding's common-law liability. The court granted National Union's motion for summary judgment in part, declaring SIF's duty to reimburse National Union for one-half of the reasonable settlement and defense costs, and remanded for a trial to ascertain these amounts.

Antisubrogation RuleDeclaratory JudgmentSummary JudgmentInsurance Coverage DisputeCo-Insurer LiabilityDefense Costs ReimbursementSettlement CostsEmployer's LiabilityComprehensive General LiabilityThird-Party Action
References
8
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
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