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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

Pension Advisory Group, Ltd. v. COUNTRY LIFE INSURANCE COMPANY

Plaintiffs Pension Advisory Group, Ltd., Paul Hinson, and Larry Walters, along with Third Party Plaintiff Diversified Growth Solutions, sued Country Life Insurance Company and its Vice President, Dale Hall. The lawsuit stems from an alleged breach of confidentiality, theft of trade secrets related to an innovative insurance product developed by Hinson, unfair competition, libel, business disparagement, theft, and tortious interference with prospective contracts. Plaintiffs claim they disclosed trade secrets to Defendants under a mutual confidentiality agreement, only for Defendants to later assert ownership of the product information and file a protest with the USPTO, causing significant financial impact. The court partially granted and denied motions to dismiss for failure to state a claim and for a more definite statement, dismissed Plaintiffs' breach of contract claim against Hall, and denied motions to dismiss for lack of personal jurisdiction against Hall and to transfer venue. Multiple claims were ordered to be re-pled for greater specificity.

Intellectual PropertyTrade Secrets MisappropriationBreach of ContractUnfair CompetitionLibelBusiness DisparagementTortious InterferencePersonal JurisdictionMotion to DismissMotion to Transfer Venue
References
93
Case No. MISSING
Regular Panel Decision

Associated Indemnity Co. v. Hartford Accident & Indemnity Co.

Hartford Accident & Indemnity Company, a workmen's compensation insurer for a temporary labor contractor (Greene's Temporaries, Inc.), sued Associated Indemnity Company, the insurer for a customer (Frito-Lay Company), seeking subrogation for a compensation claim paid to an injured temporary employee. Hartford contended the loss was covered by Associated's policy as the employee was under Frito-Lay's control. The court reversed the trial court's decision in favor of Hartford, denying equitable subrogation. The appellate court found that Hartford had collected premiums for the temporary employees and was charged with knowledge of the contractual arrangement, thus preventing unjust enrichment if subrogation were granted.

Workmen's CompensationTemporary EmploymentSubrogationInsurance LawBorrowed Servant DoctrineRight of ControlEquitable RemediesUnjust EnrichmentInsurance PremiumsContractual Agreements
References
17
Case No. No. 14-CV-6449 (E.D.N.Y.)
Regular Panel Decision

AEI Life, LLC v. Lincoln Benefit Life Co.

This memorandum addresses whether a pending appeal in another circuit concerning a jurisdictional dismissal precludes the Eastern District of New York from exercising jurisdiction. The New Jersey District Court had previously dismissed an action by Lincoln Benefit Life Company (LBL) against AEI Life, LLC (AEI) for lack of subject matter jurisdiction, which LBL appealed. Subsequently, AEI initiated the current lawsuit in New York, seeking a declaration of policy validity and damages for alleged breach. The court concluded that the first-to-file rule is inapplicable here because the New Jersey court never secured jurisdiction. Additionally, a balance of convenience analysis favored New York as the appropriate venue, citing AEI's home forum, witness locations, and the locus of operative facts. Consequently, LBL's motion to dismiss or stay the action is denied, allowing the case to proceed in the Eastern District of New York.

JurisdictionSubject Matter JurisdictionPersonal JurisdictionFirst-to-File RuleFinal Judgment RuleChoice of LawVenueDiversity JurisdictionInsurance PolicySTOLI Scheme
References
36
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. 14-07-00880-CV
Regular Panel Decision
Apr 21, 2009

Symetra National Life Insurance Company and Symetra Life Insurance Company v. Rapid Settlements, LTD

Symetra National Life Insurance Co. and Symetra Life Insurance Co. appealed a trial court's confirmation of an arbitration award that directed them to make structured settlement payments to Rapid Settlements, Ltd., instead of the original payee, Paul Patterson. Symetra argued that the transfer lacked the required court approval under the Texas Structured Settlement Protection Act (SSPA) and violated public policy, while Rapid Settlements asserted it was not a 'transfer' under SSPA, federal law preempted SSPA, and Symetra lacked standing. The court rejected Rapid's arguments, emphasizing that the SSPA mandates court preapproval for structured settlement payment transfers to protect payees and their dependents. Consequently, the court held that the arbitration award violated Texas public policy by effectuating an unapproved transfer. The trial court's judgment was reversed, and the arbitration award was vacated.

Structured Settlement Protection Act (SSPA)Arbitration AwardPublic PolicyFederal Arbitration Act (FAA)PreemptionStandingGarnishmentTransfer of PaymentsAnnuity IssuerTexas Law
References
20
Case No. 03-07-00429-CV
Regular Panel Decision
Dec 12, 2008

Texas Health Insurance Risk Pool v. Southwest Service Life Insurance Company and Regal Life of America Insurance Company

Southwest Service Life Insurance Company and Regal Life of America Insurance Company (Appellees) brought a declaratory-judgment action against the Texas Health Insurance Risk Pool (Appellant) to challenge assessments levied against them, arguing their policies qualified as 'other limited benefit coverage' under the Texas Insurance Code. The trial court granted summary judgment in favor of the Appellees and awarded attorney's fees. The Pool appealed, contending the summary judgment was erroneous and the attorney's fee award should be reversed. The appellate court affirmed the trial court's judgment, holding that the policies issued by Southwest and Regal were indeed covered by the 'limited benefit coverage' exception, and thus the summary judgment and attorney's fee award were proper.

Insurance LawHealth InsuranceStatutory ConstructionDeclaratory JudgmentSummary JudgmentAttorney's FeesTexas Insurance CodeLimited Benefit CoverageHIPAAAdministrative Law
References
15
Case No. MISSING
Regular Panel Decision

Texas General Indemnity Co. v. Hearn

This workers' compensation case involves Margaret Ann Hearn (appellee) and Texas General Indemnity Company (appellant). Hearn alleged a work-related injury at Louisiana-Pacific and filed a claim for benefits under the Texas Workers’ Compensation Act. Texas General Indemnity Company, the workers' compensation insurer, contended that Hearn made an election of remedies by previously filing for and receiving medical and disability benefits from Louisiana-Pacific's group health carrier, Metropolitan Life Insurance Company, based on representations that her condition was not work-related. The trial court prevented the introduction of evidence regarding the election of remedies, and a jury returned a verdict in favor of Hearn. The appellant appealed, and the higher court reversed the judgment, remanding the case for a full trial on the merits, ruling that the exclusion of evidence regarding the election of remedies was an error.

election of remediesworkers' compensationevidentiary errorreversalremandgroup health benefitsjob-related injurynon-work related injuryappellate proceduretrial court error
References
9
Case No. ADJ147194 (LBO 0326325)
Regular
Sep 07, 2010

MIRTHA SHIMIZU vs. UNITED AIRLINES, GALLAGHER BASSETT

The Appeals Board granted reconsideration to address the defendant's contentions regarding Cost of Living Adjustments (COLAs) and the calculation of a life pension and attorney's fees. The Board affirmed the finding of 92% permanent disability but rescinded the previous award regarding COLAs, life pension, and attorney's fees. The matter was returned to the trial level for the Workers' Compensation Judge to calculate the specific amounts for the life pension and attorney's fees. Pending this finalization, the defendant was ordered to continue paying permanent disability indemnity.

Workers' Compensation Appeals BoardReconsiderationPermanent DisabilityLife PensionAttorney's FeesCOLALabor Code Section 4659Date of InjuryWCJDisability Evaluation Unit
References
2
Case No. MISSING
Regular Panel Decision

Spear, Leeds & Kellogg v. Central Life Assurance Co.

Plaintiff Spear, Leeds & Kellogg (SLK), a registered futures commission merchant and a member of the New York Stock Exchange, sought a preliminary injunction against three life insurance companies (Defendants) to prevent compulsory arbitration. Defendants had filed an arbitration demand with the NYSE, seeking recovery of monies they paid out on life insurance policies of a customer named Marvin Goodman. Defendants alleged that SLK either falsified account documents or knew of their falsification by Goodman, leading to their losses. SLK argued it had no transactional nexus with Defendants and thus no obligation to arbitrate under NYSE Constitution and Rules. The court found no valid arbitration agreement between the parties and granted SLK's motion for a preliminary injunction, enjoining Defendants from compelling arbitration. The court emphasized that arbitration is a creature of contract, and no such contract existed between SLK and the Defendant insurance companies.

ArbitrationPreliminary InjunctionNYSE RulesContract LawSecuritiesInsuranceDispute ResolutionNon-Member ArbitrationFinancial FraudFalsified Documents
References
9
Case No. 11 CV 1471
Regular Panel Decision

Martinez v. Bakery & Confectionery Union & Industry International Pension Fund

The case involves multiple plaintiffs, participants in the Bakery and Confectionery Union and Industry International Pension Fund Pension Plan, who challenged an amendment to the plan. This amendment eliminated the ability for participants no longer in covered employment to "age into" certain early retirement benefits (Plan C and Plan G). Plaintiffs alleged this violated Section 204(g) of ERISA, the anti-cutback rule, which protects accrued benefits. The Court, applying the standard for judgment on the pleadings, found that the Plan C and Plan G benefits are early retirement or retirement-type subsidies and thus accrued benefits under ERISA. Relying on statutory text and precedent like *Ahng v. Allsteel, Inc.*, the Court ruled that the amendment impermissibly cut back accrued benefits for those employees who had met the years of service requirement and could continue to age into their pension benefits even after separation from employment. Consequently, the Court granted the plaintiffs' motions for judgment on the pleadings and denied the defendants' motions.

ERISAPension PlanRetirement BenefitsAnti-cutback RuleEmployee BenefitsJudgment on the PleadingsDefined Benefit PlanEarly RetirementAccrued BenefitsPlan Amendment
References
24
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