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

Case No. 03 Civ. 0332(AKH)
Regular Panel Decision
Oct 29, 2004

In Re September 11th Liability Insurance Coverage Cases

This opinion and order addresses two Rule 12(c) motions regarding insurance coverage for the World Trade Center properties following the September 11, 2001, attacks. The Port Authority of New York and New Jersey sought a declaration that it is an "Additional Insured" under Zurich American Insurance Company's policies, while World Trade Center Properties LLC (WTCP) sought a declaration that Zurich is obligated to cover defense costs. The court, presided over by District Judge Hellerstein, denied both motions. It found ambiguity in the binder regarding the Port Authority's "Additional Insured" status, stating that the issue was premature without further discovery. Furthermore, the court held that New York Insurance Regulation 107 does not require rewriting Zurich's binder and policies to include defense costs, considering the unique circumstances, the sophistication of the insured, and the fact that Zurich explicitly excluded defense costs, which Silverstein (WTCP's affiliate) accepted after failing to secure conventional coverage. The court also affirmed supplemental jurisdiction over the insurance claims due to their close relation to the underlying September 11th liability cases.

Insurance CoverageSeptember 11 AttacksWorld Trade CenterRule 12(c) MotionDeclaratory ReliefAdditional Insured StatusDefense CostsInsurance BinderNew York Insurance LawRegulation 107
References
48
Case No. MISSING
Regular Panel Decision

Oneida Ltd. v. Utica Mutual Insurance

Oneida Ltd., a self-insured employer, initiated a declaratory judgment action against its insurers, Utica Mutual and Republic Western, to determine liability for a substantial claim arising from a workplace accident involving the Ketchum brothers. The core dispute centered on whether Republic Western's excess workers' compensation policy, designed for self-insureds, was legally mandated to provide unlimited employer's liability coverage, or if its stated $1,000,000 limit was valid. Oneida Ltd. argued for the validity of the limit, which would then obligate Utica Mutual's $10,000,000 umbrella policy for the excess. Utica Mutual contended that employer's liability coverage must be unlimited in New York and that its policy disclaimed such coverage. The court ultimately sided with Oneida Ltd. and Republic Western, ruling that excess reinsurance policies for self-insured employers are not required to provide unlimited employer's liability coverage, thus upholding Republic Western's $1,000,000 limit. The court also found that Utica Mutual's policy did not effectively disclaim coverage, making it liable for amounts exceeding Republic Western's limit.

Insurance Policy DisputeDeclaratory ReliefEmployer Liability InsuranceExcess CoverageUmbrella LiabilitySelf-Insurance RegulationsInsurance Contract InterpretationThird-Party IndemnificationRegulatory Agency InterpretationSummary Judgment Motion
References
12
Case No. MISSING
Regular Panel Decision

Weiss v. Tri-State Consumer Insurance

This case involves an appeal concerning the amount of supplementary uninsured/underinsured motorist (SUM) coverage available under an insurance policy issued by Tri-State Consumer Insurance Company. The plaintiffs, daughters and administrators of the estates of Rifka and Anton Goldenberg who died in a car accident, sought $400,000 in SUM coverage. Tri-State contended the coverage was limited to $145,000, arguing that payments from the tortfeasor's insurer ($100,000) and a Dram Shop recovery ($255,000) reduced the $500,000 policy limit. The Supreme Court initially granted the plaintiffs' motion for $400,000 in coverage and denied Tri-State's cross-motion. However, the appellate court reversed this decision, ruling that the Dram Shop recovery, as damages from sources other than motor vehicle liability insurance, correctly reduced the SUM endorsement, thus limiting the available coverage to $145,000.

Supplementary Uninsured/Underinsured MotoristSUM CoverageInsurance Policy InterpretationDram Shop ActWrongful DeathSummary JudgmentAppellate ReviewInsurance LawContract LawAutomobile Insurance
References
8
Case No. W2015-00067-COA-R3-CV
Regular Panel Decision
Sep 21, 2015

Baxter Bailey Investments LLC v. APL Limited Inc.

Plaintiffs, a debt collection company and a motor carrier, sued defendant APL Limited Inc. in general sessions court to collect unpaid transportation and delivery charges. Defendant moved for summary judgment and sanctions, arguing it was not the proper defendant. Plaintiffs voluntarily nonsuited, but the general sessions court awarded defendant attorney's fees as sanctions. The circuit court affirmed the award, albeit modifying the amount. On appeal, the Court of Appeals reversed, holding that the general sessions court lacked the statutory and inherent authority to impose attorney's fees as sanctions, noting that the Tennessee Rules of Civil Procedure (including Rule 11) do not apply to general sessions courts, and the Tennessee Consumer Protection Act was not properly raised.

Appellate ProcedureSanctionsAttorney's FeesGeneral Sessions Court JurisdictionInherent Authority of CourtsAmerican RuleTennessee Consumer Protection ActLimited JurisdictionAbuse of Discretion StandardDe Novo Review
References
83
Case No. 2021 NY Slip Op 03990 [195 AD3d 536]
Regular Panel Decision
Jun 22, 2021

Bosquez v. RXR Realty LLC

The Appellate Division, First Department, affirmed two orders of the Supreme Court, New York County. The case involves an injured plaintiff, Jose Rodriguez Bosquez, who sued Hunter Roberts, RXR Pier 57, and Super P57 for negligence and Labor Law violations. The defendants, as third-party plaintiffs, sought contribution and common-law indemnification from Global Iron Works, Inc., the injured plaintiff's employer. Global moved to dismiss the third-party complaint, arguing that the claims were barred by the anti-subrogation rule because Global was covered under the same CCIP GL Tower policies as the third-party plaintiffs. The Supreme Court partially granted Global's motion, ruling that the anti-subrogation rule only applied to the extent of the common coverage provided by the Arch CGL Policy and Corridor Excess Policy, allowing claims to proceed once those policy limits were exhausted. The Appellate Division affirmed, noting that certain AIG Excess Policies contained an "Employer's Liability Exclusion Endorsement," which unambiguously excluded Global from coverage under those policies due to unlimited Workers' Compensation/Employer's Liability coverage, thus not implicating the anti-subrogation rule for those policies. The denial of Global's motion to renew was also affirmed.

Anti-subrogation ruleIndemnificationContributionCPLR 3211(a)(7)CPLR 3212Employer's Liability Exclusion EndorsementCommercial General LiabilityExcess Liability PolicyWorkers' CompensationGrave Injury
References
3
Case No. 14-04-00651-CV
Regular Panel Decision
Mar 08, 2007

Coastal Refining & Marketing, Inc., Coastal Offshore Insurance Limited, and Lexington Insurance Company v. United States Fidelity and Guaranty Company

This insurance coverage dispute centers on whether United States Fidelity and Guaranty Company (USF&G) had a duty to reimburse its insured, Coastal Refining & Marketing, Inc., and two other carriers, Coastal Offshore Insurance Limited and Lexington Insurance Company, for costs incurred in settling a personal injury lawsuit. USF&G moved for summary judgment, arguing late notice, settlement without consent, and failure to cooperate by its insured. The appellate court reversed the trial court's summary judgment, finding that USF&G failed to produce evidence of actual prejudice resulting from the insured's actions. The court clarified that for bodily injury and property damage claims, actual, not merely speculative, prejudice must be demonstrated to void coverage. The case was remanded for further proceedings consistent with this opinion.

Insurance CoverageSummary JudgmentPrejudice (Insurance Law)Late Notice (Insurance)Voluntary Payment ClauseDuty to Cooperate (Insurance)IndemnificationContract LawAppellate ReviewTexas Law
References
41
Case No. 03-10-00430-CV
Regular Panel Decision
Mar 15, 2012

Nucor Steel - Texas, a Division of Nucor Corporation v. Public Utility Commission of Texas, Oncor Electric Delivery Company and Texas Energy Future Holdings Limited Partnership

Texas Energy Future Holdings Partnership (Texas Energy) sought to acquire Oncor Electric Delivery Company (Oncor), a regulated electric utility. The Public Utility Commission (Commission) approved the acquisition, determining it was in the public interest, a decision upheld by the district court. Nucor Steel - Texas (Nucor) appealed, challenging the Commission's statutory interpretation regarding the scope of its public-interest analysis and its evidentiary rulings. Nucor argued the Commission improperly limited evidence to only direct effects on Oncor and that the decision lacked substantial evidence. The appellate court affirmed the district court's judgment, deferring to the Commission's reasonable interpretation of its authority in a deregulated electricity market and finding its evidentiary rulings and public-interest determination supported by substantial evidence.

Public Utility CommissionRegulatory AuthorityUtility AcquisitionPublic Interest AnalysisStatutory InterpretationDeregulation of Electricity MarketEvidentiary RulingsDue ProcessSubstantial EvidenceStipulation Agreement
References
35
Case No. MISSING
Regular Panel Decision

Liberty Mutual Fire Insurance Co. v. Richards

This appeal concerns a jury verdict against Liberty Mutual for breaching its duty of good faith and fair dealing to an insured whose worker's compensation benefits were terminated. The termination was deemed unreasonable as the supporting medical opinions were obtained after the decision to cease benefits was made, leading the jury to award substantial damages, including exemplary damages. The central legal issue revolved around the evolving application of the two-year statute of limitations for such claims in Texas, specifically as interpreted by the Texas Supreme Court in Robinson, Arnold, and Murray. Although a prior Supreme Court ruling (Arnold) supported the claimant's case, a subsequent ruling (Murray) modified the law, dictating that the statute of limitations begins at the denial of coverage, not the resolution of the underlying contract. Consequently, the intermediate appellate court, bound by the Murray decision, reversed the trial court's judgment, ruling the claimant's cause of action was barred by limitations.

Worker's CompensationInsurance Bad FaithDuty of Good Faith and Fair DealingStatute of LimitationsAccrual of Cause of ActionJudicial PrecedentRetroactive Application of LawAppellate ProcedureTexas LawExemplary Damages
References
4
Case No. M2021-00921-COA-R3-CV
Regular Panel Decision
Aug 05, 2022

Christopher McCoy v. Katelyn Conway

The plaintiff, Christopher McCoy, was injured in a car accident with an uninsured driver. He initially received $5,000 from his medical payments coverage from Allstate. After a jury awarded him $80,000 in compensatory damages, Allstate paid $45,000 under his uninsured motorist policy, asserting a $5,000 offset for the previous medical payment. McCoy sought to compel Allstate to pay the full $50,000 uninsured motorist limit without the offset, and the trial court agreed. On appeal, the Court of Appeals of Tennessee reversed the trial court's decision, ruling that Allstate was entitled to the $5,000 offset, consistent with Tennessee's limited coverage rule for uninsured motorist statutes and the insurance policy's non-duplication clause.

Motor Vehicle AccidentUninsured Motorist CoverageInsurance Policy InterpretationMedical Payments OffsetAppellate ReviewContractual LanguageStatutory InterpretationDuplication of BenefitsLimited Coverage RuleLegal Responsibility
References
22
Case No. MISSING
Regular Panel Decision
Jun 10, 2008

Preserver Ins. Co. v. Ryba

This case involves a dispute between two insurers, Preserver Insurance Company and Northern Assurance Company of America, regarding the scope of an employers' liability policy. The central issue was whether Preserver's employers' liability coverage for East Coast Stucco & Construction, Inc. was limited to $100,000 or was unlimited, particularly after a construction worker, Arthur Ryba, suffered a grave injury in New York. The Court of Appeals found that the policy, issued and delivered in New Jersey, was not "issued for delivery" in New York, thus Preserver was not subject to New York's timely disclaimer rule under Insurance Law § 3420 (d). The Court further concluded that the policy's clear terms limited the employers' liability coverage to $100,000 per accident, rejecting arguments that New York insurance manual provisions for unlimited coverage applied when New York was listed as an "Other States Insurance" (Item 3.C.) state without explicit notification and reclassification to an "Item 3.A." state. The Appellate Division's order was reversed, limiting Preserver's indemnification duty.

Workers' CompensationEmployers' LiabilityInsurance PolicyCoverage LimitsDisclaimer of CoverageNew York LawNew Jersey LawInter-insurer DisputeConstruction AccidentGrave Injury
References
2
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