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Case No. FRE 193678

Regular

Apr 11, 2008

JAMES GROVER vs. MVP HYDRATEC, INC., CLARENDON NATIONAL INSURANCE COMPANY, REMEDYTEMP, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, RELIANCE NATIONAL INDEMNITY CO.

This case concerns whether Clarendon Insurance, covering the special employer, constitutes "other insurance" under Insurance Code section 1063.1(c)(9), relieving CIGA of liability for an injured worker whose general employer's insurer is insolvent. The Appeals Board granted reconsideration, rescinded the prior award due to incomplete findings and an unclear record regarding the "other insurance" issue, and returned the case to the trial level. The Workers' Compensation Administrative Law Judge must clarify the evidence and make specific findings on general and special employment and whether Clarendon's policy qualifies as "other insurance" before issuing a new decision and award.

Workers' Compensation Appeals BoardCIGAMVP HydratecClarendon National Insurance CompanyRemedyTempgeneral employerspecial employerpermanent disabilityfuture medical treatmentjudicial notice

References

Case No. ADJ1976073

Regular

Nov 09, 2009

JAMES GROVER vs. MVP HYDRATEC, INC., CLARENDON NATIONAL INSURANCE COMPANY, administered by F. A. RICHARDS and ASSOCIATES, REMEDYTEMP, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION by INTERCARE INSURANCE SERVICES for RELIANCE NATIONAL INDEMNITY CO., in liquidation

The WCJ erred in making CIGA liable; Clarendon is "other insurance" available to applicant within the meaning of Insurance Code section 1063.1(c)(9) and liable for workers' compensation benefits.

California Insurance Guarantee AssociationCIGAgeneral employerspecial employerother insuranceReliance National Indemnity CompanyClarendon National Insurance CompanyInsurance Code section 1063.1(c)(9)covered claimsinsolvency

References

Case No. No. 47

Regular Panel Decision

Nov 20, 2017

Michael J. Carlson, Sr. v. American International Group, Inc.

A jury awarded Michael Carlson $20 million following his wife's death in an accident involving an MVP truck driven by William Porter. The Appellate Division later reduced the judgment and dismissed claims against DHL. Carlson then sued DHL's insurers, National Union and AAIC, under Insurance Law § 3420, arguing the MVP vehicle qualified as a "hired auto" and that the policies were "issued or delivered" in New York. While the Supreme Court initially allowed the claims, the Appellate Division reversed both, finding no "hired auto" coverage and that the policies were not "issued or delivered" in New York. The Court of Appeals reinstated Carlson's claims against the insurers, holding that the "hired auto" issue presented a question of fact and that "issued or delivered" in Insurance Law § 3420 applies to policies covering insureds and risks within New York. The court, however, affirmed the dismissal of Carlson's other claims for fraud, bad faith, General Business Law violations, and conspiracy.

Insurance CoverageHired AutoInsurance Policy InterpretationRespondeat SuperiorIndependent ContractorVehicle and Traffic LawInsurance Law § 3420Automobile AccidentLiability InsurancePersonal Injury

References

Case No. ADJ19417386

Regular

Mar 17, 2025

LOURDES AVILA vs. PRIORITY WORKFORCE, MVP PAYROLL FINANCING, LLC, SUNZ INSURANCE COMPANY

The Workers' Compensation Appeals Board denied the defendant's Petition for Removal regarding a WCJ's order to replace a Qualified Medical Evaluator (QME) panel. The defendant argued that their due process rights were violated and that they were entitled to an additional strike due to an initial double strike of a QME. The Board found that removal is an extraordinary remedy, and the petitioner failed to demonstrate substantial prejudice or irreparable harm. They upheld the WCJ's decision, emphasizing that the subsequent strikes by both parties were untimely and the order to obtain a replacement panel did not determine substantive rights.

Removal PetitionPanel StrikesQualified Medical EvaluatorIrreparable AmbiguityDue ProcessMailbox RuleTimelinessLabor Code Section 4062.2(c)Agreed Medical EvaluatorAlvarado v. WCAB

References

Case No. ADJ15799667

Regular

Mar 08, 2023

RICARDA DURAN SONIA TINEO TOLEDO vs. PRIORITY WORKFORCE, INC. dba MVP PAYROLL FINANCING LLC, PRIORITY BUSINESS SERVICES INC., UNITED WISCONSIN INSURANCE COMPANY administered by NEXT LEVEL ADMINISTRATORS

This case involves an applicant injured by a car while waiting for a ride home on her employer's premises after work. The Workers' Compensation Appeals Board (WCAB) granted reconsideration and found the injury compensable, holding that it arose out of and occurred in the course of employment (AOE/COE). The Board clarified that the applicant's presence on employer premises while waiting for transportation home was within the scope of employment, not a material deviation. The WCAB rescinded the prior order and substituted a new one finding AOE/COE injury to the applicant's head, deferring other issues.

AOE/COECourse and Scope of EmploymentGoing and Coming RulePremises RulePersonal ConvenienceSubstantial DeviationMedical OpinionsPermanent Disability RatingQMEAMA Guides

References

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JAMES GROVER vs. MVP HYDRATEC, INC., CLARENDON NATIONAL INSURANCE COMPANY, REMEDYTEMP, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, RELIANCE NATIONAL INDEMNITY CO.

Workers' Compensation Appeals BoardCIGAMVP HydratecClarendon National Insurance CompanyRemedyTempgeneral employerspecial employerpermanent disabilityfuture medical treatmentjudicial notice

JAMES GROVER vs. MVP HYDRATEC, INC., CLARENDON NATIONAL INSURANCE COMPANY, administered by F. A. RICHARDS and ASSOCIATES, REMEDYTEMP, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION by INTERCARE INSURANCE SERVICES for RELIANCE NATIONAL INDEMNITY CO., in liquidation

The WCJ erred in making CIGA liable; Clarendon is "other insurance" available to applicant within the meaning of Insurance Code section 1063.1(c)(9) and liable for workers' compensation benefits.

Michael J. Carlson, Sr. v. American International Group, Inc.

Insurance CoverageHired AutoInsurance Policy InterpretationRespondeat SuperiorIndependent ContractorVehicle and Traffic LawInsurance Law § 3420Automobile AccidentLiability InsurancePersonal Injury

LOURDES AVILA vs. PRIORITY WORKFORCE, MVP PAYROLL FINANCING, LLC, SUNZ INSURANCE COMPANY

Removal PetitionPanel StrikesQualified Medical EvaluatorIrreparable AmbiguityDue ProcessMailbox RuleTimelinessLabor Code Section 4062.2(c)Agreed Medical EvaluatorAlvarado v. WCAB

RICARDA DURAN SONIA TINEO TOLEDO vs. PRIORITY WORKFORCE, INC. dba MVP PAYROLL FINANCING LLC, PRIORITY BUSINESS SERVICES INC., UNITED WISCONSIN INSURANCE COMPANY administered by NEXT LEVEL ADMINISTRATORS

AOE/COECourse and Scope of EmploymentGoing and Coming RulePremises RulePersonal ConvenienceSubstantial DeviationMedical OpinionsPermanent Disability RatingQMEAMA Guides