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

Case No. 2014 NY Slip Op 06377
Regular Panel Decision
Sep 25, 2014

National Union Fire Ins. Co. of Pittsburgh, PA v. 221-223 W. 82 Owners Corp.

The Appellate Division, First Department, reversed a Supreme Court order, granting National Union Fire Insurance Company's motion for summary judgment against JRP Contracting, Inc. The court declared that National Union had no duty to defend or indemnify JRP in an underlying personal injury action. National Union successfully argued that the plaintiff's alleged injuries (ligament and meniscal tears) were not "grave injuries" under Workers' Compensation Law § 11. Additionally, National Union's policy contained an exclusion for "liability assumed under a contract," further absolving it from the contractual indemnification claim. JRP's claim of prejudice due to National Union's withdrawal from defense was also rejected, as National Union had expressly reserved its rights.

Summary JudgmentGrave InjuryWorkers' Compensation LawDuty to DefendDuty to IndemnifyInsurance Policy ExclusionContractual IndemnificationPersonal InjuryAppellate Review
References
4
Case No. MISSING
Regular Panel Decision

NECA Ins., Ltd. v. National Union Fire Ins. Co.

Plaintiff NIL Insurance Ltd., a reinsurance company, initiated a diversity action against National Union Fire Insurance Co. and Buchanan Management Company. NIL sought recovery for moneys paid in connection with a personal injury settlement by National Union and punitive damages, alleging negligence, bad faith, and breach of contract related to settlement discussions and payment. National Union and Buchanan moved to compel arbitration of these claims. The court granted National Union's motion, finding that the reinsurance agreement's arbitration clause broadly covered all disputes, including those concerning negligence and recklessness, which could be established within arbitration. The action was dismissed without prejudice, pending the outcome of the arbitration.

ReinsuranceArbitration ClauseContract InterpretationNegligence ClaimsBad FaithBreach of ContractSettlement DisputesFederal JurisdictionMotion to Compel ArbitrationDismissal Without Prejudice
References
6
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. MISSING
Regular Panel Decision

National Union Fire Insurance Co. v. Valdez

This original mandamus action, brought by National Union Fire Insurance Co., challenges a trial court's order compelling the production of its attorney's entire litigation files from a prior, related workers' compensation case. Jimmy Ray Haynes, the injured employee, had prevailed in the compensation case and subsequently filed a bad faith insurance claim against National Union. In the bad faith case, Haynes sought discovery of all records from National Union's former law firm, Hirsch, Glover, Robinson & Sheiness, related to the compensation case. National Union objected, asserting attorney-client and work-product privileges. The Supreme Court of Texas held that a request for an attorney's entire file is objectionable under the work-product exemption because it inherently reveals the attorney's mental processes and trial strategy. The Court further determined that National Union had not waived its privileges through offensive use, as it was not seeking affirmative relief and had removed reliance on its attorney's testimony. Consequently, the Supreme Court conditionally granted the writ of mandamus, directing the trial court to vacate its order for file production.

MandamusDiscoveryAttorney Work ProductAttorney-Client PrivilegeBad Faith InsuranceWorkers' Compensation LawPrivilege WaiverTrial StrategyLitigation FilesSubpoena Duces Tecum
References
11
Case No. 01-19-00852-CV
Regular Panel Decision
Sep 21, 2021

National Union Fire Insurance Company of Pittsburgh, PA v. Exxon Mobil Corporation

This case involves two related appeals concerning insurance coverage for bodily injury claims against Exxon Mobil Corporation by its contractor's employees, Kevin Roberts and Arturo Munoz. National Union Fire Insurance Company of Pittsburgh, Pa. challenged a trial court's summary judgment in favor of Exxon and Starr Indemnity and Liability Insurance Company, arguing its umbrella policy did not provide coverage beyond its CGL policy, as dictated by the Exxon-Savage Contract. Exxon also challenged a summary judgment favoring Starr. The appeals court reversed the judgment against National Union, finding that 'Commercial General Liability insurance' in the contract referred only to primary coverage, not umbrella or excess policies. Consequently, Exxon was not entitled to coverage under National Union's umbrella policy. The court affirmed the summary judgment in favor of Starr, as its bumbershoot policy was also considered an umbrella policy. The case was remanded for reconsideration of attorney's fees and costs.

Insurance Policy InterpretationCommercial General LiabilityUmbrella Liability InsuranceExcess Liability InsuranceAdditional Insured EndorsementSummary Judgment ReviewBreach of ContractDeclaratory JudgmentAppellate ProcedurePersonal Injury Claims
References
34
Case No. MISSING
Regular Panel Decision

McKinney v. National Union Fire Insurance Co. of Pittsburgh

Doris McKinney filed a workers' compensation claim against Weber Aircraft's insurer, National Union Fire Insurance Company, alleging an occupational disease. The Industrial Accident Board awarded McKinney, but National Union filed a suit in District Court. A jury found McKinney did not sustain an occupational injury, leading to a take-nothing judgment, which the court of appeals affirmed. The Supreme Court granted a rehearing and substituted its previous opinion. The central issue was the admission of testimony from Todd Miller, an undisclosed fact witness called by National Union, despite McKinney's objection regarding discovery requests. The Court determined that National Union, under the then-applicable Peeples rule, had the burden to request a hearing on its discovery objection and failed to do so. However, the Court concluded that the admission of Miller's testimony, even if erroneous, was cumulative and therefore not reversible error, ultimately affirming the judgment of the court of appeals.

Workers' CompensationDiscovery AbuseUndisclosed Witness TestimonyReversible Error AnalysisTexas Civil ProcedureAppellate JurisdictionObjection PreservationBurden of Requesting HearingCumulative EvidenceMotion for Rehearing
References
12
Case No. 2014-2225 K C
Regular Panel Decision
Oct 27, 2017

Acupuncture Approach, P.C. v. NY Cent. Mut. Fire Ins. Co.

This case concerns an appeal from an order of the Civil Court of the City of New York, Kings County, relating to assigned first-party no-fault benefits. Acupuncture Approach, P.C., as assignee, sought to recover sums from NY Central Mutual Fire Ins. Co. The defendant moved for summary judgment, arguing timely payment according to the workers' compensation fee schedule for some claims, and lack of medical necessity for others. The plaintiff cross-moved for summary judgment. The Appellate Term modified the Civil Court's order, denying the defendant's motion for summary judgment on claims totaling $3,495, $2,695, and $1,965, due to the defendant's failure to demonstrate timely denial. The Appellate Term affirmed the reduction of the amount in controversy for other claims and the denial of the plaintiff's cross-motion.

No-Fault BenefitsSummary JudgmentAppellate ReviewInsurance ClaimsWorkers' Compensation Fee ScheduleMedical NecessityTimely DenialCivil Court OrderAssignee ClaimsPreclusion
References
4
Case No. 2015-2415 K C
Regular Panel Decision
May 18, 2018

Valdan Acupuncture, P.C. v. NY Cent. Mut. Fire Ins. Co.

In an action by Valdan Acupuncture, P.C., as assignee of Daequan Woods, to recover assigned first-party no-fault benefits, the defendant, NY Central Mutual Fire Ins. Co., moved for summary judgment. The Civil Court denied parts of the defendant's motion. On appeal, the Appellate Term, Second Department, reversed the Civil Court's order in part. The appellate court granted the defendant's motion for summary judgment regarding a $883.80 claim, confirming the assignor's failure to appear for independent medical examinations (IMEs) and proper mailing of IME scheduling letters. However, for other claims, the IME no-show defense was deemed not preserved, leading to a remittal of those remaining branches of the motion to the Civil Court for a new determination based on alternative grounds. The decision was reversed in part, with a partial grant of summary judgment to the defendant and remittal for further proceedings.

No-fault benefitsIndependent Medical Examination (IME)Summary judgmentAppellate reviewAssignor's failure to appearDenial of benefitsMedical claimsCivil CourtKings CountyInsurance dispute
References
3
Case No. MISSING
Regular Panel Decision

National Union Fire Insurance Co. of Pittsburgh v. Ninth Court of Appeals

In this original mandamus proceeding, National Union Fire Insurance Company sought relief from an order of the Ninth Court of Appeals that had withdrawn an extension of time for filing an electronic statement of facts in an underlying workers’ compensation appeal involving Floyd Smith. The Texas Supreme Court found that the Ninth Court of Appeals abused its discretion by misapplying the legal standard for a "reasonably explaining" the need for an extension under the Texas Rules of Appellate Procedure. The Court determined that National's confusion regarding special electronic recording rules for Liberty County constituted a reasonable explanation. Concluding that National lacked an adequate remedy at law, the Supreme Court conditionally granted the writ of mandamus, instructing the Ninth Court of Appeals to allow the filing of the electronic statement of facts.

MandamusAppellate ProcedureExtension of TimeStatement of FactsElectronic Recording RulesAbuse of DiscretionReasonable ExplanationWorkers' Compensation AppealTexas Rules of Appellate ProcedureJudicial Discretion
References
5
Case No. MISSING
Regular Panel Decision
Jul 26, 1990

National Union Fire Insurance Co. v. Wyar

Dennis K. Wyar, the appellee, initially won a worker's compensation award from the Industrial Accident Board. Appellant National Union Fire Insurance Company sued to overturn this award. The trial court granted Wyar a directed verdict on liability and awarded damages based on a jury verdict. On appeal, National challenged the sufficiency of Wyar's pleadings, the exclusion of witnesses (Wyar and Diane Johnson), the refusal to withdraw deemed admissions, and the sufficiency of evidence for the directed verdict and jury award of medical expenses. The appellate court sustained National's points regarding the exclusion of Wyar's testimony and the right to an offset for payments already made, leading to a reduction in the benefits awarded to Wyar. The court also sustained Wyar's cross-point for post-judgment interest and reformed the judgment accordingly.

Workers' CompensationWitness ExclusionDeemed AdmissionsMedical ExpensesPost-Judgment InterestOffsetDirected VerdictJury VerdictPleading SufficiencyAppellate Review
References
17
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