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

Case No. ADJ12096808
Regular
2020-01-33

LARRY REASNER vs. CASEY JOHNSON, dba ROCKIN CJ TRANSPORT COMMERCE & INDUSTRY INSURANCE COMPANY, AIG; NEW YORK MARINE AND GENERAL INSURANCE COMPANY

This case concerns a Petition for Removal filed by Commerce and Industry Insurance Company regarding an order to proceed to trial on an injury AOE/COE. The dispute arises from a prior Stipulated Award between the applicant and New York Marine and General Insurance Company for a cumulative trauma injury. Commerce and Industry argues that its contribution claim against New York Marine is subject to mandatory arbitration under Labor Code section 5500.5. The Appeals Board granted removal, rescinded the trial order, and found that the inter-insurer dispute over contribution must be arbitrated, as the applicant is not involved in this separate proceeding.

Petition for RemovalStipulated AwardCumulative TraumaPetition for ContributionMandatory ArbitrationLabor Code Section 5500.5Successive EmployersInsurers Jointly and Severally LiableContribution ProceedingsDe Novo
References
4
Case No. MISSING
Regular Panel Decision

Stellar Mechanical Services of New York, Inc. v. Merchants Insurance of New Hampshire

This case involves an appeal concerning an insurance dispute over the duty to defend and indemnify. The plaintiff, Stellar Mechanical Services of New York, Inc., sought a declaratory judgment against Merchants Insurance of New Hampshire, claiming primary insurer obligations in an underlying personal injury action. Stellar, insured by American Empire Surplus Lines Insurance Company, had subcontracted duct work to Serge Duct Design, which was insured by Merchants. Serge was obligated to name Stellar as an additional insured. After a worker's injury and subsequent lawsuit, Merchants disclaimed coverage. The appellate court modified the lower court's order, ruling that Merchants is obligated as the primary insurer to defend Stellar from the time the second amended complaint was served, but not to indemnify Stellar. The case was remitted to the Supreme Court, Queens County, for an assessment of costs incurred by American Empire Surplus Lines Insurance Company.

Insurance CoverageAdditional Insured StatusDuty to DefendDuty to IndemnifyPrimary InsurerExcess InsurerSummary JudgmentContract LawSubcontract AgreementPersonal Injury Action
References
13
Case No. MISSING
Regular Panel Decision

New York Insurance Association, Inc. v. State of New York

The New York Insurance Association, Inc. and several insurance companies challenged assessment fees levied by the Department of Financial Services (DFS) and its predecessor, arguing the inclusion of 'sub-allocated programs' costs and the transfer of unused assessment funds to the State's general fund were unconstitutional. Plaintiffs contended these were unauthorized taxes and constituted a taking of private property. The appellate court affirmed the dismissal of the complaint, ruling that the inclusion of sub-allocated program costs was statutorily mandated and not arbitrary. It also found that the relevant law did not unlawfully delegate taxing power and that the assessments were regulatory fees, not taxes, thus constitutional provisions were inapplicable. Furthermore, the court determined that the insurers' right to a refund or credit had not vested before the statutes authorizing the transfers were enacted, negating the takings claims.

Insurance AssessmentsRegulatory FeesState BudgetFiscal PolicyConstitutional LawTaxation PowerTakings ClauseProperty RightsDepartment of Financial ServicesNew York State
References
43
Case No. MISSING
Regular Panel Decision
Dec 22, 1992

Aetna Casualty & Surety Co. v. Greater New York Mutual Insurance

This case involves an appeal concerning an insurer's claim for contribution. Aetna Casualty & Surety Company, the liability insurer for Trio Drug Corporation and additional insured 58 Realopp Corporation, sought contribution from Greater New York Mutual Insurance Company, Trio's workers' compensation carrier. Aetna had settled an underlying injury action where it represented both Realopp and Trio, and subsequently sued for 50% of the settlement amount. The Supreme Court affirmed the denial of Aetna's summary judgment motion and the granting of Greater New York's cross-motion for summary judgment. The appellate court applied the anti-subrogation rule, finding that Aetna could not assert a subrogated claim against its own insured, Trio, due to potential conflicts of interest arising from its dual representation in the underlying action.

anti-subrogation ruleconflict of interestsummary judgmentcontributionworkers' compensationliability insurancethird-party claimcommon law indemnityappellate reviewinsurer dispute
References
3
Case No. CA 11-00156
Regular Panel Decision
Jun 17, 2011

MERCHANTS MUTUAL INSURANCE COMPANY v. NEW YORK STATE INSURANCE FUND

Plaintiff, Merchants Mutual Insurance Company, initiated an action against New York State Insurance Fund to recover funds related to an underlying wrongful death lawsuit. The core issue was the defendant's obligation to indemnify Jerrick Waterproofing Co., Inc. for a construction accident. The Supreme Court granted summary judgment to the plaintiff, which the defendant appealed. The Appellate Division, Fourth Judicial Department, affirmed the lower court's decision, ruling that the defendant was indeed obligated to provide unlimited coverage to Jerrick Waterproofing, despite a policy exclusion, as a common-law right to indemnity existed. Consequently, the plaintiff's excess coverage was not triggered.

Insurance disputeWorkers' CompensationIndemnificationExcess coverageSummary judgmentAppellate reviewNew York lawEmployer liabilityPolicy exclusionCommon-law indemnity
References
4
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. 96
Regular Panel Decision
Oct 24, 2017

American Economy Insurance Company v. State of New York

The New York Court of Appeals examined the constitutionality of a 2013 amendment to Workers' Compensation Law § 25-a, which closed the Special Fund for Reopened Cases to new applications. Plaintiff insurance companies argued this imposed unfunded liabilities for policies finalized before the amendment, violating constitutional clauses. The Appellate Division had found the amendment unconstitutional as retroactively applied. However, the Court of Appeals reversed, concluding that even assuming a retroactive impact, it was constitutionally permissible under the Contract, Takings, and Due Process Clauses. The court found the amendment did not impair contracts, identify a vested property interest, or violate due process, as its retroactive application served a rational legislative purpose to benefit New York businesses.

Workers' CompensationInsurance LawRetroactive LegislationContract ClauseTakings ClauseDue ProcessSpecial Fund for Reopened CasesConstitutional LawLegislative AmendmentPolicy Liability
References
45
Case No. MISSING
Regular Panel Decision

Serio v. Ardra Insurance

The Supreme Court, New York County, affirmed a judgment in favor of Gregory V. Serio, Superintendent of Insurance of the State of New York, as Liquidator of Nassau Insurance Company, against the DiLoreto defendants. The trial court's decision to pierce the corporate veil of Ardra Insurance Company, controlled from New York by Richard DiLoreto, was upheld based on New York law, despite Ardra's Bermuda incorporation. The court rejected the defendants' equitable estoppel claim, asserting that governmental agencies can alter positions in governmental functions. Furthermore, the evidence supported the jury's finding that transactions between Ardra and Nassau Insurance Company were unfair and inequitable, as the DiLoretos diverted funds, thereby denying Nassau coverage. The appellate court found the verdict consistent with the evidence and noted the defendants waived their claim regarding the jury's composition by consent.

Corporate Veil PiercingReinsuranceEquitable EstoppelGovernmental FunctionInsurance LawJury VerdictAppellate ReviewUnfair TransactionsCorporate DebtNew York Law
References
12
Case No. MISSING
Regular Panel Decision
May 01, 1981

State v. New Hampshire Merchants Insurance

This case involves cross-appeals concerning insurance coverage for a State employee, David L. Sinnamon, after an accident. The Attorney-General defended Sinnamon when New Hampshire Merchants Insurance Company, Inc. and Travelers Indemnity Company both refused to provide coverage, despite a prior ruling establishing their respective primary and secondary duties to defend. The State then commenced an action seeking reimbursement for legal fees incurred. Initially, summary judgment was granted against Merchants but dismissed against Travelers due to perceived lack of contractual privity. The appellate court modified this decision, concluding that both insurers breached their independent duty to defend Sinnamon, thus granting summary judgment on liability against both companies and remanding for a damages hearing.

Insurance CoverageDuty to DefendSummary JudgmentCross AppealsReimbursement of Legal FeesPublic Officers LawState Employee DefenseBreach of ContractAppellate ReviewDeclaratory Judgment
References
3
Case No. MISSING
Regular Panel Decision

Lang v. FIRST AMERICAN TITLE INS. CO. OF NEW YORK

Plaintiffs Cliff and Betsy Lang filed a putative class action against First American Title Insurance Company of New York, alleging violations of the Real Estate Settlement Procedures Act (RESPA) and New York General Business Law § 349. The plaintiffs claimed they were overcharged for title insurance during a mortgage refinancing, as they did not receive a discounted rate they believed they were entitled to under state law. Defendant moved to dismiss the RESPA claim, arguing that RESPA § 8(b) does not provide a private right of action for 'overcharges'. The court granted the motion to dismiss the RESPA claim, finding that RESPA § 8(b) prohibits fees for unperformed services or splits, not simply excessive charges. Consequently, the court declined to exercise supplemental jurisdiction over the remaining state law claims, dismissing them without prejudice.

RESPATitle InsuranceMortgage RefinancingOvercharge ClaimsMotion to DismissFederal CourtState LawSupplemental JurisdictionStatutory InterpretationPleading Standards
References
31
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