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Case Law Database

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

Case No. MISSING
Regular Panel Decision
Dec 27, 2001

MacRo v. Independent Health Ass'n, Inc.

Plaintiffs Cheryl Macro and Kim Zastrow, insured under a group health contract with Independent Health through the Tonawanda City School District, initiated a class action in state court to challenge Independent Health's modification of infertility treatment coverage. Defendant Independent Health removed the case to federal court, asserting ERISA preemption. Plaintiffs moved to remand, arguing that their claims fell under New York Insurance Law, which is exempt from ERISA preemption by the saving clause, and that their health plan qualified as a 'governmental plan' also exempt from ERISA. The District Court granted the plaintiffs' motion, concluding that the claims were indeed saved from ERISA preemption and that the plan was exempt, thus rendering federal subject matter jurisdiction absent. The court accordingly remanded the case back to New York State Supreme Court.

Infertility CoverageHealth Insurance DisputesERISA PreemptionSaving ClauseGovernmental PlansRemoval to Federal CourtSubject Matter JurisdictionNew York Insurance LawClass Action LitigationEmployee Benefits Plan
References
31
Case No. ADJ1528926 (LBO 0378215)
Regular
Jul 02, 2012

DORIS SIMPSON vs. ORC MACRO, LIBERTY MUTUAL ORANGE

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award of back surgery for applicant Doris Simpson. The Board found the Agreed Medical Examiner's (AME) opinion regarding industrial causation for the surgery was inadequately explained. The case is returned to the trial level for further medical development, specifically to clarify whether the 2006 industrial injury contributed to the applicant's need for the surgery. The applicant has a history of prior lumbar surgeries and pre-existing degenerative conditions.

Workers' Compensation Appeals BoardDORIS SIMPSONORC MACROLIBERTY MUTUAL ORANGEADJ1528926LBO 0378215OPINION AND ORDER GRANTING RECONSIDERATIONDECISION AFTER RECONSIDERATIONPrimary Treating PhysicianDr. Mudiyam
References
2
Case No. MISSING
Regular Panel Decision

Baginski v. Queen Grand Realty, LLC

Plaintiff Mariusz Baginski was injured in a fall from a wooden plank while working as an asbestos remover. He and his wife commenced a consolidated action alleging common-law negligence and Labor Law violations against Queen Grand Realty, LLC (owner) and Manhattan Beer Distributors, LLC (lessee). Queen then commenced a third-party action against Milcon Construction Corp. (general contractor), who then brought a second third-party action against Macro Contracting Corp. (plaintiff's employer and subcontractor). The core issue revolved around a contractual indemnification provision in the agreement between Milcon and Macro, and its applicability under Workers' Compensation Law § 11. The Supreme Court's decision regarding summary judgment on contractual indemnification claims was appealed, leading to a modification of the original order. The appellate court found that summary judgment for contractual indemnification should have been granted to Queen against Macro, but properly denied for Manhattan against Macro.

Contractual IndemnificationThird-Party ActionWorkers' Compensation LawLabor LawSummary JudgmentConstruction AccidentScaffold FallStrict ConstructionEmployer LiabilitySubcontractor Agreement
References
10
Case No. MISSING
Regular Panel Decision
Apr 11, 2007

Macro Enterprises, Ltd. v. QBE Insurance

The Supreme Court, New York County, affirmed an order denying plaintiff's motion for summary judgment and granting defendant's cross motion for summary judgment. The court declared that the plaintiff is not entitled to defense and indemnity coverage in an underlying third-party action. The decision was based on the plaintiff's failure to notify the defendant insurer for over two years about an employee's injury at a construction site, which constituted noncompliance with a condition precedent to coverage and vitiated the insurance contract. The plaintiff's claimed belief of nonliability, premised on the Workers' Compensation Law, was deemed unreasonable under the circumstances.

Summary JudgmentInsurance CoverageLate NoticeCondition PrecedentWorkers' Compensation LawConstruction AccidentIndemnity CoverageDefense CoverageAppellate AffirmationContract Vitiation
References
2
Case No. MISSING
Regular Panel Decision

Amity Leather Products Co. v. RGA Accessories, Inc.

Amity Leather Products Co. moved to hold RGA Accessories, Inc. in civil contempt for violating a prior injunction that prohibited RGA from using Amity's product photographs for its own competing products. Amity alleged RGA used a photo of its 'Macro bag' to promote the 'Petite Valise' through their joint venture, Smithy Accessories. The court found clear and convincing evidence of the violation, noting identical markings on the products in photographs. It rejected RGA's defenses of diligence and shifting blame to its joint venture partner. The court granted Amity's motion, ordering RGA to account for and pay profits from sales to J.C. Penney, cease further use of the promotional material, and issue a disclaimer to all recipients.

Contempt of CourtInjunction ViolationLanham ActFalse AdvertisingJoint Venture LiabilityCivil ContemptUnjust EnrichmentCease and DesistDisclaimerPhotographic Evidence
References
7
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