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

Case No. 2-07-133-CV
Regular Panel Decision
Mar 06, 2008

Mark Rotella Custom Homes, Inc. D/B/A Benchmark Custom Homes and Mark David Rotella v. Joan Cutting

This case involves an appeal by Mark Rotella Custom Homes, Inc. d/b/a Benchmark Custom Homes and Mark David Rotella (Appellants) against Joan Cutting (Appellee). Appellants challenged the trial court's decision to grant summary judgment and deny their motion for a new trial, primarily arguing a lack of proper notice. The Court of Appeals, Second District of Texas, affirmed the trial court's judgment, concluding that evidence of selective refusal of service established constructive notice. The court also upheld Mark Rotella's joint and several liability, citing his personal guarantee in the construction contract and his liability for tortious acts as an agent. Appellants' claim regarding a lack of fraudulent intent was overruled due to insufficient briefing.

Summary JudgmentMotion for New TrialNotice RequirementsDue ProcessConstructive NoticeService of ProcessJoint and Several LiabilityCorporate Agent LiabilityFraudulent IntentAppellate Review
References
26
Case No. MISSING
Regular Panel Decision

Catania v. Hartford Accident & Indemnity Co.

This case involves a submitted controversy under sections 546 to 548 of the Civil Practice Act, concerning whether a liability policy issued to John Schiro extends coverage to the plaintiff for injuries sustained by Schiro's wife. Schiro's wife alleged negligence against her spouse in the operation of his vehicle during his employment with the plaintiff. The court analyzed Insurance Law section 167 (subd. 3), which states that policies do not cover liability for spousal injuries unless expressly provided. Citing Morgan v. Greater New York Taxpayers Mut. Ins. Assn., the court treated the policy as if issued to the plaintiff alone, determining that Schiro's wife is not the plaintiff's spouse, thus making section 167 (subd. 3) inapplicable. The decision, supported by Manhattan Cas. Co. v. Cholakis, concluded that the insurer is liable. Therefore, judgment was granted in favor of the plaintiff, requiring the defendant to defend the pending negligence action and pay any judgment up to the policy limits.

Liability PolicyInsurance CoverageSpousal LiabilityCivil Practice ActInsurance LawNegligenceDeclaratory JudgmentAutomobile AccidentEmployer LiabilityInterspousal Immunity
References
2
Case No. MISSING
Regular Panel Decision

American Home Assurance Co. v. McDonald

This declaratory judgment action involves American Home Assurance Company seeking to limit its liability under professional liability policies issued to social workers Rory M. McDonald and Helene Ina Anisfeld, who are defendants in an underlying malpractice action brought by Randy Kamhi. Kamhi alleges sexual misconduct and professional negligence against McDonald, and vicarious liability and direct negligence against Anisfeld as McDonald's partner. American Home sought summary judgment to limit indemnification to $25,000 for sexual misconduct claims and punitive damages. The court granted summary judgment in part, affirming the $25,000 limit for McDonald's sexual misconduct and for punitive damages for both McDonald and Anisfeld. However, the court denied the request to terminate American Home's duty to defend McDonald upon exhausting the $25,000 limit and granted Kamhi's cross-motion to stay further summary judgment applications until discovery in the underlying action is complete. Crucially, the court found that extending the sexual misconduct coverage limit to non-sexual malpractice claims violates New York public policy.

Professional Liability InsuranceSexual MisconductInsurance Coverage DisputeDeclaratory JudgmentSummary Judgment MotionPublic Policy ArgumentTherapist MalpracticeDuty to DefendDuty to IndemnifyUnconscionability Claim
References
22
Case No. MISSING
Regular Panel Decision

Custom Transit, L.P., Richway Cartage, Inc., and Custom Operations, LLC v. Flatrolled Steel, Inc.

Flatrolled Steel Inc. sued Custom Transit, L.P., Custom Operations, LLC, and Richway Cartage, Inc., for breach of contract, negligence, and conversion related to damaged and lost steel coils. A jury found Custom Transit liable for breach of contract and conversion, and Custom Transit and Richway liable for negligence and gross negligence. The trial court entered a final judgment on July 9, 2010, allowing Flatrolled to recover contract damages from Custom Transit and actual and exemplary damages from Richway. On appeal, the court affirmed the trial court's judgment regarding contract damages and attorney's fees against Custom Transit and Custom Operations. However, the appellate court reversed the judgment for actual and exemplary damages against Richway, rendering a take-nothing judgment for Flatrolled against Richway, finding insufficient evidence to establish a duty of care for a negligent activity claim.

Contract LawNegligenceGross NegligenceConversionBreach of ContractEconomic Loss RuleAccord and SatisfactionProperty Owner RuleExpert TestimonySufficiency of Evidence
References
47
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. 2-07-226-CV
Regular Panel Decision
Jan 31, 2008

Mark Rotella, Individually, and Mark Rotella Custom Homes, Inc., D/B/A Benchmark Custom Homes v. Dozier Cabinet Works, Inc.

Appellants Mark Rotella, individually, and Mark Rotella Custom Homes, Inc., d/b/a Benchmark Custom Homes, appealed a trial court's default judgment in favor of Dozier Cabinet Works, Inc. Appellants contended that the trial court abused its discretion by denying their motion for new trial, arguing they failed to set up a meritorious defense. The court found that mere allegations of beliefs or legal conclusions were insufficient for a meritorious defense. Appellants also argued that the trial court erred in holding Rotella vicariously liable under the Texas Property Code, claiming no contract existed in the record. However, the default judgment stated that the trial court heard evidence and found Rotella personally liable under Chapter 162 of the Texas Property Code. The appellants failed to provide a reporter's record to show error in the trial court's judgment. Therefore, the appellate court affirmed the trial court's judgment.

Default JudgmentMotion for New TrialAbuse of DiscretionMeritorious DefenseVicarious LiabilityTexas Property CodeConstruction Trust FundsAppellate ReviewReporter's Record BurdenCivil Procedure
References
7
Case No. MISSING
Regular Panel Decision

Capps v. American Mutual Liability Insurance Co.

Archie Capps appealed a take-nothing judgment, arguing that American Mutual Liability Insurance Company improperly deducted both worker's compensation and social security benefits from his disability insurance payments. Capps, disabled in 1972, received disability policy payments from 1973 and a lump-sum worker's compensation settlement in 1974, which included attorney's fees. He also received monthly social security benefits. The court affirmed the judgment, holding that the insurance policy's anti-duplication clause permitted the deduction of both worker's compensation and social security payments. Furthermore, the court found that attorney's fees awarded in the worker's compensation case were part of the total amounts payable and were properly deducted, and that the calculation of payments was correct.

AppealDisability InsuranceWorker's CompensationSocial Security BenefitsAnti-duplication ClauseAttorney's FeesLump-sum SettlementBenefit DeductionsPolicy InterpretationInsurance Law
References
2
Case No. 2024 NY Slip Op 00832 [224 AD3d 1052]
Regular Panel Decision
Feb 15, 2024

Matter of Singh v. Atlas NY Constr. Corp.

Sukhwinder Singh, a claimant, was injured while working for Atlas NY Construction Corporation, a subcontractor on a construction project. National Liability & Fire Insurance Company (NLF) denied liability for the claim, asserting it had canceled its workers' compensation policy for nonpayment of premiums prior to the accident. Initially, a Workers' Compensation Law Judge ruled in favor of NLF, placing liability on the general contractor. However, the Workers' Compensation Board modified this decision, concluding there was insufficient evidence of proper policy cancellation by NLF. The Appellate Division, Third Department, affirmed the Board's decision, reiterating that carriers must strictly comply with Workers' Compensation Law § 54 (5) for policy cancellation and that the Board's credibility determinations, when supported by substantial evidence, are not to be disturbed. The court found NLF failed to meet its burden of establishing proper cancellation.

Workers' Compensation Policy CancellationInsurance Coverage DisputeNotice RequirementsStrict ComplianceNonpayment of PremiumsWorkers' Compensation Board DecisionAppellate ReviewCredibility DeterminationsSubstantial EvidenceBurden of Proof
References
9
Case No. MISSING
Regular Panel Decision

United States Liability Ins. v. Mountain Valley Indemnity Co.

This diversity action involves an insurance dispute between plaintiffs United States Liability Insurance Co. (U.S. Liability) and Mobile Air Transport, Inc., and defendant Mountain Valley Indemnity Co. The conflict arose from a fatal truck accident involving a Mobile Air employee driving a truck leased from Leroy Holding Company, Inc. After an underlying personal injury action settled, U.S. Liability and Mountain Valley each paid $225,000 towards the remaining $450,000 portion of the settlement. The core disagreement is whether the Truck Lease Agreement, which designates Mobile Air's insurance as primary, or the specific 'other insurance' clauses within U.S. Liability's and Mountain Valley's respective policies, which would make Mountain Valley's coverage primary, should govern. Applying New York law, the court ruled that the insurance policy provisions take precedence over the lease agreement. Consequently, U.S. Liability's motion for summary judgment was granted, and Mountain Valley's cross-motion was denied, holding Mountain Valley liable for the entire $450,000 in dispute.

Insurance DisputePrimary vs Excess CoverageTruck Lease AgreementInsurance Policy InterpretationSummary JudgmentNew York LawDiversity JurisdictionIndemnificationSubrogationAutomobile Accident
References
5
Case No. CV-22-2011
Regular Panel Decision
Feb 15, 2024

In the Matter of the Claim of Sukhwinder Singh

Claimant Sukhwinder Singh was injured while working for Atlas NY Construction Corporation. National Liability & Fire Insurance Company (NLF) denied liability, asserting it had canceled its workers' compensation policy for nonpayment of premiums prior to the accident. A Workers' Compensation Law Judge (WCLJ) initially found NLF's cancellation effective, placing liability on the general contractor. However, the Workers' Compensation Board modified this, ruling NLF failed to prove proper cancellation and was the liable carrier. NLF appealed this decision. The Appellate Division affirmed the Board's decision, emphasizing the requirement for strict compliance with Workers' Compensation Law § 54 (5) regarding policy cancellation notice and deferring to the Board's credibility determinations.

Policy CancellationInsurance LiabilityNonpayment of PremiumsStrict ComplianceNotice RequirementsCertified MailReturn Receipt RequestedBurden of ProofCredibility DeterminationsAppellate Review
References
9
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