Updated Daily

Case Law Database

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

Case No. 2018 NY Slip Op 07432 [166 AD3d 621]

Regular Panel Decision

Nov 07, 2018

Matter of Progressive Advanced Ins. Co. v. New York City Tr. Auth.

This case involves an appeal by Progressive Advanced Insurance Company (Progressive) against the New York City Transit Authority (NYCTA) concerning an arbitration award. The dispute arose under Insurance Law § 5105 regarding a loss transfer claim, where NYCTA sought reimbursement from Progressive for workers' compensation benefits paid to its employee after a collision involving Progressive's insured. The central issue was whether a 20% no-fault offset applied to the workers' compensation wages, with the arbitrator ruling it did not, as a one-third offset had already been applied. Progressive's petition to vacate the award was denied by the Supreme Court, Queens County. The Appellate Division affirmed this denial, concluding that the arbitrator's determination was supported by a reasonable hypothesis and was not arbitrary or capricious.

Arbitration AwardLoss TransferInsurance LawWorkers' Compensation BenefitsNo-Fault OffsetAppellate ReviewStatutory InterpretationEvidentiary SupportArbitrary and CapriciousReasonable Hypothesis

References

Case No. MISSING

Regular Panel Decision

Progressive Casualty Insurance v. New York State Insurance Fund

Zimone Brown, a sanitation worker insured by the New York State Insurance Fund (NYSIF), was injured after being struck by an automobile insured by Progressive Casualty Insurance Company (Progressive). The NYSIF sought reimbursement of workers’ compensation benefits from Progressive through arbitration, citing Insurance Law § 5105. Progressive contended that the garbage truck was not 'involved' in the accident as statutorily required. Although the arbitration panel sided with NYSIF, the Supreme Court denied Progressive's petition to vacate the award. This appellate court reversed the Supreme Court's decision, finding no evidentiary support or rational basis for the arbitrators' determination, thus granting Progressive's petition and vacating the arbitration award.

Arbitration Award VacaturInsurance LawWorkers' Compensation BenefitsLoss Transfer ProvisionsStatutory InterpretationMotor Vehicle AccidentEvidentiary SupportArbitrary and CapriciousJudicial ScrutinyCPLR Article 75

References

Case No. MISSING

Regular Panel Decision

Jan 27, 1965

Rivera v. Hellman

This case involves a motion to confirm a Special Referee's report concerning the amounts and priorities of various liens. The Special Referee conducted a hearing and reported on claims from an attorney for the plaintiff ($793.50), Roosevelt Hospital ($846.53), and the Millinery Health Fund ($641.00, later adjusted to $528). The report established the amounts of each lien and recommended priorities, placing the attorney's lien first, followed by the hospital lien (except for a $12 outpatient service), and then the compensation lien. The court concurred with the Special Referee's report and recommendations, granting the motion to confirm.

Lien PriorityAttorney's LienHospital LienDisability BenefitsWorkmen's Compensation LawSpecial Referee ReportMotion GrantedNew York Supreme CourtLien LawMotion Practice

References

Case No. MISSING

Regular Panel Decision

Colindres v. Carpenito

Plaintiff Rochelle Colindres sought a protective order to deny defendants' demand for a medical report from her former treating psychologist, Diane Henry, or alternatively, relief from compliance with Uniform Rules for Trial Courts § 202.17(b)(1). Colindres argued that the defendants waived their right to the report as the independent medical examination (IME) already occurred, and that obtaining the report would be an undue hardship since Henry ceased treatment due to Colindres' attendance issues. Defendants Mario Carpenito, Jr., City of White Plains, and White Plains Parking Department opposed, asserting that the report was necessary to clarify alleged injuries, prepare for cross-examination, and facilitate settlement, highlighting Colindres' complex medical history predating the incident. The court denied both branches of Colindres' motion, finding that the rule applies broadly to personal injury actions, defendants did not waive their entitlement, and Colindres failed to prove it was impossible to obtain the report. The court ordered Colindres to exchange a compliant medical report from Diane Henry by March 27, 2017.

protective ordermedical report disclosurediscovery disputepsychological treatmentindependent medical examinationCPLR 310322 NYCRR 202.17waiver of discoveryundue hardshippersonal injury damages

References

Case No. MISSING

Regular Panel Decision

Chaplin v. Pathmark Supermarkets

This case addresses a motion by defendants, including Supermarkets General Corp., for a protective order to vacate the plaintiff Mimi Chaplin's notice for discovery and inspection of accident reports. Mimi Chaplin sought these reports after sustaining personal injuries from a fall at the defendant's premises. The court, presided over by Justice James F. Niehoff, analyzed the newly enacted CPLR 3101 (g), which mandates full disclosure of accident reports prepared in the regular course of business. The court found that the accident report in question was prepared in Supermarkets General Corp.'s regular course of business, rendering it discoverable regardless of its potential use in litigation, thus denying the defendants' motion.

DiscoveryProtective OrderAccident ReportsCPLR 3101(g)Litigation PreparationRegular Course of BusinessPersonal InjuryNegligenceDisclosureEvidence

References

Case No. SAL SJO 252436 (MF); SJO 246192

Regular

Jul 02, 2007

NIHAL HORDAGODA vs. State Compensation Insurance Fund

This case involves an employer's petition for reconsideration of an order authorizing medical treatment and admitting the Qualified Medical Examiner's (QME) reports. The employer argued the QME reports were inadmissible due to an alleged ex parte communication between the applicant and the QME, and that the awarded treatments were improper. The report recommends denying the petition, finding the communication was permissible under LC § 4062.3(h) and that the QME's opinions and awarded treatments for chronic pain were reasonable and not governed by ACOEM guidelines.

Workers' Compensation Appeals BoardPetition for ReconsiderationQualified Medical EvaluatorLabor Code Section 4062.3Ophthalmological evaluationFunctional capacity evaluationUtilization ReviewACOEM GuidelinesChronic spinal conditionTreating physician

References

Case No. MISSING

Regular Panel Decision

Progressive Transportation Services, Inc. v. County of Essex

Progressive Transportation Services, Inc. sued Essex County, James Pierce, and Clifford Donaldson, asserting a 42 U.S.C. § 1983 civil rights claim for First Amendment retaliation and a state law claim for breach of contract. Progressive claimed the County retaliated against it by rejecting bids and withholding funds after Progressive combined transportation routes for efficiency, arguing this was a matter of public concern regarding taxpayer money and fuel usage. The Court determined that Progressive's speech, made in the context of contract negotiations to secure payment, was primarily an issue of economic self-interest and not a matter of public concern protected by the First Amendment. Consequently, the Court granted the defendants' motion for summary judgment, dismissing the federal claim with prejudice. The state law breach of contract claim was dismissed without prejudice, as the court declined to exercise supplemental jurisdiction after the dismissal of the federal claim.

42 U.S.C. Section 1983Civil RightsBreach of ContractFirst Amendment RetaliationSummary JudgmentGovernment ContractsFreedom of SpeechPublic Concern DoctrineSupplemental JurisdictionGovernmental Waste

References

Case No. MISSING

Regular Panel Decision

Progressive Northern Insurance Co. v. Sentry Insurance A Mutual Co.

Progressive Northern Insurance Company initiated an arbitration against Sentry Insurance A Mutual Company to recover first-party benefits paid to its insured following an automobile accident. After an initial arbitration claim (priority-of-payment) was denied, Progressive commenced a second arbitration based on a loss-transfer claim for the same reimbursement. Sentry raised the affirmative defense of res judicata, which the arbitrator upheld, denying Progressive's claim. Progressive then petitioned the Supreme Court, Nassau County, to vacate this arbitration award, but the petition was denied. The appellate court affirmed the Supreme Court's order, ruling that the arbitrator properly exercised its authority in applying res judicata, as both claims arose from the same transaction despite different legal theories.

Res JudicataArbitration Award VacaturInsurance ReimbursementAutomobile Accident ClaimLoss Transfer ClaimPriority-of-Payment ClaimAppellate ReviewSupreme Court NassauCPLR Article 75Arbitration Forum

References

Case No. MISSING

Regular Panel Decision

Garden State Anesthesia Associates, PA v. Progressive Casualty Insurance

Garden State Anesthesia Associates (GSAA) sued Progressive Casualty Insurance Company for unpaid first-party no-fault benefits after providing services to Angela Gowan-Walker. Progressive delayed payment, citing the need for Gowan-Walker's examination under oath (EUO) and extensive medical and workers' compensation records. Although Gowan-Walker completed her EUO, Progressive continued to issue delay letters, requesting information primarily from third parties and Gowan-Walker's attorney, without directly contacting GSAA for verification. The court denied Progressive's motion for summary judgment, ruling that an insurer cannot indefinitely toll the 30-day payment period by requesting verification unrelated to the specific provider's claim or by failing to request verification directly from the provider.

No-fault benefitsSummary JudgmentInsurance LawVerification RequestDelay LetterEUOMedical RecordsInsurance ClaimsTimelinessTolling

References

Case No. MISSING

Regular Panel Decision

Aug 14, 2013

Chiari v. New York Racing Ass'n

Plaintiff Luis Alberto Chiari filed an action against the New York Racing Association (NYRA) and Local Union 3, I.B.E.W., alleging violations of COBRA, ADA, and LMRA stemming from his employment termination. Magistrate Judge A. Kathleen Tomlinson issued a Report and Recommendation, advising that the defendants' motions for summary judgment be granted and all of the plaintiff's claims be dismissed. District Judge Feuerstein reviewed the plaintiff's objections to this report. Finding the objections to be either reiterations of prior arguments or insufficiently specific, and discerning no clear error in the Magistrate Judge's findings, the Court adopted the Report and Recommendation in its entirety, thereby granting summary judgment to the defendants and dismissing all of Chiari's claims with prejudice.

Employment LawDiscriminationSummary JudgmentCOBRA ViolationsADA ClaimsLMRA ClaimsBreach of Collective Bargaining AgreementDuty of Fair RepresentationPro Se PlaintiffTermination

References

Showing 1-10 of 5,083 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.

Updated Daily

Case Law Database

Chiari v. New York Racing Ass'n

Employment LawDiscriminationSummary JudgmentCOBRA ViolationsADA ClaimsLMRA ClaimsBreach of Collective Bargaining AgreementDuty of Fair RepresentationPro Se PlaintiffTermination

References

Showing 1-10 of 5,083 results

Ready to streamline your practice?

Apply these legal strategies instantly. CompFox helps you find decisions, analyze reports, and draft pleadings in minutes.