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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

Seemann v. Sterling Insurance

Plaintiff Seemann, while at work in New Jersey, injured a co-worker with a paintball. Four months later, advised by the co-worker's attorney, Seemann notified Sterling Insurance, his homeowner's insurer in Schoharie County. Sterling Insurance disclaimed coverage due to delayed notice. The Supreme Court found Seemann's belief of no coverage justifiable and his delay reasonable, obligating Sterling Insurance to defend and pay. The Appellate Division affirmed, concluding that Seemann's good-faith belief that his homeowner's policy did not cover an off-premises incident was reasonable, and he acted diligently upon receiving the attorney's letter, thereby providing a reasonable excuse for the delay in notice.

Homeowner's InsuranceCoverage DisputeNotice RequirementsGood-Faith BeliefOff-Premises InjuryDeclaratory JudgmentAppellate ReviewReasonableness of DelayInsurance Policy InterpretationPaintball Incident
References
3
Case No. MISSING
Regular Panel Decision
Jul 19, 2012

Lewis v. East Ramapo Central School District

This case concerns an appeal by the East Ramapo Central School District against an order that granted a petitioner leave to serve a late notice of claim. The Supreme Court, Appellate Division, reversed the lower court's decision, denying the petition and dismissing the proceeding. The court considered four factors for granting leave: actual knowledge of the claim by the school district, the petitioner's infancy and its nexus to the delay, a reasonable excuse for the delay, and substantial prejudice to the school district. The petitioner failed to provide a reasonable excuse for the 15-month delay after reaching the age of majority and did not demonstrate that the school district had timely actual knowledge of the claim or that it would not be substantially prejudiced by the three-year-and-eight-month delay.

Late Notice of ClaimGeneral Municipal Law § 50-e(5)School District LiabilityNegligent SupervisionInfancy ExcuseActual Knowledge RequirementSubstantial PrejudiceAppellate DivisionAssault in SchoolTimeliness of Claim
References
17
Case No. 2015 NY Slip Op 00361 [124 AD3d 636]
Regular Panel Decision
Jan 14, 2015

Williams v. Jamaica Hospital Medical Center

The infant plaintiff alleged personal injuries resulting from a delayed transport by the City of New York's Emergency Medical Service during his mother's labor. Approximately four years after the alleged negligence, the plaintiff served a notice of claim and moved to have it deemed timely or for leave to serve a late notice. The Supreme Court granted the plaintiff's motion and denied the City's cross-motion to dismiss. The Appellate Division, Second Department, reversed this order, finding that the City did not acquire actual knowledge of the essential facts of the claim within the statutory 90-day period or a reasonable time thereafter. The court further determined that the plaintiff's delay substantially prejudiced the City's ability to defend the action and that the plaintiff failed to provide a reasonable excuse for the significant delay, noting that infancy alone without a demonstrated nexus to the delay was insufficient.

Late Notice of ClaimGeneral Municipal LawActual Knowledge RequirementPrejudice to MunicipalityReasonable Excuse for DelayInfancyPersonal InjuryMedical Malpractice AllegationAppellate ReviewMunicipal Negligence
References
13
Case No. MISSING
Regular Panel Decision

Furtado v. Mario's Bakery

In this action, the plaintiff appealed an order from the Supreme Court, Suffolk County, which denied her motion for judicial approval of a compromise of a third-party personal injury claim under Workers’ Compensation Law § 29 (5). The appellate court affirmed the denial, noting an excessive delay of over three years between the compromise and the application for approval, the absence of a reasonable explanation for this delay, and the resulting prejudice to the workers’ compensation carrier. The court held that the Supreme Court providently exercised its discretion in denying the motion, as judicial approval beyond the statutory three-month period requires demonstrating reasonableness, lack of fault for the delay, and no prejudice to the carrier, none of which were adequately met by the plaintiff.

Workers' Compensation LawJudicial ApprovalThird-Party ClaimCompromise SettlementMotion DenialAppellate ReviewDiscretionary PowerInordinate DelayPrejudice to CarrierPersonal Injury Damages
References
11
Case No. ADJ2786953 (ANA 0317684), ADJ3789377 (ANA 0393014), ADJ3880205 (ANA 0317683), ADJ808964 (ANA 0317682)
Regular
Oct 04, 2011

OSCAR ORTEGA vs. DATA ANALYSIS; CHARTIS INSURANCE COMPANY

The Workers' Compensation Appeals Board granted the defendant's petition for reconsideration regarding a penalty award. The Board rescinded the prior award, finding the Administrative Law Judge erred in applying penalty provisions and attorney fees without sufficient findings on unreasonable delay and a proper consideration of relevant factors. The case is returned to the trial level for further proceedings to determine the reasonableness of the delay and the appropriate penalty amount, with a requirement for the WCJ to explain their reasoning. Any claims for attorney fees should be properly submitted with supporting documentation.

WCABIndustrial InjuryPenaltyLabor Code Section 5814Labor Code Section 5814.5Petition for ReconsiderationAmended Findings and AwardCompromise & ReleaseSelf-Imposed PenaltyUnreasonable Delay
References
4
Case No. ADJ1974548 (SJO 0083025)
Regular
Jan 13, 2012

CHARLES ABERNATHY vs. WHITWOOD BAPTIST CHURCH, FARMERS WESTLAKE VILLAGE

The Workers' Compensation Appeals Board denied the defendant's petition for reconsideration of an attorney fee award. The administrative law judge ordered the defendant to pay $112,948.00 in attorney fees for enforcing a medical treatment award that the defendant had unreasonably delayed. The Board found the fee reasonable based on the attorney's experience and the necessity of the services, clarifying that Labor Code section 5814.5 awards reasonable fees to compensate for costs incurred due to unreasonable delay, not as punitive damages. Therefore, the defendant was liable for the attorney's fees.

Workers' Compensation Appeals BoardAttorney Fee OrderLabor Code Section 5814.5Unreasonable DelayMedical Treatment AwardPetition for ReconsiderationWCJ Report and RecommendationCertified SpecialistReasonable Hourly RateEnforcing Award
References
1
Case No. MISSING
Regular Panel Decision

O'Halloran v. City of New York

The petitioner, a police officer, sought permission to file a late notice of claim against the City of New York for injuries sustained from toxic substance exposure during World Trade Center rescue and recovery operations. The court evaluated the reasonableness of the petitioner's delay in filing, the City's actual knowledge of the claim, and any potential prejudice to the City. It was determined that the petitioner had a reasonable excuse for the delay, attributed to the gradual manifestation of symptoms, and that the City possessed sufficient actual knowledge due to the widespread awareness of WTC-related health issues. Furthermore, the court found no prejudice to the City's ability to investigate the claim. Consequently, the petition was granted, and the notice of claim was deemed timely filed.

World Trade CenterToxic ExposureLate Notice of ClaimGeneral Municipal LawPolice OfficerRespiratory Illness9/11Municipal LiabilitySpecial ProceedingInjury Claim
References
5
Case No. 2018 NY Slip Op 05594 [164 AD3d 506]
Regular Panel Decision
Aug 01, 2018

Matter of Murnane v. New York City Sch. Constr. Auth.

In this case, the petitioner, Daniel Murnane, appealed an order from the Supreme Court, Kings County, which denied his application for leave to serve a late notice of claim. Murnane alleged he was injured after tripping and falling at a construction site in Brooklyn on July 19, 2016. The Appellate Division, Second Department, affirmed the lower court's decision, finding that Murnane failed to provide a reasonable excuse for the delay in serving the notice of claim. Furthermore, the court determined that the respondents, the New York City School Construction Authority, did not acquire actual knowledge of the essential facts of the claim within the statutory 90-day period or a reasonable time thereafter. The court also concluded that Murnane did not demonstrate that the delay would not substantially prejudice the respondents in their defense.

trip and falllate notice of claimGeneral Municipal Law § 50-eactual knowledgereasonable excuseprejudiceconstruction site injuryAppellate Divisionorder affirmednegligence
References
19
Case No. MISSING
Regular Panel Decision

Bruzzese v. City of New York

This case involves an appeal from an order of the Supreme Court, Richmond County, which had granted a petition for leave to serve a late notice of claim. The appellate court reversed this order, denying the petition and dismissing the proceeding. The court found that the petitioners failed to provide a reasonable excuse for their delay, rejecting their assertions of misunderstanding workers' compensation versus personal injury claims and a mistaken belief that their attorney would automatically handle the latter. Additionally, the petitioners did not establish that the City of New York acquired actual knowledge of the claim's essential facts within the statutory 90-day period or a reasonable time thereafter. The court also noted that the petitioners failed to demonstrate that the City was not prejudiced by the delay in receiving notice of the specific facts of the claim.

Late Notice of ClaimGeneral Municipal LawWorkers' Compensation DistinctionActual Knowledge RequirementPrejudice ArgumentAppellate ProcedureDiscretionary RulingPersonal Injury ActionCity of New YorkRichmond County
References
12
Case No. MISSING
Regular Panel Decision

Cohoes Rod & Gun Club, Inc. v. Firemen's Insurance

Plaintiff commenced an action seeking a declaration that the defendant insurer was obligated to defend and indemnify it in a pending personal injury lawsuit brought by Nicholas J. Kdidnasky, III. The underlying lawsuit alleged negligence by plaintiff and Cali Building Company, Inc., leading to Kdidnasky's injury on December 1, 1981. Defendant denied coverage, asserting that plaintiff failed to provide notice of the incident "as soon as practicable" as required by their insurance policy. The Supreme Court initially granted plaintiff's motion for summary judgment, finding the delay reasonable. On appeal, the court reversed this order, concluding that unresolved questions of fact existed regarding the reasonableness of plaintiff's delay in providing notice, specifically concerning possible earlier contact with an insurance representative.

Insurance Coverage DisputeSummary Judgment AppealTimely NoticeAs Soon As PracticableGood-Faith BeliefReasonableness of DelayDuty to DefendDuty to IndemnifyConstruction AccidentPersonal Injury Liability
References
4
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