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

Case No. MISSING
Regular Panel Decision

Continental Casualty Co. v. Employers Insurance

Plaintiff insurance companies, Continental Insurance Co. and American Casualty Co. (CNA), initiated a declaratory judgment action seeking a declaration that they have no duty to indemnify Robert A. Keasbey Co. (Keasbey) for asbestos-related claims, arguing that all claims fall under exhausted products hazard/completed operations coverage. The defendant class of asbestos claimants sought coverage under a new 'operations' theory not subject to aggregate limits. The trial court ruled in favor of the claimants, but the appellate court reversed. The appellate court found that equitable affirmative defenses like laches applied against the claimants, who stood in Keasbey’s shoes. It further determined that coverage is triggered by 'injury-in-fact' rather than mere exposure to asbestos, and that the aggregate limits of the primary and excess policies were exhausted, thus absolving CNA of further indemnity obligations.

AsbestosInsurance Coverage DisputeDeclaratory JudgmentProducts HazardCompleted OperationsOperations CoverageAggregate LimitsExcess InsuranceBodily InjuryInjury-in-Fact
References
29
Case No. MISSING
Regular Panel Decision
Jan 13, 1995

National Union Fire Insurance Co. of Pittsburgh, PA v. State Insurance Fund

Plaintiff National Union Fire Insurance Company of Pittsburgh, PA (National Union) initiated a declaratory judgment action against The State Insurance Fund (SIF) to recover defense and settlement costs. These costs were expended on behalf of Regional Scaffolding and Hoisting Co., Inc., a mutually insured party in an underlying personal injury action. The Supreme Court initially denied National Union's motion for summary judgment and ruled in favor of SIF. However, the appellate court reversed this decision, concluding that the antisubrogation rule did not apply in this context. Consequently, it determined that National Union and SIF were co-insurers for Regional Scaffolding's common-law liability. The court granted National Union's motion for summary judgment in part, declaring SIF's duty to reimburse National Union for one-half of the reasonable settlement and defense costs, and remanded for a trial to ascertain these amounts.

Antisubrogation RuleDeclaratory JudgmentSummary JudgmentInsurance Coverage DisputeCo-Insurer LiabilityDefense Costs ReimbursementSettlement CostsEmployer's LiabilityComprehensive General LiabilityThird-Party Action
References
8
Case No. MISSING
Regular Panel Decision
May 12, 1995

Wausau Underwriters Insurance v. Continental Casualty Co.

This case addresses a dispute between Wausau Underwriters Insurance Company (Wausau) and Continental Casualty Company (Continental), along with The Hartford Insurance Group. Wausau, as the employer's liability carrier for H. Sand & Company, successfully argued that a third-party action by Slattery-Argrett, subrogor of Continental, against H. Sand & Company, constituted an impermissible subrogation claim by an insurer against its own insured. The underlying matter involved a personal injury sustained by an employee of H. Sand & Company. Continental had initially disclaimed coverage for Sand in the third-party action. The Supreme Court granted Wausau's motion for summary judgment, declaring the subrogation action a violation of public policy and awarding Wausau damages. The appellate court affirmed this judgment, distinguishing the present case from prior rulings like *North Star Reins. Corp. v Continental Ins. Co.*, and emphasizing the distinction between claims for indemnification and contribution within insurance policy exclusions.

Subrogation ClaimInsurance Coverage DisputeIndemnification vs. ContributionPublic Policy in InsuranceSummary JudgmentEmployer LiabilityGeneral Liability InsuranceExcess Liability InsuranceConstruction AccidentWorkers' Compensation Carrier
References
9
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. MISSING
Regular Panel Decision

National Union Fire Insurance Co. of Pittsburgh v. American Re-Insurance Co.

The case revolves around a dispute between National Union Fire Insurance Company and American Re-Insurance Company regarding a pollution exclusion clause in a reinsurance policy. National Union sought reimbursement from American Re after settling claims where employees were exposed to metalworking fluids. American Re denied coverage, arguing its pollution exclusion applied. The court, applying Ohio law, found American Re's pollution exclusion ambiguous due to its broad language and its intended purpose of covering environmental contamination. Consequently, American Re's motion for summary judgment was denied, and National Union's motion to strike American Re's defense was granted, requiring American Re to "follow the fortunes" of National Union.

ReinsurancePollution Exclusion ClauseContract InterpretationFollow the Fortunes DoctrineSummary JudgmentInsurance CoverageAmbiguity in ContractsOhio State LawDiversity JurisdictionIndustrial Contamination
References
31
Case No. MISSING
Regular Panel Decision

NECA Ins., Ltd. v. National Union Fire Ins. Co.

Plaintiff NIL Insurance Ltd., a reinsurance company, initiated a diversity action against National Union Fire Insurance Co. and Buchanan Management Company. NIL sought recovery for moneys paid in connection with a personal injury settlement by National Union and punitive damages, alleging negligence, bad faith, and breach of contract related to settlement discussions and payment. National Union and Buchanan moved to compel arbitration of these claims. The court granted National Union's motion, finding that the reinsurance agreement's arbitration clause broadly covered all disputes, including those concerning negligence and recklessness, which could be established within arbitration. The action was dismissed without prejudice, pending the outcome of the arbitration.

ReinsuranceArbitration ClauseContract InterpretationNegligence ClaimsBad FaithBreach of ContractSettlement DisputesFederal JurisdictionMotion to Compel ArbitrationDismissal Without Prejudice
References
6
Case No. MISSING
Regular Panel Decision
Sep 13, 2000

AIU Insurance v. American Motorists Insurance

This case concerns an appeal regarding primary liability coverage for HRH Construction Corp. and Hotel Grand Central in an underlying personal injury action. Plaintiffs, including their excess insurer AIU Insurance Co., sought to compel American Motorists Insurance Co. and St. Paul Fire & Marine Ins. Co. to provide primary defense and reimbursement. The court found American Motorists obligated to defend HRH and the Hotel, as their policy covered them as additional insureds for claims "arising out of" work performed by American Motorists' primary insured, Cord Contracting Co. However, St. Paul was not similarly obligated, as the injury did not "arise out of" work by its insured, Forest Electric Corp. Consequently, the court modified the prior declaration, vacating the plaintiffs' favor against St. Paul and dismissing Cord Contracting Co.'s cross-appeal.

Insurance DisputePrimary Liability CoverageExcess InsuranceAdditional InsuredPersonal InjuryConstruction SiteSubcontractorContractual ObligationDuty to DefendIndemnification
References
1
Case No. ADJ391084 (GOL 0102020) ADJ1292455 (GOL 0100312)
Regular
May 26, 2015

MICHAEL LOPEZ vs. ED & TED'S EXCELLENT LIGHTING, FIREMAN'S FUND INSURANCE COMPANY, REDWOOD FIRE & CASUALTY COMPANIES

This case involves two workers' compensation claims for applicant Michael Lopez against Ed & Ted's Excellent Lighting, insured by Redwood Fire & Casualty and Fireman's Fund Insurance Company. The Arbitrator found industrial injuries to Lopez's back and extremities and allocated partial liability to both insurers for the second injury period. Both insurers sought reconsideration, alleging clerical errors and disputes over liability allocation. The Workers' Compensation Appeals Board granted reconsideration to correct these clerical errors. The Board rescinded the original decision and returned the case to the Arbitrator for further proceedings and a new decision.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and OrderArbitratorIndustrial InjuryLumbar BackUpper ExtremitiesHerniaCumulative TraumaInsurance Company
References
0
Case No. MISSING
Regular Panel Decision
Dec 24, 1996

Aetna Casualty & Surety Co. v. National Union Fire Insurance

Eldee Mike, an employee of Vanderbilt Biltmore Corp., was injured at a construction project owned and managed by Harry Macklowe, Harry Macklowe Real Estate Co., Inc., and McGraw Hudson Construction Corp. Vanderbilt, a subcontractor, was contractually obligated to indemnify Macklowe and name them as additional insureds on its liability policy with National Union. Mike subsequently sued Macklowe, who then brought a third-party action against Vanderbilt. National Union disclaimed coverage due to Vanderbilt's late notice, as Vanderbilt had been dissolved. Macklowe's insurer, Aetna Casualty & Surety Company, defended Macklowe and paid the judgment and legal fees, then sued National Union for reimbursement. The IAS Court initially denied Aetna's summary judgment motion and granted National Union's cross-motion, finding Aetna's notice untimely. The appellate court reversed, holding that Aetna, as Macklowe's subrogee, provided timely notice and that National Union's disclaimer, based solely on Vanderbilt's late notice, was ineffective against Aetna/Macklowe because their late notice was not asserted as a ground for disclaimer.

Insurance Coverage DisputeDuty to DefendContractual IndemnificationAdditional InsuredsLate Notice DisclaimerSummary JudgmentAppellate ReversalSubrogation ClaimConstruction LiabilityDissolved Corporation
References
6
Case No. ADJ6542364
Regular
Sep 21, 2009

Denise Patterson Crumrine vs. SISKIYOU HOSPITAL INC., BERSHIRE HATHAWAY PASADENA, State Compensation Insurance Fund, Redwood Fire and Casualty Insurance Company

The Workers' Compensation Appeals Board granted reconsideration to State Fund. While affirming the joinder of State Fund as a party defendant, the Board rescinded the prior order requiring State Fund to reimburse Redwood Fire and Casualty Insurance Company for 25.48% of applicant benefits. This rescission was based on State Fund's due process rights, which were violated by the lack of opportunity for discovery and defense. The case is returned to the trial level for further proceedings consistent with due process and relevant Labor Code sections.

State FundRedwood Fire and CasualtyPetition for ReconsiderationOrder Joining Party DefendantDue ProcessDiscoveryContributionReimbursementJoinderWCJ
References
1
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