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

Case No. 2017 NY Slip Op 27428
Regular Panel Decision
Dec 14, 2017

New York State Workers' Compensation Bd. v. Compensation Risk Mgrs., LLC

This action was brought by the New York State Workers' Compensation Board (WCB), as an assignee of former members of the Healthcare Industry Trust of New York (HITNY), against Compensation Risk Managers, LLC (CRM), HITNY trustees, and auditing firm UHY LLP. The WCB alleged mismanagement, breach of fiduciary duty, and negligent auditing, leading to the Trust's insolvency. Defendants moved to dismiss on grounds of standing, statute of limitations, and pleading particularity. The court dismissed certain derivative claims and negligent misrepresentation claims against some trustees due to standing issues and statute of limitations. All claims against UHY LLP were dismissed for lack of a near-privity relationship or prior precedent. An implied indemnity claim against the trustees was sustained. The WCB's cross-motion to consolidate related actions was denied.

Workers' Compensation LawGroup Self-Insured Trust (GSIT)Fiduciary DutyNegligenceNegligent MisrepresentationStatute of LimitationsStandingDerivative ActionImplied IndemnityAuditing Firm Liability
References
46
Case No. 2017 NY Slip Op 04184 [150 AD3d 1589]
Regular Panel Decision
May 25, 2017

New York State Workers' Compensation Board v. Program Risk Management, Inc.

The New York State Workers' Compensation Board, acting as administrator and successor to the Community Residence Insurance Savings Plan, initiated legal action against various entities and individuals after the trust became severely underfunded. Defendants include Program Risk Management, Inc. (administrator), PRM Claims Services, Inc. (claims administrator), individual officers of PRM, the Board of Trustees, and Thomas Gosdeck (trust counsel). The plaintiff sought damages for claims such as breach of contract, breach of fiduciary duty, and legal malpractice. The Supreme Court's order partially dismissed some claims and denied others. On cross-appeal, the Appellate Division, Third Department, modified the Supreme Court's order, notably reversing the dismissal of several breach of fiduciary duty claims and common-law indemnification against PRMCS, while affirming denials of motions to dismiss breach of contract, legal malpractice, and unjust enrichment claims. The court's decision was influenced by recent rulings in State of N.Y. Workers' Compensation Bd. v Wang.

Workers' Compensation LawGroup Self-Insured TrustBreach of ContractBreach of Fiduciary DutyLegal MalpracticeUnjust EnrichmentStatute of LimitationsEquitable EstoppelAlter Ego LiabilityCommon-Law Indemnification
References
20
Case No. CA 12-01329
Regular Panel Decision
May 03, 2013

MULLIN, CARL D. v. WASTE MANAGEMENT OF NEW YORK, LLC

Carl D. Mullin, an employee of Riccelli Enterprises, Inc., sustained injuries after falling from a ladder at a Waste Management of New York, LLC facility. Mullin initiated an action against Waste Management, which subsequently filed a third-party claim against Riccelli for breach of contract. Waste Management alleged that Riccelli failed to name it as an additional insured on various required insurance policies, including workers' compensation, commercial general liability, and automobile liability. The Supreme Court granted Waste Management's motion for partial summary judgment on the breach of contract claim. The Appellate Division unanimously affirmed the Supreme Court's order, also upholding the denial of Riccelli's motion to introduce new evidence, deeming it untimely and unlikely to alter the determination.

Breach of ContractInsurance CoverageAdditional Insured ClauseSummary Judgment MotionAppellate AffirmationThird-Party LitigationPersonal InjuryWorkplace AccidentLadder FallContractual Indemnity
References
2
Case No. ADJ6814425
Regular
Apr 23, 2012

JIMMY WILLIAMS vs. SAN FRANCISCO 49ers; TIG INSURANCE COMPANY Administered By RISK ENTERPRISE MANAGEMENT LIMITED; SUCCESSOR IN INTEREST BY MERGER TO GULF INSURANCE COMPANY THE TRAVELERS INDEMNITY COMPANY; BERKELEY SPECIALTY UNDERWRITING MANAGERS, LLC; NEW ORLEANS SAINTS; LOUISIANA WORKERS' COMPENSATION CORPORATION; SEATTLE SEAHAWKS; PSI; HOUSTON TEXANS; BERKELEY SPECIALTY UNDERWRITING MANAGERS, LLC.

In this Workers' Compensation Appeals Board case, applicant Jimmy Williams' Petition for Removal has been denied. The order signifies the Board's decision not to further review or remove the case from its current proceedings. The specific grounds for denial are not detailed in this excerpt. The decision was issued by the Workers' Compensation Appeals Board on April 23, 2012.

Petition for RemovalWorkers' Compensation Appeals BoardSan Francisco 49ersTIG Insurance CompanyRisk Enterprise Management LimitedGulf Insurance CompanyThe Travelers Indemnity CompanyBerkeley Specialty Underwriting Managers LLCNew Orleans SaintsLouisiana Workers' Compensation Corporation
References
0
Case No. MISSING
Regular Panel Decision
Jul 26, 2000

AIU Insurance v. Unicover Managers, Inc.

This case involves plaintiff insurance companies, AIG, seeking a declaration that defendant ReliaStar Life Insurance Company was bound to reinsure AIG for certain workers' compensation risks based on reinsurance slips signed by Unicover Managers, Inc., ReliaStar's managing general underwriter. The Supreme Court, New York County, dismissed AIG's complaint against ReliaStar and Unicover, and ReliaStar's third-party complaint against E.W. Blanch Company. The appellate court affirmed the dismissal, finding that the parties' correspondence and conduct established that reinsurance would only be bound upon ReliaStar's own signature, negating any actual or apparent authority of Unicover or ratification by ReliaStar. Estoppel and misrepresentation claims against both defendants were also dismissed. The judgment was modified to explicitly dismiss all remaining cross claims and counterclaims, and the initial dismissal was otherwise affirmed.

Reinsurance AgreementSummary JudgmentContract InterpretationAgency AuthorityApparent AuthorityRatificationEstoppelMisrepresentationWorkers' Compensation RisksCross Claims
References
3
Case No. MISSING
Regular Panel Decision

In re Exotic Island Enterprises

This case involves appeals by Exotic Island Enterprises and Sliffer Enterprises, Inc., corporations owned by Keith Slifstein, against decisions from the Unemployment Insurance Appeal Board. The Department of Labor had initially determined that exotic dancers performing at their venues, Fantasy Island Gent Club and Pleasure Island II, were employees, leading to assessments for additional unemployment insurance contributions. An Administrative Law Judge and subsequently the Unemployment Insurance Appeal Board affirmed this determination. The court, in turn, affirmed the Board’s decision, finding substantial evidence that the corporations exercised sufficient direction and control over the dancers to establish an employment relationship. Factors included Slifstein's involvement in dancer selection, scheduling, pricing for private dances, retention of a percentage of earnings, and provision of performance infrastructure. The court also noted the corporations' failure to provide remuneration documentation, allowing the Department to assess contributions based on available information.

Unemployment Insurance AppealExotic Dancers Employee StatusEmployer ControlUnemployment Insurance ContributionsAdministrative Law Judge DecisionWorkers Compensation CoverageLabor Law ComplianceAppellate ReviewSubstantial EvidenceBusiness Operations
References
7
Case No. ADJ158605 (RIV 0028842)
Regular
Nov 14, 2008

CHARLES WEBSTER vs. COUNTY OF RIVERSIDE RISK MANAGEMENT

The Workers' Compensation Appeals Board denied Charles Webster's petition for reconsideration in his case against County of Riverside Risk Management. The Board adopted the findings and reasoning of the workers' compensation administrative law judge in their decision. This order formally denies Webster's request to have the case reconsidered.

Workers' Compensation Appeals BoardOrder Denying ReconsiderationWCJ ReportPetition for ReconsiderationTapia v. Skill Masters StaffingAppeals Board en bancADJ158605RIV 0028842County of Riverside Risk ManagementCharles Webster
References
1
Case No. ADJ292306 (SJO 0140094) ADJ1470334 (SFO 0139424) ADJ7101503
Regular
Feb 10, 2011

DONALD DAVIS vs. ALMADEN MAZDA, TIG SPECIALTY INSURANCE COMPANY, RISK ENTERPRISE MANAGEMENT, LIMITED

The Workers' Compensation Appeals Board denied the defendant's Petition for Reconsideration in the case of Donald Davis. This denial was based on the WCJ's report, which the Board adopted. The defendant's counsel was admonished for violating WCAB Rule 10842 by inappropriately attaching previously admitted exhibits to the petition. Further violations of this rule may result in sanctions.

WORKERS' COMPENSATION APPEALS BOARDDENYING RECONSIDERATIONWCJ reportWCAB Rule 10842recycled exhibitsadmonishedLab. Code § 5813sanctionsALMADEN MAZDATIG SPECIALTY INSURANCE COMPANY
References
0
Case No. ADJ7572145
Regular
Aug 09, 2012

ALBERTO CARMONA vs. MEDINA CONCRETE CONSTRUCTION, DELOS INSURANCE COMPANY, RISK ENTERPRISE MANAGEMENT LIMITED

The Workers' Compensation Appeals Board denied reconsideration of a decision that found no industrial injury occurred. The applicant, Alberto Carmona, alleged he fractured his arm in a trench but provided inconsistent accounts of the incident. The Workers' Compensation Judge found the applicant not credible based on contradictory testimony, including evidence that the injury may have occurred from a fall off a ladder inside a house. The Board adopted the Judge's report and reasoning, giving great weight to the credibility findings.

Workers' Compensation Appeals BoardReconsiderationWCJCredibilityIndustrial InjuryFractured HumerusConstruction SiteTrenchLadderMedical Reports
References
1
Case No. ADJ3968337 (LAO 0844136) ADJ4336885 (LAO 0805868) ADJ672008 (LAO 0805870)
Regular
Sep 24, 2015

ARMIDA BELTRAN vs. MCDONALD'S, HAZELRIGG RISK MANAGEMENT SERVICES

This case involves a petition for reconsideration by McDonald's and Hazelrigg Risk Management Services regarding deposition attorney fees. The Workers' Compensation Appeals Board (WCAB) is dismissing the petition because the petitioner has withdrawn it. This withdrawal is consistent with a prior WCJ order rescinding the attorney fee orders, allowing for further discovery on deposition attorney fee payments. Consequently, the petition for reconsideration is dismissed.

Petition for ReconsiderationWCJrescindeddeposition attorney fee ordersCIGAOrder of Rescissioncrossed in the mailwithdrawn petitionfurther discoveryprior payment
References
0
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