CompFox Logo
AboutWorkflowFeaturesPricingCase LawInsights

Updated Daily

Case Law Database

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

Case No. MISSING
Regular Panel Decision

U.S. Specialty Insurance Co. v. Beale

Petitioner sought a stay of arbitration and a declaratory judgment arguing that a police vehicle operated by Respondent Beale lacked Supplementary Uninsured/Underinsured Motorist (SUM) coverage for an October 2011 accident. Although the court initially agreed that the policy did not mandate SUM coverage for police vehicles based on the law at the time of execution, it ultimately applied the doctrine of equitable estoppel. The court found that the petitioner had delayed over four years in denying coverage, participating in discovery, negotiations, and arbitration, leading the respondent to rely on the belief of coverage and settle an underlying negligence action. Due to this unreasonable delay and the resulting prejudice to the respondent, the court estopped the petitioner from denying SUM coverage. Consequently, the petition for a stay of arbitration was denied, and the respondents' motions to proceed with SUM arbitration and for a declaratory judgment of equitable estoppel were granted.

Equitable EstoppelSUM CoverageUninsured/Underinsured Motorist CoverageInsurance Policy InterpretationStay of ArbitrationDeclaratory JudgmentPolice Vehicle CoverageDelay in Denying CoveragePrejudiceCPLR 7503 (b)
References
9
Case No. MISSING
Regular Panel Decision

Weiss v. Tri-State Consumer Insurance

This case involves an appeal concerning the amount of supplementary uninsured/underinsured motorist (SUM) coverage available under an insurance policy issued by Tri-State Consumer Insurance Company. The plaintiffs, daughters and administrators of the estates of Rifka and Anton Goldenberg who died in a car accident, sought $400,000 in SUM coverage. Tri-State contended the coverage was limited to $145,000, arguing that payments from the tortfeasor's insurer ($100,000) and a Dram Shop recovery ($255,000) reduced the $500,000 policy limit. The Supreme Court initially granted the plaintiffs' motion for $400,000 in coverage and denied Tri-State's cross-motion. However, the appellate court reversed this decision, ruling that the Dram Shop recovery, as damages from sources other than motor vehicle liability insurance, correctly reduced the SUM endorsement, thus limiting the available coverage to $145,000.

Supplementary Uninsured/Underinsured MotoristSUM CoverageInsurance Policy InterpretationDram Shop ActWrongful DeathSummary JudgmentAppellate ReviewInsurance LawContract LawAutomobile Insurance
References
8
Case No. MISSING
Regular Panel Decision
Jun 08, 2016

Matter of Government Empls. Ins. Co. v. Sherlock

Peter Sherlock died in a car collision with an underinsured driver. His widow, Maria E. Tramontozzi Sherlock, sought supplementary uninsured/underinsured motorist (SUM) benefits from Government Employees Insurance Company (GEICO). GEICO denied the claim, asserting that the SUM coverage was fully offset by prior settlements received from the tortfeasor's insurer and the Old Brookville defendants' insurer, relying on conditions 6 and 11(e) of the SUM endorsement. GEICO then commenced a proceeding to permanently stay arbitration, and the Supreme Court granted GEICO's petition. On appeal, the Appellate Division reversed the Supreme Court's order, denying GEICO's petition and dismissing the proceeding. The court clarified that the non-duplication clause in SUM coverage is intended to prevent double recoveries for the same injuries, not to prevent an insured from obtaining full compensation, and that the amount of SUM coverage should not be reduced without regard to the actual amount of bodily injury damages suffered. Consequently, Tramontozzi Sherlock is entitled to proceed to arbitration.

SUM coverageunderinsured motoristuninsured motoristarbitrationinsurance policybodily injury damagesnon-duplication clauseAppellate DivisionCPLR article 75Insurance Law 60-2.3
References
2
Case No. 03 Civ. 0332(AKH)
Regular Panel Decision
Oct 29, 2004

In Re September 11th Liability Insurance Coverage Cases

This opinion and order addresses two Rule 12(c) motions regarding insurance coverage for the World Trade Center properties following the September 11, 2001, attacks. The Port Authority of New York and New Jersey sought a declaration that it is an "Additional Insured" under Zurich American Insurance Company's policies, while World Trade Center Properties LLC (WTCP) sought a declaration that Zurich is obligated to cover defense costs. The court, presided over by District Judge Hellerstein, denied both motions. It found ambiguity in the binder regarding the Port Authority's "Additional Insured" status, stating that the issue was premature without further discovery. Furthermore, the court held that New York Insurance Regulation 107 does not require rewriting Zurich's binder and policies to include defense costs, considering the unique circumstances, the sophistication of the insured, and the fact that Zurich explicitly excluded defense costs, which Silverstein (WTCP's affiliate) accepted after failing to secure conventional coverage. The court also affirmed supplemental jurisdiction over the insurance claims due to their close relation to the underlying September 11th liability cases.

Insurance CoverageSeptember 11 AttacksWorld Trade CenterRule 12(c) MotionDeclaratory ReliefAdditional Insured StatusDefense CostsInsurance BinderNew York Insurance LawRegulation 107
References
48
Case No. MISSING
Regular Panel Decision
Nov 04, 1999

Leftwich v. Travelers Indemnity Co.

The Supreme Court, New York County, denied the petitioner insured's application to compel arbitration for supplementary underinsured motorist (SUM) coverage and granted the respondent insurer's cross-motion to permanently stay arbitration. This decision was unanimously affirmed. The court found that the petitioner's automobile insurance policy clearly stipulated that all amounts received from jointly and severally liable persons and workers' compensation benefits would be offset against the $500,000 SUM coverage. Since the petitioner had received over $1.4 million from tortfeasors and workers' compensation, the SUM coverage was fully offset. The regulations relied upon by the petitioner were deemed inapplicable as they were promulgated after the policy's effective date and the accident date.

SUM coverageArbitration stayInsurance policy offsetWorkers' Compensation offsetTortfeasor paymentsRetrospective applicationAppellate affirmationContract interpretationNew York lawUnderinsured motorist
References
1
Case No. MISSING
Regular Panel Decision

Maryland Casualty Co. v. Graham

The appellant, Maryland Casualty Company, challenged the award of lump-sum compensation to the appellee, A. Graham, arguing that the issue was improperly presented and evidence was insufficient. A. Graham, suffering total permanent incapacity, sought a lump sum due to debts for basic necessities and medical treatment, claiming 'manifest hardship and injustice.' The court found that while Graham faced pecuniary embarrassment, the evidence did not meet the statutory criteria for a lump sum, which requires more than just present financial difficulty. The court affirmed the jury's finding of total permanent incapacity. However, it reformed the district court's judgment, ruling that A. Graham would receive weekly payments of $4.80, and his attorney, W. Y. Brown, $2.40 weekly, for a period of 401 weeks, rather than a lump sum.

Workers' CompensationLump Sum PaymentWeekly CompensationManifest HardshipTotal Permanent IncapacityAppellate ReviewJudgment ReformationAttorney FeesStatutory InterpretationEvidence Sufficiency
References
9
Case No. MISSING
Regular Panel Decision

Claim of Kenney v. Walsh Construction Co.

This Per Curiam decision addresses appeals concerning whether employers and their carriers are entitled to credit for lump-sum settlements in reopened workers' compensation cases. The cases of Kenney v. Walsh Construction Co. and Yurivich v. Sans Souci Nursing Home both involve claimants who received lump-sum awards for partial disabilities but later experienced worsening conditions, leading to reopened cases and increased awards. The Workmen’s Compensation Board denied credit to the carriers for the original lump-sum settlements, a decision affirmed by the Appellate Division. The court held that lump-sum settlements under Workmen’s Compensation Law § 15(5-b) cannot be indefinitely extended by excluding weeks where the claimant earned pre-injury wages. It affirmed that carriers assume the risk of reopened cases due to changed conditions, with no statutory or decisional basis for adjusting for claimant earnings during the period the lump-sum award covered.

Lump-sum settlementWorkmen's Compensation Law § 15(5-b)Credit for settlementReopened caseIncreased disabilityPost-disability earningsPre-disability earningsNonschedule adjustmentCaisson diseaseHerniated disc
References
5
Case No. MISSING
Regular Panel Decision

McLaughlin v. Midrox Insurance

This case involves an appeal concerning an insurance coverage dispute. Plaintiffs sought to compel Midrox Insurance Company to indemnify the Blodgett Brothers Partnerships for a $1 million judgment in an underlying personal injury action. The accident involved a motorcycle operated by plaintiff Charles R. McLaughlin and a pickup truck driven by Ronald Blodgett. Midrox had disclaimed coverage, arguing the accident occurred off insured premises and involved a registered vehicle. The court affirmed the lower court's decision, ruling that the farmowner's policy did provide coverage. The court determined that public roadways used for transporting materials between farm parcels could be considered 'insured premises' and that the pickup truck's agricultural registration did not negate coverage given its exclusive use for farming purposes.

Personal InjuryFarmowner's InsuranceInsurance CoverageAgricultural TruckPolicy InterpretationOff-Premises AccidentPublic RoadwaysSummary JudgmentIndemnificationVehicle and Traffic Law
References
5
Case No. MISSING
Regular Panel Decision

In re the Liquidation of Midland Insurance

Policyholders New York Dock Railway (NYDR) and Brooklyn Eastern District Terminal (BEDT), joined by claimants Buividas and Romacho, moved to confirm a referee's report that found coverage for their claims by the Stock Workers' Compensation Security Fund. The Superintendent of Insurance, as liquidator of Midland Insurance Company, cross-moved to disaffirm the report, arguing against Security Fund coverage based on his interpretation of relevant statutes. The court reviewed the referee's decision, finding it erroneous due to a misinterpretation of legislative history and intent regarding security fund coverage limitations, particularly concerning Chapter 801 amendments. Upholding the Superintendent's rational interpretation, the court denied the motion to confirm and granted the cross-motion to disaffirm, affirming the denial of security fund coverage.

Workers' Compensation Security FundInsurance Coverage DisputeMidland Insurance Company LiquidationFederal Employers' Liability ActJones ActLongshoremen's and Harbor Workers' Compensation ActStatutory InterpretationLegislative HistoryThird-Party IndemnificationEmployer's Liability
References
6
Case No. MISSING
Regular Panel Decision

U. P. Iron Works v. Investors Insurance

Plaintiff insured brought a declaratory judgment action against their insurer, who issued both workers' compensation and general liability policies. The dispute arose after a partner was injured, leading to a third-party products liability action against the partnership. The insurer disclaimed coverage, citing lack of coverage for a direct suit by a partner and late notice of the accident. The court found that coverage existed for the third-party claim, extending it to a partner similar to an employee. Furthermore, the court determined that the notice provided by the insured, though three years after the accident, was not unreasonably late given the complexities involved. Consequently, the court declared the policy to be in full force and effect for the accident.

Declaratory JudgmentInsurance CoverageWorkers' Compensation PolicyGeneral Liability PolicyThird-Party ClaimPartner InjuryEmployee ExclusionLate Notice DisclaimerDuty to DefendSummary Judgment Motion
References
2
Showing 1-10 of 1,621 results

Ready to streamline your practice?

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

CompFox Logo

The AI standard for workers' compensation professionals. Faster research, deeper analysis, better outcomes.

Product

  • Platform
  • Workflow
  • Features
  • Pricing

Solutions

  • Defense Firms
  • Applicants' Attorneys
  • Insurance carriers
  • Medical Providers

Company

  • About
  • Insights
  • Case Law

Legal

  • Privacy
  • Terms
  • Trust
  • Cookies
  • Subscription

© 2026 CompFox Inc. All rights reserved.

Systems Operational