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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
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

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
Feb 28, 1991

North River Insurance v. United National Insurance

This appellate decision addresses the apportionment of liability between North River Insurance Co. and United National Insurance Company arising from a settlement for an injured employee. The court clarified that North River, as the workers' compensation carrier, is solely responsible for its waived lien, reversing a lower court's finding. It further determined that both insurers' "other insurance" clauses called for pro rata contribution, not equal shares, for the $588,245 settlement payment and defense costs. The court calculated specific shares for each insurer and ruled that North River is entitled to interest from the original payment date in 1982. The Supreme Court's order was thus modified to reflect these findings.

Insurance disputePro rata contributionEquitable apportionmentWorkers' compensation lienDefense costsOther insurance clausesSettlement apportionmentInterest calculationAppellate decisionInsurer liability
References
10
Case No. MISSING
Regular Panel Decision

Home Depot U.S.A., Inc. v. National Fire & Marine Insurance

Home Depot U.S.A., Inc., the general contractor, commenced an action against its subcontractor's insurer, National Fire & Marine Insurance Company, seeking a declaration of coverage. Home Depot, individually and as assignee of Westward Contracting, Inc., sought to compel National Fire to defend and indemnify it as an an additional insured in an underlying action, and to indemnify Westward. The Supreme Court denied Home Depot's discovery motion, granted National Fire summary judgment declaring Home Depot was not an additional insured, and denied National Fire's motion to dismiss Home Depot's claims as Westward's assignee for lack of standing and for summary judgment on the indemnification obligation to Westward. The appellate court affirmed the Supreme Court's order, finding Home Depot was not an additional insured and that the assignment to Home Depot was valid and did not relieve National Fire of its indemnification obligation to Westward.

Insurance CoverageAdditional InsuredIndemnificationSummary JudgmentStandingAssignment of ClaimsSubcontractor LiabilityGeneral ContractorCommercial General Liability PolicyAppellate Review
References
13
Case No. MISSING
Regular Panel Decision

Servidone Construction Corp. v. Security Insurance

The case examines if an insurer's breach of the duty to defend obligates it to indemnify the insured for a settlement, even when coverage is contested. Plaintiff Servidone Construction Corporation, an insured, settled an underlying claim after its insurer, Security Insurance Company, withdrew defense citing a policy exclusion. The lower courts ruled that Security was liable to indemnify Servidone due to its breach and the possibility of coverage. The Court of Appeals reversed, asserting that a duty to indemnify only arises from an actual covered loss, not merely from a breach of the duty to defend. It placed the burden on the insurer to prove the loss was not covered and remitted the case for further proceedings to determine actual policy coverage.

Duty to DefendDuty to IndemnifyBreach of ContractInsurance LawSettlement AgreementCoverage DisputeWorkers' CompensationFederal Tort Claims ActCommon Law IndemnityContractual Indemnity
References
13
Case No. MISSING
Regular Panel Decision

National Casualty Co. v. Allcity Insurance

This case concerns an appeal from an order of the Supreme Court, Bronx County, which initially denied Allcity Insurance Company's motion for summary judgment and granted National Casualty Company's cross-motion for reimbursement. The underlying dispute involved National's request for one half of settlement and defense costs from Allcity, stemming from a personal injury action where the owner and general contractor were additional insureds on a subcontractor's general liability policy. The appellate court unanimously reversed the lower court's decision, granting Allcity's motion and denying National's cross-motion. The reversal was based on the antisubrogation rule, which precluded National from seeking recovery from Allcity, the subcontractor's workers' compensation carrier, as Allcity would not have been obligated to contribute to the settlement. Consequently, the complaint against Allcity was dismissed.

Summary JudgmentAntisubrogation RuleAdditional InsuredReimbursementDefense CostsGeneral Liability PolicyWorkers' Compensation CarrierAppellate DivisionInsurance LawPersonal Injury Action
References
2
Case No. ADJ11391724, ADJ11391757
Regular
Oct 03, 2019

PABLO LOPEZ DURAN vs. SOUTH HILLS ACADEMY, CHURCH MUTUAL INSURANCE COMPANY, SECURITY NATIONAL INSURANCE COMPANY, AMTRUST NORTH AMERICA, CRESCENT HOTELS & RESORTS, LLC, CHUBB INSURANCE GROUP, GALLAGHER BASSETT SERVICES, INC.

This Workers' Compensation Appeals Board case involves applicant Pablo Lopez Duran and multiple defendants including South Hills Academy, Church Mutual Insurance Company, Security National Insurance Company, Crescent Hotels & Resorts, LLC, and Chubb Insurance Group. The Board granted a petition for reconsideration and affirmed a prior order regarding sanctions and costs. Specifically, Chubb Insurance Group, administered by Gallagher Bassett Services, Inc., was ordered to pay an additional $395 for attorneys' fees related to a petition for fees, less any credit for prior payments.

WORKERS' COMPENSATION APPEALS BOARDSOUTH HILLS ACADEMYCHURCH MUTUAL INSURANCE COMPANYSECURITY NATIONAL INSURANCE COMPANYAMTRUST NORTH AMERICACRESCENT HOTELS & RESORTSLLCCHUBB INSURANCE GROUPGALLAGHER BASSETT SERVICESINC.
References
0
Case No. MISSING
Regular Panel Decision

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

National Union Fire Insurance Company (National Union) initiated a declaratory judgment action against the State Insurance Fund (SIF) seeking reimbursement for funds spent to settle an underlying personal injury lawsuit, Daza v City of New York. National Union had issued general liability policies to EMD Construction Corp. (EMD), which also covered the City of New York as an additional insured. SIF, in turn, insured EMD for workers' compensation and employers' liability. The Daza action, involving an injured EMD employee, was settled for $175,000, with a stipulation that EMD was 99% actively negligent and the City 1%. National Union disclaimed coverage for the City due to untimely notice and paid the settlement on behalf of EMD. The Supreme Court granted summary judgment to National Union, finding SIF obligated to repay. The appellate court affirmed this decision, holding that National Union's disclaimer was valid, the antisubrogation rule was not violated, and the indemnification agreement between EMD and the City was unenforceable due to the City's active negligence, thus shifting the obligation to SIF for common-law indemnification.

Insurance CoverageDeclaratory JudgmentIndemnificationSubrogationUntimely NoticeActive NegligenceContractual LiabilityWorkers' CompensationEmployer's LiabilitySummary Judgment
References
16
Case No. AHM 90917 AHM 90918
Regular
Jul 11, 2007

ANGEL SOSA vs. D.W. FOODS, EVEREST NATIONAL INSURANCE COMPANY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, VILLANOVA INSURANCE

This case concerns a dispute over reimbursement between an insurer, Everest, and the California Insurance Guarantee Association (CIGA), which is handling claims for a liquidated insurer, Villanova. The Board denied Everest's petition, upholding a prior award for reimbursement from Everest to CIGA. However, the Board granted CIGA's petition to amend the award to include Villanova Insurance as a party defendant.

CIGAEverest National Insurance CompanyVillanova Insuranceliquidationreconsiderationreimbursementbill review chargesjoint and several liabilitycumulative traumadenied due process
References
0
Case No. 2015 NY Slip Op 07554 [132 AD3d 500]
Regular Panel Decision
Oct 15, 2015

Bridge Street Contracting Inc. v. Everest National Insurance

This case addresses an insurer's disclaimer of coverage due to late notice of claims. The Appellate Division, First Department, modified a lower court order, declaring that Everest National Insurance Company has no duty to defend or indemnify Bridge Street Contracting Inc. in the underlying action. The court ruled that Everest properly disclaimed coverage without needing to demonstrate prejudice, as it was not participating in the defense when Bridge Street was served with the claims. Arguments regarding waiver of the late notice defense and antisubrogation were rejected. CastlePoint Insurance Company's motion to intervene was also denied as academic.

Insurance CoverageLate NoticeDisclaimer of CoverageSummary JudgmentDuty to DefendDuty to IndemnifyAntisubrogationInterventionAppellate DivisionContract Law
References
4
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