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. 2017 NY Slip Op 07909 [155 AD3d 1208]
Regular Panel Decision
Nov 09, 2017

NYAHSA Services, Inc., Self-Insurance Trust v. People Care Inc.

Plaintiff, a self-insured trust, commenced a collection action against defendant, a former member, for unpaid assessments related to workers' compensation claims. Defendant counterclaimed and filed a third-party action against Cool Insuring Agency, the trust's administrators, alleging mismanagement. During discovery, a dispute arose over a report commissioned by defendant's counsel from a consultant, which Cool and plaintiff sought to compel. Defendant asserted attorney-client privilege, attorney work product, and material prepared in anticipation of litigation. The Supreme Court partially granted the motions to compel, a decision largely affirmed by the Appellate Division, Third Department, with a modification regarding a specific email exchange found to be protected attorney work product.

Discovery DisputeAttorney-Client PrivilegeAttorney Work ProductMaterial Prepared for LitigationSelf-Insurance TrustWorkers' Compensation BenefitsBreach of ContractUnjust EnrichmentThird-Party ActionClaims Administration
References
20
Case No. 2018 NY Slip Op 08737
Regular Panel Decision
Dec 20, 2018

NYAHSA Servs., Inc., Self-Insurance Trust v. Recco Home Care Servs., Inc.

This case concerns an appeal from an order of the Supreme Court in Albany County. Plaintiff NYAHSA Services, Inc., Self-Insurance Trust, a self-insured trust providing workers' compensation coverage, sued defendant Recco Home Care Services, Inc. for unpaid adjustments after the defendant terminated its membership. Following an amendment to the complaint adding individual trustees as plaintiffs, the defendant asserted counterclaims for fraud, breach of fiduciary duty, and negligence against these trustees, which the Supreme Court dismissed as time-barred. The defendant also sought to amend its answer to include a counterclaim under General Business Law, which was denied. The Appellate Division, Third Department, found that the Supreme Court erred in dismissing the counterclaims for fraud and breach of fiduciary duty and in denying the cross-motion to amend for the General Business Law claim. Consequently, the Appellate Division modified the Supreme Court's order, reversing parts of the dismissal and denial, and affirmed the order as modified.

Workers' Compensation CoverageSelf-Insurance TrustFraud AllegationsBreach of Fiduciary DutyGeneral Business LawStatute of LimitationsAmended PleadingsCounterclaimsAppellate ReviewMotion to Dismiss
References
2
Case No. 09-17-00364-CV
Regular Panel Decision
Nov 16, 2017

in Re Texas Alliance of Energy Producers – Workers' Compensation Self-Insured Group Trust

Texas Alliance of Energy Producers – Workers’ Compensation Self-Insured Group Trust (Texas Alliance) sought mandamus relief after a trial court denied its plea to the jurisdiction. Texas Alliance contended that John Bennett's claims fell within the exclusive jurisdiction of the Division of Workers’ Compensation. Bennett had filed a new suit alleging negligence, intentional infliction of emotional distress, and fraud against Texas Alliance regarding his workers' compensation claim. The Court of Appeals concluded that all of Bennett's claims arose from the workers' compensation claims-handling process, which is exclusively governed by the Workers’ Compensation Act. Therefore, the trial court abused its discretion by denying the plea to the jurisdiction, and the mandamus relief was conditionally granted, directing the trial court to dismiss Bennett's lawsuit.

MandamusPlea to JurisdictionExclusive JurisdictionWorkers' Compensation ActClaims Handling ProcessAbuse of DiscretionTexas Court of AppealsSelf-Insured Group TrustJudicial ReviewAdministrative Remedies
References
1
Case No. MISSING
Regular Panel Decision
Aug 30, 2006

State ex. rel. Flowers v. Tennessee Trucking Ass'n Self Insurance Group Trust

This appeal involves three members of a workers’ compensation self-insured group trust, Ocoee River Transport, Western Express, Inc., and DCI Transportation, LLC, challenging two trial court orders. The appellants were held in contempt and sanctioned for failing to make periodic payments of assessments as ordered by the court. Additionally, one appellant contested the assessment of the Liquidator’s administrative fees, arguing they were denied the opportunity for discovery regarding the reasonableness and necessity of these fees. The appellate court affirmed the trial court's finding of contempt and the imposition of sanctions. However, the court reversed the decision regarding administrative fees, remanding the issue for further proceedings to allow for appropriate discovery and a determination of the applicability of privilege or work product doctrine to the Liquidator's records.

contemptworkers' compensationself-insured group trustliquidationadministrative feesdiscoverydue processwillfulnesssanctionsappellate review
References
66
Case No. MISSING
Regular Panel Decision

NYAHSA Servs., Inc., Self-Insurance Trust v. People Care Inc.

This case involves an appeal from an order of the Supreme Court, which granted the plaintiff's motions for leave to amend complaints. The plaintiff, a group self-insured trust, initiated collection actions against former member employers, People Care Incorporated and Recco Home Care Services, Inc., for unpaid workers' compensation adjustment bills. The plaintiff sought to add its trustees as party plaintiffs and to update allegations to include subsequently accrued unpaid bills. The appellate court affirmed the Supreme Court's decision, clarifying that an evidentiary showing of merit is not required for leave to amend pleadings under CPLR 3025 (b) unless there is prejudice, surprise, palpable insufficiency, or patent lack of merit. The court found no such grounds for denial and also rejected the defendants' statute of limitations arguments, affirming that for contracts requiring continuing performance, each breach can restart the limitations period.

Workers' Compensation CoverageSelf-Insured TrustBreach of ContractUnjust EnrichmentPleading AmendmentCPLR 3025 (b)Statute of LimitationsPrejudiceAppellate ReviewSupreme Court Order
References
18
Case No. MISSING
Regular Panel Decision
Mar 28, 2000

Oil Heat Institute of Long Island Insurance Trust v. Gerber Life Insurance

Plaintiff Oil Heat Institute of Long Island Insurance Trust (OHI) sued Gerber Life Insurance Company (Gerber), Island Group Administration, Inc. (IGA), and RMTS Associates, alleging Gerber refused to reimburse stop-loss claims and issue a letter of certification to a lender. OHI had established a self-insurance program, and Gerber issued an aggregate stop-loss (ASL) policy. OHI commenced the action on the day the ASL policy expired, before the attachment point for reimbursement could be calculated and before submitting proper documentation. The Supreme Court denied Gerber's motion for summary judgment. The Appellate Division reversed, finding that OHI failed to demonstrate compliance with the ASL policy's reimbursement terms, lacked material facts to support its claims, and initiated the action prematurely. Both causes of action were dismissed against Gerber.

Insurance LawSummary JudgmentAggregate Stop-Loss PolicyContract DisputeReimbursementPolicy TermsAppellate ReviewGood FaithDocumentation RequirementsAgency
References
3
Case No. 09-16-00437-CV
Regular Panel Decision
May 17, 2018

Texas Alliance of Energy Producers - Workers Compensation Self-Insured Group Trust v. John Bennett

This case involves an appeal concerning a workers' compensation claim filed by John Bennett against Texas Alliance of Energy Producers – Workers’ Compensation Self-Insured Group Trust. Bennett suffered a work-related injury and received a summary judgment in his favor in April 2016 for supplemental income benefits. Later, in October 2016, the trial court issued another order substantially increasing Bennett's awards. Texas Alliance appealed the October order, arguing the trial court lacked plenary jurisdiction. The Court of Appeals agreed, concluding that the trial court's plenary power had expired before signing the October order, rendering it void as the changes were judicial rather than clerical. As Texas Alliance failed to timely appeal the final April 2016 order, the Court of Appeals vacated the October 2016 order and dismissed Texas Alliance's appeal.

Workers' CompensationPlenary JurisdictionSummary JudgmentFinal OrderVoid OrderAppellate ProcedureClerical ErrorJudicial ErrorTimely AppealJurisdiction
References
21
Case No. 03-22-00241-CV
Regular Panel Decision
Oct 31, 2023

Texas Political Subdivisions Joint Self-Insurance Fund v. Texas Department of Insurance - Division of Workers' Compensation and Commissioner Cassie Brown in Her Official Capacity

The Texas Political Subdivisions Joint Self-Insurance Fund (TPS Fund) appealed the denial of its plea to the jurisdiction and summary-judgment motion by the 455th District Court of Travis County. The TPS Fund, a self-insured governmental entity, was assessed administrative penalties totaling $132,500 by the Texas Department of Insurance–Division of Workers’ Compensation for violations of the Texas Labor Code related to nonpayment or late payment of workers’ compensation benefits. The TPS Fund asserted governmental immunity from these penalties. The Court of Appeals reviewed the legislative history and prior common law, including Texas Workers’ Comp. Comm’n v. City of Eagle Pass, to determine if immunity was waived. It concluded that the 2019 amendment to Labor Code Section 504.053(e) merely codified existing law, which had already established a clear waiver of immunity for such regulatory actions against self-insured political subdivisions. Therefore, the appellate court affirmed the trial court’s order, holding that the TPS Fund’s governmental immunity is waived for the administrative penalties.

Workers' CompensationGovernmental ImmunityAdministrative PenaltiesTexas Labor CodeSelf-InsurancePolitical SubdivisionsStatutory InterpretationAppellate ReviewRegulatory AuthoritySovereign Immunity
References
13
Case No. 2017 NY Slip Op 08595 [156 AD3d 1043]
Regular Panel Decision
Dec 07, 2017

New York State Workers' Compensation Board v. Any-Time Home Care Inc.

The New York State Workers' Compensation Board, acting as administrator for a dissolved self-insured trust, initiated an action to recover a $133 million cumulative deficit from former trust members. Various defendants sought to dismiss the complaint, asserting claims were time-barred by a three-year statute of limitations for statutory liabilities, failed to adequately state claims against individual partners, and were barred by the doctrine of laches. The Supreme Court denied these motions. On appeal, the Appellate Division, Third Department, affirmed the Supreme Court's order, ruling that the claims were contractual, subject to a six-year limitation period, and that laches did not apply against the state enforcing a public right. The court also found the complaint sufficiently specific regarding the liability of individual defendants.

Workers' Compensation LawSelf-Insurance TrustJoint and Several LiabilityStatute of LimitationsContractual LiabilityLaches DoctrineAppellate ReviewGroup Self-InsurerDeficit RecoveryPartnership Liability
References
16
Case No. 2017 NY Slip Op 08244
Regular Panel Decision
Nov 22, 2017

Matter of New York State Workers' Compensation Bd. v. Murray Bresky Consultants, Ltd

This appeal concerns the allocation of settlement proceeds from a defunct group self-insured trust. The New York State Workers' Compensation Board, as administrator of the Manufacturing Self Insurance Trust Fund, sought judicial apportionment of settlement funds recovered from third parties. Murray Bresky Consultants, Ltd, a former member of the trust, objected to the Board receiving all proceeds and asserted a counterclaim for its share and an accounting. The Supreme Court granted the Board all proceeds and dismissed Murray Bresky's objections. The Appellate Division modified this decision, ruling that Murray Bresky was entitled to share in the jointly-recovered settlement proceeds and that the Board must file a verified accounting, remitting the matter for further proceedings.

Workers' Compensation LawSelf-Insurance TrustSettlement ProceedsJudicial ApportionmentVerified AccountingCPLR Article 77Contractual InterpretationTrust DeficitAppellate ReviewFiduciary Duty
References
13
Showing 1-10 of 16,547 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