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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

Claim of Arena v. Crown Asphalt Co.

Thomas Arena (decedent) sustained a work-related foot injury in 1980, leading to workers' compensation benefits and subsequent renal failure. Decedent and his wife (claimant) filed a third-party medical malpractice action against treating physicians and the hospital, which was settled in 1988 through a structured settlement. A stipulation between the carrier and decedent outlined the carrier's offset credit against decedent's workers' compensation claim and reserved rights against future death benefits claims, but claimant was not a signatory. After decedent's death in 1993, claimant filed for death benefits, prompting the carrier to seek an offset credit from the third-party settlement proceeds. The Workers’ Compensation Board initially found the carrier entitled to a credit, but later reversed itself, ruling against any credit. The appeals court determined that the carrier sufficiently preserved its offset rights through a general release signed by both claimant and decedent. However, it found no clear agreement on the specific offset amount in the stipulation or settlement that applied to claimant's death benefits. Consequently, the Board's decision of zero credit was reversed, and the matter was remitted for a factual determination of the precise credit amount.

Offset CreditThird-Party SettlementDeath Benefits ClaimRenal FailureMedical MalpracticeStipulation AgreementGeneral ReleaseWaiver of RightsStructured SettlementApportionment of Damages
References
12
Case No. MISSING
Regular Panel Decision

Rapid Settlements Ltd. v. SSC Settlements, LLC

This case involves an appeal and mandamus proceeding filed by Rapid Settlements, Ltd. and Rapid Management Corporation (Rapid) against SSC Settlements, L.L.C. and Stone Street Capital, Inc. (SSC). Rapid challenged a final summary judgment related to the transfer of structured settlement payments from William Prante. Rapid sought to stay litigation pending arbitration, arguing the dispute with SSC fell under an arbitration clause in their agreement with Prante, which also included a right of first refusal and a security interest. The appellate court denied the mandamus petition, vacated the trial court's denial of Rapid's motion to stay, and reversed parts of the summary judgment concerning Rapid's security interest and right of first refusal. The court affirmed the trial court's award of attorney's fees to SSC and its injunction preventing Rapid from compelling SSC to arbitrate.

Arbitration AgreementMandamus ProceedingSummary JudgmentDeclaratory JudgmentStructured SettlementRight of First RefusalSecurity InterestEquitable EstoppelDirect Benefits EstoppelContract Law
References
42
Case No. MISSING
Regular Panel Decision

Symetra Life Insurance v. Rapid Settlements, Ltd.

This case involves the National Association of Settlement Purchasers (NASP) seeking a permanent injunction against Rapid Settlements, Ltd., a factoring company. NASP alleged that Rapid Settlements improperly uses arbitration and enforces rights of first refusal and security interests in structured settlement payment rights without state-court approval, thereby circumventing state Structured Settlement Protection Acts (SSPAs). The court found that Rapid Settlements' practices illegally circumvent the SSPAs, cloud title to annuitants' payment rights, raise transaction costs for NASP members, and place them at a competitive disadvantage. The court rejected Rapid Settlements' defenses, including preemption by the Federal Arbitration Act and an 'unclean hands' argument against NASP. The court granted NASP's application, permanently enjoining Rapid Settlements from using arbitration or enforcing unapproved rights of first refusal and security interests to effectuate transfers of structured settlement payment rights.

Structured SettlementsFactoring CompaniesAnnuity PaymentsArbitrationInjunctionState LawFederal LawStructured Settlement Protection ActsRights of First RefusalSecurity Interests
References
33
Case No. MISSING
Regular Panel Decision

Claim of Figelman v. Goldfarb

This case involves an appeal by an employer and the State Insurance Fund from a Workers’ Compensation Board decision denying the Fund's request to offset future workers' compensation benefits against a claimant's third-party settlement proceeds. The claimant, injured in 1988, received a third-party settlement of $225,000 in 1992, after which the Fund sought to offset a $5,520 award for lost earnings during an initial abeyance period (March-August 1988). The Workers’ Compensation Board denied the offset, a ruling upheld by the appellate court. The court reasoned that the $5,520 award constituted "basic economic loss" under Insurance Law § 5102 (a) and was therefore exempt from offset provisions of Workers’ Compensation Law § 29 (4) due to Workers’ Compensation Law § 29 (1-a). Additionally, the Fund's failure to explicitly reserve its right to offset against this specific award at the time of the third-party settlement further supported the Board's decision.

Workers' Compensation LawThird-Party SettlementOffset RightsBasic Economic LossInsurance LawAppellate ReviewPermanent Partial DisabilityAutomobile Accident ClaimState Insurance FundWorkers' Compensation Board
References
3
Case No. MISSING
Regular Panel Decision
Nov 14, 2000

Claim of Martin v. Levest Electric Corp.

The claimant, having suffered work-related injuries, pursued both workers' compensation benefits and a third-party personal injury action, which was subsequently settled. A contention arose concerning the workers' compensation carrier's entitlement to offset future benefits against the net settlement proceeds, as outlined in Workers' Compensation Law § 29. The Workers’ Compensation Board determined that the carrier had correctly preserved its right to this offset. On appeal, the claimant argued that the carrier had consented to the settlement, thereby waiving its offset right, and that a court possessed the authority to waive such a right. The appellate court upheld the Board's finding, concluding that there was no substantial evidence of carrier consent to the settlement, and reaffirmed that a court cannot override a carrier's explicit reservation of its offset rights.

Workers' CompensationThird-Party ActionSettlementOffset RightsCarrier ConsentFuture BenefitsJudicial ReviewAppellate DecisionBoard RulingReservation of Rights
References
4
Case No. MISSING
Regular Panel Decision

In re Settlement Capital Corp.

Settlement Capital Corporation (SCC) sought court approval, under New York's Structured Settlement Protection Act (SSPA), to acquire $125,000 of a $225,000 annuity payment due to Richard C. Ballos on October 1, 2010. Ballos, a totally disabled father of two, agreed to transfer these rights for a net advance of $36,500, reflecting a 15.591% annual discount rate. The court, presided over by Justice Patricia E. Satterfield, denied the petition after a hearing on April 23, 2003. The decision hinged on a two-pronged test: whether the transfer was in Ballos's 'best interest' and if the transaction terms were 'fair and reasonable.' The court found that Ballos did not demonstrate 'true hardship' given his other income sources and previous transfer of structured settlement payments, concluding it was not in his or his dependents' best interest. Furthermore, the court deemed the 15.591% discount rate, resulting in Ballos receiving only 29% of the transferred amount, unconscionable and not 'fair and reasonable.'

Structured SettlementStructured Settlement Protection Act (SSPA)Annuity TransferDiscount RateBest Interest StandardFair and Reasonable StandardPayee ProtectionFinancial HardshipCourt ApprovalGeneral Obligations Law
References
12
Case No. MISSING
Regular Panel Decision

Davison v. Chemical Leaman Tank Lines, Inc.

This case involves an appeal concerning a settlement order in a workers' compensation matter. The court initially erred by concluding that New Hampshire Insurance Company (NHIC), the compensation carrier, had sufficient notice of an initial settlement conference in 1984 and had waived its right to contest the reasonableness of the settlement. It was undisputed that NHIC was not served with papers prior to the initial conference, as required by Workers’ Compensation Law section 29 (5). The court also addressed the timeliness of the plaintiff's application for a nunc pro tunc compromise order, made 19 months after the initial settlement, ruling it timely as the delay was not due to plaintiff's neglect or fault and NHIC was not prejudiced. However, due to doubts about whether NHIC was fully heard and if adequate consideration was given to its concerns regarding the settlement's fairness (specifically regarding medical expenses, loss of consortium offset, and allocations to children not parties), the order was reversed. The matter was remitted for the development of a record and specific findings on the reasonableness of the settlement.

Workers' CompensationSettlement AgreementNotice RequirementsNunc Pro Tunc OrderCompromise OrderCarrier LiabilityReasonableness of SettlementLoss of ConsortiumMedical ExpensesAppellate Review
References
6
Case No. 14-07-00880-CV
Regular Panel Decision
Apr 21, 2009

Symetra National Life Insurance Company and Symetra Life Insurance Company v. Rapid Settlements, LTD

Symetra National Life Insurance Co. and Symetra Life Insurance Co. appealed a trial court's confirmation of an arbitration award that directed them to make structured settlement payments to Rapid Settlements, Ltd., instead of the original payee, Paul Patterson. Symetra argued that the transfer lacked the required court approval under the Texas Structured Settlement Protection Act (SSPA) and violated public policy, while Rapid Settlements asserted it was not a 'transfer' under SSPA, federal law preempted SSPA, and Symetra lacked standing. The court rejected Rapid's arguments, emphasizing that the SSPA mandates court preapproval for structured settlement payment transfers to protect payees and their dependents. Consequently, the court held that the arbitration award violated Texas public policy by effectuating an unapproved transfer. The trial court's judgment was reversed, and the arbitration award was vacated.

Structured Settlement Protection Act (SSPA)Arbitration AwardPublic PolicyFederal Arbitration Act (FAA)PreemptionStandingGarnishmentTransfer of PaymentsAnnuity IssuerTexas Law
References
20
Case No. MISSING
Regular Panel Decision

Claim of Cruz v. City of New York Department of Children's Services

Claimant, injured in an automobile accident while working, received workers' compensation benefits and later settled a third-party action. A Workers’ Compensation Law Judge (WCLJ) and the Workers’ Compensation Board ruled that the self-insured employer was not entitled to offset the third-party settlement against a schedule loss of use (SLU) award, even for the portion initially designated as temporary total disability. The employer appealed, arguing the offset was permissible because the weekly award exceeded statutory thresholds for basic economic loss. However, the court affirmed the Board's decision, clarifying that a schedule loss of use award is not allocable to any specific period of disability and thus is not subject to offset under Workers’ Compensation Law § 29 against first-party benefits, regardless of initial labeling or monthly rate.

Schedule Loss of Use Award OffsetThird-Party SettlementTemporary Total DisabilityPermanent Partial DisabilityBasic Economic LossNo-Fault LawInsurance LawStatutory InterpretationWorkers' Compensation Law § 29Appellate Division
References
6
Case No. MISSING
Regular Panel Decision

Richter v. Ramistain Systems

A claimant sustained a compensable injury, and subsequently initiated a third-party action against GAP, Inc. and Clayco Construction Company, Inc., for whom Zurich also served as the liability carrier. A settlement was reached, including an $800,000 payment to the claimant and a waiver of Zurich’s workers’ compensation lien. Although the claimant initially rejected it, the settlement was enforced by court order. Zurich later attempted to preserve its rights to offsets against future workers’ compensation benefits under Workers’ Compensation Law § 29 (4) after the settlement was finalized. The Workers’ Compensation Board affirmed a judge's determination that Zurich failed to specifically reserve its right to offsets in a timely and unambiguous manner. The court affirmed the Board's decision, finding substantial evidence that Zurich consented to the settlement without timely preserving its offset rights.

Third-Party Action SettlementWorkers' Compensation LienOffset Rights PreservationCarrier ConsentEstoppelJudicial ReviewSubstantial EvidenceWorkers' Compensation Board DecisionMedical Expense Reimbursement
References
7
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