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Case Law Database

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

Case No. MISSING
Regular Panel Decision
May 08, 2003

Allianz Underwriters Insurance v. Landmark Insurance

This case involves an appeal by Allianz Underwriters Insurance Company, an excess liability insurer, against the law firm Underberg & Kessler, LLP. Allianz alleged that Underberg, retained by the primary insurer General Star Indemnity Corporation to represent their mutual insured Dunlop Tire Corporation in an underlying wrongful death action, breached its fiduciary duty and committed professional negligence. Allianz claimed Underberg failed to initiate a third-party action against Nicholson & Hall, Dunlop's employer (also insured by General Star), to protect General Star's interests over Dunlop's and Allianz's. The Supreme Court initially dismissed Allianz's complaint against Underberg. However, the Appellate Division, First Department, reversed this decision, holding that Allianz could pursue its claim against Underberg based on principles of equitable subrogation and a "near privity" relationship, thereby reinstating the complaint.

Equitable SubrogationLegal MalpracticeProfessional NegligenceExcess InsurancePrimary InsuranceFiduciary DutyNear PrivityDismissal ReversalAppellate ReviewIndemnification Clause
References
15
Case No. MISSING
Regular Panel Decision

Nationwide Insurance v. Empire Insurance Group

This case concerns a dispute over insurance coverage. Marcos Ramirez was injured while working for Fortuna Construction, Inc. at premises owned by 11194 Owners Corp. Fortuna had subcontracted work from Total Structural Concepts, Inc. and agreed to add Total Structural as an additional insured on its general liability policy with Empire Insurance Group and Allcity Insurance Company. Ramirez sued 11194 Owners Corp. and Total Structural. Total Structural then commenced a third-party action against Fortuna. Nationwide Insurance Company, as Total Structural's insurer and subrogee, initiated a declaratory judgment action against Empire and Allcity after discovering Total Structural was an additional insured on their policy, demanding coverage for the Ramirez action. The Supreme Court granted Nationwide's motion for summary judgment, but the appellate court reversed, finding that Total Structural failed to provide timely notice of the Ramirez action to Empire and Allcity as required by the policy. The court emphasized that timely notice is a condition precedent to recovery and that lack of diligent effort to ascertain coverage vitiates the policy. Consequently, the appellate court granted Empire and Allcity's cross-motion, declaring they are not obligated to defend or indemnify Nationwide/Total Structural.

Insurance CoverageTimely NoticeCondition PrecedentDeclaratory JudgmentAdditional InsuredSubrogationSummary JudgmentBreach of ContractPersonal InjuryGeneral Liability Policy
References
8
Case No. ADJ8521155
Regular
Sep 02, 2014

VICENTE AGUILAR vs. U-TURN SEVEN CORPORATION, EMPLOYERS COMPENSATION INSURANCE COMPANY, STAR INSURANCE COMPANY

The Workers' Compensation Appeals Board (WCAB) vacated its prior order granting reconsideration and denied the petitions for reconsideration filed by Employers Compensation Insurance Company and Star Insurance Company. The WCAB adopted the WCJ's report, finding Star's petition contained inflammatory and intemperate language that impugned the integrity of the WCJ and the Board. Consequently, the WCAB granted removal on its own motion and issued a notice of intent to sanction Star and its attorney for approximately $1,500 due to these statements.

Workers' Compensation Appeals BoardVicente AguilarU-Turn Seven CorporationEmployers Compensation Insurance CompanyStar Insurance CompanyFindings and Awardcumulative injurybilateral handswristsarms
References
1
Case No. MISSING
Regular Panel Decision

Transcontinental Insurance v. State Insurance Fund

This case involves a dispute between two insurers, Transcontinental Insurance Company (plaintiff) and State Insurance Fund (defendant), regarding their contribution to the defense and settlement of an underlying personal injury action. Transcontinental, which insured the contractor Master, sought a declaration that State Insurance Fund, Master's workers' compensation insurer, should contribute as a co-insurer for expenses incurred defending and settling the action on behalf of NYPA. The Supreme Court dismissed the complaint, applying the antisubrogation rule. The Appellate Division modified the judgment, vacating the dismissal but affirming the application of the antisubrogation rule, declaring that State Insurance Fund is not obligated to reimburse Transcontinental for the expenses.

Insurance DisputeAntisubrogation RuleDeclaratory JudgmentCommercial General Liability PolicyWorkers' Compensation InsuranceIndemnificationCo-insurancePersonal Injury ActionAppellate ReviewContractual Obligation
References
5
Case No. ADJ9350015
Regular
Feb 24, 2017

LAURA SIERRA vs. RUIZ CONTRACTING, STAR INSURANCE COMPANY, Administered by MEADOWBROOKS INSURANCE GROUP, ICW

The Workers' Compensation Appeals Board denied Star Insurance Company's petition for reconsideration. The Board found that Star Insurance failed to meet its burden of proof by a preponderance of the evidence to establish entitlement to contribution. Furthermore, the petition did not adequately explain why new medical evidence was unavailable prior to the close of discovery. Therefore, the petition was denied.

Petition for ReconsiderationArbitrator's ReportBurden of ProofAffirmative of the IssuePreponderance of the EvidenceSubstantial EvidenceMedical OpinionReasonable Medical ProbabilityInadequate Medical HistoriesCumulative Trauma
References
4
Case No. MISSING
Regular Panel Decision
May 12, 1995

Wausau Underwriters Insurance v. Continental Casualty Co.

This case addresses a dispute between Wausau Underwriters Insurance Company (Wausau) and Continental Casualty Company (Continental), along with The Hartford Insurance Group. Wausau, as the employer's liability carrier for H. Sand & Company, successfully argued that a third-party action by Slattery-Argrett, subrogor of Continental, against H. Sand & Company, constituted an impermissible subrogation claim by an insurer against its own insured. The underlying matter involved a personal injury sustained by an employee of H. Sand & Company. Continental had initially disclaimed coverage for Sand in the third-party action. The Supreme Court granted Wausau's motion for summary judgment, declaring the subrogation action a violation of public policy and awarding Wausau damages. The appellate court affirmed this judgment, distinguishing the present case from prior rulings like *North Star Reins. Corp. v Continental Ins. Co.*, and emphasizing the distinction between claims for indemnification and contribution within insurance policy exclusions.

Subrogation ClaimInsurance Coverage DisputeIndemnification vs. ContributionPublic Policy in InsuranceSummary JudgmentEmployer LiabilityGeneral Liability InsuranceExcess Liability InsuranceConstruction AccidentWorkers' Compensation Carrier
References
9
Case No. MISSING
Regular Panel Decision

Same Day Delivery Service, Inc. v. Penn Star Insurance

Same Day Delivery Service, Inc. sued its insurer, Penn-Star Insurance Company, seeking a declaration that Penn-Star must cover a personal injury lawsuit filed against Same Day. Penn-Star moved for summary judgment, arguing Same Day failed to provide timely notice of the claim and that the incident was excluded from the policy. The Court granted Penn-Star's motion for summary judgment, concluding that Same Day's notice to Penn-Star was untimely by approximately ten months, or at least two months even under Same Day's arguments, and that the delay was inexcusable under New York law. Consequently, Penn-Star is not obligated to provide coverage.

Insurance LawSummary JudgmentTimely NoticePolicy CoverageDeclaratory JudgmentPersonal InjuryNew York LawInsurance Policy ExclusionCommercial General LiabilityAs Soon As Practicable Clause
References
39
Case No. ADJ8231938
Regular
Nov 07, 2016

MARIA RIVERA vs. ERA PRODUCTS, INC., CALIFORNIA INSURANCE GUARANTEE ASSOCIATION For ULLICO CASUALTY COMPANY, STAR INSURANCE COMPANY, SUSSEX INSURANCE COMPANY

This case concerns determining the correct date of injury for applicant Maria Rivera's cumulative injury claim. Defendant Sussex Insurance Company sought reconsideration of the administrative law judge's finding that the date of injury was February 17, 2012. Sussex argued for an earlier date, which would shift liability to a prior insurer, Star Insurance. The Workers' Compensation Appeals Board denied reconsideration, finding insufficient evidence that Rivera suffered wage loss or ratable permanent disability before February 17, 2012, as required by Labor Code section 5412. Therefore, Sussex remains liable for the claim.

Labor Code 5412Cumulative InjuryDate of InjuryDisabilityWage LossInsurance Guarantee AssociationReconsiderationFindings of FactOpinion and OrderWorkers' Compensation Appeals Board
References
8
Case No. ADJ7432904
Regular
Sep 24, 2012

NEDA MOTAVAKEL vs. FANTASTIC SAM'S, TOWER SELECT INSURANCE CO., ILLINOIS MIDWEST INSURANCE AGENCY, LLP, STAR INSURANCE CO., ILLINOIS MIDWEST INSURANCE AGENCY, LLP, ENDURANCE WORKERS' COMPENSATION, SOUTHERN INSURANCE CO., FIRSTCOMP OMAHA

This case involves an appeal by Star and Tower Insurance Companies regarding a workers' compensation award. The primary issue is the applicant's average weekly earnings, specifically the inclusion of tip income, which was not adequately substantiated by documentary evidence. The Appeals Board found the initial decision lacked substantial evidence regarding earnings and rescinded the award. The matter is remanded for further proceedings to properly develop the evidentiary record on earnings and insurance coverage dates before a new decision is issued.

Workers' Compensation Appeals BoardNeda MotavakelFantastic Sam'sTower Select Insurance CompanyStar Insurance CompanyIllinois Midwest Insurance AgencyLLEndurance Workers' CompensationSouthern Insurance CompanyFirstComp Omaha
References
6
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
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