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

State Farm Mutual Automobile Insurance v. Aetna Casualty & Surety Co.

This case concerns a dispute between insurance carriers following a workers' compensation claim. Douglas K. Ellsmore was injured while unloading a hospital bed when Shirley S. Miller, insured by State Farm Mutual Automobile Insurance Company, backed her car into him. Ellsmore's employer's workers' compensation carrier, Aetna Casualty and Surety Company, paid over $65,000 in benefits and then sought reimbursement from State Farm via a loss transfer claim and demanded arbitration under Insurance Law § 5105. State Farm initiated a special proceeding to permanently stay arbitration, arguing that Aetna's claim lacked legal basis. Special Term denied the stay, but the appellate court reversed this decision. The court clarified that the "for hire" provision in Insurance Law § 5105 modifies "vehicle," limiting its application to vehicles hired for transporting people (like taxis) or livery vehicles for property, and does not extend to commercial deliveries by an owner's vehicle. Consequently, Aetna was not entitled to recover compensation payments under this statute.

Insurance LawWorkers' CompensationAutomobile InsuranceLoss Transfer ClaimArbitration StayStatutory Interpretation"For Hire" ClauseCommercial DeliveryVehicle InsuranceFirst-Party Payments
References
1
Case No. MISSING
Regular Panel Decision

Admiral Insurance v. State Farm Fire & Casualty Co.

The case involves an insurance dispute between Admiral Insurance Company and P&K (plaintiffs) and State Farm (defendant) concerning coverage for an underlying personal injury lawsuit. P&K, a contractor, was supposed to be covered as an additional insured under a State Farm policy through its subcontractor, Shahid Enterprises. After a Shahid employee was injured, triggering a lawsuit against P&K, Admiral sought defense and indemnification from State Farm, which disclaimed coverage due to late notice. The Supreme Court denied both parties' motions for summary judgment, finding that Insurance Law § 3420 (d) applied but a factual dispute existed regarding the timeliness of State Farm's disclaimer. The Appellate Division affirmed this decision, concluding that triable issues of fact remained as to whether Admiral's failure to provide information contributed to State Farm's delay in disclaiming coverage.

Insurance disputeDisclaimer of coverageLate noticeAdditional insuredSummary judgmentTriable issues of factInsurance Law § 3420 (d)Co-primary insurerIndemnificationDeclaratory judgment
References
17
Case No. MISSING
Regular Panel Decision

Duffy v. State Farm Mutual Automobile Insurance

Plaintiff Mary Duffy sued her former employer, State Farm Mutual Automobile Insurance Company, alleging age discrimination and retaliation after she was terminated at age 59. Duffy claimed harassment and a vendetta by supervisors, while State Farm maintained she was incompetent, accommodated her performance issues repeatedly, and fired her for poor work and bad attitude. The court reviewed her Age Discrimination in Employment Act (ADEA) claim and her retaliation claim, applying the McDonnell Douglas burden-shifting analysis. Though Duffy established a prima facie case, she failed to demonstrate that State Farm's legitimate, non-discriminatory reasons for termination were a pretext for discrimination or retaliation. Consequently, the court granted summary judgment in favor of State Farm on both claims.

Age DiscriminationRetaliation ClaimSummary JudgmentADEA (Age Discrimination in Employment Act)McDonnell Douglas AnalysisPrima Facie CasePretext for DiscriminationJob PerformanceEmployee TerminationWorkplace Harassment
References
17
Case No. MISSING
Regular Panel Decision

State Farm Mutual Automobile Insurance Companies v. Brooks

This action arises from an alleged overpayment of no-fault benefits by State Farm to James Brooks. Brooks, injured in an automobile accident, received lost earnings benefits from State Farm, but was later furloughed from his job due to lack of work, not his injury, yet continued to receive full benefits. State Farm sought to recover the alleged overpayment, arguing an insurance regulation (11 NYCRR 65.6 (n) (2) (vi)) required a reduction to unemployment benefits if the position would have been lost regardless of the accident. The court, in a case of first impression, found this regulation invalid as applied to Brooks, conflicting with the Insurance Law's purpose of compensating for actual economic loss. Consequently, summary judgment was granted in favor of the defendant, James Brooks.

No-fault insuranceAutomobile accidentOverpayment of benefitsLost earningsUnemployment benefitsInsurance Law interpretationSummary judgmentStatutory conflictRegulation validityEconomic loss
References
13
Case No. 2020 NY Slip Op 05626
Regular Panel Decision
Oct 09, 2020

Matter of O'Connell (State Farm Mut. Auto. Ins. Co.)

The case involves Christine M. O'Connell and State Farm Mutual Automobile Insurance Company regarding a supplemental uninsured/underinsured motorist (SUM) claim following a motor vehicle accident. After an arbitrator awarded O'Connell $1,775,228.79, State Farm appealed the Supreme Court's judgment that confirmed the award and denied their cross-motion to vacate it. The Appellate Division, Fourth Department, affirmed the judgment, rejecting State Farm's argument that the arbitration award was arbitrary, capricious, irrational, and unsupported by evidence. The court found the arbitrator's findings rational and supported by evidence, including medical records and testimony, concluding that O'Connell was entitled to SUM benefits.

Motor Vehicle AccidentUninsured MotoristUnderinsured MotoristArbitration AwardAppellate ReviewCompulsory ArbitrationEvidentiary SupportJudicial ScrutinyDamagesPersonal Injury
References
14
Case No. ADJ1143803 (OXN 0128653) ADJ2709854 (OXN 0142376)
Regular
Nov 01, 2011

SALVADOR PAZ vs. MARTINEZ PAINTING & WALL COVERING, MB PAINTING, CIGA, for CREDIT GENERAL INSURANCE COMPANY, INTERCARE, CIGA for UNITED PACIFIC INSURANCE COMPANY, INTERCARE, STATE FARM INSURANCE COMPANY, ACE USA

This case involves a painter, Salvador Paz, who sustained cumulative and specific injuries to his back, shoulder, wrist, neck, and foot. The Workers' Compensation Appeals Board denied petitions for reconsideration from State Farm, CIGA, and the applicant. The Board upheld the original findings, which apportioned permanent disability at 72% to the specific injury (CIGA via Credit General) and 28% to the cumulative trauma (ACE USA and State Farm). Liability for temporary disability was also divided, and State Farm's arguments regarding an unequal division and due process were rejected.

CIGAState Farmcumulative injuryspecific injuryapportionmenttemporary disabilitypermanent disabilityvocational expertPetition for ReconsiderationCredit General Insurance
References
1
Case No. MISSING
Regular Panel Decision

Insurance Corp. of New York v. United States Fire Insurance

This case concerns a dispute between a primary insurer, The Insurance Corporation of New York, and an excess insurer, United States Fire Insurance Company (US Fire), regarding the timeliness of claim notice and US Fire's subsequent disclaimer. The motion court initially denied US Fire's cross-motion for summary judgment, deeming its disclaimer untimely. However, the appellate court determined that US Fire received proper notice on April 20, 2006, not March 16, 2006, making its disclaimers, issued eight days later, timely as a matter of law. Consequently, the appellate court reversed the lower court's decision, granting US Fire's cross-motion for summary judgment and dismissing the complaint against it. Additionally, an appeal from a separate order regarding US Fire's request to rescind an insurance policy was dismissed as abandoned.

Insurance PolicyExcess InsurancePrimary InsuranceTimely NoticeDisclaimer of CoverageSummary JudgmentAppellate ReviewClaim NotificationInsurance ContractLiability Insurance
References
9
Case No. MISSING
Regular Panel Decision

Champagne v. State Farm Mutual Automobile Insurance

Selma Champagne appealed an order denying her motion for summary judgment and granting cross-motions by State Farm and John L. Homan. The case originated from a 1987 motor vehicle accident where Homan allegedly struck Samuel Champagne, who later settled with State Farm for the policy limit. Selma, Samuel's wife, then sought a declaratory judgment that State Farm was obligated to defend and indemnify Homan in her separate suit for loss of consortium. The Supreme Court initially granted summary judgment to both defendants. The appellate court modified the order, denying Homan's cross-motion, ruling that Selma's loss of consortium claim remained viable despite her husband's settlement as she was not a party to it. However, the court affirmed the summary judgment for State Farm, holding that State Farm had fulfilled its policy obligations by paying the "per person" bodily injury limit to Samuel, as loss of consortium damages are derivative and do not constitute a separate "bodily injury" under the insurance policy.

Loss of ConsortiumMotor Vehicle AccidentDeclaratory JudgmentSummary JudgmentInsurance Policy LimitsBodily InjuryDerivative ClaimSettlementAppellate ReviewPolicy Interpretation
References
10
Case No. ADJ7531724, ADJ7531690
Regular
Dec 01, 2017

AURORA LEMUS vs. FREEBIRDS WORLD BURRITO, GRANITE STATE INSURANCE COMPANY, MARK ORFALIA, REDWOOD FIRE AND CASUALTY COMPANY

This case involves a dispute between Granite State Insurance Company and Redwood Fire and Casualty Company regarding contribution for workers' compensation benefits paid to applicant Aurora Lemus. Granite, initially denied contribution by the WCJ, petitioned for reconsideration. The parties subsequently settled the contribution claim for $22,500.00 through mediation, which has been approved by the Board. This stipulation fully resolves Granite's claims against Redwood.

Workers' Compensation Appeals BoardReconsiderationContributionReimbursementJoint Findings of FactCompromise and ReleaseStipulationVoluntary MediationCommissioners' Settlement ConferenceInsurer
References
0
Case No. 2024 NY Slip Op 00646
Regular Panel Decision
Feb 07, 2024

State Farm Mut. Auto. Ins. Co. v. Amtrust N. Am., Inc.

In this subrogation action, State Farm Mutual Automobile Insurance Company, as a no-fault insurer, sought to recover benefits paid to its subrogors who were also seeking workers' compensation benefits from Amtrust North America, Inc. The Supreme Court initially dismissed State Farm's unjust enrichment complaint, asserting the Workers' Compensation Board's primary jurisdiction over the coverage dispute. On appeal, the Appellate Division reversed the Supreme Court's order. The court held that the Workers' Compensation Board indeed has primary jurisdiction to determine the applicability of the Workers' Compensation Law and the causal relationship of medical expenses to the accident. Therefore, the matter was remitted to the Supreme Court for a new determination after a resolution by the Workers' Compensation Board.

SubrogationUnjust EnrichmentNo-Fault InsuranceWorkers' CompensationPrimary JurisdictionAppellate ReviewMedical ExpensesMotor Vehicle AccidentReimbursementRemittal
References
9
Showing 1-10 of 16,129 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