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

Case No. 2014-1081 K C
Regular Panel Decision
Oct 05, 2016

High Quality Med. Supplies, Inc. v. Mercury Ins. Group

This case involves an appeal concerning assigned first-party no-fault benefits sought by High Quality Medical Supplies, Inc., as assignee of Charles Botwee. The defendant, Mercury Ins. Group, appealed an order from the Civil Court that denied its motion for summary judgment to dismiss the complaint. Mercury Ins. Group contended that billing for durable medical equipment not listed in a fee schedule is not compensable. However, the Appellate Term affirmed the lower court's decision, citing 11 NYCRR 68.5, which specifically permits reimbursement for healthcare services not explicitly covered by fee schedules, thereby rejecting the defendant's argument.

No-Fault BenefitsFirst-Party BenefitsDurable Medical EquipmentFee ScheduleSummary JudgmentAppellate TermAssigned BenefitsInsurance LawReimbursementCivil Court
References
3
Case No. MISSING
Regular Panel Decision

Dewan v. Blue Man Group Limited Partnership

Plaintiff Brian Dewan, a musician, sued the Blue Man Group entities and individuals, seeking a declaration of co-authorship for musical compositions used in their "Blue Man Group: Tubes" performance and damages for state law claims. Dewan claimed he collaborated with the defendants in composing music for the show and was repeatedly assured of his co-authorship rights and that an agreement would be formalized, but it never materialized. Defendants moved to dismiss, arguing the co-authorship claim under the Copyright Act was time-barred. The court found that Dewan's equitable estoppel argument was unreasonable after late 1993 or 1994, as he had sufficient notice that a lawsuit was necessary. Consequently, the court dismissed the federal co-authorship claim due to the expiration of the statute of limitations and declined to exercise supplemental jurisdiction over the remaining state law claims.

Copyright ActCo-authorshipStatute of LimitationsEquitable EstoppelMotion to DismissFederal JurisdictionState Law ClaimsMusical CompositionsCollaborationDeclaratory Judgment
References
11
Case No. 06 Civ. 0822(RJH)
Regular Panel Decision

Vanamringe v. Royal Group Technologies Ltd.

This Memorandum Opinion and Order addresses two consolidated securities fraud actions against Royal Group Technologies Limited and its officers and directors. The plaintiffs, known as the 'Snow Group', allege a fraudulent scheme involving false and misleading statements to inflate Royal Group's stock price, violating Sections 10(b) and 20(a) of the Exchange Act. The Court consolidated the two actions, Vanamringe v. Royal Group Technologies Limited and Messinger v. Royal Group Technologies Limited, under the caption In re Royal Group Technologies Securities Litigation. The Snow Group's motion for appointment as lead plaintiff was granted, as they demonstrated the largest financial interest and satisfied Rule 23 requirements for typicality and adequacy. The Court also approved the Snow Group's selection of Lerach Coughlin Stoia Geller Rudman & Robbins LLP and Labaton Sucharow & Rudoff LLP as co-lead counsel for the class.

Securities FraudClass ActionLead PlaintiffConsolidationPSLRAFederal Rules of Civil Procedure Rule 23Corporate FraudStock ManipulationInvestor ProtectionExchange Act
References
8
Case No. MISSING
Regular Panel Decision
Jul 27, 2015

Merrick v. UnitedHealth Group Inc.

This case involves a class action brought by four chiropractors against United-Health Group and its subsidiaries, alleging ERISA violations concerning claims regulations and payment recoupments. Defendant United moved to compel arbitration for Plaintiff Timothy Merrick's claims and to dismiss them. The court determined Merrick's claims were "amount of payment" disputes arising from his provider agreements, not "right to payment" claims under the healthcare plans. Therefore, the claims fell within the scope of the broad arbitration provisions in Merrick's agreements. The court granted the motion to compel arbitration and stayed Merrick's claims, while denying the motion to dismiss.

ArbitrationERISAHealthcare ProvidersChiropractorsContract DisputeRecoupment of PaymentsOverpaymentsProvider AgreementsClaims RegulationFederal Arbitration Act
References
39
Case No. 2022 NY Slip Op 02801 [204 AD3d 1016]
Regular Panel Decision
Apr 27, 2022

Matter of Panos v. Mid Hudson Med. Group, P.C.

Spyros Panos was terminated from Mid-Hudson Medical Group (MHMG) for submitting fraudulent medical bills and subsequently pleaded guilty to healthcare fraud. Panos initiated an action for breach of contract against MHMG, which proceeded to arbitration. The arbitrator applied the faithless servant doctrine and granted MHMG's motion for summary judgment, dismissing Panos's claims. Panos then sought to vacate the arbitration award in the Supreme Court, Dutchess County, but the court denied his petition and dismissed the proceeding. On appeal, the Appellate Division affirmed the lower court's judgment, concluding that Panos failed to demonstrate that the arbitrator manifestly disregarded the law.

Arbitration awardVacaturFaithless servant doctrineBreach of contractSummary judgmentHealth care fraudAppellate reviewJudicial reviewEmployment agreementFiduciary duty
References
18
Case No. 1:10-cv-03461-PAC
Regular Panel Decision

Richman v. Goldman Sachs Group, Inc.

This Memorandum and Order addresses six consolidated class actions against Goldman Sachs & Co. and its officers and directors, alleging violations of the Securities Exchange Act of 1934. The plaintiffs claim the defendants made false and misleading statements regarding a collateralized debt obligation (CDO) security and failed to disclose a Wells notice from the SEC and a subsequent criminal investigation, which led to a significant drop in Goldman Sachs' stock price. The Court consolidated the actions and proceeded to determine the 'most adequate plaintiff' to serve as lead plaintiff under the Private Securities Litigation Reform Act (PSLRA). After evaluating several contenders and applying the four *Lax* factors for financial interest, the Court designated the Pension Group as the lead plaintiff. The Pension Group comprises the Arkansas Teachers Retirement System, the West Virginia Investment Management Board, and the Plumbers and Pipefitters Pension Group, and their selection of Robbins Geller Rudman & Dowd, LLP and Labaton Sucharow, LLP as co-lead counsels was approved.

Securities LitigationClass ActionLead Plaintiff AppointmentPSLRAConsolidation of CasesFinancial InterestRule 23 RequirementsMisleading StatementsCollateralized Debt Obligation (CDO)Goldman Sachs
References
15
Case No. 2023 NY Slip Op 02549 [216 AD3d 833]
Regular Panel Decision
May 10, 2023

Santiago v. Hanley Group, Inc.

David Santiago, a construction worker, was allegedly injured after falling from a roof while performing construction work. He and his wife initiated a lawsuit against the general contractor, Hanley Group, Inc., asserting, among other claims, a violation of Labor Law § 240 (1) for failure to provide adequate safety devices. The Supreme Court, Westchester County, granted the plaintiffs' motion for summary judgment on the issue of liability on the Labor Law § 240 (1) cause of action against Hanley Group, Inc. Hanley Group, Inc. appealed, contending that it had complied with its statutory duty or that Santiago's conduct was the sole proximate cause of his injuries, or that he was a recalcitrant worker. The Appellate Division, Second Department, found that the defendant failed to raise a triable issue of fact on any of its contentions and therefore affirmed the lower court's order.

Personal InjuryLabor Law § 240 (1)Summary JudgmentAppellate ReviewConstruction AccidentFall from HeightRecalcitrant Worker DefenseSole Proximate CauseGeneral Contractor LiabilitySafety Devices
References
6
Case No. 2019 NY Slip Op 05955 [174 AD3d 850]
Regular Panel Decision
Jul 31, 2019

Davies v. Simon Prop. Group, Inc.

The plaintiff, Gerald Davies, was injured while pushing a cart of concrete over a plywood sheet that covered a hole at a construction site. He initiated an action against the premises operator, Simon Property Group, Inc., the general contractor, E.W. Howell Co., LLC, and the sidewalk removal company, Ruttura & Sons Construction Co., Inc., alleging common-law negligence and violations of Labor Law §§ 200, 240 (1), and 241 (6). E.W. Howell Co., LLC also filed a third-party action against Allstate Interior Demolition Corporation, the plaintiff's employer, seeking contractual indemnification. The Supreme Court's initial order, which partially granted and denied various summary judgment motions, was subject to appeals and cross-appeals. The Appellate Division ultimately reversed the order in part, granting Ruttura & Sons Construction Co., Inc.'s motion for summary judgment on the Labor Law § 200 and common-law negligence claims, and denying Simon Property Group, Inc. and E.W. Howell Co., LLC.'s motion to dismiss the Labor Law §§ 240 (1) and 241 (6) causes of action. The Appellate Division affirmed the denial of Simon Property Group, Inc. and E.W. Howell Co., LLC.'s motion concerning Labor Law § 200, common-law negligence, and contractual indemnification.

Personal InjuryConstruction AccidentLabor LawPremises LiabilitySummary JudgmentContractual IndemnificationElevation DifferentialScaffold LawIndustrial CodeSafe Work Environment
References
15
Case No. MISSING
Regular Panel Decision
Aug 02, 2013

National Integrated Group Pension Plan v. Dunhill Food Equipment Corp.

This case, filed under ERISA, involves the National Integrated Group Pension Plan and its Board of Trustees (Plaintiffs) seeking to collect withdrawal liability from Dunhill Food Equipment, Esquire Mechanical, Geoffrey Thaw, Sanford Associates, and Custom Stainless (Defendants). The core dispute revolved around whether the non-Dunhill defendants were part of a commonly controlled group at the time of Dunhill's withdrawal from the pension plan, and whether Geoffrey Thaw could be held personally liable through veil piercing. The court ruled that Dunhill, Esquire, and Thaw were jointly and severally liable for the withdrawal liability, attorney's fees, costs, interest, and liquidated damages, finding Thaw's complete domination and misuse of corporate funds justified piercing the corporate veil. However, the claims against Sanford and Custom Stainless were dismissed, as they were determined to have effectively dissolved prior to the withdrawal date, thus not being members of the controlled group.

ERISA LitigationMPPAA LiabilityPension WithdrawalCorporate Veil PiercingSummary Judgment MotionControlled Group LiabilityCorporate DissolutionPersonal LiabilityEmployee Benefits LawFiduciary Breach
References
48
Case No. MISSING
Regular Panel Decision
Mar 30, 1981

Claim of Kosak v. Dana Group, Inc.

This case involves appeals from decisions of the Workers’ Compensation Board. The central issue was whether the claimant was an employee of Dana Group, Inc. The Board found an employer-employee relationship, citing payroll stubs and checks from Dana Group, Inc. to the claimant. Despite being advised, the employer did not appear at a subsequent hearing. The Workers’ Compensation Law Judge's decision regarding the employer-employee relationship was deemed proper. The appellate court affirmed these decisions, concluding they were supported by substantial evidence.

Workers' CompensationEmployer-Employee RelationshipPayroll EvidenceAppellate ReviewSubstantial EvidenceAdministrative ProceedingsConcurring OpinionBoard DecisionAppealClaimant
References
0
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