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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

Cephalon, Inc. v. Travelers Companies, Inc.

Plaintiff Cephalon, Inc. initiated a declaratory judgment action against The Travelers Companies, Inc. and its four subsidiaries in the Southern District of New York. Cephalon sought a declaration that its off-label promotion of the drug Actiq did not violate the FDCA and caused no injury to Travelers. This suit was filed after Travelers, a workers' compensation insurer, sent pre-suit settlement demands to Cephalon, accusing it of causing damages through off-label drug promotion. Travelers moved to dismiss or transfer the case. The court granted Travelers' motion to dismiss, ruling that Cephalon's declaratory action was improperly anticipatory, having been filed in direct response to Travelers' specific threat of litigation and impending deadlines.

Declaratory JudgmentImproperly AnticipatoryFirst-Filed RuleMotion to DismissFederal Rule of Civil Procedure 12(b)(6)Off-Label Drug PromotionFood, Drug and Cosmetics ActInsurance DisputeWorkers' CompensationForum Selection
References
19
Case No. MISSING
Regular Panel Decision

Travelers Insurance v. Nory Construction Co.

Plaintiff Travelers Insurance Company initiated a subrogation action against Nory Construction Co., Inc. to recover over $3.5 million paid to satisfy a judgment against its insured, the State of New York, following a construction accident. Travelers sought common-law indemnification, arguing Nory was entirely at fault, including amounts paid beyond its policy limits. Nory countered that Travelers could not recover voluntary payments, and the claim was barred by the antisubrogation rule and untimely disclaimer. The court denied Travelers' motion for summary judgment due to insufficient evidence regarding Nory's sole fault. Ultimately, the court granted Nory's motion for summary judgment, concluding that Travelers' overpayment, made without legal compulsion or Nory's request, constituted a voluntary payment and was therefore not recoverable under equitable subrogation principles.

SubrogationIndemnificationInsurance Policy LimitsAntisubrogation RuleVoluntary Payment DoctrineSummary Judgment MotionConstruction LawWorkers' Compensation InsuranceCommercial General LiabilityUmbrella Policy
References
48
Case No. MISSING
Regular Panel Decision

Pecker Iron Works of New York, Inc. v. Traveler's Insurance

This case involves a dispute between Pecker Iron Works and Travelers Indemnity Company of Connecticut concerning the primary versus excess coverage obligations of two liability insurance carriers. Pecker, designated as an 'additional insured' under Upfront Enterprises' policy with Travelers, sought primary coverage after an Upfront worker was injured on a construction site. Travelers contended its policy provided only excess coverage for additional insureds unless explicitly designated as primary in a written contract. The Supreme Court initially agreed with Travelers, but the Appellate Division reversed, holding that coverage for additional insureds is presumed primary unless unambiguously stated otherwise. The Court of Appeals affirmed the Appellate Division's decision, concluding that Pecker was entitled to primary coverage.

Insurance CoverageAdditional InsuredPrimary CoverageExcess CoverageSubcontractor AgreementDeclaratory JudgmentContract InterpretationLiability InsuranceConstruction ProjectAppellate Review
References
4
Case No. MISSING
Regular Panel Decision
Feb 04, 1999

Chase Manhattan Bank, N. A. v. Travelers Group, Inc.

The Supreme Court, New York County, granted plaintiffs' motion for summary judgment, compelling The Travelers Group to indemnify plaintiffs for a $2.3 million judgment in a personal injury action, and denied Travelers' cross-motion. The Travelers Group had issued a workers' compensation policy to FTJ Environmental, Inc., whose employees were injured while working in New York City. The policy's coverage was explicitly conditioned on the work in New York being necessary or incidental to FTJ's work in New Jersey, which was listed as the coverage state. The appellate court found no evidence in the record to support this condition and noted that the policy limit was $100,000 per accident, not $2.3 million. Consequently, the appellate court modified the order, denying plaintiffs' motion for summary judgment.

Summary JudgmentIndemnificationWorkers' Compensation PolicyEmployers Liability PolicyPolicy CoverageLabor Law § 240Burden of ProofInsurance Policy LimitsAppellate DecisionPersonal Injury
References
1
Case No. ADJ2828753 (MON 0248336) ADJ1706360 (MON 0247675)
Regular
Jun 19, 2012

MICHAEL LEZINE vs. LOS ANGELES COUNTY METROPOLITAN TRANSPORTATION AUTHORITY, THE TRAVELERS INSURANCE COMPANY, CONSTITUTION STATE SERVICE COMPANY

This case involves Travelers Insurance seeking reconsideration of two separate Workers' Compensation Appeals Board (WCAB) findings. The WCJ initially found applicant sustained industrial injuries resulting in permanent disability and need for medical treatment. However, the WCJ later rescinded the decision for one case (ADJ2828753) and Travelers withdrew its petition for the other (ADJ1706360). Consequently, as there are no outstanding issues for reconsideration, the WCAB dismissed Travelers' Petition for Reconsideration.

Workers' Compensation Appeals BoardMichael LezineLos Angeles County Metropolitan Transportation AuthorityTravelers Insurance CompanyConstitution State Service CompanyADJ2828753ADJ1706360cumulative injuryhypertensionpermanent disability
References
0
Case No. ADJ3292672
Regular
Nov 08, 2012

SUSAN VIRDIER vs. CONCENTRA MANAGED CARE, ATLANTIC MUTUAL INSURANCE COMPANY (in liquidation), CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, TRAVELERS INDEMNITY INSURANCE COMPANY

This case concerns Travelers Indemnity Insurance Company's petition for reconsideration regarding its liability for applicant Susan Verdier's medical treatment. Travelers argued it should not be responsible for medical care in ADJ4661775, as it did not insure the employer at the time of the specific left wrist injury in ADJ3701452, and the cumulative trauma injury in ADJ4661775 involved different body parts. The Board denied the petition, holding that medical treatment expenses are not apportionable and that Travelers' coverage for the cumulative trauma period constitutes "other insurance" when the primary insurer is insolvent. The Board found no medical evidence distinguishing the need for treatment between the upper extremities and the wrist, thus upholding the finding that Travelers is available coverage for the award.

Workers Compensation Appeals BoardConcentra Managed CareAtlantic Mutual Insurance CompanyCalifornia Insurance Guarantee AssociationTravelers Indemnity Insurance CompanyreconsiderationFindings and Ordersother coveragemedical treatmentcumulative trauma
References
4
Case No. MISSING
Regular Panel Decision

In re Relativity Fashion, LLC

This Memorandum Opinion addresses a motion for attorneys' fees and expenses filed by Relativity Media, LLC (and its affiliates RML Distribution Domestic, LLC, Armored Car Productions, LLC, and DR Productions, LLC, collectively 'Relativity') and Mr. Ryan Kavanaugh against Netflix, Inc. The dispute arose from Netflix's refusal to execute 'Date Extension Amendments' related to a License Agreement, prompting Relativity to seek relief under Section 1142 of the Bankruptcy Code. The Court previously ruled that Netflix was barred by res judicata and judicial estoppel from asserting its claimed contractual rights to distribute films before theatrical release. In this opinion, the Court determined that Relativity was the 'prevailing party' under California Civil Code Section 1717 and the License Agreement's fee provision. Consequently, Relativity is entitled to reimbursement for its own reasonable attorneys' fees and litigation expenses. However, the Court denied Mr. Kavanaugh's request for reimbursement of his counsel's fees and expenses, concluding that he was not a party to the License Agreement and did not meet the exceptions for non-signatories to recover fees. The Court awarded Relativity $818,547.48, comprising $795,732.50 in attorneys’ fees and $22,814.98 in litigation expenses, against Netflix.

Attorneys FeesLitigation ExpensesContract LawCalifornia Civil Code Section 1717Bankruptcy Code Section 1142Prevailing PartyLodestar MethodHourly RatesJudicial EstoppelRes Judicata
References
85
Case No. 2017 NY Slip Op 04009 [150 AD3d 1507]
Regular Panel Decision
May 18, 2017

Matter of Jie Cao v. Five Star Travel of NY Inc.

Claimant, a bus driver, was involved in a 2007 accident and successfully applied for workers' compensation benefits, naming "Five Stars Travel Bus Inc." as his employer. Five Star Travel of NY Inc. (Five Star) did not appear after being served, leading to a WCLJ finding it liable for awards and assessments. After subsequent awards and medical treatment authorizations, a settlement was approved in 2013. In May 2015, Five Star sought to reopen the claim and challenge the prior decisions and settlement, but the Workers' Compensation Board denied the application due to untimely submission of new material evidence and the non-reviewable nature of an approved waiver agreement. The Appellate Division affirmed the Board's decision.

Workers' CompensationBus AccidentUninsured EmployerClaim ReopeningSettlement AgreementBoard ReviewAppellate DivisionTimelinessContinuing JurisdictionDue Process
References
6
Case No. 2017 NY Slip Op 04008 [150 AD3d 1505]
Regular Panel Decision
May 18, 2017

Claim of Jie Cao v. Five Star Travel of NY Inc.

Norman Lan Chen, a bus driver, was involved in a 2007 bus accident. He successfully applied for workers' compensation benefits, and the Workers' Compensation Board found Five Star Travel of NY Inc. (his employer) to be uninsured and liable for awards. A settlement agreement was approved by the Board in October 2011. In May 2015, Five Star Travel of NY Inc. sought to reopen the claim and revisit the settlement approval, but the Board denied the application. The Appellate Division, Third Department, affirmed the Board's decision, finding that no material new evidence was presented and the application was untimely. The court also held that the Board was correct in declining to revisit the previously approved Workers' Compensation Law § 32 settlement agreement.

Workers' Compensation BoardAppealClaim ReopeningSettlement AgreementUninsured EmployerTimelinessJudicial ReviewAppellate DivisionBus Accident
References
6
Case No. ADJ3344826 (SAL 0075781)
Regular
Jun 08, 2011

Ronald Fryer vs. CORNUCOPIA COMMUNITY MARKET, TRAVELERS INSURANCE

The Workers' Compensation Appeals Board reviewed Travelers Insurance's petition for reconsideration of a $10,000 sanction order. The Board affirmed that Travelers engaged in sanctionable conduct by violating a prior order to allow applicant treatment outside their Medical Provider Network and by failing to pay authorized medical bills. However, the Board reduced the total sanction amount to $2,500, finding the initial imposition excessive given the circumstances. Applicant's separate claims for reimbursement of expenses were not addressed in this decision but may be pursued in future proceedings.

Workers' Compensation Appeals BoardTravelers InsuranceFindings and OrdersanctionsMedical Provider NetworkMPNprimary treating physicianDr. Nicodemusself-procured medical treatmentcontinuity of care
References
2
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