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

Case No. 2014 NYSlipOp 06892 [121 AD3d 481]
Regular Panel Decision
Oct 14, 2014

Matter of Emerald Claims Mgt. for Ullico Cas. Ins. Co. v. A. Cent. Ins. Co.

Petitioner, Emerald Claims Management for Ullico Casualty Insurance Company, as subrogee of Randolph Meyers, sought "loss transfer" reimbursement from A. Central Insurance Company, an adverse insurer, under Insurance Law § 5105. Petitioner had paid workers' compensation benefits to its insured after a motor vehicle accident and sought reimbursement for no-fault benefits. Respondent asserted a disclaimer of coverage due to noncooperation. The Supreme Court confirmed two arbitration awards in favor of the petitioner, and the Appellate Division unanimously affirmed this judgment. The arbitrators' decision was upheld as rational, construing Insurance Law § 5105 (a) to provide a direct right to reimbursement regardless of the respondent's disclaimer of coverage. The Appellate Division also found that the respondent waived any jurisdictional arguments by fully participating in the arbitration.

Insurance LawWorkers' CompensationSubrogationLoss TransferCompulsory ArbitrationDisclaimer of CoverageNoncooperationAppellate ReviewJudgment AffirmationInsurance Policy
References
6
Case No. MISSING
Regular Panel Decision
May 09, 2008

Continental Casualty Co. v. Employers Insurance Co. of Wausau

This class action for declaratory judgment addresses complex insurance coverage disputes arising from asbestos-related personal injury claims against Robert A. Keasbey Company. Plaintiffs, Continental Casualty Company and American Casualty Company, sought declarations on the interpretation of their general liability and excess insurance policies. The court made various rulings, including that asbestos exposures trigger coverage, that pollution exclusions do not bar coverage, and that class defendants are not subject to certain insurer defenses like laches or statute of limitations. The decision also clarified per-occurrence limits and the scope of coverage for specific excess policies, ultimately outlining the obligations of the insurers for the ongoing asbestos litigation.

Asbestos LitigationInsurance Coverage DisputeDeclaratory Judgment ActionProducts Hazard CoveragePremises Operations CoverageClass Action LawsuitInsurance Policy InterpretationPollution Exclusion ClauseNotice of OccurrenceStatute of Limitations Defense
References
65
Case No. ADJ8002816, ADJ8316468
Regular
Oct 05, 2016

LORENZO TOSCANO CORONA vs. KOOSHAREM, doing business as SELECT STAFFING, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION (CIGA), ULLICO CASUALTY INSURANCE COMPANY, ACE AMERICAN INSURANCE COMPANY, RSI HOME PRODUCTS, TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA, LIBERTY MUTUAL INSURANCE COMPANY

This case involves a dispute over workers' compensation coverage where applicant Lorenzo Toscano Corona was injured, allegedly while employed through a staff leasing arrangement between Koosharem (Select Staffing) and RSI Home Products. The Appeals Board granted reconsideration to address arguments by ACE American Insurance Company and Travelers Property Casualty Company that their policies excluded coverage for the applicant. The Board rescinded the prior decision due to the arbitrator's failure to adequately document the proceedings and admitted exhibits as required by law. The matter is returned to the arbitrator to create a proper record and evaluate whether ACE and Travelers' policies contained valid exclusions for the applicant's injuries, considering relevant insurance code provisions and endorsements.

Staff leasingGeneral employerSpecial employerJoint and several liabilityOther insuranceInsurance Code section 1063.1(c)(9)Hold harmless clauseWCAB Rule 10566Hamilton v. Lockheed Corp.Labor Code section 3602(d)
References
6
Case No. ADJ9651491
Regular
Aug 22, 2016

JUDITH DIAZ vs. EXCELL SECURITY, INC., XL STAFFING, INC., XL CONSTRUCTION STAFFING; CALIFORNIA INSURANCE GUARANTEE ASSOCIATION for ULLICO CASUALTY COMPANY, in liquidation by its servicing facility, SEDGWICK CLAIMS MANAGEMENT SERVICES; SPARTA INSURANCE COMPANY by GALLAGHER BASSETT

The Workers' Compensation Appeals Board affirmed a prior finding that Sparta Insurance Company provided workers' compensation coverage for Judith Diaz. The Board found that Sparta's policy with Excell Security, Inc. did not exclude Diaz from coverage, despite Excell also having a policy with Ullico Casualty Company. Therefore, Sparta is considered "other insurance" and liable for applicant's benefits, upholding the Arbitrator's initial decision.

WORKERS' COMPENSATION APPEALS BOARDPetition for ReconsiderationFindings and OrderArbitratorother insuranceLabor Code section 1063California Insurance Guarantee AssociationCIGAULLICO CASUALTY COMPANYliquidation
References
2
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

Atlantic Casualty Insurance v. Value Waterproofing, Inc.

Atlantic Casualty Insurance Company sought a declaratory judgment that it had no duty to defend or indemnify Value Waterproofing, Inc. in an underlying breach of contract and negligence lawsuit. Value counterclaimed, requesting a declaration that Atlantic Casualty was required to defend and indemnify. The court granted Atlantic Casualty's request, finding that Value failed to provide timely notice of the claim, thereby prejudicing Atlantic Casualty's investigation capabilities. Additionally, the court ruled that Value's work on a commercial property was not covered by its residential-only roofing insurance policy, further justifying the denial of coverage.

Insurance disputeBreach of contractNegligenceDeclaratory judgmentTimely noticeCoverage exclusionCommercial General LiabilityResidential roofingPolicy interpretationPrejudice
References
46
Case No. MISSING
Regular Panel Decision

National Casualty Co. v. Allcity Insurance

This case concerns an appeal from an order of the Supreme Court, Bronx County, which initially denied Allcity Insurance Company's motion for summary judgment and granted National Casualty Company's cross-motion for reimbursement. The underlying dispute involved National's request for one half of settlement and defense costs from Allcity, stemming from a personal injury action where the owner and general contractor were additional insureds on a subcontractor's general liability policy. The appellate court unanimously reversed the lower court's decision, granting Allcity's motion and denying National's cross-motion. The reversal was based on the antisubrogation rule, which precluded National from seeking recovery from Allcity, the subcontractor's workers' compensation carrier, as Allcity would not have been obligated to contribute to the settlement. Consequently, the complaint against Allcity was dismissed.

Summary JudgmentAntisubrogation RuleAdditional InsuredReimbursementDefense CostsGeneral Liability PolicyWorkers' Compensation CarrierAppellate DivisionInsurance LawPersonal Injury Action
References
2
Case No. 2014 NY Slip Op 06060
Regular Panel Decision
Sep 10, 2014

Key Fat Corp. v. Rutgers Casualty Insurance

This case involves an appeal concerning an insurer's obligation to reimburse attorney's fees. Key Fat Corp. and Seneca Insurance Company sued Rutgers Casualty Insurance Company after Rutgers disclaimed coverage to Key Fat's indemnitee, Bando Construction, Inc., in an underlying personal injury action. The Appellate Division affirmed the Supreme Court's decision, which found Rutgers Casualty estopped from disclaiming coverage because it failed to provide timely notice to Key Fat Corp. as required by Insurance Law § 3420 (d)(2). The court ruled that this provision applies to defense costs incurred in connection with an underlying personal injury action, thus obligating Rutgers Casualty to reimburse Key Fat Corp. for attorney's fees and litigation costs.

Insurance CoverageDisclaimer of CoverageAttorney's FeesLitigation CostsPersonal Injury ActionTimely NoticeEstoppelCommercial General Liability PolicyContractual IndemnificationCommon-Law Indemnification
References
7
Case No. MISSING
Regular Panel Decision

Logan Bus Co. v. Discover Property & Casualty Insurance

The plaintiff, Logan Bus Company, Inc., initiated a declaratory judgment action against Discover Property & Casualty Insurance Company to establish Discover's obligation to defend and indemnify Logan in an underlying lawsuit. The underlying action involved a sexual assault perpetrated by a student on another student on a bus owned by Logan, allegedly due to inadequate supervision. Logan appealed two orders from the Supreme Court, Queens County: one denying its motion for summary judgment for coverage and another granting Discover's motion to declare no obligation and dismiss the complaint. The appellate court affirmed both lower court orders, concluding that the "abuse or molestation" endorsement in Logan's insurance policy with Discover explicitly limited coverage to acts committed by "employees" or "volunteer workers." Since the alleged incident was perpetrated by a student, Logan failed to demonstrate a prima facie entitlement to coverage, leading to the affirmation of Discover's non-obligation to defend or indemnify.

Declaratory JudgmentInsurance Policy InterpretationCoverage DisputeAbuse or Molestation EndorsementDuty to DefendDuty to IndemnifySummary JudgmentAppellate ReviewAutomobile InsuranceStudent Assault
References
11
Case No. MISSING
Regular Panel Decision
Dec 22, 1992

Aetna Casualty & Surety Co. v. Greater New York Mutual Insurance

This case involves an appeal concerning an insurer's claim for contribution. Aetna Casualty & Surety Company, the liability insurer for Trio Drug Corporation and additional insured 58 Realopp Corporation, sought contribution from Greater New York Mutual Insurance Company, Trio's workers' compensation carrier. Aetna had settled an underlying injury action where it represented both Realopp and Trio, and subsequently sued for 50% of the settlement amount. The Supreme Court affirmed the denial of Aetna's summary judgment motion and the granting of Greater New York's cross-motion for summary judgment. The appellate court applied the anti-subrogation rule, finding that Aetna could not assert a subrogated claim against its own insured, Trio, due to potential conflicts of interest arising from its dual representation in the underlying action.

anti-subrogation ruleconflict of interestsummary judgmentcontributionworkers' compensationliability insurancethird-party claimcommon law indemnityappellate reviewinsurer dispute
References
3
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