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

Case No. ADJ7979998
Regular
Sep 09, 2013

JOSE OCOTOXTLE vs. McDONALD'S, US FIDELITY & GUARANTY INSURANCE COMPANY, SEDGWICK CMS, INC.

This case involves US Fidelity & Guaranty Insurance Company seeking reconsideration of a Compromise and Release Agreement approved in a separate workers' compensation claim. US Fidelity argues the judge exceeded authority by approving a settlement that did not account for apportionment with a McDonald's claim where they were the insurer. The Appeals Board denied reconsideration, holding that the settlement of a separate cumulative trauma claim against a different employer does not affect US Fidelity's liability for applicant's McDonald's injury. The Board noted US Fidelity can pursue contribution proceedings under Labor Code section 5500.5(h) if needed.

US Fidelity & Guaranty Insurance CompanyMcDonald'sJose OcotoxtleLiberty MutualDarden RestaurantsOlive Gardencumulative trauma injuryAugust 212009 industrial injuryADJ7979998
References
1
Case No. 2020 NY Slip Op 07642
Regular Panel Decision
Dec 17, 2020

Matter of Thomas (US Pack Logistics, LLC--Commissioner of Labor)

Aston R. Thomas, a claimant, was hired by US Pack Logistics, LLC to deliver blood samples. The Unemployment Insurance Appeal Board determined that Thomas was an employee of US Pack Logistics, LLC, making the company liable for unemployment insurance contributions. US Pack Logistics, LLC appealed this decision to the Appellate Division, Third Department. The Appellate Division affirmed the Board's finding of an employer-employee relationship, noting that US Pack Logistics, LLC exercised sufficient supervision, direction, and control over significant aspects of Thomas's work, despite Thomas using his own vehicle and not being reimbursed for expenses. The court emphasized that the determination of an employment relationship is a question of fact, and the Board's decision, if supported by substantial evidence, is beyond further judicial review.

Unemployment Insurance LawEmployer-Employee RelationshipIndependent ContractorControl TestAppellate ReviewUnemployment Insurance ContributionsLabor LawSubstantial EvidenceUnemployment Insurance Appeal BoardJudiciary Law
References
6
Case No. MISSING
Regular Panel Decision

Wang v. Phoenix Satellite Television US, Inc.

Plaintiff Lihuan Wang, an unpaid intern, sued Phoenix Satellite Television US, Inc. for employment discrimination under the NYSHRL and NYCHRL. She alleged hostile work environment, quid pro quo sexual harassment, and retaliation by bureau chief Zhengzhu Liu, and a failure to hire her due to discriminatory animus. Phoenix moved to dismiss the Second Amended Complaint. The Court granted Phoenix's motion to dismiss Ms. Wang's hostile work environment claim, ruling that as an unpaid intern, she does not qualify as an 'employee' under the NYCHRL. However, the Court denied Phoenix's motion to dismiss Ms. Wang's remaining failure to hire claims, finding she plausibly alleged an informal application process for unposted vacancies.

Employment DiscriminationSexual HarassmentHostile Work EnvironmentFailure to HireUnpaid InternNYSHRLNYCHRLMotion to DismissEmployee DefinitionQuid Pro Quo
References
38
Case No. MISSING
Regular Panel Decision

474431 Associates v. AXA Global Risks US Insurance

This case involves an appeal by Allcity Insurance Company in a consolidated action seeking a declaratory judgment regarding co-insurance liability between Allcity and AXA Global Risks US Insurance Company. The dispute arose from an underlying action where an injured worker obtained a judgment against a property owner, which was satisfied by the owner's insurer, AIG. AIG then sought reimbursement from the worker's employer's carriers, Allcity (worker's compensation) and AXA (general liability). The Supreme Court initially favored AXA, but the appellate court reversed, holding that AXA's disclaimer of coverage was untimely under Insurance Law § 3420 (d). The matter was remitted to declare AXA a co-insurer with Allcity.

Insurance Law § 3420 (d)Disclaimer of CoverageTimely Notice RequirementCo-Insurance DisputeGeneral Liability InsuranceWorker's Compensation InsuranceSummary Judgment MotionAppellate Court DecisionDeclaratory ReliefPolicy Exclusion
References
6
Case No. MISSING
Regular Panel Decision

Moll v. US Life Title Insurance Co. of New York

The case involves plaintiffs Moll, Elser, McGuire, and Harlow suing US Life Title Insurance Company of New York, asserting claims under RESPA, RICO, and state laws. Plaintiffs alleged misrepresentation, failure to disclose kickbacks to attorneys, and aiding and abetting fraud related to title insurance premiums. The court found plaintiffs failed to adequately allege mail fraud or commercial bribery as predicate acts for RICO claims, citing insufficient evidence of misrepresentation, a duty to disclose, substantial assistance in fraud, or economic harm due to non-negotiable premiums. Consequently, the defendant's motion to dismiss the Consolidated Complaint was granted, leave to replead was denied, and pendent state law claims were dismissed for lack of federal jurisdiction.

RICO ActRESPA ActMail FraudCommercial BriberyFraud AllegationsMotion to DismissPendent State ClaimsRule 12(b)(6)Rule 9(b)Title Insurance
References
33
Case No. MISSING
Regular Panel Decision

Van Deusen v. United States Fidelity & Guaranty Co.

Petitioners Duane and Barbara Van Deusen appealed the denial of their request for apportionment of attorney's fees against United States Fidelity and Guaranty Company (USF&G). USF&G was the workers' compensation and liability insurer for Duane's employer, Goettle, and its lien was satisfied from the Van Deusens' third-party award for personal injuries. Special Term had denied the apportionment based on the precedent set in *France v Abstract Tit. Div. of Tit. Guar. Co.*, which held that when the lienor is also the employer's liability insurer, the attorney's efforts are considered adverse, extinguishing the contribution obligation. This court reconsidered the *France* ruling, deeming it unfair to injured plaintiffs and contrary to the legislative intent behind the Workers' Compensation Law amendment regarding lienor contribution to litigation costs. The court found no legal or logical reason to differentiate an injured employee's recovery based on whether the employer's compensation and liability insurance were with one or two carriers. Consequently, the court reversed the Special Term's order and remitted the matter for further proceedings, instructing that litigation costs be calculated based on the direct benefit the lienor received from the recovery through lien recoupment, with an additional consideration for any wrongfully withheld compensation benefits.

Workers' Compensation LawAttorney's Fees ApportionmentInsurance LienThird-Party ActionEmployer LiabilityIndemnificationContributionDole-Dow DoctrineAppellate ReviewLegal Precedent Reconsideration
References
8
Case No. 2015 NY Slip Op 30039[U]
Regular Panel Decision
Jan 20, 2015

Lend Lease (US) Construction LMB Inc. v. Zurich American Insurance

Plaintiffs Extell West 57th Street and Lend Lease (US) Construction LMB Inc. sued their insurers, including Zurich and Travelers, after a construction crane at the One57 building was damaged by Superstorm Sandy. The insurers denied coverage under a builder's risk policy, leading to a dispute over whether the crane qualified as a 'temporary work' and if it was excluded as 'contractor's tools.' The lower court denied summary judgment, finding factual issues. On appeal, the majority granted summary judgment to the defendants, declaring no coverage. The dissenting opinion argues that the crane should be considered a 'temporary structure' and the 'contractor's tools' exclusion should not apply, but concurs that summary judgment for plaintiffs was improper due to a factual dispute regarding whether the crane's value was included in the total project value.

Insurance coverage disputeBuilder's risk policyTemporary structuresContractor's tools exclusionSuperstorm SandyConstruction crane damageSummary judgmentContract interpretationEjusdem generisNoscitur a sociis
References
17
Case No. 2020 NY Slip Op 00383
Regular Panel Decision
Jan 21, 2020

U-Trend N.Y. Inv. L.P. v. US Suite LLC

This case involves an appeal concerning a judgment awarding mortgage damages to U-Trend New York Investment L.P. against US Suite LLC and Aura Investments Ltd. The Appellate Division, First Department, modified the Supreme Court's judgment by reducing the principal amount of mortgage damages awarded to U-Trend, stating that interest should be calculated at 13.5% instead of 20%. The court affirmed the judgment in other respects, including the limitation of Aura's liability for looting damages and the denial of sale damages and attorneys' fees. An appeal from a separate order denying Aura's motion to correct or vacate the judgment was dismissed as academic. The court addressed various arguments from Aura regarding liability, causation, and damages calculations, ultimately upholding liability for breach of contract but adjusting the damages amount based on the proper interest rate.

Mortgage DamagesBreach of ContractFiduciary DutyLooting DamagesInterest Rate CalculationAppellate ReviewBusiness Judgment RuleJudicial AdmissionsDerivative ClaimsAttorneys' Fees
References
20
Case No. MISSING
Regular Panel Decision

Zinaman v. USTS New York, Inc.

Lawrence M. Zinaman sued USTS New York, Inc. and US-Travel Systems, Inc. for breach of contract, fraud, and age discrimination under the ADEA and New York's Human Rights Law. Defendants moved to dismiss several claims. The court granted the motion to dismiss all claims against US-Travel Systems, Inc., finding insufficient pleading for an 'alter ego' theory. The fraud claim against USTS New York, Inc. was also dismissed, as it merely restated the breach of contract claim. However, the court denied the dismissal of Zinaman's state common law contract claims and state age discrimination claims against USTS. The court also denied the defendants' motion to strike portions of the complaint. Zinaman was directed to amend his complaint regarding the state age discrimination claim.

Age DiscriminationBreach of ContractFraudEmployment AgreementAlter Ego TheoryPendent JurisdictionMotion to DismissRule 12(b)(6)Rule 12(f)ADEA
References
20
Case No. 2015 NY Slip Op 00842
Regular Panel Decision
Feb 04, 2015

Fidelity & Guaranty Insurance v. DiGiacomo

This case involves an action to recover on a Workers' Compensation lien. The Appellate Division, Second Department, modified a Supreme Court order by granting the plaintiffs' motion for summary judgment, thereby awarding them $123,442.47 for a net Workers' Compensation lien. The Court affirmed the Supreme Court's decision to grant judicial approval for a $2,050,000 third-party settlement, finding the settlement reasonable and the delay in seeking approval adequately explained and non-prejudicial to the insurance carrier. The decision clarified that Workers' Compensation Law § 29 (5) mandates judicial approval for settlements, even when the settlement amount is not less than the compensation already received, due to potential future benefit entitlements.

Workers' Compensation LienSummary JudgmentJudicial Approval of SettlementThird-Party ActionWorkers' Compensation Law Section 29(5)Insurance Carrier ConsentEquitable Share of Litigation CostsPermanent Partial DisabilityAppellate Division Second DepartmentNunc Pro Tunc Approval
References
12
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