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Case Law Database

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

Case No. MISSING
Regular Panel Decision

Claim of Shutter v. Philips Display Components Co.

The claimant, injured in a work-related single-car accident, received workers' compensation benefits and also pursued an uninsured motorist claim, recovering $124,697.95. The Workers' Compensation Board ruled that the employer's insurance carrier was entitled to offset this recovery against future compensation benefits, overturning a prior WCLJ decision. The claimant appealed, arguing that Workers' Compensation Law § 29's offset provisions apply only to third-party tortfeasor actions, not uninsured motorist proceeds. The court rejected this argument, finding the statute's general terminology encompasses uninsured motorist benefits and that legislative intent for exclusion only exists for no-fault benefits, not uninsured motorist benefits under Insurance Law § 3420 (f). Consequently, the Board's decision was affirmed.

Uninsured motoristWorkers' Compensation LawOffsetInsurance carrierThird-party tortfeasorLien provisionsStatutory interpretationLegislative intentNo-fault insuranceCompensation benefits
References
3
Case No. MISSING
Regular Panel Decision

In re the Arbitration between Williams

Amoco Oil appealed two judgments from the Supreme Court, Nassau County, concerning arbitration for uninsured motorist and no-fault benefits. The first judgment, dated January 6, 1977, granted New Hampshire Insurance Company's application to stay arbitration, deeming Amoco Oil's coverage primary and New Hampshire's secondary for uninsured motorist benefits. The second judgment, dated March 30, 1977, permanently stayed arbitration for no-fault benefits under New Hampshire's policy. The Appellate Division affirmed both judgments, concluding that the claimant was "occupying" the Amoco Oil vehicle, making Amoco Oil primarily liable for uninsured motorist benefits. However, the claimant was precluded from receiving these benefits due to already receiving workers' compensation benefits in excess of the maximum, and was also ineligible for no-fault benefits under the New Hampshire policy.

Insurance DisputeArbitration ProceedingsUninsured Motorist CoverageNo-Fault InsuranceWorkers' CompensationPrimary vs Secondary LiabilityAppellate DivisionNassau County Supreme CourtVehicle OccupancyBenefit Eligibility
References
3
Case No. MISSING
Regular Panel Decision
Feb 26, 2010

IDS Property Casualty Insurance v. Wynter

The Supreme Court, New York County, denied the petitioner's application to stay arbitration of an uninsured motorist claim brought by the respondent. The case involved an accident where the respondent was a passenger in an uninsured vehicle, driven by a fellow employee during a personal errand unrelated to work. The court found that because the accident did not occur within the scope of employment, Workers' Compensation Law § 29 [6] did not provide an exclusive remedy. This decision was unanimously affirmed by the Appellate Division.

uninsured motoristarbitrationstay arbitrationscope of employmentpersonal errandfellow employeeexclusive remedyappellate reviewaffirmance
References
1
Case No. MISSING
Regular Panel Decision
Jan 09, 2013

Richard Liput v. Bobby Grinder

Richard Liput was involved in an automobile accident with Bobby Grinder. Grinder died, and Liput settled with Grinder's insurer. Liput then sued his Uninsured Motorist carrier, State Auto Mutual Insurance Company, for damages. The trial court granted summary judgment to the Uninsured Motorist carrier because Liput failed to properly and timely serve Grinder or his estate, a requirement to impose liability on the uninsured motorist carrier. Liput appealed, arguing issues related to service, the Uninsured Motorist Statute, and waiver of defenses. The appellate court affirmed the trial court's decision, holding that the direct action procedure against the uninsured motorist carrier was not triggered because the summons for Grinder was not returned "not to be found," and Liput could not rely on waiver of defenses as he knew Grinder was not served.

Summary JudgmentUninsured Motorist CoverageService of ProcessStatute of LimitationsAffirmative DefensesWaiverEquitable EstoppelSurvival StatutePersonal RepresentativeAppellate Review
References
41
Case No. 3562
Regular Panel Decision

American Motorists Insurance Co. v. Simecek

This case concerns an appeal by American Motorists Insurance Company against Bobby J. Simecek regarding the timely filing of an appeal to set aside an Industrial Accident Board award. The trial court initially ruled in favor of Simecek, maturing the award, as it found American Motorists had failed to timely file its appeal. On appeal, the central question was whether American Motorists' petition was timely filed under Tex.Rev.Civ.Stat.Ann. art. 8307, § 5, considering it was mailed within the statutory twenty-day period but received later. The appellate court extended the 'Ward' rule, which applies to notices of intent not to abide by an award, to the 'bring suit' provision, thereby deeming a petition timely filed if mailed before the deadline and received within ten days after the deadline. Consequently, the appellate court reversed the trial court's judgment and ruled that Simecek should take nothing by his suit to mature the award.

Worker's CompensationAppellate ProcedureTimely FilingStatutory InterpretationTexas LawIndustrial Accident BoardJurisdictionMailbox RuleNotice of AppealTexas Rules of Civil Procedure
References
6
Case No. MISSING
Regular Panel Decision
Sep 13, 2000

AIU Insurance v. American Motorists Insurance

This case concerns an appeal regarding primary liability coverage for HRH Construction Corp. and Hotel Grand Central in an underlying personal injury action. Plaintiffs, including their excess insurer AIU Insurance Co., sought to compel American Motorists Insurance Co. and St. Paul Fire & Marine Ins. Co. to provide primary defense and reimbursement. The court found American Motorists obligated to defend HRH and the Hotel, as their policy covered them as additional insureds for claims "arising out of" work performed by American Motorists' primary insured, Cord Contracting Co. However, St. Paul was not similarly obligated, as the injury did not "arise out of" work by its insured, Forest Electric Corp. Consequently, the court modified the prior declaration, vacating the plaintiffs' favor against St. Paul and dismissing Cord Contracting Co.'s cross-appeal.

Insurance DisputePrimary Liability CoverageExcess InsuranceAdditional InsuredPersonal InjuryConstruction SiteSubcontractorContractual ObligationDuty to DefendIndemnification
References
1
Case No. MISSING
Regular Panel Decision

Elrac, Inc. v. Exum

This case addresses whether a self-insured employer is liable to its employee for uninsured motorist benefits, despite the Workers' Compensation Law's exclusivity provision. Birtis Exum, an employee of self-insured Elrac, Inc., was injured in an accident with an uninsured driver while driving an Elrac car in the course of his employment. Exum sought uninsured motorist benefits from Elrac, which Elrac attempted to stay. The Appellate Division allowed arbitration to proceed, and this Court affirmed that decision. The Court referenced Matter of Allstate Ins. Co. v Shaw to establish that self-insurers have the same liability for uninsured motorist coverage as insurance companies. Despite the exclusivity clause of Workers’ Compensation Law § 11, the Court determined that an action to enforce uninsured motorist liability against a self-insurer is essentially contractual, and therefore not barred by the Workers' Compensation Law.

Self-insured employeruninsured motorist benefitsWorkers' Compensation Lawexclusivity provisioncontractual liabilityautomobile accidentstatutory interpretationappellate reviewNew York lawElrac
References
4
Case No. MISSING
Regular Panel Decision

Dennis Michael Harris v. Mickey Deanne Haynes

The Tennessee Supreme Court affirmed the Court of Appeals' judgment, holding that a governmental fund established under Tennessee Code Annotated sections 29-20-401 to -408, such as the Tennessee Risk Management Trust (TRMT), is statutorily exempt from Tennessee's insurance statutes, including the uninsured motorist coverage requirements. The case arose from an incident where Dennis Michael Harris, an Anderson County patrolman, was struck by an uninsured driver and sought uninsured motorist benefits from TRMT, Anderson County's motor vehicle liability coverage provider. Both the trial court and the Court of Appeals granted summary judgment to TRMT, finding that it was a governmental risk pool, not an insurance company, and thus not subject to the uninsured motorist statute. The Supreme Court agreed, emphasizing that the relevant statute plainly exempts such funds from insurance regulation and that Anderson County had validly rejected uninsured motorist coverage for employees receiving workers' compensation benefits.

Governmental Tort Liability ActRisk Management TrustUninsured Motorist CoverageStatutory ExemptionSelf-InsuranceInterlocal AgreementsGovernmental ImmunitySummary JudgmentStatutory ConstructionAppellate Review
References
22
Case No. E2020-00225-COA-R3-CV
Regular Panel Decision
Dec 30, 2021

David Hughes v. The Liberty Mutual Fire Insurance Company

David Hughes was involved in an automobile accident and filed an uninsured motorist claim with Liberty Mutual Fire Insurance Company. The named insured, Health Management Associations, Inc. (HMA), had previously rejected uninsured motorist coverage for vehicles in Tennessee. Hughes argued that this prior rejection was invalid because HMA submitted a new application during the policy renewal process. However, the trial court found that no new application was submitted, and the prior rejection remained effective, thus denying uninsured motorist coverage. The Court of Appeals of Tennessee affirmed the trial court's decision, concluding that the 2010 written rejection of uninsured motorist coverage was still in effect for the 2011 renewal policy.

Uninsured Motorist CoverageInsurance Policy RenewalContract InterpretationBusiness Automobile PolicyRejection of CoverageStatutory InterpretationAppellate ReviewAgency LawCommercial InsuranceFleet Coverage
References
11
Case No. MISSING
Regular Panel Decision

Sherlin v. Hall

Plaintiff Teresa D. Sherlin sued Sandra G. Hall for personal injuries and property damage sustained in a head-on collision with an uninsured motorist, Ms. Hall. Sherlin's uninsured/underinsured motorist carrier, Farmers Insurance Exchange, was granted summary judgment by the Trial Court. The Trial Court found that Sherlin was receiving workers' compensation benefits that exceeded the limits of her uninsured motorist policy, and pursuant to the policy's terms and Tennessee law, Farmers had no liability due to the offset. Sherlin appealed, arguing the court should revisit the established law regarding offsets. The appellate court affirmed the Trial Court's decision, stating that Tennessee law is well-settled on the issue of uninsured motorist policy offsets by workers' compensation benefits, and any change in this statutory and case law must originate from the legislature, not an intermediate appellate court.

uninsured motoristworkers' compensation benefitssummary judgmentinsurance policy offsetappellate reviewstatutory interpretationTennessee lawcomparative faultpersonal injuryhead-on collision
References
19
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