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

Case No. 2024 NY Slip Op 02505
Regular Panel Decision
May 07, 2024

New York City Hous. Auth. v. Admiral Ins. Co.

The Appellate Division, First Department, affirmed a Supreme Court order that granted summary judgment to the New York City Housing Authority (NYCHA). The Supreme Court had declared that Admiral Insurance Company (Admiral) had untimely disclaimed insurance coverage. The Appellate Division agreed, finding that Admiral's August 2018 disclaimer was untimely as a matter of law because Admiral had knowledge of a basis for disclaimer as early as 2016, based on an 'action over' exclusion. The court also rejected Admiral's contention that its duty to disclaim was triggered only when excess coverage might be reached, concluding that Admiral had notice of such a possibility no later than 2017.

Insurance CoverageDisclaimer of CoverageTimeliness of DisclaimerSummary JudgmentExcess Liability PolicyLabor LawAction Over ExclusionAppellate ReviewFirst DepartmentInsurance Litigation
References
4
Case No. MISSING
Regular Panel Decision

Tower Insurance v. Classon Heights, LLC

This case is a declaratory judgment action regarding an insurance coverage disclaimer based on late notice of a personal injury claim. Plaintiff Tower Insurance issued a liability policy to Classon Heights and Renaissance Realty, who were notified of an accident involving Elizabeth Gonzalez on their premises in October 2006. Despite knowing about the incident where Gonzalez fell and was taken to a hospital, the insureds waited five months, until March 2007, to notify Tower Insurance. Tower Insurance subsequently disclaimed coverage due to the untimely notice and initiated this action to declare it had no duty to defend or indemnify the insureds. The Supreme Court granted summary judgment to Tower Insurance, concluding that a five-month delay was untimely as a matter of law and the insureds' belief in nonliability was unreasonable given their immediate knowledge of Gonzalez's fall and hospital transport.

Insurance CoverageDisclaimer of CoverageLate Notice of ClaimPersonal InjuryDeclaratory JudgmentSummary JudgmentDuty to NotifyPolicy ConditionsTimeliness of NoticeReasonable Belief
References
11
Case No. MISSING
Regular Panel Decision
Nov 16, 2004

Bovis Lend Lease LMB, Inc. v. Royal Surplus Lines Insurance

This case involves an insurance coverage dispute between National Union Fire Insurance Company of Pittsburgh, PA (National Union), The Trustees of Columbia University in the City of New York (Columbia), and Bovis Lend Lease LMB, Inc. (Bovis) against Royal Surplus Lines Insurance Company (Royal). The core issue is whether Royal's disclaimer of liability under Insurance Law § 3420 (d) was timely. The court found that Royal's disclaimer to Bovis and Columbia was untimely as a matter of law because its internal staffing issues were not a reasonable excuse for the delay. However, the court also ruled that § 3420 (d) does not apply to disclaimers between co-insurers, thus Royal's disclaimer was timely as to National Union. Furthermore, the court determined that Royal's "New Residential Work or Products Exclusion" did not apply to Millennium's work on a mixed-use building, thus obligating Royal to defend and indemnify Bovis and Columbia, and Royal was ordered to reimburse National Union for defense costs incurred from March 3, 2003.

Insurance CoverageDisclaimer of LiabilityDenial of CoverageInsurance Law § 3420 (d)Timeliness of DisclaimerInternal Staffing IssuesCo-Insurer LiabilityAdditional InsuredPolicy ExclusionNew Residential Work Exclusion
References
22
Case No. MISSING
Regular Panel Decision

Claim of Wilkinson v. Bendix Friction Corp.

Claimant filed a workers' compensation claim after being diagnosed with a lung condition, which a Workers' Compensation Law Judge (WCLJ) determined in August 2003 was an occupational disease causally related to 1969 asbestos exposure while working for the employer, though not currently disabling. The claimant sought review. The Workers' Compensation Board, in January 2004, found the employer's rebuttals to be untimely. Subsequently, the employer and its third-party administrator filed an application for Board review in February 2004, which the Board denied as untimely in October 2004. The employer appealed this denial. The appellate court affirmed the Board's decision, finding no abuse of discretion in denying the application as untimely, given that the employer had received proper notice of the WCLJ decision.

Workers' CompensationUntimely ApplicationBoard ReviewOccupational DiseaseAsbestos ExposureCausal RelationDisability ClaimAppellate Decision
References
4
Case No. MISSING
Regular Panel Decision
Apr 17, 1990

Claim of Rogers v. Evans Plumbing & Heating

The claimant appealed a decision from the Workers’ Compensation Board, filed on April 17, 1990, which ruled his application untimely. The claimant had applied on August 31, 1988, to review two Workers’ Compensation Law Judge decisions from August 5, 1985, and October 1, 1985, denying compensation benefits for a period between February 7, 1983, and September 23, 1985. The Board correctly determined that the claimant's application was untimely as it was filed more than 30 days after the original decisions, citing Workers’ Compensation Law § 23 and 12 NYCRR 300.13 (a). The Board's decision to not entertain the untimely application was found to be neither arbitrary nor capricious. The higher court subsequently affirmed the Board's decision.

Untimely ApplicationWorkers' Compensation LawAppellate ReviewBoard DecisionProcedural TimelinessJudicial ReviewAppealSection 23NYCRR 300.13Claimant Benefits
References
1
Case No. MISSING
Regular Panel Decision
Jan 10, 2008

Magen v. Hartford Fire Insurance

This case addresses whether the prompt disclaimer requirement of the Insurance Law is triggered when one insurance carrier notifies another carrier on behalf of a mutual insured, requesting defense and indemnity. The court reiterates its holding in Bovis Lend Lease LMB, Inc. v Royal Surplus Lines Ins. Co., confirming that such a tender triggers the insurer's obligation to issue a timely disclaimer under Insurance Law § 3420 (d). In this specific instance, J.T. Magen's insurer, Travelers, tendered notice to Hartford on behalf of J.T. Magen, IDA, and Magen David Yeshiva, who were additional insureds under a Hartford policy. Hartford's 51-day delay in disclaiming coverage was deemed untimely, precluding them from denying coverage. The Supreme Court's decision granting J.T. Magen summary judgment was affirmed.

Insurance LawDisclaimer of CoverageTimely NoticeAdditional InsuredDeclaratory JudgmentCondition PrecedentInter-insurer ClaimsConstruction Site InjurySubcontractor LiabilitySummary Judgment
References
20
Case No. MISSING
Regular Panel Decision

Fulton Boiler Works, Inc. v. American Motorists Insurance

Fulton Boiler Works, Inc., filed an action against several insurance companies regarding defense and indemnification for thousands of asbestos claims. The court addressed multiple pending motions for summary judgment, focusing on the proper allocation of indemnity costs among the liable parties, Fulton's obligation for uninsured years, the applicability of equitable estoppel against insurers, and Travelers' specific obligations concerning notice of claims and disclaimers. The court ruled that a pro rata allocation of indemnity costs is appropriate, with Fulton liable for periods it was uninsured. Equitable estoppel was deemed inapplicable to bar insurers from seeking contribution, and Travelers was found to have received proper notice for many claims and is barred from disclaiming coverage due to untimely disclaimers. This order, along with a previous one, sets the 'ground rules' for resolving past, pending, and future asbestos claims.

Asbestos LiabilityInsurance Coverage DisputeIndemnity AllocationSummary JudgmentEquitable EstoppelNotice ProvisionsDisclaimer of CoveragePro Rata AllocationInjury-in-factComprehensive General Liability Policy
References
23
Case No. MISSING
Regular Panel Decision

Insurance Corp. of New York v. United States Fire Insurance

This case concerns a dispute between a primary insurer, The Insurance Corporation of New York, and an excess insurer, United States Fire Insurance Company (US Fire), regarding the timeliness of claim notice and US Fire's subsequent disclaimer. The motion court initially denied US Fire's cross-motion for summary judgment, deeming its disclaimer untimely. However, the appellate court determined that US Fire received proper notice on April 20, 2006, not March 16, 2006, making its disclaimers, issued eight days later, timely as a matter of law. Consequently, the appellate court reversed the lower court's decision, granting US Fire's cross-motion for summary judgment and dismissing the complaint against it. Additionally, an appeal from a separate order regarding US Fire's request to rescind an insurance policy was dismissed as abandoned.

Insurance PolicyExcess InsurancePrimary InsuranceTimely NoticeDisclaimer of CoverageSummary JudgmentAppellate ReviewClaim NotificationInsurance ContractLiability Insurance
References
9
Case No. MISSING
Regular Panel Decision
Dec 16, 2004

US Underwriters Ins. Co. v. CITY CLUB HOTEL

The New York Court of Appeals addresses whether an insured who prevails in a declaratory judgment action brought by an insurer to deny coverage may recover attorneys' fees, regardless of whether the insurer provided a defense in the underlying suit. U.S. Underwriters Insurance Company had disclaimed coverage for City Club Hotel, LLC and Shelby Realty, LLC after a construction worker's injury, but still provided Shelby a defense. The insurer then initiated a declaratory judgment action to establish it had no duty to defend or indemnify. The District Court's finding that the disclaimer was untimely and its denial of attorneys' fees were appealed. The Court of Appeals, responding to certified questions from the Second Circuit, affirmed that Shelby, as a prevailing insured, is entitled to recover attorneys' fees because these expenses arose as a direct consequence of the insurer's unsuccessful attempt to disclaim policy obligations. The court explicitly answered the first certified question in the affirmative, while declining to answer the second.

Insurance LawDeclaratory JudgmentAttorneys' FeesDuty to DefendDuty to IndemnifyNew York Court of AppealsCertified QuestionsInsurer ObligationsPolicy DisclaimerTimeliness of Disclaimer
References
7
Case No. MISSING
Regular Panel Decision
Dec 24, 1996

Aetna Casualty & Surety Co. v. National Union Fire Insurance

Eldee Mike, an employee of Vanderbilt Biltmore Corp., was injured at a construction project owned and managed by Harry Macklowe, Harry Macklowe Real Estate Co., Inc., and McGraw Hudson Construction Corp. Vanderbilt, a subcontractor, was contractually obligated to indemnify Macklowe and name them as additional insureds on its liability policy with National Union. Mike subsequently sued Macklowe, who then brought a third-party action against Vanderbilt. National Union disclaimed coverage due to Vanderbilt's late notice, as Vanderbilt had been dissolved. Macklowe's insurer, Aetna Casualty & Surety Company, defended Macklowe and paid the judgment and legal fees, then sued National Union for reimbursement. The IAS Court initially denied Aetna's summary judgment motion and granted National Union's cross-motion, finding Aetna's notice untimely. The appellate court reversed, holding that Aetna, as Macklowe's subrogee, provided timely notice and that National Union's disclaimer, based solely on Vanderbilt's late notice, was ineffective against Aetna/Macklowe because their late notice was not asserted as a ground for disclaimer.

Insurance Coverage DisputeDuty to DefendContractual IndemnificationAdditional InsuredsLate Notice DisclaimerSummary JudgmentAppellate ReversalSubrogation ClaimConstruction LiabilityDissolved Corporation
References
6
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