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

Case No. 6:09-CV-853
Regular Panel Decision

Utica Mutual Insurance Co. v. Fireman's Fund Insurance Co.

This case details a dispute between Utica Mutual Insurance Company (Utica) and Fireman’s Fund Insurance Company (FFIC) concerning reinsurance contracts, with Utica seeking substantial damages for alleged breach of contract and bad faith. FFIC counterclaimed for rescission of the reinsurance agreements. A central contention revolves around whether Utica's primary liability policies issued to Goulds from 1966-1972 contained aggregate limits for bodily injury, a condition critical to triggering FFIC's reinsurance obligations. The court dismissed Utica's bad faith claim (Count II) and its request for declaratory relief (Count III) but denied all other motions for summary judgment by both parties, including those regarding the 'follow the settlement' doctrine, FFIC's rescission counterclaim, and the timeliness of notice. Consequently, the core breach of contract claim (Count I) and FFIC's counterclaims for rescission are slated to proceed to trial.

Reinsurance DisputeBreach of ContractSummary JudgmentFollow the Settlement DoctrineAggregate LimitsBad Faith ClaimRescissionNotice of ClaimInsurance LawAsbestos Claims
References
56
Case No. 2019 NY Slip Op 06250
Regular Panel Decision
Aug 22, 2019

Utica Mut. Ins. Co. v. Abeille Gen. Ins. Co.

Utica Mutual Insurance Company appealed an order and judgment from the Supreme Court, Oneida County, which had dismissed its complaint against Abeille General Insurance Company et al. The appeal was heard by the Appellate Division, Fourth Department. Following a stipulation of discontinuance signed by the attorneys for the parties in July 2019, the Appellate Division unanimously dismissed the appeal without costs on August 22, 2019.

Insurance disputeAppellate reviewStipulation of discontinuanceComplaint dismissalOneida CountyFourth DepartmentInter-company litigationLegal costsCivil procedureOrder and judgment
References
3
Case No. MISSING
Regular Panel Decision
Jun 13, 2000

Utica Mutual Insurance v. 215 West 91st Street Corp.

Utica Mutual Insurance Company initiated a declaratory judgment action against Atlantic Mutual Insurance Company and 215 West 91st Street Corp. to determine Atlantic Mutual's obligation to defend and indemnify 215 West in underlying personal injury lawsuits. Utica Mutual had initially defended 215 West but later sought to recover costs from Atlantic Mutual. The Supreme Court denied the defendants' motion for summary judgment and granted Utica Mutual's cross-motion. On appeal, the higher court reversed the Supreme Court's order, finding that Utica Mutual was equitably estopped from denying coverage after assuming the defense without reserving its rights. Consequently, the complaint against Atlantic Mutual and 215 West was dismissed, and it was declared that Atlantic Mutual was not obligated to reimburse Utica Mutual for the defense costs.

Declaratory JudgmentInsurance CoverageEquitable EstoppelSummary JudgmentDuty to DefendIndemnificationAppellate ReviewInsurance LawNew York LawPersonal Injury
References
7
Case No. 2017 NY Slip Op 04774 [151 AD3d 504]
Regular Panel Decision
Jun 13, 2017

Nationwide Mutual Insurance Co. v. U.S. Underwriters Insurance Co.

This case concerns an insurance coverage dispute where Nationwide Mutual Insurance Company and Artimus Construction Corp., Inc., as subrogees, sought coverage from U.S. Underwriters Insurance Company. The Appellate Division, First Department, affirmed the lower court's decision to dismiss the complaint. The court found that the plaintiffs were collaterally estopped from relitigating insurance coverage issues because these matters had been decided in a prior declaratory judgment action. The majority concluded that Nationwide's subrogor, Artimus, and Artimus's subrogor, Armadillo, had a full and fair opportunity to litigate the coverage issues previously. Furthermore, the court held that the doctrine of res judicata also barred the claims, applying a transactional analysis which dictates that all claims arising from the same transaction that could have been raised in prior litigation are precluded.

Insurance CoverageSubrogationCollateral EstoppelRes JudicataAppellate ReviewDeclaratory JudgmentPersonal Injury ActionEmployer Liability ExclusionLate Notice of ClaimPrivity
References
12
Case No. CA 11-00156
Regular Panel Decision
Jun 17, 2011

MERCHANTS MUTUAL INSURANCE COMPANY v. NEW YORK STATE INSURANCE FUND

Plaintiff, Merchants Mutual Insurance Company, initiated an action against New York State Insurance Fund to recover funds related to an underlying wrongful death lawsuit. The core issue was the defendant's obligation to indemnify Jerrick Waterproofing Co., Inc. for a construction accident. The Supreme Court granted summary judgment to the plaintiff, which the defendant appealed. The Appellate Division, Fourth Judicial Department, affirmed the lower court's decision, ruling that the defendant was indeed obligated to provide unlimited coverage to Jerrick Waterproofing, despite a policy exclusion, as a common-law right to indemnity existed. Consequently, the plaintiff's excess coverage was not triggered.

Insurance disputeWorkers' CompensationIndemnificationExcess coverageSummary judgmentAppellate reviewNew York lawEmployer liabilityPolicy exclusionCommon-law indemnity
References
4
Case No. 2014 NY Slip Op 08848 [123 AD3d 933]
Regular Panel Decision
Dec 17, 2014

Public Service Mutual Insurance v. Fiduciary Insurance Co. of America

This case involves an appeal by Fiduciary Insurance Company of America (appellant) from an order and judgment confirming an arbitration award in favor of Public Service Mutual Insurance Company (respondent), as subrogee of Peter Daversa. The Supreme Court, Queens County, granted the petition to confirm and denied Fiduciary's cross-petition to vacate the arbitration award. The Appellate Division, Second Department, dismissed the appeal from the intermediate order, finding it merged into the judgment, and affirmed the judgment. The court applied closer judicial scrutiny to the compulsory arbitration award, determining that the arbitrator's decision had ample evidentiary support and was not arbitrary or capricious. The appellant's contentions regarding proximate cause, burden of proof, and prejudgment interest were found to be without merit.

Arbitration Award ConfirmationInsurance SubrogationAppellate ReviewJudicial ScrutinyEvidentiary SupportArbitrator's DeterminationProximate CausationBurden of ProofPrejudgment InterestCPLR Article 75 Proceeding
References
8
Case No. MISSING
Regular Panel Decision
Aug 01, 2007

Utica Mutual Insurance v. Johnston

Utica Mutual Insurance Company, the plaintiff, sued several corporate entities and William Johnston for breach of contract and on an account stated. The lawsuit stemmed from alleged unpaid additional premiums on general liability and worker's compensation insurance policies issued by Utica National Assurance Company and Graphic Arts Mutual Insurance Co., respectively, both affiliated with Utica Mutual. The defendants moved for summary judgment, contending that Utica Mutual was not a direct party to the insurance contracts. The Supreme Court initially denied this motion. However, the appellate court reversed the decision, granting the defendants' motion for summary judgment and dismissing the complaint, finding that Utica Mutual lacked standing as it was not the issuer or a party to the subject insurance contracts.

Breach of ContractAccount StatedSummary JudgmentAppellate ReversalInsurance DisputesUnpaid PremiumsCorporate OwnershipStanding (Law)Insurance LawCivil Procedure
References
6
Case No. CA 13-00513
Regular Panel Decision
May 09, 2014

DRYDEN MUTUAL INSURANCE COMPANY v. GOESSL, STANLEY

Plaintiff Dryden Mutual Insurance Company initiated an action seeking a declaration that it was not obligated to defend or indemnify Stanley Goessl in an underlying tort action, which arose from a fire during plumbing work. Defendants AP Daino & Plumbing, Inc. and its insurer, The Main Street America Group, also denied coverage for Goessl. The Supreme Court initially ruled in favor of Dryden Mutual and against Main Street America Group. However, the Appellate Division reversed this judgment, declaring that Dryden Mutual is obligated to defend and indemnify Goessl and reimburse his attorney's fees, based on his status as a sole proprietor insured by them. Conversely, The Main Street America Group was found to have no duty to defend or indemnify Goessl, as he was deemed an independent contractor, not an employee of AP Daino, according to their policy's plain meaning and their business arrangement. Sconiers, J., dissented, arguing that the trial court's finding of Goessl as an employee should have been upheld.

Insurance coverage disputeBusiness liabilityIndependent contractor classificationEmployee statusDuty to indemnifyDuty to defendSubcontracting agreementDeclaratory judgment actionAppellate review of judgmentContract interpretation
References
22
Case No. MISSING
Regular Panel Decision
Jan 22, 2007

Liberty Mutual Insurance v. Insurance Co. of Pennsylvania

This case concerns an appeal regarding an insurance dispute between Liberty Mutual (excess insurer) and AIG (primary insurer) over a $1.5 million settlement payment in a personal injury action. The underlying action involved an employee of General Industrial Service Corporation, a subcontractor, suing the project's owner and construction manager under the Labor Law. AIG, General's primary insurer, had refused to participate in the defense or settlement. The Supreme Court's order, which limited plaintiff's recovery to $500,000, was modified on appeal. The appellate court increased AIG's potential liability limit to $1,000,000, pending a determination of whether the employee sustained a 'grave injury' under Workers' Compensation Law § 11. The court affirmed that AIG, as a primary insurer, must exhaust its coverage before Liberty's excess coverage is implicated and is not entitled to apportionment with the excess insurer.

Insurance Coverage DisputeExcess InsurancePrimary InsuranceIndemnificationSubrogationWorkers' Compensation LawGrave InjurySummary JudgmentPolicy LimitsApportionment of Liability
References
6
Case No. MISSING
Regular Panel Decision
Feb 16, 1979

Gross Veneer Co. v. American Mutual Insurance

This case concerns an appeal from an order of the Supreme Court at Special Term in St. Lawrence County, which granted plaintiff, Gross Veneer Company, Inc., partial summary judgment. The dispute arose from a manufacturer’s blanket crime policy issued by defendant, American Mutual Insurance Companies, insuring against employee dishonesty. Plaintiff sought to recover funds embezzled by Chester Shockley, whom it alleged was an employee. The central issue was whether Shockley met the policy’s three-pronged definition of an 'employee,' which required compensation by the insured, the insured's right to govern and direct, and not being a broker or agent. The appellate court found that Special Term improperly relied on unsupported explanations regarding Shockley's compensation by Litchfield Park Corporation and failed to address whether this arrangement affected plaintiff's right to control Shockley or if Shockley acted as plaintiff's agent. Consequently, the order was reversed, and the motion for partial summary judgment was denied.

employee dishonestyinsurance policysummary judgmentcontract interpretationemployment definitionappellate reviewcompensationright to controlcorporate relationsembezzlement
References
0
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