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

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

Employers Insurance v. General Accident, Fire & Life Assurance Corp.

Employers Insurance of Wausau (Wausau) sought summary judgment for 50% reimbursement of a $500,000 settlement and defense costs. The settlement stemmed from an underlying personal injury action where Frank Rayno, an employee of Sage Garage, was injured on a construction site in 1976. Wausau provided workers' compensation and employer's liability insurance to Sage Garage, while General Accident provided general liability coverage. Wausau paid the full settlement and then pursued General Accident for contribution. General Accident argued for a pro rata contribution based on policy limits. The court granted Wausau's motion for summary judgment, ruling that both insurers should contribute equally up to the limit of the smaller policy, which was General Accident's $500,000 policy, meaning General Accident owed $250,000. The defendants' cross-motion was denied.

Insurance disputeSummary judgmentDeclaratory judgmentContribution among insurersReimbursementPolicy limitsEmployer's liability insuranceGeneral liability insuranceWorkers' compensationPro rata contribution
References
0
Case No. MISSING
Regular Panel Decision

Wausau Underwriters Insurance v. Old Republic General Insurance

This case addresses a dispute between Wausau Underwriters Insurance Company and Old Republic General Insurance Company concerning their respective obligations to defend and indemnify the "Broadway Defendants" in an underlying personal injury lawsuit. Wausau, providing coverage to the Broadway Defendants, sought a declaratory judgment that Old Republic, as the insurer for construction manager McGowan Builders Inc., was required to provide coverage as the Broadway Defendants were additional insureds. The Court, applying New York law, determined that the injury sustained by a potential subcontractor's employee on the construction site arose from McGowan's "ongoing operations," thus triggering Old Republic's duty to both defend and indemnify. Furthermore, the Court rejected Old Republic's defense of untimely notice, finding no material prejudice to its ability to investigate or defend the claim. Consequently, Wausau's motion for summary judgment was granted, ordering Old Republic to fulfill its defense and indemnification duties and reimburse Wausau for its costs and interest.

Insurance DisputeDeclaratory JudgmentSummary JudgmentDuty to DefendDuty to IndemnifyAdditional InsuredOngoing OperationsConstruction Site InjuryNew York LawLate Notice Defense
References
40
Case No. MISSING
Regular Panel Decision

Claim of McGuinness v. John P. Picone, Inc.

Wausau Insurance Company appealed a Workers' Compensation Board decision that found the doctrine of laches inapplicable against the State Insurance Fund (SIF). Wausau argued that SIF inexcusably delayed raising a noncoverage defense, causing prejudice. However, the Board found that SIF acted diligently in its defense and secured a reduction in the award. Additionally, Wausau itself failed to appear at hearings for approximately eight years despite repeated notices and penalties. The court affirmed the Board's determination, concluding it was supported by substantial evidence.

Workers' Compensation LawLaches DoctrineInsurance Coverage DisputeAppellate ReviewBoard DecisionAffirmanceInexcusable DelayPrejudiceSubstantial EvidenceCarrier Responsibility
References
5
Case No. MISSING
Regular Panel Decision

Nationwide Insurance v. Empire Insurance Group

This case concerns a dispute over insurance coverage. Marcos Ramirez was injured while working for Fortuna Construction, Inc. at premises owned by 11194 Owners Corp. Fortuna had subcontracted work from Total Structural Concepts, Inc. and agreed to add Total Structural as an additional insured on its general liability policy with Empire Insurance Group and Allcity Insurance Company. Ramirez sued 11194 Owners Corp. and Total Structural. Total Structural then commenced a third-party action against Fortuna. Nationwide Insurance Company, as Total Structural's insurer and subrogee, initiated a declaratory judgment action against Empire and Allcity after discovering Total Structural was an additional insured on their policy, demanding coverage for the Ramirez action. The Supreme Court granted Nationwide's motion for summary judgment, but the appellate court reversed, finding that Total Structural failed to provide timely notice of the Ramirez action to Empire and Allcity as required by the policy. The court emphasized that timely notice is a condition precedent to recovery and that lack of diligent effort to ascertain coverage vitiates the policy. Consequently, the appellate court granted Empire and Allcity's cross-motion, declaring they are not obligated to defend or indemnify Nationwide/Total Structural.

Insurance CoverageTimely NoticeCondition PrecedentDeclaratory JudgmentAdditional InsuredSubrogationSummary JudgmentBreach of ContractPersonal InjuryGeneral Liability Policy
References
8
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

Wausau Business Insurance v. Horizon Administrative Services LLC

Wausau Business Insurance Company sued multiple defendants, including Horizon Administrative Services LLC, alleging failure to pay outstanding premiums for two Workers Compensation and Employers Liability Insurance policies. Defendants counterclaimed and asserted an affirmative defense, arguing that Wausau's negligent handling of workers' compensation claims increased their policy premiums. Wausau moved to dismiss the counterclaim and strike the affirmative defense, contending they are not cognizable under New York law. Defendants conceded this for New York but argued Pennsylvania and Delaware law should apply. The court applied New York's choice of law analysis, determining that New York law should govern all defendants and policies due to the majority of insureds and the first named insured being in New York, and policies being issued there. Consequently, the court granted Wausau's motion, dismissing the defendants' counterclaim and striking their affirmative defense.

Choice of LawFederal Rules of Civil ProcedureMotion to DismissAffirmative DefenseWorkers' Compensation InsuranceInsurance Policy PremiumsNegligent Claims HandlingNew York LawPennsylvania LawDelaware Law
References
25
Case No. MISSING
Regular Panel Decision

Transcontinental Insurance v. State Insurance Fund

This case involves a dispute between two insurers, Transcontinental Insurance Company (plaintiff) and State Insurance Fund (defendant), regarding their contribution to the defense and settlement of an underlying personal injury action. Transcontinental, which insured the contractor Master, sought a declaration that State Insurance Fund, Master's workers' compensation insurer, should contribute as a co-insurer for expenses incurred defending and settling the action on behalf of NYPA. The Supreme Court dismissed the complaint, applying the antisubrogation rule. The Appellate Division modified the judgment, vacating the dismissal but affirming the application of the antisubrogation rule, declaring that State Insurance Fund is not obligated to reimburse Transcontinental for the expenses.

Insurance DisputeAntisubrogation RuleDeclaratory JudgmentCommercial General Liability PolicyWorkers' Compensation InsuranceIndemnificationCo-insurancePersonal Injury ActionAppellate ReviewContractual Obligation
References
5
Case No. MISSING
Regular Panel Decision

Wausau Business Insurance v. Sentosa Care LLC

Wausau Business Insurance Co. sued Sentosa Care LLC and numerous other entities for breach of contract, specifically non-payment of retrospective premiums for workers’ compensation and employer liability policies. Defendants challenged the contracts' validity, asserting illegality due to a lack of common ownership among combined insureds, and contested Wausau's methods for calculating unpaid premiums and damages. The Court denied Defendants' motion for reconsideration of diversity jurisdiction and their cross-motion for summary judgment. It found the insurance policies to be valid and enforceable, Wausau to have fully performed its obligations, and Defendants to have breached the agreements by failing to pay the outstanding balances. The Court granted Wausau's motion for summary judgment, rejecting the illegality argument and affirming Wausau's damage calculations, awarding over $6.7 million plus interest to the plaintiff.

Workers' Compensation InsuranceBreach of ContractSummary JudgmentInsurance Policy DisputeRetrospective PremiumsCorporate GroupingEmployer Liability PoliciesDamages CalculationContract EnforceabilityFederal Court Litigation
References
16
Case No. MISSING
Regular Panel Decision
Feb 28, 1991

North River Insurance v. United National Insurance

This appellate decision addresses the apportionment of liability between North River Insurance Co. and United National Insurance Company arising from a settlement for an injured employee. The court clarified that North River, as the workers' compensation carrier, is solely responsible for its waived lien, reversing a lower court's finding. It further determined that both insurers' "other insurance" clauses called for pro rata contribution, not equal shares, for the $588,245 settlement payment and defense costs. The court calculated specific shares for each insurer and ruled that North River is entitled to interest from the original payment date in 1982. The Supreme Court's order was thus modified to reflect these findings.

Insurance disputePro rata contributionEquitable apportionmentWorkers' compensation lienDefense costsOther insurance clausesSettlement apportionmentInterest calculationAppellate decisionInsurer liability
References
10
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