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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

In re the Arbitration between Country-Wide Insurance & Manning

Daisy P. Manning, an employee of the Department of Transportation, was injured by an uninsured vehicle while driving a city-owned vehicle. She sought arbitration from her personal insurer, Country-Wide, which then moved to permanently stay arbitration. Country-Wide argued that the City of New York, a permissibly self-insured municipality, should provide primary uninsured motorist coverage. Judge Bloom dissents in part, agreeing with the necessity of reversal but advocating for a remand with specific directions to join the City of New York as a party. This would allow for a full determination of rights, particularly concerning the City's potential primary liability under uninsured motorist provisions and the exclusivity of the Workers' Compensation Law.

Uninsured Motorist CoverageWorkers' Compensation LawSelf-Insured MunicipalityStay of ArbitrationPrimary vs. Secondary LiabilityJoinder of PartiesVehicle and Traffic LawInsurance LawExclusive RemedyAppellate Dissent
References
1
Case No. MISSING
Regular Panel Decision

Massachusetts Mutual Life Insurance v. Avon Associates, Inc.

This case addresses a motion by defendants mortgagors to vacate an ex parte order appointing a receiver during a mortgage foreclosure action. Defendants asserted that the lack of notice for the receiver's appointment violated CPLR 6401 and their Federal constitutional due process rights, citing Fuentes v Shevin. The court found that New York's Real Property Actions and Proceedings Law § 1325 (subd 1) permits ex parte receiver appointments when the mortgage contract explicitly waives notice. Furthermore, the court distinguished the present case from Fuentes, concluding that the sophisticated business operators involved had knowingly and voluntarily waived their right to notice, akin to the circumstances in Overmyer Co. v Frick Co. Based on these findings, the court affirmed the validity of the ex parte order and denied the defendants' motion to vacate the appointment of the receiver.

Mortgage ForeclosureReceiver AppointmentEx Parte OrderDue ProcessWaiver of NoticeContractual WaiverCPLRReal Property Actions and Proceedings LawConstitutional LawBusiness Disputes
References
9
Case No. MISSING
Regular Panel Decision

In re the Claim of Sweet

A claimant, formerly a sewage treatment worker for a municipality, left his job and moved to Hawaii after receiving a conditional job offer at a tropical fish farm and his girlfriend's relocation there. Upon arrival, he discovered the position was no longer available. The Unemployment Insurance Appeal Board subsequently ruled that the claimant was disqualified from receiving unemployment insurance benefits, determining he had voluntarily left his employment without good cause. The appellate court affirmed the Board's decision, finding substantial evidence that the claimant failed to verify the job offer before moving and had primarily relocated for personal reasons without definite employment.

Unemployment benefitsVoluntary quitGood cause for leavingJob availabilityRelocation for personal reasonsDisqualification for benefitsAppellate reviewSubstantial evidenceMunicipality employmentHawaii job offer
References
0
Case No. 2014-1040 K C
Regular Panel Decision
Jul 14, 2017

TAM Med. Supply Corp. v. Country Wide Ins. Co.

This case involves an appeal concerning a claim for first-party no-fault benefits. The Civil Court initially denied the plaintiff-provider's motion for summary judgment and granted the defendant-insurer's cross-motion for summary judgment. The Appellate Term modified this order, finding that a discrepancy in the defendant's affidavit prevented a summary judgment dismissal based on late notice of the accident. However, the plaintiff had failed to comply with discovery demands, leading the Appellate Term to grant the defendant's alternative request to compel discovery responses and an examination before trial from the plaintiff within specified timeframes.

No-fault benefitsSummary judgmentDiscoveryInterrogatoriesExamination before trialTimely denialLate notice of accidentCPLR 3126Appellate TermCivil Court
References
6
Case No. MISSING
Regular Panel Decision

Country-Wide Insurance v. Frolich

Plaintiff Country-Wide Insurance Company sued Dr. Sylvia C. Frolich to recover an alleged $10,000 overpayment for medical services provided to an insured following an automobile accident, citing a mistake and violation of no-fault fee schedules. The defendant doctor sought to compel arbitration of this dispute, arguing that the no-fault law grants the claimant the option to arbitrate first-party benefit disputes. The court examined whether the defendant waived her right to arbitration and concluded she did not, as she was unaware of the $10,000 dispute when she cashed an earlier partial payment. Emphasizing the legislative intent for speedy and expert determinations in no-fault arbitration, particularly for health service fees, the court ruled in favor of arbitration. The defendant's motion to compel arbitration was granted, conditioned on her timely requesting arbitration and depositing the disputed $10,000 into an interest-bearing escrow account.

No-Fault InsuranceArbitrationOverpaymentMedical Services BillingInsurance LawClaimant RightsWaiverJurisdictionCompulsory ArbitrationFirst-Party Benefits
References
10
Case No. MISSING
Regular Panel Decision

321 Henderson Receivables, L.P. v. Martinez

The case concerns a petition by 321 Henderson Receivables to purchase structured settlement payments from Pedro Martinez, Jr. under the Structured Settlement Protection Act (SSPA). Justice Alice Schlesinger examined whether the proposed transfer met the statutory requirements of being in the "best interest" of the payee and "fair and reasonable." The court found the transaction unreasonable, noting a significant discount rate (55.70% of current value) and a 16.39% interest rate. Additionally, Mr. Martinez, a 21-year-old with no income or assets, lacked a concrete and viable plan for the funds, indicating the transfer was not in his best interest. Consequently, the court denied the petition and dismissed the proceeding, emphasizing the SSPA's role in protecting vulnerable payees.

Structured Settlement Protection ActStructured Settlement TransferFactoring CompanyPayee ProtectionBest Interest StandardGeneral Obligations LawDiscount RateFinancial HardshipJudicial ReviewDenial of Petition
References
10
Case No. MISSING
Regular Panel Decision

Stein v. World-Wide Plumbing Supply Inc.

This memorandum decision addresses motions to dismiss civil RICO and human trafficking claims brought by an unnamed plaintiff against her husband, Yoel Weiss, and several family members and entities, including Chaim and Suri Lefkowitz, World-Wide Plumbing Supply Inc., and Gedalia Daniel Katz. The plaintiff alleged a campaign of abuse, forced servitude, and involvement in an illegal fencing operation. The court dismissed the RICO claims, RICO conspiracy, and claims for benefiting from human trafficking against all defendants due to issues with standing and the definition of a RICO enterprise. Claims for peonage and enticement into slavery were also largely dismissed against many defendants for insufficient factual allegations regarding knowledge or benefit. However, the plaintiff's claims for forced labor and attempted forced labor against Chaim and Suri Lefkowitz survived the motion, along with state labor law claims against them and a declaratory judgment claim against Yoel Weiss.

Civil RICOHuman TraffickingForced LaborPeonageEnticement into SlaveryMotion to DismissRacketeering ActivityIllegal Fencing OperationConspiracyLabor Law Violations
References
34
Case No. ADJ2714448, ADJ778707
Regular
Apr 09, 2013

ZELIE MEDINA vs. ADVANCED RECEIVABLE STRATEGY, ST. PAUL TRAVELERS

This is an order granting reconsideration for both the applicant and defendant in the case of Zelie Medina vs. Advanced Receivable Strategy and St. Paul Travelers. The Workers' Compensation Appeals Board granted reconsideration to allow further study of the factual and legal issues. This action is deemed necessary for a complete understanding of the record and to issue a just decision. All future correspondence must now be filed in writing with the WCAB Commissioners' office in San Francisco, not district offices or e-filed.

Workers' Compensation Appeals BoardReconsideration GrantedPetitions for ReconsiderationFactual IssuesLegal IssuesJust and Reasoned DecisionOffice of the CommissionersSan FranciscoElectronic Adjudication Management SystemFresno District Office
References
0
Case No. ADJ3953602 (SRO 0260827) ADJ2646453 (SRO 0133845)
Regular
Nov 14, 2012

ROBERTO HERNANDEZ vs. MILL VALLEY SCHOOL DISTRICT, SUBSEQUENT INJURIES BENEFITS TRUST FUND

The Subsequent Injuries Benefits Trust Fund (SIBTF) seeks reconsideration of an award finding the applicant totally permanently disabled due to industrial injuries sustained in 2004. The WCJ found the combined injuries greater than 70% and the second injury itself greater than 35%, entitling the applicant to SIBTF benefits. SIBTF argues the applicant's disability is solely due to the subsequent injury, thus disqualifying them from SIBTF benefits. The Appeals Board granted reconsideration to review the admissibility of two vocational reports and deposition transcripts, Exhibits M and N, which were previously marked for identification only. The Board intends to receive these documents into evidence unless timely objections are filed.

SIBTFPetition for ReconsiderationFindings and AwardPermanent DisabilityIndustrial InjuryVocational Rehabilitation EvaluationDiminished Future Earning CapacityDeposition TranscriptExhibits M and NWCJ Report
References
0
Case No. ADJ6981750
Regular
Jan 13, 2017

GUMERSINDO DELEON vs. ESPARZA ENTERPRISES, INC.

This case concerns a lien claimant's failure to pay a $100.00 lien activation fee required by Labor Code section 4903.06 by the date of a lien conference. The Workers' Compensation Appeals Board (WCAB) is considering rescinding the order dismissing the lien, but only if the fee is paid within ten days of this notice. The WCAB's intention is based on a court order allowing lien activation fees to be paid between November 9, 2015, and December 31, 2015, and the lien claimant's assertion of computer problems. If payment is received, the lien claim will be returned to the trial level for further proceedings.

Lien activation feeLabor Code Section 4903.06ReconsiderationOrder Dismissing Lien ClaimWCJDWCAngelotti Chiropractic v. BakerPreliminary injunctionNinth CircuitVacating injunction
References
7
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