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

Case No. SAC 0297421
Regular
Mar 11, 2008

MICHAEL THAO vs. COCA COLA BOTTLING COMPANY, SELECT PERSONNEL SERVICES, ZURICH NORTH AMERICA INSURANCE COMPANY, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, On Behalf Of LEGION INSURANCE COMPANY, Adjusted By CAMBRIDGE INTEGRATED GROUP

The Workers' Compensation Appeals Board granted reconsideration to address whether Zurich's insurance policy constituted "other insurance" under Insurance Code § 1063.1(c)(9), which would absolve CIGA of liability and entitle it to reimbursement from Zurich. The Board returned the case for further proceedings to allow the WCJ to make an explicit finding on this issue, as it was not fully developed or addressed in the original decision. The special employment finding concerning Coca Cola Bottling Company was not reached pending the "other insurance" determination.

Special employmentCIGAother insurancereimbursementliquidationindustrial injurywarehousemanreconsiderationFindings and OrderWCJ
References
Case No. ADJ8207723
Regular
Oct 22, 2013

MARTA LINARES CLEMENTE vs. FEDERAL CLEANING CONTRACTORS, ZURICH NORTH AMERICA CLAIMS

This case involves Marta Linares Clemente as the applicant against Federal Cleaning Contractors and Zurich North America Claims. The Workers' Compensation Appeals Board (WCAB) considered a Petition for Removal filed by the applicant. The WCAB has issued an order denying this Petition for Removal, adopting the reasoning of the workers' compensation administrative law judge. Therefore, the applicant's request to remove the case from its current procedural status has been rejected.

Petition for RemovalWorkers' Compensation Appeals BoardWCJ reportdeny removalADJ8207723Federal Cleaning ContractorsZurich North America ClaimsMarta Linares Clementeadministrative law judgeMarina del Rey District Office
References
Case No. ADJ9198656; ADJ9192994
Regular
Jul 07, 2025

JEANETTE LIRA vs. COTTAGE HEALTH SYSTEM, PSI, SANSUM SANTA BARBARA MEDICAL, ZURICH AMERICAN INSURANCE COMPANY

Defendants Cottage Health System and Zurich American Insurance Company sought reconsideration of a Joint Findings and Award. Cottage Health contended it was incorrectly identified as the liable employer instead of Sansum Santa Barbara Medical, insured by Zurich. Zurich argued there were multiple injuries or that compensation was barred by the statute of limitations. The Appeals Board denied Zurich's petition, granted Cottage Health's petition, and amended the award to reflect Sansum Santa Barbara Medical, insured by Zurich American Insurance Company, as the liable party.

Workers' Compensation Appeals BoardJeanette LiraCottage Health SystemGallagher BassettZurich American Insurance CompanySansum Santa Barbara MedicalAdjudication NumbersJoint Findings and AwardPetition for ReconsiderationComplex Regional Pain Syndrome
References
Case No. ADJ625812 (POM 0280514)
Regular
Aug 24, 2011

William McCarther vs. USS Cal Builders, Zurich North America, State Compensation Insurance Fund

Zurich North America sought removal after applicant's invalid election against SCIF, arguing it was precluded from discovery and entitled to its own medical evidence for a specific injury. The Board granted removal, finding the election void and the discovery delay unjustified. The case involves a specific industrial injury where both SCIF and Zurich may be liable, with Zurich having made its first appearance nearly twenty months after being joined. The Board redesignated the upcoming trial as a status conference to allow Zurich to present policy information and clarify its coverage stance.

Petition for RemovalZurich North AmericaSCIFElection Against SCIFLabor Code section 5500.5(c)Specific InjuryJoinder of Party DefendantCoverage DenialASCIPWorkers' Compensation Appeals Board
References
Case No. ADJ1256092 (VNO 0458544)
Regular
Oct 07, 2011

MARIA TOLEDO vs. WELLPOINT HEALTH NETWORK INC, CIGA for FREMONT in liquidation, administered by XCHANGING, ZURICH AMERICAN INSURANCE

This case involves Zurich American Insurance seeking reconsideration of a decision that extended applicant Maria Toledo's cumulative trauma injury period to November 1, 2001, placing liability on Zurich. Zurich argued the injury date should be December 2000, during Fremont/CIGA's coverage, as medical evidence, including the Agreed Medical Examiner (AME) Dr. Sohn's reports, allegedly only supported exposure until that earlier date. The Board denied reconsideration, affirming that the AME found the totality of applicant's employment duties, including those as a sales assistant after a job change, contributed to her cumulative trauma until November 1, 2001. Therefore, Zurich remains liable for the injury.

Cumulative traumaDate of injuryPeriod of injurious exposureLabor Code section 5412Section 5500.5Agreed Medical Examiner (AME)Dr. Roger SohnMedical evidenceZurich North AmericaFremont Compensation Insurance
References
Case No. ADJ937954 (POM 0254711)
Regular
Aug 18, 2010

ANGELITA (ANGIE) FERNANDEZ vs. OAK TREE RACING ASSOCIATION, LOS ANGELES TURF CLUB, CADDIE SERVICES, INCORPORATED, CIGA by its servicing agent CAMBRIDGE INTEGRATED SERVICES for LEGION INSURANCE, in liquidation, CRAWFORD & COMPANY on behalf of ZURICH INSURANCE

This case involved an applicant claiming industrial injury to her shoulders and upper extremities. A prior insurer, Legion Insurance, erroneously paid benefits through its administrator, REM, before its insolvency. The Workers' Compensation Appeals Board denied reconsideration of the arbitrator's decision, which held Zurich Insurance (adjusted by Crawford & Company) liable for reimbursement to CIGA. This is because Zurich provided "other insurance" for a portion of the cumulative trauma injury, making it solely responsible for benefits where both an insolvent and solvent insurer would be liable. The Board found CIGA could recover pre-insolvency and mistaken payments, and Zurich's due process claims were unpersuasive.

CIGAZurich InsuranceCrawford & CompanyOak Tree Racing AssociationLegion InsuranceFremont Indemnitycumulative traumainsolvent insurersolvent insurerreimbursement
References
Case No. ADJ8973046
Regular
Dec 28, 2015

FERMIN CEJA vs. SAUSALITO MOVING & STORAGE, INC., ZURICH AMERICAN INSURANCE CO.

In this workers' compensation case, the defendant insurer, Zurich American Insurance Co., sought reconsideration of an order compelling them to comply with a stipulation agreement. Zurich argued they entered the stipulation by mistake, as they did not provide insurance coverage on the date of the applicant's specific injury. The Appeals Board granted reconsideration, rescinded the order to comply, and deferred Zurich's petition to set aside the stipulation. The Board emphasized that Zurich remains bound by the original stipulations until the petition to set aside is fully adjudicated.

Workers' Compensation Appeals BoardPetition for ReconsiderationPetition to Set Aside StipulationMistake of FactInsurance CoverageStipulation and OrdersTemporary Total DisabilityHernia InjuryMPNAppeal
References
Case No. ADJ915105
Regular
Oct 08, 2008

ALEJANDRO ZAVALA vs. HOUSEHOLD INTERNATIONAL, ZURICH, SPECIALTY RISK SERVICES

This case concerns an applicant, Alejandro Zavala, and his employer, Household International, and their workers' compensation insurer, Zurich. The Workers' Compensation Appeals Board granted reconsideration of the original judge's decision. The Board rescinded the previous decision and returned the matter to the trial level for further proceedings and a new decision by the WCJ.

WORKERS' COMPENSATION APPEALS BOARDAlejandro ZavalaHousehold InternationalZurichSpecialty Risk ServicesADJ915105SAL 0116450Santa AnaOpinion and Order Granting ReconsiderationDecision After Reconsideration
References
Case No. ADJ9022579
Regular
Nov 16, 2013

ROEL ATEGA vs. SUPER STORE INDUSTRIES, AMERICAN ZURICH INSURANCE COMPANY, adjusted by ZURICH NORTH AMERICA

The Workers' Compensation Appeals Board (WCAB) denied Roel Atega's Petition for Reconsideration in case ADJ9022579. The Board adopted the findings and reasoning of the workers' compensation administrative law judge (WCJ). Therefore, the WCAB's decision stands, denying Atega's request for reconsideration of the original decision.

ATEGASUPER STORE INDUSTRIESAMERICAN ZURICH INSURANCE COMPANYZURICH NORTH AMERICAADJ9022579Stockton District OfficeOPINION AND ORDER DENYING PETITION FOR RECONSIDERATIONWORKERS' COMPENSATION APPEALS BOARDADMINISTRATIVE LAW JUDGEPetition for Reconsideration
References
Case No. ADJ4072860 (AHM 0083472) ADJ2211265 (AHM 0083473)
Regular
Feb 28, 2012

DARLYN PIPER vs. DANKA OFFICE IMAGING, ZURICH NORTH AMERICA, LIBERTY MUTUAL INSURANCE COMPANY

This case involves cross-petitions for reconsideration of an award for applicant's industrial injuries. The Board denied the applicant's petition and granted the defendant's, clarifying that Zurich North America is solely liable. The Board affirmed the WCJ's decision, amending the award to reflect the applicant's election against Zurich and allowing Zurich to seek contribution from Liberty Mutual. A dissenting opinion argued that the apportionment of permanent disability was speculative and unsupported by substantial medical evidence.

Workers' Compensation Appeals BoardDarlyn PiperDanka Office ImagingZurich North AmericaLiberty Mutual Insurance CompanyADJ4072860ADJ2211265permanent disabilitycumulative traumacustomer service technician
References
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