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

Case No. CA 10-00545
Regular Panel Decision
Feb 10, 2011

HAHN AUTOMOTIVE WAREHOUSE, INC. v. AMERICAN ZURICH INSURANCE COMPANY

Hahn Automotive Warehouse, Inc. (plaintiff) initiated a breach of contract action against American Zurich Insurance Company and Zurich American Insurance Company (defendants), contending that bills issued under insurance contracts were time-barred. Defendants counterclaimed for damages stemming from plaintiff's alleged breach of these contracts. The Supreme Court partially granted plaintiff's cross-motion, deeming counterclaims for debts arising over six years prior as time-barred. Concurrently, it permitted defendants to utilize a $400,000 letter of credit to satisfy any outstanding debt, including those deemed time-barred. On appeal, the Appellate Division affirmed the use of the letter of credit for time-barred debts, reasoning that the statute of limitations only bars the remedy, not the underlying obligation. The court also affirmed that defendants' counterclaims for debts over six years old were time-barred, as the right to demand payment accrued earlier. Finally, the court modified the order to dismiss plaintiff's second through fourth causes of action. A dissenting opinion argued that the counterclaims were not time-barred, asserting that the cause of action accrued upon demand and refusal of payment, not merely when the right to demand payment existed.

Breach of contractInsurance contractsStatute of limitationsLetter of creditSummary judgmentAppellate reviewContract interpretationTime-barred claimsAccrual of cause of actionRetrospective premiums
References
23
Case No. MISSING
Regular Panel Decision
Nov 13, 2002

Zurich American Insurance v. Luis Bastos Construction

Zurich American Insurance Co. initiated an action seeking a declaratory judgment that it was not obligated to defend or indemnify Luis Bastos Construction, Inc. in an underlying personal injury lawsuit filed by Hermilo Cruz. Cruz, an employee of Bastos, sustained injuries in New York while working on a job that was not related to any work being performed in New Jersey. Zurich's insurance policy provided employers' liability coverage specifically for claims arising from accidents in New Jersey or those incidental to New Jersey operations. The Supreme Court, Westchester County, granted Zurich's motion for summary judgment, ruling that Zurich had no obligation to defend or indemnify Bastos. Defendant A.E Roofing & Siding Corp. appealed this decision. The appellate court affirmed the Supreme Court's order and judgment, concluding that the terms of the policy were clear and unambiguous.

Declaratory JudgmentInsurance CoverageEmployers' LiabilityWorkers' CompensationSummary JudgmentPolicy InterpretationPersonal InjuryAppellate ReviewJurisdictionNew York Law
References
2
Case No. 2023 NY Slip Op 04168 [219 AD3d 1003]
Regular Panel Decision
Aug 03, 2023

Matter of Campos v. Performance Master, Inc.

Claimant Denis Campos, a construction worker, filed for workers' compensation benefits after falling from a ladder. A Workers' Compensation Law Judge (WCLJ) established the claim and put American Zurich Insurance Company on notice regarding a specific workers' compensation policy. American Zurich contested, arguing the policy was canceled or that other policies applied, but failed to provide evidence for the identified policy despite being directed to do so. The WCLJ determined the policy remained in effect, making American Zurich the liable carrier. The Workers' Compensation Board affirmed this decision, declining to consider new evidence submitted by American Zurich on administrative appeal, and subsequently denied their application for reconsideration. The Appellate Division affirmed the Board's decisions, finding no abuse of discretion in refusing new evidence or denying reconsideration.

Workers' Compensation BenefitsInsurance Coverage DisputePolicy CancellationAdministrative ReviewEvidence SubmissionAppellate DivisionWCLJ DecisionBoard AffirmationReconsideration DenialAbuse of Discretion
References
5
Case No. ADJ559526 (STK 0208625)
Regular
Jan 03, 2011

MICHAEL OZUNA vs. WEBCOR BUILDERS, ZURICH NORTH AMERICA, AMERICAN HOME ASSURANCE COMPANY

This case concerns whether Zurich North America or American Home Assurance Company provided workers' compensation coverage for an applicant's severe injury. An arbitrator initially ruled Zurich solely responsible, finding American Home's policy was limited and did not cover the claim. Zurich contends American Home's policy endorsement limiting coverage to a specific site was invalid due to non-compliance with Insurance Code requirements. The Appeals Board granted reconsideration to allow further proceedings, holding American Home bears the burden to prove its policy effectively excluded this claim.

Workers Compensation Appeals BoardReconsiderationArbitrationInsurance CoverageDefense and IndemnificationPolicy EndorsementInsurance Code Section 11657Insurance Code Section 11660Burden of ProofAffirmative of the Issue
References
1
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
6
Case No. ADJ2103088
Regular
Nov 13, 2012

DONNA FUNCHEON vs. SAN LEANDRO HOSPITAL, CNA CLAIMS PLUS, AMERICAN CASUALTY, ZURICH AMERICAN INSURANCE CO.

This case involves Zurich American Insurance petitioning for reconsideration of an order awarding applicant's counsel $181,883.97 in attorney fees based on a finding of permanent total disability. Zurich argued that their subsequent petition for a writ of review stayed the attorney fee order. The Workers' Compensation Appeals Board denied reconsideration, clarifying that a writ petition does not automatically stay or suspend the effect of a WCAB decision. The Board further noted that execution of an award requires a certified copy, which is not issued during pending judicial review, but warned Zurich of potential penalties for non-payment.

Workers' Compensation Appeals BoardPetition for ReconsiderationAttorney FeesPermanently Totally DisabledWrit of ReviewLabor Code § 5956Certified CopyCivil JudgmentLabor Code § 5814Penalty
References
1
Case No. MISSING
Regular Panel Decision
Feb 05, 1999

State Insurance Fund v. Zurich-American Insurance Companies

The Supreme Court, New York County, initially denied Zurich's motion for summary judgment and granted the State Insurance Fund's (SIF) cross-motion, awarding SIF one-half of a settlement and its net Workers' Compensation lien. This decision was unanimously reversed on appeal. The appellate court found that the motion court erred in its determination, stating that a stipulation entered in open court clearly indicated SIF had waived its workers' compensation lien in full, with no evidence supporting a limited waiver. Zurich and SIF had previously agreed to share their insured's settlement liability, and Zurich's payment of $95,000 fulfilled its financial obligation under the stipulation. Since SIF was the sole Workers' Compensation insurance carrier, Zurich had no further obligation or interest in the lien.

Summary JudgmentWorkers' Compensation LienStipulationWaiverInsurance LiabilitySettlement AgreementAppellate ReviewContract InterpretationInsurance Carrier
References
0
Case No. MISSING
Regular Panel Decision

Hawthorne v. South Bronx Community Corp.

The case involves an appeal concerning a dispute between two insurers, State Insurance Fund and Zurich-American Insurance Companies, both of whom insured a subcontractor, Bri-Den Construction Co., Inc. The subcontractor was held liable to indemnify an owner and a general contractor for injuries sustained by an employee. State Fund provided coverage for common-law indemnity, while Zurich-American covered contractual indemnity. The central issue was whether a contractual duty to indemnify supersedes a common-law duty, thereby relieving the common-law insurer of its policy obligations. The Appellate Division found that contractual and common-law indemnity liabilities can coexist, meaning an insured with obligations on both grounds is entitled to coverage from both insurers. The court affirmed this decision, ruling that the mere existence of an indemnity provision does not replace common-law liability and both insurers are equally responsible for the loss.

Insurer disputeContractual indemnityCommon-law indemnitySubcontractor liabilityGeneral contractor liabilityOwner liabilityWorkers' compensationEmployer's liabilityInsurance coverage interpretationCoexisting liabilities
References
8
Case No. 2015 NY Slip Op 30039[U]
Regular Panel Decision
Jan 20, 2015

Lend Lease (US) Construction LMB Inc. v. Zurich American Insurance

Plaintiffs Extell West 57th Street and Lend Lease (US) Construction LMB Inc. sued their insurers, including Zurich and Travelers, after a construction crane at the One57 building was damaged by Superstorm Sandy. The insurers denied coverage under a builder's risk policy, leading to a dispute over whether the crane qualified as a 'temporary work' and if it was excluded as 'contractor's tools.' The lower court denied summary judgment, finding factual issues. On appeal, the majority granted summary judgment to the defendants, declaring no coverage. The dissenting opinion argues that the crane should be considered a 'temporary structure' and the 'contractor's tools' exclusion should not apply, but concurs that summary judgment for plaintiffs was improper due to a factual dispute regarding whether the crane's value was included in the total project value.

Insurance coverage disputeBuilder's risk policyTemporary structuresContractor's tools exclusionSuperstorm SandyConstruction crane damageSummary judgmentContract interpretationEjusdem generisNoscitur a sociis
References
17
Case No. MISSING
Regular Panel Decision

Longo v. Graphic Packaging Corp.

The claimant, a maintenance mechanic, was employed from 1961 to 2001, last by Graphic Packaging Corporation, a subsidiary of Coors Brewing Company. In 2007, he was diagnosed with interstitial lung disease due to workplace asbestos exposure, establishing March 15, 2007, as the date of disablement for workers' compensation benefits. A Workers' Compensation Law Judge determined that Zurich American Insurance Company, the carrier for Coors, was liable, a decision affirmed by the Workers' Compensation Board. Zurich and Graphic Packaging appealed, contending they were denied the right to present proof and that there was a lack of substantial evidence regarding Coors' employer status and Zurich's liability. The court found that Zurich failed to present evidence despite notice and opportunities, and the claimant's uncontroverted testimony provided substantial evidence supporting the Board's determination.

Asbestos exposureInterstitial lung diseaseOccupational diseaseWorkers' compensation benefitsEmployer liabilityInsurance carrier liabilitySubstantial evidenceUncontroverted testimonyWorkers' Compensation BoardAppellate review
References
3
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