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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
Apr 12, 2002

Gerosa v. Savasta

The trustees of the Cement Masons Local 780 Pension Fund initiated a lawsuit against their actuary, Savasta and Company, Inc., alleging negligence. The actuary's erroneous report of an over-funded plan led the trustees to increase beneficiary benefits. Subsequently, the actuary disclosed its mistake, revealing the fund was actually underfunded and that critical data was lost. The lawsuit seeks to recover substantial damages inflicted upon the fund due to this actuarial malpractice. The court ultimately ruled that the dispute falls under exclusive federal jurisdiction, governed by ERISA, denying the defendant's motion to dismiss the federal claim and preempting the plaintiffs' state law claims.

Employee Benefit PlanActuarial NegligenceERISA PreemptionFederal JurisdictionMotion to DismissFiduciary DutyPension Fund ManagementUnderfundingOverfundingProfessional Malpractice
References
22
Case No. MISSING
Regular Panel Decision

Health Acquisition Corp. v. Program Risk Management Inc.

The plaintiffs, home health care companies (Health Acquisition Corp., Bestcare, Inc., and Aides at Home, Inc.), sued various defendants, including accounting firm DeChants, Fuglein & Johnson, LLP (DFJ) and actuarial firm SGRisk, LLC, for professional negligence and negligent misrepresentation. The suit arose after the self-insurance trust they were members of became insolvent, leading to significant assessments from the Workers' Compensation Board. Plaintiffs alleged defendants concealed the trust's true financial state and their liability risks. The Supreme Court initially dismissed claims against DFJ and SGRisk. However, the appellate court reversed this decision, finding the complaint adequately alleged "near-privity" and negligence against both firms, even clarifying that actuaries could be held liable for common-law negligence despite not being licensed professionals for malpractice claims. A partial appeal concerning leave to amend the complaint was dismissed.

professional negligencenegligent misrepresentationCPLR 3211 (a)motion to dismissgroup self-insurance trustWorkers' Compensation Law § 50joint and several liabilityactuariesaccountantsnear-privity
References
15
Case No. MISSING
Regular Panel Decision

Ndremizara v. Swiss Re America Holding Corp.

Plaintiff Jason Ndremizara sued Swiss Re America Holding Corporation for age discrimination under the ADEA and NYSHRL after being denied an actuarial analyst position. Despite multiple applications and claims of being more qualified than younger hires, the plaintiff's complaint was challenged by the defendant's Motion to Dismiss. The Court had previously allowed the plaintiff to amend his complaint twice to address deficiencies, but he declined to do so further. Ultimately, the District Court granted the defendant's Motion to Dismiss with prejudice, ruling that the plaintiff failed to plausibly allege facts supporting an inference of age discrimination.

Age DiscriminationEmployment DiscriminationActuarial AnalystMotion to DismissPro Se LitigantADEANYSHRLFailure to HirePrima Facie CaseInference of Discrimination
References
63
Case No. MISSING
Regular Panel Decision

McKee v. Sithe Independence Power Partners

The Supreme Court's decision to extinguish the workers' compensation lien of Liberty Mutual Insurance Company on damages awarded to the petitioners in a third-party action was unanimously reversed. The appellate court found that the Supreme Court erred by extinguishing the lien, as the future benefits for petitioner Thomas McKee, who was not receiving ongoing compensation for total disability or scheduled loss of use, could not be reliably quantified by actuarial or other means. Consequently, the present value of Liberty Mutual's estimated future compensation payments could not be ascertained. The matter was remitted to the Supreme Court to determine the exact amount recoverable by Liberty Mutual.

Workers' Compensation Lien LawThird-Party LitigationLien Extinguishment CriteriaFuture Benefit ValuationActuarial Quantification DifficultyTotal Disability RequirementScheduled Loss of Use ClaimAppellate Reversal GroundsRemittal for Further ProceedingsInsurance Carrier Rights
References
2
Case No. 13 Civ. 1580; 12 Civ. 6811
Regular Panel Decision
Jun 17, 2015

U.S. Bank National Ass'n v. PHL Variable Life Insurance

This decision and order by District Judge McMahon addresses numerous motions in limine filed by both U.S. Bank National Association (applicant) and PHL Variable Life Insurance Company (Phoenix, defendant). The court evaluates the admissibility of expert testimony, evidence relating to actuarial justifications for cost of insurance (COI) rate increases, and Phoenix's financial condition. Key rulings concern claims of breach of the covenant of good faith and fair dealing, the relevance of life settlement investments, and the application of hearsay and prejudice rules. The decision provides detailed findings on specific exhibits and types of testimony, balancing probative value against potential unfair prejudice.

Insurance LawContract LawCovenant of Good Faith and Fair DealingCost of Insurance RatesActuarial AnalysisExpert Witness AdmissibilityMotions in LimineHearsay EvidenceRule 403 Balancing TestLife Settlement Industry
References
48
Case No. MISSING
Regular Panel Decision

Claim of Murtaugh v. P & D GMC Sales, Inc.

The case involves an appeal from a Workers' Compensation Board decision concerning an award for occupational lung disease. The claimant, an autobody repairer, was found to have a permanent total disability, and the Board held the employer and its insurer fully liable for the benefits. A Workers' Compensation Law Judge ordered the present value of the award to be deposited into the Aggregate Trust Fund, which the Board affirmed. The employer appealed, arguing for a hearing on the award's present value and consideration of the claimant's life expectancy in actuarial computations. However, the Court affirmed the Board's decision, finding the employer's arguments lacked merit and citing Workers' Compensation Law § 27 (5) and prior case law.

Occupational Lung DiseasePermanent Total DisabilityAggregate Trust FundActuarial ComputationWorkers' Compensation BenefitsLiability ApportionmentLife ExpectancyAppellate ReviewStatutory Interpretation
References
3
Case No. MISSING
Regular Panel Decision

Braniff Airways, Inc. v. Bankers Trust Co. (In Re Braniff Airways, Inc.)

Braniff Airways Incorporated, the debtor, initiated this class action seeking a court-ordered termination date for its Retirement Plan for Pilots, Part A, and instructions on fiduciary responsibilities under ERISA. The court set the plan termination date as August 30, 1982. It denied claims for lump sum distributions made in anticipation of termination, ruling they violated ERISA's priority scheme. The court also denied the request by Panagra pilots for segregation of specific assets, finding it would disrupt allocation priorities. Finally, the court ordered a modification to the definition of "eligible spouses" to facilitate actuarial calculations for annuities, limiting it to spouses married to participants at the plan termination date.

ERISAPension Plan TerminationDefined Benefit PlanFiduciary DutyLump Sum DistributionAsset AllocationPriority CategoriesActuarial CalculationsMarital StatusBankruptcy
References
8
Case No. MISSING
Regular Panel Decision
Sep 10, 2013

Deacy v. Port Authority

The Supreme Court, Bronx County, issued an order on September 10, 2013, which partially granted the defendants' motion to compel nonparty Iron Workers Locals 40, 361, & 417 Union Security Funds (Security) to comply with a subpoena duces tecum. This subpoena requested raw data for actuarial reports. Concurrently, Security's cross-motion to quash the subpoena and for a protective order was denied. The Appellate Court unanimously affirmed this decision, finding that the raw data sought by defendants, which includes information on fund participants to assess plaintiffs' potential lost income, is discoverable. Defendants also agreed to redact personal identifying information and cover the costs associated with document production.

Subpoena Duces TecumDiscoveryActuarial ReportsRaw DataUnion Security FundsMotion to CompelMotion to QuashProtective OrderAppellate AffirmationBronx County
References
1
Case No. MISSING
Regular Panel Decision

Wallace v. American Petrofina, Inc.

Plaintiff Harles H. Wallace filed an action under ERISA against the Retirement Committee of PINA, alleging the arbitrary and capricious administration of his retirement plan, specifically regarding the calculation of his pension benefits. Wallace contested the exclusion of 1982, a strike year, from his 'final average earnings,' which led to a reduced lump sum benefit. The Retirement Committee, with legal and actuarial advice, interpreted the plan to exclude 1982 due to a 'break in service' and no 'basic earnings in effect' during the strike. The court, applying an arbitrary and capricious standard, found the Committee's interpretation and consistent application of the plan to be correct and in good faith. Consequently, the defendant's motion for summary judgment was granted, and Wallace's cause of action was dismissed.

ERISAPension BenefitsRetirement PlanSummary JudgmentArbitrary and Capricious StandardPlan InterpretationStrike PeriodBreak in ServiceFinal Average EarningsNormal Basic Earnings
References
10
Case No. MISSING
Regular Panel Decision

Saur v. M & M Transportation

The case involves an appeal regarding the actuarial computation of present value and interest payable to the Aggregate Trust Fund under the Workers' Compensation Law. The Workers' Compensation Board made several recomputations and assessments for interest against an employer and its insurance carrier. The insurer objected, disputing the basis for interest payments prior to a specific directive. The appellate court reviewed the Board's decision, particularly its determination of the present value computation date. The court ultimately found the Board's decision to be erroneous as a matter of law, lacking statutory or factual basis. Consequently, the court reversed the decision, awarded costs to the employer and insurance carrier, and remitted the matter back to the Workers' Compensation Board for further proceedings consistent with its ruling.

Actuarial computationPresent valueAggregate Trust FundWorkers' Compensation LawInterest assessmentStatutory interpretationAppellate reviewRemittitur
References
1
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