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

Case No. ADJ1508875 (SAL 0120616) ADJ10261915 ADJ7549983
Regular
Oct 31, 2019

DERREL FELDMAN vs. CRITCHFIELD MECHANICAL, ENSTAR U.S., INC., d.b.a ENSTAR ADMINISTRATORS, SEABRIGHT INSURANCE COMPANY, O.C. MCDONALD, TRAVELERS INDEMNITY COMPANY of CT, PARAGON MECHANICAL, INC., STATE COMPENSATION INSURANCE FUND

This case involved a clerical error in a prior Workers' Compensation Appeals Board (WCAB) decision that inadvertently awarded a second Labor Code section 4658(d) increase. The defendant requested a correction, which the WCAB granted. The WCAB has the authority to correct clerical errors at any time. Therefore, the September 16, 2019 decision was affirmed but amended to remove the erroneous second increase, clarifying the permanent disability indemnity awarded.

Workers' Compensation Appeals BoardPetition for ReconsiderationClerical ErrorLabor Code section 4658(d)Permanent disability indemnityAttorney feesSeabright Insurance CompanyTravelers Indemnity CompanyState Compensation Insurance FundCritchfield Mechanical
References
1
Case No. ADJ7723776
Regular
Nov 02, 2013

DEBRA CALORA vs. COUNTY OF SAN LUIS OBISPO

The Workers' Compensation Appeals Board granted reconsideration and amended the original award. The WCJ had found the applicant sustained a 100% permanent disability and was entitled to a 15% increase in indemnity under Labor Code section 4658(d) for the employer's failure to offer work. However, the Board determined that Labor Code section 4658(d)'s provisions, including the 15% increase, do not apply to awards of 100% permanent disability. Therefore, the applicant is not entitled to the 15% increase in permanent disability indemnity.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardCookRight upper extremityBilateral carpal tunnelPermanent disabilityLabor Code section 4658(d)Permanent total disabilityLifetime award
References
0
Case No. 15 Civ. 3975 (NRB)
Regular Panel Decision

National Indemnity Co. v. IRB Brasil Resseguros S.A.

This case involves a dispute between National Indemnity Company (NICO) and IRB Brasil Resseguros S.A. (IRB) over reinsurance obligations. Following contentious arbitrations, a tribunal issued three awards favoring NICO. NICO petitioned the U.S. District Court to confirm these awards, while IRB cross-petitioned for vacatur, citing alleged 'evident partiality' of the neutral umpire, Daniel Schmidt, due to his concurrent service in an unrelated arbitration involving a NICO affiliate (Equitas) and challenging the tribunal's jurisdiction. The court found Schmidt's disclosures reasonable and his concurrent assignments insufficient to demonstrate partiality. It also affirmed the arbitration panel's jurisdiction over the disputed 2008 premium and associated fees. Consequently, the court granted NICO's petition to confirm the awards and denied IRB's cross-petition to vacate them.

ArbitrationReinsurance DisputeEvident PartialityUmpire DisclosureVacatur of Arbitration AwardConfirmation of Arbitration AwardFederal Arbitration ActNew York ConventionArbitration ClauseContract Interpretation
References
42
Case No. MISSING
Regular Panel Decision
Jun 30, 1992

National General Insurance v. Hartford Accident & Indemnity Co.

This case concerns a declaratory judgment action regarding insurance coverage following a fatal airplane crash. Warren Geddes, president of American Investor Services, Inc. (AIS), was piloting a plane carrying Gary Conway, an AIS employee, when it crashed, killing both. National General Insurance Company, insurer of the plane owner, sought for Hartford Accident and Indemnity Company, AIS's workers' compensation insurer, to defend and indemnify AIS and Geddes' Estate in a wrongful death action. Hartford denied coverage for Geddes' Estate, arguing he was not a named or additional insured under their policy. The court modified the initial judgment, declaring that Hartford has no duty to defend or indemnify the Estate of Geddes, while otherwise affirming the judgment.

Insurance CoverageDeclaratory JudgmentWrongful DeathDuty to DefendDuty to IndemnifyNamed InsuredAdditional InsuredWorkers' Compensation PolicyAirplane CrashEstate Liability
References
5
Case No. MISSING
Regular Panel Decision

Hartford Accident & Indemnity Co. v. Commercial Union Insurance

This case involves a dispute between two insurance companies, Hartford Accident and Indemnity Company (excess insurer) and Commercial Union Insurance Company (primary insurer), concerning liability for an injury claim. Michael Jutt, an employee of Minuteman Press International, Inc., was injured while on a Minuteman-owned boat. Commercial Union, the primary insurer, denied coverage and refused to defend Minuteman, leading Hartford, the excess insurer, to provide defense and settle Jutt's claim for $135,000. Hartford subsequently sued Commercial Union for breach of fiduciary duty. The District Court affirmed Hartford's standing to sue, recognizing a direct fiduciary duty owed by a primary insurer to an excess insurer, and found that the "paid employees" exclusion in Commercial Union's policy was ambiguous. Consequently, the Court ruled in favor of Hartford, ordering Commercial Union to pay $135,000 plus interest.

Insurance LawExcess InsurancePrimary InsuranceFiduciary DutyEquitable SubrogationPolicy ExclusionAmbiguous Contract TermDeclaratory Judgment ActionStanding to SueMarine Insurance
References
5
Case No. MISSING
Regular Panel Decision

Hartford Accident & Indemnity Co. v. Coastal Dry Dock & Repair Corp.

This case concerns an appeal by Hartford Accident and Indemnity Co. (insurer) against Coastal Dry Dock and Repair Corp. (insured) regarding unpaid retrospective premiums on a workers' compensation policy. The insurer sought to recover additional premiums calculated based on the insured's loss record, as stipulated by a 'Retrospective Premium Endorsement.' The defendant raised multiple defenses and counterclaims, alleging improper calculations, misrepresentation, and mishandling of claims. The Supreme Court initially denied the plaintiff's motion for summary judgment. However, the Appellate Division reversed this decision, ruling that the defendant's opposition, primarily an attorney's affidavit lacking personal knowledge, was insufficient to raise a genuine issue of material fact. The court found the defendant's defenses and counterclaims legally insufficient, affirming the insurer's contractual right to negotiate and settle claims.

Workers' Compensation PolicyRetrospective PremiumSummary JudgmentContract DisputeInsurance LawAppellate ReviewAffidavit SufficiencyEvidentiary FactsClaims SettlementPolicy Interpretation
References
6
Case No. MISSING
Regular Panel Decision
May 18, 2017

TransAtlantic Lines LLC v. American Steamship Owners Mutual Protection & Indemnity Ass'n

TransAtlantic Lines LLC sought to overturn an adverse insurance coverage decision by the Board of Directors of American Steamship Owners Mutual Protection and Indemnity Association, following a shipping accident. TransAtlantic argued for a de novo review, asserting the alternative dispute resolution (ADR) process was fundamentally unfair due to the Board's inherent financial bias and violated public policy. The district court, however, applied the contractually agreed-upon "arbitrary and capricious" standard of review. The court rejected TransAtlantic's claims of bias and public policy violations, finding that TransAtlantic had voluntarily consented to the ADR framework. Consequently, the court upheld the Board's decision to deny coverage for attorney's fees, U.S. Government cargo losses, and perishable cargo expenses, concluding that these denials were not arbitrary or capricious.

Alternative Dispute Resolution (ADR)Insurance Coverage DisputeSummary JudgmentArbitrary and Capricious StandardContract LawMarine InsuranceJudicial Review of ArbitrationWaiver of RightsPublic Policy ExceptionAttorney Ethics
References
24
Case No. 2017 NY Slip Op 04775
Regular Panel Decision
Jun 13, 2017

Ironshore Indemnity, Inc. v. W&W Glass, LLC

Ironshore Indemnity, Inc., as subrogee of The Related Companies, L.P., appealed a judgment that dismissed their action. The Supreme Court initially granted the Related Companies' motion to intervene, quash subpoenas, and dismiss the complaint. The Appellate Division, First Department, affirmed this judgment, finding that the Related Companies had a strong interest in the litigation. The court concluded that Ironshore had no subrogation rights because it had not made any payments or covered defense costs on behalf of the Related Companies in the underlying personal injury action. Additionally, Ironshore's subrogation claims were barred by Workers' Compensation Law § 11, as no 'grave injury' was alleged or proven.

subrogation rightsinterventionworkers' compensation lawgrave injuryadditional insuredindemnificationcontributiondefense costsappellate divisionjudgment dismissal
References
6
Case No. ADJ6748402
Regular
Nov 14, 2014

KRUKOR KEREMIAN vs. QUEEN OF THE VALLEY HOSPITAL, HARTFORD INSURANCE COMPANY OF THE MIDWEST, SEDGWICK CMS

The Workers' Compensation Appeals Board granted reconsideration to amend the original award. The applicant's injury to bilateral shoulders and psyche on March 18, 2009, was affirmed. The key amendment increased the permanent disability indemnity rate to $264.50 per week as stipulated by the parties. The Board also ordered an increase in the applicant's attorney's fee, reflecting the amended indemnity award.

Krukor KeremianQueen of the Valley HospitalHartford InsuranceSedgwick CMSPetition for ReconsiderationFindings Award and Orderemergency room technicianbilateral shoulders psycheright upper extremitypermanent disability indemnity
References
0
Case No. ADJ8824230
Regular
Apr 03, 2017

Braulina Rodriguez vs. ANAHEIM HEALTH CARE CENTER, AIG administered by CORVEL

The Appeals Board granted reconsideration, amending the original award regarding permanent disability indemnity. The primary issue deferred for further development is whether a 15% rate increase under Labor Code section 4658(d)(2) applies, contingent on employer size and failure to offer suitable work. The original findings of a 34% permanent disability and 159 weeks of indemnity remain, but the payment rate is now to be determined. The Board adopted the WCJ's report, which highlighted the need for record development on employer employee count relevant to the rate increase.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings Award & OrdersAdministrative Law JudgeCervical spineLumbar spineLeft anklePsycheTemporary disabilityPermanent disability
References
3
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