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

Case No. 2016 NY Slip Op 04185
Regular Panel Decision
Jun 01, 2016

Mecca Contracting, Inc. v. Scottsdale Insurance

Mecca Contracting, Inc., a general contractor, sought a declaratory judgment against Scottsdale Insurance Company after Scottsdale disclaimed coverage for an underlying personal injury action. Mecca, designated as an additional insured under a policy issued by Scottsdale to subcontractor Salcora Construction Corp., sought defense and indemnity, arguing the Scottsdale policy was primary. The Supreme Court granted summary judgment to Mecca, a decision affirmed by the Appellate Division, Second Department. The Appellate Division found Mecca was entitled to the declaration that Scottsdale was obligated to defend and indemnify it, and that the Scottsdale policy was primary, based on the contract between Mecca and Salcora and the 'Blanket Additional Insured Endorsement.' The matter was remitted to the Supreme Court, Kings County, for the entry of a formal judgment.

Insurance CoverageDeclaratory JudgmentAdditional Insured EndorsementPrimary CoverageGeneral Contractor LiabilitySubcontractor AgreementConstruction LawIndemnityDefense ObligationBreach of Contract
References
6
Case No. 2015 NY Slip Op 07554 [132 AD3d 500]
Regular Panel Decision
Oct 15, 2015

Bridge Street Contracting Inc. v. Everest National Insurance

This case addresses an insurer's disclaimer of coverage due to late notice of claims. The Appellate Division, First Department, modified a lower court order, declaring that Everest National Insurance Company has no duty to defend or indemnify Bridge Street Contracting Inc. in the underlying action. The court ruled that Everest properly disclaimed coverage without needing to demonstrate prejudice, as it was not participating in the defense when Bridge Street was served with the claims. Arguments regarding waiver of the late notice defense and antisubrogation were rejected. CastlePoint Insurance Company's motion to intervene was also denied as academic.

Insurance CoverageLate NoticeDisclaimer of CoverageSummary JudgmentDuty to DefendDuty to IndemnifyAntisubrogationInterventionAppellate DivisionContract Law
References
4
Case No. MISSING
Regular Panel Decision

GuideOne Specialty Insurance v. Admiral Insurance

This case involves an insurance coverage dispute where Weingarten Custom Homes (WCH) contracted with Torah Academy for construction, designating Torah Academy as an additional insured under WCH's liability policy with Admiral Insurance Company. The Admiral policy had lower coverage limits ($1,000,000) than required by the contract ($2,000,000/$5,000,000), with GuideOne Specialty Insurance Company providing secondary and excess coverage to Torah Academy. After a construction worker's injury led to a $1,225,000 settlement, Admiral paid $1,000,000, and GuideOne paid $225,000. GuideOne then sued Admiral to recover its payment, arguing that a letter signed by Admiral's claims superintendent effectively modified Admiral's policy to higher limits. The appellate court reversed the Supreme Court's decision, ruling that the letter did not constitute a valid policy endorsement and that the policy's unambiguous terms could not be altered by extrinsic evidence, thereby granting Admiral's motion to dismiss GuideOne's complaint.

Insurance Policy DisputeContract InterpretationLiability InsuranceAdditional InsuredPolicy LimitsMotion to DismissAppellate ReversalDocumentary EvidenceExtrinsic Evidence RulePolicy Amendment
References
12
Case No. 6:09-CV-853
Regular Panel Decision

Utica Mutual Insurance Co. v. Fireman's Fund Insurance Co.

This case details a dispute between Utica Mutual Insurance Company (Utica) and Fireman’s Fund Insurance Company (FFIC) concerning reinsurance contracts, with Utica seeking substantial damages for alleged breach of contract and bad faith. FFIC counterclaimed for rescission of the reinsurance agreements. A central contention revolves around whether Utica's primary liability policies issued to Goulds from 1966-1972 contained aggregate limits for bodily injury, a condition critical to triggering FFIC's reinsurance obligations. The court dismissed Utica's bad faith claim (Count II) and its request for declaratory relief (Count III) but denied all other motions for summary judgment by both parties, including those regarding the 'follow the settlement' doctrine, FFIC's rescission counterclaim, and the timeliness of notice. Consequently, the core breach of contract claim (Count I) and FFIC's counterclaims for rescission are slated to proceed to trial.

Reinsurance DisputeBreach of ContractSummary JudgmentFollow the Settlement DoctrineAggregate LimitsBad Faith ClaimRescissionNotice of ClaimInsurance LawAsbestos Claims
References
56
Case No. MISSING
Regular Panel Decision
Sep 13, 2000

AIU Insurance v. American Motorists Insurance

This case concerns an appeal regarding primary liability coverage for HRH Construction Corp. and Hotel Grand Central in an underlying personal injury action. Plaintiffs, including their excess insurer AIU Insurance Co., sought to compel American Motorists Insurance Co. and St. Paul Fire & Marine Ins. Co. to provide primary defense and reimbursement. The court found American Motorists obligated to defend HRH and the Hotel, as their policy covered them as additional insureds for claims "arising out of" work performed by American Motorists' primary insured, Cord Contracting Co. However, St. Paul was not similarly obligated, as the injury did not "arise out of" work by its insured, Forest Electric Corp. Consequently, the court modified the prior declaration, vacating the plaintiffs' favor against St. Paul and dismissing Cord Contracting Co.'s cross-appeal.

Insurance DisputePrimary Liability CoverageExcess InsuranceAdditional InsuredPersonal InjuryConstruction SiteSubcontractorContractual ObligationDuty to DefendIndemnification
References
1
Case No. MISSING
Regular Panel Decision
Feb 21, 2008

Indemnity Insurance Co. of North America v. St. Paul Mercury Insurance

In this insurance coverage dispute, IICNA, Romano's excess insurer, sought reimbursement from St. Paul (Yonkers' insurer) and Yonkers (general contractor) for a $2 million payment made to settle an underlying personal injury suit involving Eugene Flood. Flood, a Yonkers employee, was injured due to a cable left by subcontractor Romano. IICNA settled the underlying action without St. Paul's consent, believing St. Paul's policy was primary and Yonkers was contractually obligated to indemnify. The court denied IICNA's claims, finding St. Paul was not bound by the non-consented settlement and had properly tendered defense to Romano. Furthermore, IICNA's subrogation claim against Yonkers was barred by the antisubrogation rule, as Yonkers was an additional insured under IICNA's policy.

Insurance CoverageReimbursementSubrogationAntisubrogation RuleAdditional InsuredIndemnification AgreementLabor LawSummary JudgmentAppellate ReviewSettlement Consent
References
8
Case No. MISSING
Regular Panel Decision

Morris Park Contracting Corp. v. National Union Fire Insurance

This case concerns an appeal regarding an insurer's obligation to defend and indemnify an insured in an underlying personal injury action. The central issue revolved around the timeliness of the notice provided by the insured, Morris Park Contracting Corp., to its excess liability carrier, National Union Fire Insurance Company of Pittsburgh, Pa. The court reiterated that contractual notice requirements are conditions precedent to coverage and must be met within a reasonable time, which is heavily dependent on factual circumstances. The appellate court affirmed the lower court's denial of summary judgment, finding that triable questions of fact existed concerning the reasonableness of Morris Park's delay in notifying its excess insurer. Specifically, the court noted that the mere ad damnum clause in the underlying complaint was insufficient to trigger notice without accompanying evidence of serious injuries, and Morris Park's ongoing investigation raised issues of good faith belief of non-liability.

Insurance CoverageDeclaratory JudgmentNotice RequirementsExcess LiabilityTimeliness of NoticeSummary JudgmentConditions PrecedentReasonable BeliefAd Damnum ClausePersonal Injury Action
References
31
Case No. MISSING
Regular Panel Decision
Aug 16, 2006

Superior Ice Rink, Inc. v. Nescon Contracting Corp.

The plaintiff contracted with Nescon Contracting Corp. for painting services and required to be named an additional insured under Nescon's liability policy. Nescon's insurance broker, Seigerman-Mulvey Company, Inc., issued a certificate indicating plaintiff was an additional insured, but the insurer, Merchants Mutual Insurance Company, later disclaimed coverage after workers were injured on the plaintiff's premises. The plaintiff sued Seigerman-Mulvey for breach of contract, alleging third-party beneficiary status. The Supreme Court denied Seigerman-Mulvey's motion to dismiss the complaint. However, the appellate court reversed, granting the motion to dismiss, holding that the plaintiff was not in privity of contract with Seigerman-Mulvey, was owed no duty by them, and failed to establish itself as an intended third-party beneficiary or demonstrate fraud, collusion, or other special circumstances for recovery.

Breach of ContractInsurance Broker LiabilityThird-Party BeneficiaryMotion to DismissAdditional InsuredPrivity of ContractAppellate ReviewInsurance Coverage DisclaimerCPLR 3211(a)(7)Pecuniary Loss
References
4
Case No. MISSING
Regular Panel Decision
Oct 06, 2000

Royal Insurance Co. of America v. Commissioners of the State Insurance Fund

The claimant sought 50% reimbursement of defense costs from the State Insurance Fund (Fund) for litigation related to a bridge collapse, after the Fund ceased contributions. The Court of Claims granted summary judgment to the claimant, finding an implied contract. On appeal, the Fund argued State Finance Law § 112 (2) (a) precluded such a contract without Comptroller approval and that factual issues existed. The appellate court affirmed, holding the Fund acts as a private insurer in litigation and is estopped from denying the implied contract, also finding no material factual issues precluding summary judgment.

Reimbursement of Defense CostsImplied ContractState Insurance FundCo-insuranceSummary JudgmentEstoppelState Finance LawWorkers' Compensation LawAppellate ReviewGovernmental Immunity
References
6
Case No. MISSING
Regular Panel Decision

Nationwide Insurance v. Empire Insurance Group

This case concerns a dispute over insurance coverage. Marcos Ramirez was injured while working for Fortuna Construction, Inc. at premises owned by 11194 Owners Corp. Fortuna had subcontracted work from Total Structural Concepts, Inc. and agreed to add Total Structural as an additional insured on its general liability policy with Empire Insurance Group and Allcity Insurance Company. Ramirez sued 11194 Owners Corp. and Total Structural. Total Structural then commenced a third-party action against Fortuna. Nationwide Insurance Company, as Total Structural's insurer and subrogee, initiated a declaratory judgment action against Empire and Allcity after discovering Total Structural was an additional insured on their policy, demanding coverage for the Ramirez action. The Supreme Court granted Nationwide's motion for summary judgment, but the appellate court reversed, finding that Total Structural failed to provide timely notice of the Ramirez action to Empire and Allcity as required by the policy. The court emphasized that timely notice is a condition precedent to recovery and that lack of diligent effort to ascertain coverage vitiates the policy. Consequently, the appellate court granted Empire and Allcity's cross-motion, declaring they are not obligated to defend or indemnify Nationwide/Total Structural.

Insurance CoverageTimely NoticeCondition PrecedentDeclaratory JudgmentAdditional InsuredSubrogationSummary JudgmentBreach of ContractPersonal InjuryGeneral Liability Policy
References
8
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