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

Case No. 03 Civ. 0332(AKH)
Regular Panel Decision
Oct 29, 2004

In Re September 11th Liability Insurance Coverage Cases

This opinion and order addresses two Rule 12(c) motions regarding insurance coverage for the World Trade Center properties following the September 11, 2001, attacks. The Port Authority of New York and New Jersey sought a declaration that it is an "Additional Insured" under Zurich American Insurance Company's policies, while World Trade Center Properties LLC (WTCP) sought a declaration that Zurich is obligated to cover defense costs. The court, presided over by District Judge Hellerstein, denied both motions. It found ambiguity in the binder regarding the Port Authority's "Additional Insured" status, stating that the issue was premature without further discovery. Furthermore, the court held that New York Insurance Regulation 107 does not require rewriting Zurich's binder and policies to include defense costs, considering the unique circumstances, the sophistication of the insured, and the fact that Zurich explicitly excluded defense costs, which Silverstein (WTCP's affiliate) accepted after failing to secure conventional coverage. The court also affirmed supplemental jurisdiction over the insurance claims due to their close relation to the underlying September 11th liability cases.

Insurance CoverageSeptember 11 AttacksWorld Trade CenterRule 12(c) MotionDeclaratory ReliefAdditional Insured StatusDefense CostsInsurance BinderNew York Insurance LawRegulation 107
References
48
Case No. MISSING
Regular Panel Decision

Tennessee Farmers Mutual Insurance Co. v. American Mutual Liability Insurance Co.

This appeal concerns the obligations of three insurance companies—Tennessee Farmers, Northland, and American Mutual—to provide coverage for Bobby Clay Thomas, a driver involved in an accident while operating a loaned vehicle. Thomas, a foreman for Macon Hardwood Lumber Company, was traveling to an auto auction to purchase a company truck and look for a personal vehicle. After failing to find either, he drove a newly purchased vehicle for Lowell Smith, a used car dealer, back to Smith's lot when he was involved in a head-on collision. The trial court determined Thomas was acting within the scope of his employment, obligating American Mutual (Macon's insurer) to provide coverage. However, the appellate court reversed this decision, finding that Thomas was not acting within the scope of his employment at the time of the accident, thus relieving American Mutual of its coverage obligations.

Insurance CoverageDeclaratory JudgmentRespondeat SuperiorScope of EmploymentAutomobile AccidentVicarious LiabilityEmployee NegligenceDual Purpose TripAppellate ReviewFact vs. Law
References
30
Case No. MISSING
Regular Panel Decision

McLaughlin v. Midrox Insurance

This case involves an appeal concerning an insurance coverage dispute. Plaintiffs sought to compel Midrox Insurance Company to indemnify the Blodgett Brothers Partnerships for a $1 million judgment in an underlying personal injury action. The accident involved a motorcycle operated by plaintiff Charles R. McLaughlin and a pickup truck driven by Ronald Blodgett. Midrox had disclaimed coverage, arguing the accident occurred off insured premises and involved a registered vehicle. The court affirmed the lower court's decision, ruling that the farmowner's policy did provide coverage. The court determined that public roadways used for transporting materials between farm parcels could be considered 'insured premises' and that the pickup truck's agricultural registration did not negate coverage given its exclusive use for farming purposes.

Personal InjuryFarmowner's InsuranceInsurance CoverageAgricultural TruckPolicy InterpretationOff-Premises AccidentPublic RoadwaysSummary JudgmentIndemnificationVehicle and Traffic Law
References
5
Case No. MISSING
Regular Panel Decision

In re the Liquidation of Midland Insurance

Policyholders New York Dock Railway (NYDR) and Brooklyn Eastern District Terminal (BEDT), joined by claimants Buividas and Romacho, moved to confirm a referee's report that found coverage for their claims by the Stock Workers' Compensation Security Fund. The Superintendent of Insurance, as liquidator of Midland Insurance Company, cross-moved to disaffirm the report, arguing against Security Fund coverage based on his interpretation of relevant statutes. The court reviewed the referee's decision, finding it erroneous due to a misinterpretation of legislative history and intent regarding security fund coverage limitations, particularly concerning Chapter 801 amendments. Upholding the Superintendent's rational interpretation, the court denied the motion to confirm and granted the cross-motion to disaffirm, affirming the denial of security fund coverage.

Workers' Compensation Security FundInsurance Coverage DisputeMidland Insurance Company LiquidationFederal Employers' Liability ActJones ActLongshoremen's and Harbor Workers' Compensation ActStatutory InterpretationLegislative HistoryThird-Party IndemnificationEmployer's Liability
References
6
Case No. MISSING
Regular Panel Decision

Arrellano v. State Farm Fire & Casualty Com.

Jamie Arrellano died in a trench collapse while working for Southwest Plumbing, which lacked worker's compensation insurance. His family and estate filed a wrongful death action against Southwest Plumbing and secured a money judgment. State Farm Fire & Casualty Co., Southwest Plumbing's insurer, then brought a declaratory judgment action to deny coverage, arguing an exclusion applied because Arrellano's death occurred within the course and scope of his employment. The trial court sided with State Farm, declaring no coverage. On appeal, Arrellano's family challenged this judgment, but the appellate court affirmed, finding sufficient circumstantial evidence to support the trial court's finding that Arrellano was acting within the course and scope of his employment at the time of the accident.

Declaratory judgmentInsurance coverage denialEmployment exclusion clauseCourse and scope of employmentWrongful death actionTrench collapse accidentAppellate review TexasLegal sufficiency of evidenceFactual sufficiency of evidenceCircumstantial evidence ruling
References
14
Case No. MISSING
Regular Panel Decision

U. P. Iron Works v. Investors Insurance

Plaintiff insured brought a declaratory judgment action against their insurer, who issued both workers' compensation and general liability policies. The dispute arose after a partner was injured, leading to a third-party products liability action against the partnership. The insurer disclaimed coverage, citing lack of coverage for a direct suit by a partner and late notice of the accident. The court found that coverage existed for the third-party claim, extending it to a partner similar to an employee. Furthermore, the court determined that the notice provided by the insured, though three years after the accident, was not unreasonably late given the complexities involved. Consequently, the court declared the policy to be in full force and effect for the accident.

Declaratory JudgmentInsurance CoverageWorkers' Compensation PolicyGeneral Liability PolicyThird-Party ClaimPartner InjuryEmployee ExclusionLate Notice DisclaimerDuty to DefendSummary Judgment Motion
References
2
Case No. MISSING
Regular Panel Decision
May 09, 2008

Continental Casualty Co. v. Employers Insurance Co. of Wausau

This class action for declaratory judgment addresses complex insurance coverage disputes arising from asbestos-related personal injury claims against Robert A. Keasbey Company. Plaintiffs, Continental Casualty Company and American Casualty Company, sought declarations on the interpretation of their general liability and excess insurance policies. The court made various rulings, including that asbestos exposures trigger coverage, that pollution exclusions do not bar coverage, and that class defendants are not subject to certain insurer defenses like laches or statute of limitations. The decision also clarified per-occurrence limits and the scope of coverage for specific excess policies, ultimately outlining the obligations of the insurers for the ongoing asbestos litigation.

Asbestos LitigationInsurance Coverage DisputeDeclaratory Judgment ActionProducts Hazard CoveragePremises Operations CoverageClass Action LawsuitInsurance Policy InterpretationPollution Exclusion ClauseNotice of OccurrenceStatute of Limitations Defense
References
65
Case No. MISSING
Regular Panel Decision

Hayden v. S & W Meat & Poultry

Claimant, a partner in S & W Meat & Poultry, sustained a serious injury. A workers' compensation claim was filed, but the carrier contested coverage, arguing that claimant, as a partner, had not formally elected coverage under Workers' Compensation Law § 54 (8). The Workers' Compensation Board applied estoppel, finding the carrier failed to advise the employer of the election requirement. On appeal, the court reversed this decision, holding that the employer's insurance broker, the Fear agency, was notified of the lack of coverage, and this knowledge is imputed to the employer. The court found insufficient evidence for estoppel and remitted the matter to the Board for further proceedings.

Workers' CompensationEstoppelInsurance CoveragePartnershipAgent LiabilityImputed KnowledgePremium RefundAppellate ReviewRemittalWorkers' Compensation Law § 54 (8)
References
5
Case No. MISSING
Regular Panel Decision

Bowker v. NVR, Inc.

Defendant-third-party plaintiff NVR, Inc. appealed an order denying its motion for summary judgment against second third-party defendant New York State Insurance Fund (SIF). NVR had contracted with K-Wall Dry Wall (Harmon), whose employee, Joseph S. Bowker, was injured. NVR sought indemnification from Harmon, who defaulted, leading to an interim judgment. SIF, Harmon's insurer, disclaimed coverage based on a policy exclusion for 'liability assumed under a contract,' contending Workers' Compensation Law § 11 required a 'grave injury' finding for coverage. The appellate court determined that the applicability of Workers' Compensation Law § 11 relates to the merits of the third-party action, not merely the scope of insurance coverage. As SIF improperly disclaimed coverage by conflating contractual liability with waiver of defense, the order was reversed, and SIF was declared obligated to indemnify Harmon.

Personal InjurySummary JudgmentIndemnificationWorkers' Compensation Law § 11Insurance Law § 3420Contractual LiabilityGrave InjuryDisclaimer of CoverageThird-Party ActionAppellate Review
References
4
Case No. MISSING
Regular Panel Decision

Claim of Cerbasi v. County Metal & Glass, Inc.

A claimant injured their left arm while working at a New York construction site for a New Jersey employer insured by New Jersey Manufacturers Insurance Company (NJMIC). A dispute arose regarding coverage, with the Workers’ Compensation Law Judge and Board determining the policy covered the accident because New York was not an explicitly excluded state and NJMIC’s attempt to amend the policy was ineffective. NJMIC appealed, arguing the Board erred in its coverage finding and that Workers’ Compensation Law § 54 (5) notice requirements did not apply to partial cancellations. The Appellate Division affirmed, finding the Board's determination on coverage implicit and that NJMIC failed to demonstrate an effective exclusion or proper cancellation under Workers' Compensation Law § 54 (5). The court also noted NJMIC's argument regarding partial cancellation was unpreserved.

Workers' CompensationInsurance CoveragePolicy ExclusionNew York LawNew Jersey BusinessStatutory ComplianceCancellation NoticeAppellate ReviewJurisdictionLeft Arm Injury
References
9
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