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

Case No. 2018 NY Slip Op 03093
Regular Panel Decision
May 01, 2018

Contact Chiropractic, P.C. v. New York City Tr. Auth.

This case addresses the applicable statute of limitations for no-fault claims against a self-insured entity. The Court of Appeals determined that the three-year statute of limitations under CPLR 214 (2) governs such claims, as the obligation to provide no-fault benefits by a self-insurer is statutory rather than contractual. This decision reversed the Appellate Division, which had applied a six-year statute of limitations based on a contractual nature. The Court clarified that in the absence of a private insurance contract, the self-insurer's liability for first-party benefits is wholly statutory. The ruling impacts procedural aspects without altering the substantive no-fault obligations of self-insurers.

Statute of LimitationsNo-Fault InsuranceSelf-Insurer LiabilityCPLR 214 (2)CPLR 213 (2)Statutory ObligationContractual ObligationFirst-Party BenefitsMotor Vehicle AccidentsAppellate Review
References
30
Case No. MISSING
Regular Panel Decision

Claim of Capitelli v. Wells, Rich, Green, Inc.

The claimant's decedent died in an employment-related helicopter crash in 1984, leading to the receipt of compensation benefits by the widow and son. A subsequent third-party action settled for a significant sum, with the carrier's consent and a waiver of its compensation lien. However, a Workers’ Compensation Law Judge and the Board ruled that the carrier was still obligated to pay $3,000 to the Uninsured Employers’ Fund and $2,000 to the Vocational Rehabilitation Fund because the third-party recovery meant there were no beneficiaries *entitled* to compensation under the statutes. The carrier appealed, arguing that its lien waiver and a statutory amendment regarding litigation costs should negate this obligation. The court affirmed the Board's decision, clarifying that the carrier's voluntary lien waiver, made for its own benefit, and the amendment's purpose (to benefit claimants) did not relieve the carrier of its statutory duty to contribute to the no-dependency funds.

Third-Party Action SettlementLien WaiverNo-Dependency FundsVocational Rehabilitation FundUninsured Employers' FundStatutory InterpretationApportionment of Litigation CostsBeneficiary EntitlementEmployer LiabilityInsurance Carrier Obligation
References
13
Case No. 8 N.Y.3d 1007
Regular Panel Decision
Jun 12, 2007

MATTER OF GREENE COUNTY DEPT. OF SOCIAL SERVICES v. Ward

Dawn Ward adopted Jeffrey, a special needs child with severe behavioral and developmental issues, and received a monthly adoption subsidy. When Jeffrey's behavior escalated, posing safety risks, Ms. Ward attempted a temporary relinquishment of parental rights to the Greene County Department of Social Services (GCDSS). GCDSS, however, only allowed a permanent surrender, which Ms. Ward accepted. Subsequently, GCDSS initiated a petition for child support against Ms. Ward, who challenged the obligation on grounds of statutory exception and equitable estoppel. The Court of Appeals affirmed the lower court's decision, ruling that as an adoptive parent, Ms. Ward retained the financial support obligation, and the specific statutory exception for unwed biological mothers did not apply to her. The court also highlighted GCDSS's failure to provide Ms. Ward with required notifications and access to support services, although these omissions did not alter the child support ruling in this case.

Adoption LawChild Support ObligationParental RightsSpecial Needs ChildrenSocial Services LawEquitable EstoppelNew York Court of AppealsFamily LawChild WelfareVoluntary Surrender
References
4
Case No. MISSING
Regular Panel Decision

Tishman Construction Corp. v. Arc Electrical Construction Co.

This case concerns a declaratory judgment action brought by Morgan Trust Company and Tishman Construction Corporation (plaintiffs) against Northbrook Property & Casualty Insurance Company (defendant). Plaintiffs sought a declaration that Northbrook was obligated to defend and indemnify them in an underlying action involving an injured worker, Joseph Hickey, who fell on a construction site. The initial motion for summary judgment by plaintiffs was denied by the IAS Court. However, the appellate court unanimously reversed this decision, granting summary judgment to the plaintiffs. The court determined that prior rulings based on res judicata established Northbrook's obligation, and that a late notice of claim argument by Northbrook lacked merit. Consequently, Northbrook was declared obligated to defend and indemnify the plaintiffs.

Summary judgmentDeclaratory judgmentInsurance obligationIndemnificationAdditional insuredRes judicataLate notice of claimAppellate reviewConstruction accidentContract law
References
4
Case No. MISSING
Regular Panel Decision

Claim of Martin v. New York Telephone

This case concerns an appeal from a Workers' Compensation Board decision regarding the liability for benefits. The claimant sustained a left knee injury in 1987 and a reinjury in 1995. A 1998 Section 32 settlement agreement released the employer from future claims for a lump sum, but required it to cover medical treatment. In 2004, the claimant developed a consequential right knee injury. The Workers' Compensation Board ultimately shifted liability for benefits to the Special Fund for Reopened Cases under Workers' Compensation Law § 25-a, citing the passage of statutory timeframes. The Special Fund appealed, challenging its statutory liability and the employer's ongoing responsibility for medical expenses per the settlement. The appellate court affirmed the Board's decision, upholding the applicability of Section 25-a and noting the employer's statutory obligation for medical treatment.

Workers' Compensation Law § 25-aSpecial Fund for Reopened CasesSection 32 Settlement AgreementConsequential InjuryMedical Treatment LiabilityStatutory LiabilitySchedule Loss of UseAppellate ReviewTimelinessBoard Review
References
4
Case No. MISSING
Regular Panel Decision
Jan 23, 2008

AIU Insurance v. Nationwide Mutual Insurance

The case involves a dispute between two insurers regarding their respective coverage obligations for a mutual insured in an underlying action following a fatal construction site accident. Plaintiff, who insured both the site owner and the subcontractor, sought reimbursement from defendant, who also insured the employer under a workers’ compensation policy, for half of a settlement paid in the underlying action. The Supreme Court initially granted summary judgment to plaintiff, obligating defendant to reimburse plaintiff. However, the appellate court reversed this decision, vacating the judgment and granting summary judgment to defendant. The appellate court ruled that the antisubrogation rule would have compelled the dismissal of any third-party action, thereby precluding plaintiff from obtaining reimbursement from a coinsurer.

Insurance CoverageSubrogationSummary JudgmentWorkers' CompensationConstruction AccidentFatal AccidentCoinsuranceAppellate ReversalUnderlying ActionThird-Party Action
References
1
Case No. MISSING
Regular Panel Decision

Preserver Insurance v. Ryba

This is a declaratory judgment action where an unnamed plaintiff insurance company appealed an order denying its motion for summary judgment and granting Northern Assurance Company of America's cross-motion for summary judgment. The plaintiff sought a declaration that it was not obligated to defend and indemnify East Coast Stucco & Construction, Inc., in an underlying personal injury action. The Supreme Court affirmed the lower court's decision, finding that the plaintiff failed to raise a triable issue of fact against Northern's prima facie showing that Insurance Law § 3420 (d) applied, rendering the plaintiff’s disclaimer untimely. Additionally, Northern established that the injured party was subject to Workers’ Compensation Law, precluding the application of the policy’s liability limit. The court remitted the matter for entry of a judgment declaring the plaintiff is obligated to defend and indemnify East Coast.

Insurance LawDeclaratory JudgmentSummary JudgmentIndemnificationDuty to DefendPolicy ExclusionWorkers' CompensationAppellate ReviewTimely DisclaimerInsurance Coverage
References
11
Case No. MISSING
Regular Panel Decision
Apr 17, 1979

Hughes, Harrison & Brown Roofing, Inc. v. Merchants Insurance

Plaintiffs, a corporation and individuals, initiated an action seeking a declaration that their insurance company, the defendant, was obligated to defend and indemnify them in a negligence lawsuit filed by an employee, Patrick Paul Black. The underlying negligence action alleged that the corporation failed to secure workers' compensation insurance. The defendant insurer denied its obligation, citing policy exclusions related to workers' compensation liabilities and disputing coverage for the individual plaintiffs. Initially, the Supreme Court, Orange County, granted the plaintiffs' request for accelerated judgment, compelling the insurer to provide defense. However, this judgment was subsequently reversed on appeal, with the appellate court noting the absence of the actual insurance policy and the impropriety of adjudicating coverage without it, especially concerning the workers' compensation exclusion.

Insurance coverage disputeDuty to defendDuty to indemnifyWorkers' compensation exclusionAccelerated judgmentNegligence actionEmployer liabilityAppellate reviewPolicy interpretationSummary judgment
References
0
Case No. MISSING
Regular Panel Decision

Government Employees Insurance v. Kolodny

Government Employees Insurance Company (GEICO) initiated a declaratory judgment action to determine if it was obligated to indemnify Chaim S. Kolodny or provide coverage for claims stemming from a fatal 1990 automobile accident. GEICO argued a policy exclusion applied because the vehicle was for Kolodny's regular use. The Supreme Court initially granted GEICO's motion for summary judgment. However, the appellate court reversed this decision, ruling that GEICO's disclaimer, issued over a year after receiving notice of the accident, was untimely and lacked an adequate explanation for the delay. Consequently, GEICO was found to be obligated to provide coverage. The appeal from the intermediate order was dismissed.

Insurance CoverageAutomobile AccidentDeclaratory JudgmentTimely DisclaimerPolicy ExclusionSummary JudgmentAppellate ReviewEstate AdministrationIndemnificationRegular Use Clause
References
6
Case No. MISSING
Regular Panel Decision
Feb 04, 2004

HRH Construction Interiors, Inc. v. Royal Surplus Lines Insurance

This case involves HRH Construction Interiors, Inc. (HRH) and National Union Fire Insurance Company (National) seeking to establish Royal Surplus Lines Insurance Company's (Royal) obligation to defend HRH in an underlying action and reimburse legal fees. The Supreme Court, New York County, initially ruled that Royal was obligated to defend HRH and reimburse legal fees from December 30, 1999. Upon appeal, this order was modified to change the reimbursement start date to November 22, 2000, and otherwise affirmed. The court rejected Royal's argument that a specific endorsement overrode a general blanket additional insured endorsement, which Royal claimed would make them coprimary insurers with National. The duty to defend was clarified to be triggered upon the commencement of the underlying action against HRH.

Insurance disputeGeneral contractor liabilityAdditional insured endorsementDuty to defendInsurance reimbursementSummary judgmentPolicy interpretationConstruction site accidentPrimary insuranceOther insurance clause
References
0
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