Not a Lexis+ subscriber? Try it out for free.

Workers' Compensation

California: CIGA: A Noteworthy Board Panel Decision

In what may be a case of first impression, a Board panel has held that CIGA cannot obtain reimbursement from an insurance carrier where CIGA and the carrier both were liable to an injured worker, but the carrier entered into a complete settlement with the worker. Here’s our headnote for the Suarez case:

California Insurance Guarantee Association—Other Insurance—Reimbursement and Contribution—WCAB, granting reconsideration, rescinded WCJs finding that Liberty Mutual Insurance Company (Liberty Mutual) was “other insurance” under Insurance Code § 1063.1(c)(9) and was required to undertake administration of applicant’s medical care in connection with 7/27/86 and 9/8/93 industrial injuries, and to resolve reimbursement and contribution issues with California Insurance Guarantee Association (CIGA), which had assumed liability for insurer Unicare’s covered claims after Unicare became insolvent, and WCAB substituted new decision finding that Liberty Mutual was not available “other insurance” for applicant’s claim, when WCAB reasoned that in order to obtain reimbursement or change administrators based on existence of “other insurance,” CIGA was required to show that Liberty Mutual was jointly and severally liable with Unicare for applicant’s medical treatment, but because Unicare had previously settled its contribution rights as part of Stipulated Award issued solely against Unicare, which included stipulation that only Unicare was liable for benefits, Liberty Mutual was no longer jointly and severally liable for applicant’s medical treatment, and, therefore, CIGA was not entitled to reimbursement from Liberty Mutual. [See generally Hanna, Cal. Law of Emp. Inj. and Workers’ Comp. 2d § 2.84[3][a], [c]; Rassp & Herlick, California Workers’ Compensation Law, Ch. 3, § 3.33[3].]

Warning: Be sure to check if this case has been appealed.

Note: Board panel decisions are not binding precedent.

PDF of the case is below.

Juan Suarez.pdf