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NCCI-Mandated Assigned Risk Policy Plain Language Upheld: Cal. Comp. Cases January Advanced Postings (1/18/2012)

January 18, 2012 (2 min read)
Here’s the third batch of advanced postings for the January 2012 issue of Cal. Comp. Cases.
FEATURED CASE: NCCI-MANDATED ASSIGNED RISK POLICY PLAIN LANGUAGE UPHELD subscribers can link to the case to read the complete summary.
Ardis Kemp, Brenda Kemp, dba ABCO Distribution, Petitioners v. Workers' Compensation Appeals Board, Travelers Indemnity Company, (Edward M. McDonald, Joe Jinesta), Respondents, 2011 Cal. Wrk. Comp. LEXIS 206
Insurance Coverage—WCAB affirmed arbitrator's finding that Arizona workers' compensation insurance policy did not cover claims by two different employees of interstate trucking company that partially relocated its business from California to Arizona, and that there was no basis to reform insurance policy to cover claims or to apply principles of equitable or promissory estoppel to prevent carrier from denying coverage, when WCAB found that plain language of National Council on Compensation Insurance-mandated assigned risk policy issued by carrier to employer excluded truck drivers from coverage, that employer was adequately informed of exclusion by language of policy itself and both orally and in writing by carrier, that arbitrator found that employer was negligent in failing to investigate and seek professional advice regarding coverage after partially moving its business to Arizona and being notified of exclusion, that there was nothing inherently wrong with National Council on Compensation Insurance-mandated assigned risk policy so as to justify "reformation" of contract terms to cover excluded employees, that employer did not prove required elements of promissory or equitable estoppel since there was no evidence of any material misrepresentation by carrier or detrimental reliance by employer, and that arbitrator found that fact that carrier kept premiums for truck drivers paid by employer for over five years did not justify application of reformation or estoppel.
Here’s the rest of this week’s cases. subscribers can link to the case to read the complete headnote and summary.
Monty Lewis, Petitioner v. Workers' Compensation Appeals Board, Browning Contractors, Inc., Zurich North American Insurance Company, State Compensation Insurance Fund, Respondents, 2011 Cal. Wrk. Comp. LEXIS 207
Psychiatric Injuries—Predominant Cause Requirement—Apportionment Between Multiple Employers—WCAB held that applicant/construction foreman’s claim for psychiatric injury stemming from low back injuries incurred while employed by defendant on 3/14/2002, 5/7/2004, and 7/22/2004, and during cumulative period from 1978 through 7/28/2004, was barred under Labor Code § 3208.3(b)(1) because applicant did not meet predominant cause requirement applicable to psychiatric injuries, when agreed medical evaluator found that…
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