MA - High Court: Insurers in Run-Off, Insolvent Fund Both Eligible for Reimbursements
07/03/2025 | 0
The Massachusetts Supreme Court issued a pair of decisions finding that insurers in run-off are not precluded from receiving second-injury reimbursements, and the state's insolvent carrier fund is eligible for cost-of-living adjustments from the Workers' Compensation Trust Fund.
In Arrowood Indemnity Co. v. Workers' Compensation Trust Fund, the high court affirmed an appellate court decision holding that insurers in run-off are not precluded from receiving reimbursements on second-injury claims.
In Massachusetts Insurers Insolvency Fund v. Workers' Compensation Trust, t...
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A New York appellate court ruled that a worker was not entitled to summary judgment on the issue of liability for his Labor Law claims, but some of the defendants should have had the claims against them dismissed.
Case: Breslin v. Access Auto Sales and Service LLC, No. CV-24-0687, 06/12/2025, published.
Facts: Matthew Breslin worked as a cable technician. He suffered injuries in March 2018 while installing telephone, television and internet service at the offices of Access Auto Sales and Service LLC.
Breslin’s employer was a subcontractor hired by Charter Communications Inc. and Spect...
West Virginia’s Intermediate Court of Appeals upheld the denial of a doctor’s request for a worker to receive an oral medication prescribed for lung diseases.
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Facts and procedural history: Joseph Dorsey worked for Blackhawk Mining LLC. In May 2024, a claims administrator for Blackhawk’s insurance carrier denied a request from Dr. Ryan Waddell for OFEV.
OFEV is a brand-name oral medication used to treat lung diseases.
The administrator did not provide any reasoning, basis or rationale for th...
A Louisiana appellate court revived a claim for damages for a stevedore’s alleged industrial asbestos exposure.
Case: May v. Cooper/T. Smith Stevedoring Co. Inc., No. 2024-CA-0272, 06/11/2025, published.
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When a workers’ compensation claim settles and includes a Medicare set-aside, that’s not the end of the story; it’s the beginning of a new responsibility for the injured worker.
The responsibility? Administering the MSA in compliance with the Centers for Medicare and Medicaid Services guidelines.
There are two options for handling this responsibility: self-administration or professional administration. Each comes with its own benefits and risks. So, which is right for the injured worker? Let’s break it down.
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Case: Thornton v. City of Plano, No. 05-24-01330-CV, 06/30/2025, published.
Facts: Erin Thornton worked for the City of Plano as a police officer. She suffered an injury in the line of duty in August 2021 and missed a month of work. Thornton suffered another injury the following year and was diagnosed with post-traumatic stress disorder.
She also received an impairment rating of 10% for the August 2021 injury.
Thornton clai...
The number of employees working for private self-insured companies fell 3.9% in 2024, while the number of claims they filed fell 7.4%, resulting in private self-insured claim frequency hitting a four-year low, according to the California Workers' Compensation Institute.
At the same time, the average paid loss per claim climbed 12.3%, and the average incurred loss increased 16.8%.
Private self-insured employers covered 2.25 million workers last year, compared to nearly 2.34 million in 2023. The reduction in workforce partially explains the drop in claim volume, CWCI said.
The drop in cov...
The New Jersey Compensation Rating and Inspection Bureau on Wednesday announced the elimination of the requirement to submit the physical notice of election form under the Large Risk, Large Deductible program and retrospective rating plans.
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Ionian Re, a captive insurer, and contractors Sky...
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Case: Lobo v. Department of Justice, No. 2024-1198, 06/09/2025, published.
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West Virginia’s Intermediate Court of Appeals upheld a finding that a worker suffered a compensable back injury.
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Facts: Mark Burgess worked for Spartan Mining Co. In February 2024, he sought medical treatment for low-back pain radiating into the right hip and leg. Burgess reported that his symptoms had been present for about a week and had progressively worsened.
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A divided North Carolina Court of Appeals ruled that the state’s Self-Insurance Security Association was not a proper party to a widow’s claim for benefits after her late husband’s self-insured employer went insolvent.
Case: Cloer v. King Arthur Inc., No. COA24-587, 06/04/2025, published.
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Case: McBride v. Old Republic Insurance Co., No. 2024-C-01519, 06/27/2025, published.
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The agreement between Enable and White Oak provided that White Oak was an independent contracto...
An increase in incurred losses and expenses, coupled with a decrease in earned premium, resulted in a $1.3 billion underwriting loss in 2024, according to a new report by the Workers' Compensation Insurance Rating Bureau of California.
Total losses and expenses incurred in 2024 increased to $16.7 billion from $14.3 billion the year before. Over the same period, calendar year earned premium fell to $15.5 billion from $15.8 billion.
Total losses and expenses accounted for 108% of premiums earned in 2024, compared to 2023, when combined losses and expenses accounted for 91% of calendar year...
The Workers’ Compensation Insurance Rating Bureau of California on Tuesday announced the appointment of Eric Sanders as senior vice president and chief customer operations officer.
Sanders brings more than 25 years of insurance experience to the new position, the WCIRB said. His career includes stints at QBE, where he advanced to chief claims and risk solutions officer, and Fireman's Fund, where he held claims and loss control leadership roles for more than 10 years.
“Eric brings deep expertise in California workers’ compensation and a strategic leadership approach ...
The U.S. Attorney's Office for Central California announced that convicted fraudster Paul Randall has been charged with participating in a scheme to bilk Medi-Cal out of $270 million for medically unnecessary prescription drugs that were procured by kickbacks.
Randall, 66, made his initial appearance Friday, according to prosecutors. He was held in jail without bond and scheduled to return July 17 for arraignment. Federal prosecutors announced charges against Randall as part of a larger $14.6 billion scheme that resulted in charges against 324 defendants in 50 states, including 96 health ...
