CA - High Court Rejects Exhaustion Requirement in Actions Against Excess Carriers
08/06/2026 | 0
The California Supreme Court rejected a strict exhaustion requirement as a prerequisite for insureds to bring claims against excess carriers.
"We conclude that an insured may state a viable cause of action for declaratory relief regarding coverage and liability under an excess insurance policy even if all the underlying insurance coverage has not yet been exhausted," the high court said in Fox Paine & Company LLC et al. v. Twin City Fire Insurance Co. et al. "While insureds in this position must adequately plead their covered losses, the relevant principles governing the av
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The Washington Court of Appeals reinstated a citation against a staffing agency for failing to train its workers on asbestos hazards and for failing to file a related accident-prevention program.
Case: Department of Labor & Industries v. Tradesmen International LLC, No. 87759-3-I, 08/03/2026, unpublished.
Facts: Tradesmen International LLC leases temporary workers to other companies, most often in the construction industry.
Pacific West Construction contracted with Tradesmen to provide workers at its jobsites in 2015. The contract provided that Pacific would be solely res
The Commonwealth Court ruled that a police officer’s claim for benefits based on his contraction of COVID-19 was barred by res judicata.
Case: Bolds v. City of Philadelphia (WCAB), No. 179 C.D. 2025, 08/04/2026, unpublished.
Facts: William Bolds worked as a police officer for the City of Philadelphia. He tested positive for COVID-19 in March 2020.
The city designated the time Bolds missed from work as “E-time,” or excused time.
The city created the E-time designation during the pandemic to provide its employees full pay without depleting sick or vacation time.
In January
A federal appellate court upheld the denial of a security contractor’s claim for a psychological injury from his work in Iraq.
Case: Morales v. U.S. Department of Labor, No. 25-1112, 08/03/2026, unpublished.
Facts: Alberto Franco Morales, a native and resident of Peru, began working in Iraq as a border security guard for Triple Canopy Inc. in 2008.
According to Morales, he experienced several traumatic incidents during his employment, including a December 2008 mortar attack that caused workers to be thrown into the air, a 2009 mortar strike approximately 70 meters from his position&nb
At a meeting of California’s Commission on Health and Safety and Workers’ Compensation, a payer and network advocate argued that the state’s chaotic medical provider network system is a sterling success, despite overwhelming evidence to the contrary.
The American Association of Payers, Administrators and Networks claimed that a general provider shortage, not a broken system riddled with pitfalls for providers, is the reason injured workers struggle to find doctors willing to treat them.
AAPAN shared findings from its white paper&n
A Texas appellate court ruled that the family of a deceased worker needed to bring claims against his employer’s insurance carrier before the Division of Workers’ Compensation.
Case: In re Zurich American Insurance Co., No. 04-26-00339-CV, 07/31/2026, published.
Facts: Eliseo Barrera died after he allegedly suffered injuries while working for Mesa Southern CWS Acquisition LP.
His family members alleged that Barrera promptly reported his injuries and was told by his supervisor that he needed to seek a medical evaluation from a workers’ compensation and occupational health s
The Workers' Compensation Insurance Rating Bureau of California on Wednesday published loss-sensitive advisory plan tables for policies taking effect on or after Sept. 1.
The WCIRB develops advisory plans that describe eligibility, rules and parameters for retrospective rating, large-risk deductible and small-deductible policies. They are submitted to the insurance commissioner for informational purposes only.
Advisory plans are not regulations and have not been approved. WCIRB creates them as a resource for members.
"Insurers should independently evaluate whether to use these plan
The Washington Court of Appeals rejected challenges to the reduction in compensation based on the survivorship options that two permanently and totally disabled workers selected for their pensions and their receipt of Social Security benefits.
James Lorkowski sustained an injury in the course of employment, and the Department of Labor & Industries found that he was permanently and totally disabled. The department approved him for pension benefits beginning in August 2020.
The department sent Lorkowski a letter informing him that because he was married, he could choose from opti
The Illinois Appellate Court overturned a pension board’s denial of a police officer’s application for a line-of-duty disability pension.
Case: Guess v. Board of Trustees of the Dolton Police Pension Fund, No. 1-25-1327, 08/03/2026, unpublished.
Facts: Theresa Guess served as a police officer in the Village of Dolton. In March 2020, she applied to the Board of Trustees of the Dolton Police Pension Fund to receive line-of-duty disability benefits.
Guess claimed that she had begun experiencing disabling seizures as a result of a motor vehicle collision in September 2018.
Tha
A Texas appellate court upheld the dismissal of a worker’s claims against her employer as barred by exclusivity.
Case: Dudley v. East Texas Educational Insurance Association, No. 12-25-00179-CV, 07/31/2026, published.
Facts: Patricia Kay Dudley worked for Chapel Hill ISD as a paraprofessional and bus driver.
She suffered injuries at work in September 2022 when a bus driven by a Chapel Hill employee struck the rear of Dudley’s bus.
Dudley received workers’ compensation benefits.
Procedural history: Dudley, acting as her own attorney, sued Chapel Hill and the East Te
A divided New York appellate court ruled that a Labor Law defendant was not entitled to summary judgment dismissing the claims against it and that summary judgment should have been granted against it on a cross-claim for contractual indemnification.
Case: Mazzurco v. Broadway 52nd LP, No. 157381/17, 07/30/2026, published.
Facts: Onofrio Mazzurco was a laborer for J.T. Magen and Co. Inc. He suffered injuries when he fell down a stairwell at a jobsite.
According to Mazzurco, the stairwell was very dark as he descended, and his foot got tangled in a loop of wire, causing him to trip and f
The California Division of Occupational Safety and Health cited three roofing companies in Los Angeles a combined $282,420 for multiple workplace safety violations following an inspection of a worker's fatal fall.
The agency commonly known as Cal/OSHA said in a statement that an employee repairing a roof leak at a two-story residential property in Westchester fell to his death Jan. 9, 2026.
Cal/OSHA said its inspectors determined that three employers were responsible for protecting workers from hazards associated with the roofing work. The employers allowed the crew to work on the
A bill in Congress would mandate that injured federal workers receive medical treatment through managed care networks.
HR 9869 would also direct the Labor Department to establish treatment protocols for injured federal workers based on the best practices of the healthcare industry.
The bill would direct the head of each federal agency to contract with a managed care network to treat injured workers.
Networks would be required to "make reasonable attempts to provide" the contracted services, a requirement that would include maintaining "a sufficient number of providers&q
The Virginia Workers' Compensation Commission announced that a new validation step when uploading documents through WebFile will go into effect Thursday.
Before completing an upload, users will be asked to review selected documents and confirm they belong to the correct claim. Users will have to enter the last four characters of the claim number before documents can be uploaded.
The commission said the extra step is intended to prevent documents from being uploaded to the wrong claim.
The new step is applicable only to claimants, claims administrators and attorneys using the WebFile sys
The California Workers' Compensation Institute on Monday reported that the surge in cumulative trauma claims could not be attributed to commonly cited factors such as employment growth, worker tenure or multiple filings.
CWCI, in its report to the industry, documented substantial growth in the number of Southern California attorneys representing injured workers in cumulative trauma cases against employers in Northern California, from about one-quarter of claims to nearly four-in-five over the study period. However, it did not determine whether that change contributed to the statewide
An Ohio appellate court ruled that a worker receiving temporary total disability benefits after surgery related to an industrial injury remained eligible for TTD after she voluntarily retired.
Case: Fox v. Industrial Commission, No. 24AP-140, 07/30/2026, published.
Facts: Phyllis Fox worked for Metallus Inc. She injured her right arm at work in March 2020.
Fox’s workers’ compensation claim was allowed for fracture of the right radius with malunion.
In January 2022, Metallus offered lump-sum, early full-pension payments to certain employees. Fox was eligible, bas
