En Banc Decision Of Appeals Board Defines Ciga Role In Two Consolidated Cases
- Posted By: Harvey Brown
- August 1, 2003
This decision involves two cases that were consolidated for the Workers’ Compensation Appeals Board (WCAB) to make an en banc decision
In the first case that was consolidated for this decision there was a Stipulation With Request For Award. At the time of the stipulation there were two solvent carriers. The stipulations apportioned liability between the two carriers with the carrier mat would become insolvent to administer the award. When the carrier administering went insolvent the California Insurance Guarantee Association (CIGA) petitioned for dismissal.
In the second consolidated case the applicant alleged two separate cumulative trauma periods. The first cumulative trauma was one carriers sole responsibility. The second cumulative trauma was the responsibility of a carrier who became insolvent and CIGA began administering.
The WCAB consolidated for reconsideration of both awards and indicated that CIGA is limited to the payment of “covered claims”. They indicated that “covered claims” does not include claims where there is other insurance pursuant to Insurance Code section 1063.1 (c) (9).
In a single cumulative trauma where there are multiple carriers CIGA is relieved of liability. There is an exception where there is a previous Stipulation and Award or Compromise and Release and then CIGA is not relieved of liability.
Where there are successive injuries there must be an apportionment of liability including CIGA’s liability for any insolvent carrier.
Where there is more than one award and there is a solvent carrier and CIGA involved in the award CIGA will be relieved of administering the award.
Labor Code section 5412 was not raised as an issue in these cases and may make a significant difference depending on the facts of each individual case. This will need to be analyzed based upon each cases set of facts..
Case: GOMEZ V. SANDOVAL ET. AL and NOKES V PLACER SAVINGS BANK ET. AL
- Posted In: Work Injury