Workers’ Compensation · Primary-source case analysis

CIGA: A Settlement Allocation Did Not Eliminate Other Insurance for Workers’ Compensation Liens

Decision: California Court of Appeal, B263869; WCAB Nos. ADJ7167413, ADJ7167333, decided March 22, 2016. Document: Published California Court of Appeal opinion.

The decision explains how California’s other-insurance exclusion operates when successive carriers remain jointly and severally liable for unresolved lien claims.

Two carriers allocated remaining charges

Care West and Ullico settled an employee’s claims and agreed to split outstanding medical-legal and treatment charges. Ullico later became insolvent, and CIGA assumed only claims that met the Insurance Code definition of a covered claim.

Other insurance remained available

CIGA does not pay a claim to the extent it is covered by other insurance. Because Care West remained severally liable for the whole lien obligation, its policy was available even though the carriers had allocated responsibility between themselves.

The settlement governed contribution, not creditor rights

The approved compromise had the force of an award, but its allocation did not change the joint-and-several nature of the underlying obligation. The reserved contribution and reimbursement rights confirmed that the agreement addressed the carriers’ relationship after payment.

Disposition

The court annulled the Board’s order and directed dismissal of CIGA. The remaining solvent carrier’s coverage, rather than CIGA, answered the third-party lien claims on the record before the court.

Key takeaways

Discuss the procedural record

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