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Converium Insurance Company sought reconsideration of a decision denying its claim for reimbursement from the California Insurance Guarantee Association (CIGA). Converium had paid workers' compensation benefits to Leticia Fernandez, but later argued these payments were made in error due to applicant's denial of a specific injury. The Arbitrator recommended denying reconsideration, finding that CIGA statutes, particularly Insurance Code Sections 1063.1(c)(5) and (9), prohibit reimbursement to solvent insurance carriers for claims that are not covered claims or are made by assignees or subrogated parties. The Workers' Compensation Appeals Board adopted the Arbitrator's report, denying Converium's petition for reconsideration.
LETICIA FERNANDEZ vs. MOUNT ST. MARY'S COLLEGE, CONVERIUM INSURANCE COMPANY/SRS, CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, SEDGWICK, INC., LEGION INSURANCE COMPANY, VILLANOVA INSURANCE COMPANY is a workers' compensation case decided in San Francisco. This case addresses legal issues related to compensation claims, benefits, and court rulings.
It is commonly referenced in legal research involving workers' compensation laws in San Francisco.
Full Decision Text1 Pages
Converium Insurance Company sought reconsideration of a decision denying its claim for reimbursement from the California Insurance Guarantee Association (CIGA). Converium had paid workers' compensation benefits to Leticia Fernandez, but later argued these payments were made in error due to applicant's denial of a specific injury. The Arbitrator recommended denying reconsideration, finding that CIGA statutes, particularly Insurance Code Sections 1063.1(c)(5) and (9), prohibit reimbursement to solvent insurance carriers for claims that are not "covered claims" or are made by assignees or subrogated parties. The Workers' Compensation Appeals Board adopted the Arbitrator's report, denying Converium's petition for reconsideration.
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