Nick Leras Water Trucks, et al Juan Escutia WORKERS’ COMPENSATION APPEALS BOARDSTATE OF CALIFORNIAJUAN ESCUTIA, Applicant,vs.NICK LERAS WATER TRUCKS, et al., Defendant(s).Case No. ADJ1643143 (SRO 0122410)OPINION AND DECISION AFTER RECONSIDERATION The Workers’ Compensation Appeals Board (Appeals Board) granted reconsideration of the Findings and Orders (“F&O”) of November 12, 2008 in order to further study the factual and legal issues raised by State Compensation Insurance Fund’s petition for reconsideration. In the F&O, the Workers’ Compensation Arbitrator (“WCA”) found that the California Insurance Guarantee Association (“CIGA”), adjusting the “covered claims”1 of Fremont Insurance, in liquidation, is entitled to reimbursement from State Compensation Insurance Fund (“SCIF”) for various expenses incurred by CIGA in administering the workers’ compensation claim of the injured worker, Juan Escutia. According to the WCA’s findings, CIGA’s “pre-liquidation expenses” included “bill review” in the amount of $947.65, “medical, other” in the amount of $2,473.88, “court reporter” in the amount of $347.50, and “opposing counsel” in the amount of $481.25. CIGA’s “post-liquidation costs” included “bill review” expenses of $3,704.11 and “medical, other expenses” of $2,728.52. In its petition for reconsideration,2 SCIF contended that “no statute in the Insurance Code or the Labor Code authorizes CIGA to recover its administrative expenses,” and that expenses of 1 See Ins. Code, §§ 1063 et seq.2 In his Report and Recommendation, the WCA states that the petition for reconsideration was not timely filed. This is incorrect. The petition was timely because it was filed at the Santa Rosa District Office of the Appeals Board on December 8, 2008, within 25 days of the WCA’s decision. (See Cal. Code Regs., tit. 8, § 10866(b); 2 California Workers Compensation Practice 4th (C.E.B.) (Update June 2009) §§ 21.20-21.21.) , medical management, copying, bill review and oth
Juan Escutia vs. Nick Leras Water Trucks, Et Al
In this case, the Workers' Compensation Appeals Board granted reconsideration of a decision by the Workers' Compensation Arbitrator which found that the California Insurance Guarantee Association was entitled to reimbursement from State Compensation Insurance Fund for various expenses incurred in administering the workers' compensation claim of the injured worker, Juan Escutia. The expenses included bill review, medical, court reporter, and opposing counsel fees. The Appeals Board concluded that the WCA correctly held SCIF liable for bill review and other like costs incurred by CIGA in adjusting the injured worker's claims, and affirmed the WCA's decision.
- Filed On:
- Court: California, Santa Rosa
- Case No. ADJ1643143
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