State of Connecticut Workers' Compensation Commission, John A. Mastropietro, Chairman
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CRB Case Annotations re: Section 31-348

Insurance policy notification.

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THESE ANNOTATIONS ARE PROVIDED FOR INFORMATIONAL PURPOSES ONLY

Full texts of opinions, statutes and court decisions should be consulted and all citations and references fully researched by the reader.

The Annotations to Compensation Review Board Opinions are presented “as is” and the Commission makes no warranties as to the suitability of this information for any given purpose.
Please note also that Annotations change periodically due to several factors including, but not limited to, Appellate and Supreme Court decisions issued in workers’ compensation cases.

Lopez v. EC Tree, LLC, 5698 CRB-8-11-11 (October 11, 2012).

Claimant injured on job. Employer argued claimant an independent contractor and argued therefore lack of workers’ comp insurance not material. Trial commissioner found employer/employee relationship and found employer lacked workers’ compensation insurance. Respondent challenged this finding on appeal; arguing policy not properly cancelled. CRB dismissed appeal for failure to prosecute, but added finding was consistent with precedent in Yelunin v. Royal Ride Transportation, 121 Conn. App. 144 (2010) and Velez v. LSP Enterprises, Inc. d/b/a Domino’s Pizza, 5105 CRB-1-06-6 (September 26, 2007). See also, Lopez, § 31-321; § 31-301 Appeal procedure; § 31-284.

Pinto v. CNM Construction, LLC, 5565 CRB-4-10-6 (February 22, 2012).

Claimant injured on job. Respondent’s carrier had sent employer and Commission insurance cancellation notice. Trial commissioner concluded terms of notice cancelled coverage at 12:01 a.m. date of claimant’s injury and respondent-employer was uninsured. Second Injury Fund appealed arguing notice was ambiguous. CRB affirmed decision. Notice and policy were not ambiguous and commissioner reasonably could determine policy cancelled prior to injury. See also, Pinto, § 31-355(b).

Yelunin v. Royal Ride Transportation, 5274 CRB-1-07-9 (September 5, 2008).

Trial commissioner concluded that respondent’s insurance had been cancelled prior to date of injury. Insurer had sent appropriate notice to NCCI to notify Commission, and had sent written cancellation notice to employer which had not been returned as undeliverable. Second Injury Fund appealed, arguing cancellation did not adhere to standards in Velez v. LSP Enterprises, Inc. d/b/a Domino’s Pizza, 5105 CRB-1-06-6 (September 26, 2007). CRB upheld trial commissioner. Fund offered no evidence whatsoever to challenge the inference a properly mailed notice was received; Fund made same argument in Velez which was rejected by the Board. See also, Yelunin, § 31-301. Appeal procedure.

Omachel v. Sunshine Masonry Construction, 5148 CRB-1-06-10 (October 22, 2007), appeal dismissed, A.C. 29366 (February 27, 2008), cert. denied, 286 Conn. 923 (2008).

CRB reversed commissioner’s ruling that he was without subject matter jurisdiction to determine whether the employer had insurance on the date of claimant’s injury. Remanded for further proceedings.

Velez v. LSP Enterprises, Inc., d/b/a Domino’s Pizza, 5105 CRB-1-06-6 (September 26, 2007).

Issue was whether employer had worker’s compensation insurance on date of accident. Trial Commissioner found carrier had sent single notice of cancellation and the employer had received this notice and had failed to reinstate policy. Second Injury Fund appealed finding of no insurance, asserting policy cancellation was procedurally deficient. CRB upheld trial commissioner. Unlike Dengler v. Special Attention Health Services Inc., 62 Conn. App. 440 (2001) , notice was sufficient and unequivocal. Appellant’s argument that federal decision in Bepko v. St. Paul Fire & Marine Insurance, on point and required reversal was unpersuasive, in Bepko finder of fact found cancellation notice was not received, wherein finding in this case was notice had been received. CRB also rejected appellant’s argument Piscatello v. Boscarello, 113 Conn. 128 (1931) required reversal, unlike that case Commission received this cancellation notice. Employer’s argument that carrier should not have cancelled the policy was an effort to retry case on appeal. See also Velez, § 31-301. Factual findings, § 31-355(b).

Costa v. Brake King Automotive, 4962 CRB-1-05-6 (June 19, 2006).

CRB reversed commissioner’s conclusion that insurance was not in effect on the date claimant was injured. Insurer filed cancellation with the Chairman on December 1, 2003. Claimant was injured on December 16, 2003. Sec. 31-348 provides cancellation shall not be effective until 15 days after the cancellation notice has been filed with the Chairman. CRB construed statutory language to mean that insurance policy was still in effect on date of claimant’s injury.

DeGruchy v. Buy, Sell or Hold Co., 4676 CRB-7-03-6 (July 27, 2004).

CRB affirmed trial commissioner’s determination that no insurance policy was in effect at the time of the injury where the policy was issued without a request to do so and the record of the mistakenly issued policy only existed in another state.

Degnan v. Employee Staffing of America, Inc., a/k/a Labor Force of America, 4580 CRB-3-02-10 (October 27, 2003).

CRB is presumed to be aware of records in NCCI computer database, which indicated that insurance policy existed on date of injury. See also, Degnan, § 31-275(9), § 31-292, § 31-355(b).

Bell v. Thomas Lombardo & Charles Holt d/b/a N&E Private Investigation & Security, 4065 CRB-2-99-6; 4152 CRB-2-99-11 (November 27, 2000).

See, Bell, § 31-278.

DiBello v. Barnes Page Wire Products, 3970 CRB-7-99-2 (March 2, 2000), aff’d, 67 Conn. App. 361 (2001), cert. granted, 260 Conn. 915 (2002), appeal withdrawn (June 26, 2002).

Employer sought to assign liability to any of three different insurers. NCCI records showed no insurance in effect on 8/10/93 date of injury. First insurer, which covered employer through 2/26/93, was not required to file a notice of cancellation with NCCI in order for coverage to terminate on expiration date of the policy. Notice of nonrenewal, whether ambiguous or not, had no effect under § 31-348; cancellation requirement is only implicated where commission has reason to believe that a policy continues to be in effect. Finding of no coverage affirmed. Second insurer had not issued policy, but its agent had potentially defrauded employer out of its annual premium while providing employer with false certificates of insurance that listed second insurer as the carrier. CRB remanded for determination of whether insurer was bound to provide coverage due to agent’s conduct. See, DiBello, § 31-278. Third insurer’s policy took effect four days after injury. Filing of Form 43 by insurer that failed to mention lack of coverage as a defense did not prevent insurer from raising the issue later. Finding of no coverage affirmed. See, DiBello, § 31-294c. See also, DiBello, § 31-301. Appeal procedure, § 31-301-9. Subsequent decision at DiBello, 4290 CRB-7-00-9 (September 25, 2001), § 31-300, § 31-308a.

Dengler v. Special Attention Health Services, 3780 CRB-3-98-2 (June 15, 1999), aff’d, 62 Conn. App. 440 (2001).

Insurer sent notice to employer and this Commission stating that employer’s policy would be canceled in 30 days if payment of past due premiums was not made. Trier correctly ruled that this did not constitute a cancellation notice under § 31-348, as it did not unequivocally state that coverage would terminate on a specific date. See also, Dengler, § 31-301. Factual findings, § 31-307.

Thibodeau v. Rizzitelli, 3373 CRB-4-96-7 (October 14, 1997).

Trial commissioner had authority to consider testimony of insurer’s underwriting manager regarding the meaning of magnetic tapes sent to NCCI pursuant to § 31-348 policy coverage reporting requirements. Magnetic tapes showed that policy, originally canceled in May 1994, had been reinstated and then canceled again on August 2, 1994. Insurer’s representative testified that the reinstatement in its computer system was done solely so maintenance could be performed on the policy (agent’s commission adjustment), and not to reinstate coverage itself. Since this was relevant to whether coverage existed in the first place, commissioner had the authority to consider such evidence. See also, Thibodeau, § 31-301-9. Additional evidence.

Stickney v. Sunlight Construction, Inc., 3205 CRB-6-95-11 (April 25, 1997), rev’d, 48 Conn. App. 609 (1998), aff’d, 248 Conn. 754 (1999).

See, Stickney, § 31-315.

Bruce v. Bert Miller Associates, 15 Conn. Workers’ Comp. Rev. Op. 47, 1872 CRB-1-93-10 (December 1, 1995).

Insurance company mistakenly administered claim where effective date of policy was five days after injury occurred; insurance agent’s actions led employer to believe he was insured prior to date of injury. Commissioner found insurer’s failure to discern true date of injury was “tantamount to negligent mistake,” and Workers’ Compensation Act provided no authority to order Second Injury Fund to reimburse insurer for payments. Held, trial commissioner had jurisdiction to find insurance policy was not in effect at time of injury, and properly took into account circumstances surrounding issuance of the policy and insurer’s investigation of the claim. Evidence supported findings of commissioner, which did not include a finding of actual negligence by the insurer. (Santos, C., CONCURRING) Trial commissioner did not have jurisdiction to consider claim for reimbursement.

Stickney v. Sunlight Construction Co., 12 Conn. Workers’ Comp. Rev. Op. 364, 1738 CRB-6-93-5 (August 2, 1994), rev’d, 48 Conn. App. 609 (1998), aff’d, 248 Conn. 754 (1999).

See, Stickney, § 31-278 and § 31-315. See also, Stickney, 3205 CRB-6-95-11 (April 25, 1997), § 31-315 and this section.

Vernon v. V.J.R. Builders, Inc., 11 Conn. Workers’ Comp. Rev. Op. 237, 1360 CRD-7-91-12 (November 8, 1993).

Reversed and remanded. CRB held trier erred in limiting his consideration of whether respondent employer had in existence a workers’ compensation policy at the time of claimant’s injury to the insurance records on file at the workers’ compensation commission’s central office. Trier must consider other evidence proffered.

O’Connell v. Indian Neck General Store, 6 Conn. Workers’ Comp. Rev. Op. 42, 530 CRD-3-86 (October 6, 1988).

Trial commissioner has jurisdiction to determine if a contract of workers’ compensation insurance existed at the time of injury.

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State of Connecticut Workers' Compensation Commission, John A. Mastropietro, Chairman
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