WCPanelIQ
PanelGranted

Cortes, Paulino

PAULINO CORTES, Applicant vs. WILLIAM S. BOHAN; CAPITAL INSURANCE GROUP, Defendants

ADJ number
ADJ11541887
Decision date
Jan 16, 2025
District office
San Diego
WCJ
Robert Drakulich (Arbitrator)
Claim administrator
Capital Insurance Group
Commissioners
CRAIG SNELLINGS, COMMISSIONER, LISA A. SUSSMAN, DEPUTY COMMISSIONER, JOSÉ H. RAZO, COMMISSIONER
LC §112LC §115LC §4709LC §5270LC §5272LC §5275LC §5301LC §5315LC §5501.5LC §5701LC §5901LC §5906LC §5908LC §5908.5LC §5909LC §5911LC §5950LC §5951LC §5952LC §5953CCR §10205.12CCR §10320CCR §10330CCR §10600CCR §10605CCR §10914CCR §10995

Summary

Capital Insurance Group (CIG) sought reconsideration of a workers' compensation arbitrator's June 13, 2024 Finding and Order, which held that CIG's dwelling fire policy was subject to Insurance Code section 11590 and ordered CIG to provide coverage for applicant Paulino Cortes's claimed benefits. CIG argued that its dwelling fire policy is not a personal liability policy and that section 11590 therefore does not apply. The Appeals Board first addressed timeliness, applying equitable tolling under Shipley because the petition (timely filed July 8, 2024) was not received and reviewed by the Board until November 21, 2024, through no fault of the parties. On the merits, the Board found the arbitration record incomplete because it lacked minutes of proceedings, party pleadings, and the arbitrator's summary of evidence required under WCAB Rule 10914. The Board granted reconsideration and issued a Notice of Intention to rescind the arbitrator's decision unless a complete record per Rule 10995(c)(3) is filed in EAMS within 30 days plus 5 days for mailing.

Issues

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Holding

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Analysis

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Applicant takeaway

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Defense takeaway

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Provider takeaway

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