WCPanelIQ
PanelQMEMed-legalDenied

Johnson, Gary

GARY JOHNSON, Applicant vs. LORRENA JOHNSON and ILLINOIS MIDWEST INSURANCE AGENCY, LLC on behalf of PROCENTURY INSURANCE COMPANY, Defendants

ADJ number
ADJ10055263
Decision date
Mar 28, 2024
District office
Fresno
WCJ
Dennis G. Nard (Arbitrator); Geoffrey Sims (WCJ who issued underlying contribution order)
Claim administrator
Illinois Midwest Insurance Agency, LLC on behalf of ProCentury Insurance Company; AmGuard Insurance Company (adjusting for AmTrust Insurance Company)
Commissioners
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LC §5900LC §5903LC §5909LC §5901LC §5950LC §5273LC §5277LC §110LC §111CCR §10507CCR §10508CCR §10845CCR §10392CCR §10995CCR §10205CCR §10205.4CCR §10205.11CCR §10206CCR §10208.5CCR §10208.7CCR §10914

Summary

This is a contribution/reimbursement dispute between two insurers arising from a workers' compensation arbitration under Labor Code section 5273 et seq. An arbitrator awarded Illinois Midwest Insurance Agency, LLC (on behalf of ProCentury Insurance Company) $114,904.13 against AmGuard Insurance Company, representing 57% reimbursement of indemnity, medical, and other litigation expenses pursuant to a prior unappealed order by WCJ Geoffrey Sims. AmGuard sought reconsideration arguing the award improperly included legal fees, utilization (IMR) fees, and discovery expenses not recoverable in contribution. The Appeals Board first addressed a jurisdictional timeliness issue, applying the Shipley tolling doctrine because the district office failed to timely transmit the petition. On the merits, the Board affirmed the arbitrator's Findings and Award, adopting and incorporating the arbitrator's Opinion on Decision and Report.

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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