WCPanelIQ
PanelDenied

Hunter, Daniel

DANIEL HUNTER, Applicant vs. LOUISIANA WORKERS’ COMPENSATION CORPORATION; INSURANCE COMPANY OF NORTH AMERICA/ACE USA; DENVER BRONCOS, Defendants

ADJ number
ADJ9078233
Decision date
Oct 15, 2023
District office
Santa Ana
WCJ
Mark L. Kahn (Arbitrator)
Claim administrator
Louisiana Workers' Compensation Corporation (LWCC)
Commissioners
JOSÉ H. RAZO, COMMISSIONER, NATALIE PALUGYAI, COMMISSIONER, KATHERINE A. ZALEWSKI, CHAIR

Injury / body parts: head, neck, upper extremity, leg, multiple body parts

LC §3700LC §5909

Summary

This is an insurance coverage dispute arising from a continuous trauma claim by professional football player Daniel Hunter, who alleged injuries from January 13, 1984 to June 1, 1995. Applicant was employed by the Shreveport Pirates from January 6, 1994 to November 4, 1994, during which the team was insured by Louisiana Workers' Compensation Corporation (LWCC). LWCC sought reconsideration of an arbitrator's F&O finding that its NCCI standard policy did not contain a clear and legal exclusion of coverage for employees working temporarily out of state, and thus covered the player's injuries sustained while playing in California. The Board denied reconsideration, holding that the policy's Part Three (Other States Insurance) endorsement at page 15 was ambiguous and susceptible to multiple interpretations, and that ambiguity must be construed in favor of coverage. The Board also distinguished Stabler because the LWCC policy contained no reimbursement language and provided direct/primary liability, and found LWCC need not be a California-admitted insurer because coverage was based on the extraterritorial Part Three provision rather than Part One.

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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