WCPanelIQ
PanelRemanded

Carlos Uribe, Jr. — ADJ487398

CARLOS URIBE, JR., Applicant vs. XCEL MECHANICAL SYSTEM, INC.; CALIFORNIA INSURANCE GUARANTEE ASSOCIATION, administered by SEDGWICK CMS for RELIANCE/SABLE, in liquidation; ZURICH AMERICAN INSURANCE COMPANY, Defendants

ADJ number
ADJ487398
Decision date
Aug 7, 2022
District office
Anaheim
WCJ
Robert Drakulich (Arbitrator)
Claim administrator
Sedgwick CMS (administering for California Insurance Guarantee Association on behalf of Reliance/Sable, in liquidation); Zurich American Insurance Company
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, MARGUERITE SWEENEY, COMMISSIONER, ANNE SCHMITZ, DEPUTY COMMISSIONER
LC §5909LC §5908.5LC §5903LC §5276LC §3202LC §111LC §116LC §133LC §134LC §3201LC §5300LC §5302LC §5907LC §5952CCR §10995CCR §10914CCR §10962

Summary

CIGA sought reconsideration of a Findings and Order allegedly issued by a workers' compensation arbitrator (WCA) on August 6, 2021, in a dispute concerning which carrier (Zurich or CIGA, administering claims for insolvent Reliance/Sable) provided coverage for the employer XCEL Mechanical System, Inc. CIGA argued Zurich failed to prove its policy contained approved limiting endorsements and raised issues about premiums, OCIP/master policies, laches, prior stipulations, and the admissibility of Zurich's trial exhibits under Labor Code section 5276. The Appeals Board first addressed the section 5909 timeliness issue, holding under Shipley that the 60-day period was tolled because the petition was unavailable to the Board due to administrative irregularity outside the parties' control. On the merits, the Board found that the WCA failed to forward the complete arbitration record as required by WCAB Rule 10995(c)(3), making meaningful review impossible. The Board rescinded the F&O and returned the matter to the arbitrator to create an adequate record of arbitration.

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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