WCPanelIQ
PanelGranted

Rogelio Sanchez, Louis

LOUIS ROGELIO SANCHEZ, Applicant vs. FFBH MOTORS LLC, administered by OCCUSURE CLAIMS SERVICES, Defendants

ADJ number
ADJ18918866
Decision date
Date unavailable
District office
Fresno
WCJ
—
Claim administrator
Occusure Claims Services (claims also administered by AmTrust Claims)
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, LISA A. SUSSMAN, DEPUTY COMMISSIONER, KATHERINE WILLIAMS DODD, COMMISSIONER

Injury / body parts: back

LC §5813LC §5909LC §5900LC §5506LC §3202LC §5316CCR §10561CCR §10752CCR §10755CCR §10832CCR §10421CCR §10465CCR §10605CCR §10605

Summary

Occusure Claims Services was joined as a defendant in two specific injury claims and was sanctioned $500 under Labor Code section 5813 and WCAB Rule 10561 for failing to appear at an August 27, 2024 status conference and an October 8, 2024 MSC, and for failing to respond to the WCJ's Sanctions NOI. Occusure sought reconsideration, arguing it was erroneously joined because AmTrust Claims actually administered the claims, and that its non-appearance was the product of clerical and administrative oversight—excusable neglect under Code of Civil Procedure section 473. The Board found that determining whether Occusure's conduct was a 'pattern' or excusable neglect required a hearing, and that imposing sanctions without notice and an opportunity to be heard on the section 473/5506 issue violated due process. The Board also flagged serious service defects, noting Occusure was not served the original Application or DOR, and would have had insufficient time to answer or prepare before discovery closed at the MSC. Reconsideration was granted, the Sanctions Order was rescinded, and the cases were returned to the trial level for further proceedings.

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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