| Matter of Manticoff v American Bldg. Maintenance |
| 2009 NY Slip Op 04776 [63 AD3d 1308] |
| June 11, 2009 |
| Appellate Division, Third Department |
| In the Matter of the Claim of Luis Manticoff, Claimant, vAmerican Building Maintenance et al., Appellants and Reliance National Indemnity Company,Respondent. Workers' Compensation Board, Respondent. |
—[*1] Stewart, Greenblatt, Manning & Baez, Syosset (Patrick M. Conroy of counsel), for RelianceNational Indemnity Company, respondent.
Kavanagh, J. Appeal from a decision of the Workers' Compensation Board, filed May 1,2007, which, among other things, ruled that the doctrine of laches was not applicable againstReliance National Indemnity Company.
Claimant was injured in June 2000 when, during his employment as a janitor/custodian, hewas lifting heavy boxes and suffered pain to his back, hip and legs. A C-2 form was filed by[*2]his employer, which indicated that CNA InsuranceCompanies (hereinafter RSKCo)[FN1]was the employer's workers' compensation carrier. The Workers' Compensation Board indexedthe case in July 2000, and served notice on Reliance National Indemnity Company,[FN2]identifying it as the carrier on the claim instead of RSKCo. In July and August 2000, RSKCofiled multiple C-8.1 forms refusing to pay certain medical expenses incurred by claimant becausetreatment was rendered without authorization and a medical report was not filed on time. It alsofiled a C-7 form dated September 2000, indicating that claimant was not entitled tocompensation under the policy. Despite these filings on this claim, the Board continued to noticeReliance, rather than RSKCo, as the carrier responsible for covering the claim and, on October17, 2000, provided Reliance, and not RSKCo, with notice of a hearing scheduled for November15, 2000.
At the November 2000 hearing, Reliance appeared and raised "all C-7 [i]ssues, includingcoverage." A hearing was ultimately held and, by decision filed April 20, 2001, a Workers'Compensation Law Judge (hereinafter WCLJ) determined that claimant had established theexistence of a work-related injury and directed Reliance to pay him benefits at a tentative rate of$40 per week. Another hearing was held in August 2001 and, by decision filed August 6, 2001, afinal rate of $40 per week was established. At the same time, RSKCo, unaware of whattranspired, continued to file monthly requests with the Board for a priority hearing on themedical claims it was receiving for claimant.
On January 24, 2002, Reliance and claimant appeared before the WCLJ and again discussedcoverage issues. At that time, the WCLJ agreed with Reliance that RSKCo should be givennotice of the proceedings and RSKCo was notified to appear with its file on March 4, 2002.RSKCo filed an appeal from the WCLJ's decision, asserting that Reliance should be barred bylaches from denying coverage. After further hearings were conducted, a WCLJ ultimatelydetermined that Reliance was barred by laches from denying coverage under the claim. InJanuary 2006, a Board panel affirmed the WCLJ's determination finding that Reliance was thecarrier responsible for any payments that were to be made on the claim. However, upon reviewby the full Board, this decision was reversed and a direction was issued that the matter be placedbefore a new Board panel for further review. A new Board panel issued a decision filed May 1,2007, which found that Reliance was not barred by laches in denying responsibility for paymentsunder this claim, and further found that RSKCo, and not Reliance, was the proper carrier.RSKCo now appeals.
The doctrine of laches can apply in workers' compensation cases "when there has been aninexcusable delay in raising the defense of noncoverage together with actual injury or prejudice"(Matter of Ricciardi v JohnstownLeather, 1 AD3d 661, 663 [2003]; see Matter of [*3]Hopkins v Alcas Corp., Cutco Cutlery, 63 AD3d —[2009] [decided herewith]; Matter ofMcGuinness v John P. Picone, Inc., 36 AD3d 1032, 1032-1033 [2007]). The Board'sdetermination regarding the applicability of the laches doctrine will not be disturbed on appeal ifsupported by substantial evidence (see Matter of McGuinness v John P. Picone, Inc., 36AD3d at 1032-1033; Matter ofHolloway v West St. Trucking, 14 AD3d 816, 817 [2005]; cf. Matter of Mangum v National UnionFire Ins. Co., 14 AD3d 968, 969 [2005]). RCKCo concedes that it—and notReliance—had a policy in place that provided coverage for claimant on the date of hisaccident. In fact, it is uncontroverted that Reliance was only involved in this claim due to anadministrative error by the Board in which it served notice on Reliance regarding the claim.Moreover, Reliance denied coverage of the claim when it first appeared on the matter at theinitial November 2000 hearing. At the same time, RSKCo received the initial notice of the claimand, throughout this process, never denied its status as insurer, but instead, filed numerous formsthat, in effect, claimed that it was not responsible for payment of claimant's medical treatmentunder the policy. Therefore, the Board's determination that there was no inexcusable delay byReliance upon which the doctrine of laches would apply was supported by substantial evidence.
Peters, J.P., Rose, Lahtinen and Kane, JJ., concur. Ordered that the decision is affirmed,without costs.
Footnote 1: CNA Insurance Companies isContinental Casualty Company and RSKCo is the third-party administrator for CNA.
Footnote 2: All of Reliance's obligationswere assumed through liquidation by Planet Insurance Company and the New York StateInsurance Department Liquidation Bureau. This claim was administered by third-partyadministrator Risk Management Planning Group and, currently, by PMA Claim Services. For thepurposes of clarity, all entities will be referred to collectively as Reliance.