Catholic Healthcare West v. California Insurance Guarantee Ass'n

In 1985, a nurse working at a hospital suffered a back injury in the course of her employment. By September 2004, approximately $1.6 million had been paid on the nurse’s workers’ compensation claim for wage indemnity, medical care, and vocational rehabilitation. The nurse’s employer paid the first $150,000 under the self-insured retention on its excess workers’ compensation insurance policy. By the time the retention was exceeded, the insurance company was insolvent and, consequently, the employer continued to pay for the nurse’s medical care.

The employer or an affiliate requested the California Insurance Guarantee Association (CIGA) to reimburse it for amounts the insurance company would have paid under the policy had the insurance company remained solvent. The initial claims to CIGA may have been presented by the corporation that employed the nurse. Subsequent claims were presented by an affiliated corporation into which the employer corporation had merged.

This appeal concerns whether the CIGA is statutorily required to pay those claims. The trial court granted CIGA’s motion for summary judgment on the ground that the claims were excluded from the definition of…