ACE American Insurance Company

What they litigate

Disputed issues across the decisions this insurance carrier is named in. Every row opens the decisions it counts.

Where they appear

• Santa Ana 42
• Van Nuys 40
• Oakland 26
• Los Angeles 22
• Anaheim 20
• Sacramento 13
• Marina del Rey 12
• San Diego 12
• Long Beach 10
• Riverside 8
• Fresno 6
• Oxnard 6

How the appealed decisions came out

These are decisions that were appealed and published — the tail of a system that mostly settles. Most claims end in a compromise and release or a stipulation and never reach a panel, so nothing below describes how this insurance carrier does its work. It describes how a set of appealed disputes came out.

• 108 for the applicant
• 104 for the defense
• 44 returned for more record

Counted over 243 appealed decisions. Not this insurance carrier’s book of work. A decision that went one way on one issue and the other way on another is counted in both columns, so the figures add up to more than the total.

Decisions

Newest decisions this insurance carrier is named in, each with the passage the panel turned on and a link to the official PDF.

• ADJ12308686 · 2026-06-11 · Los Angeles District OfficeMedical treatment / UR / IMRdefendant prevailed

  Determinative passage · p.5In the present case, applicant designated Casa Colina rather than any individual physician as her primary treating physician. This designation violates AD Rule 9785(a)(1), which defines the primary treating physician as an actual physician and not a facility or other entity.

  Applicant designated a facility, not an individual physician, as primary treating physician, contrary to regulations; defendant provided access to three neurologists within the MPN, meeting statutory and regulatory requirements for access to care; applicant did not meet burden to show neglect or refusal to provide care.

  Official decision · page 5 →
• ADJ number not stated · 2026-06-10 · Santa Ana District OfficeStatute of limitationsapplicant prevailed

  Determinative passage · p.3On March 23, 2026, we issued our Decision determining in relevant part that the filing of a workers' compensation claim on applicant's behalf in 2004 did not impart the knowledge required to establish a date of injury under section 5412 and commence the running of the statute of limitations under section 5405. We observed that per applicant's testimony, he had not initiated the 2004 claim and had never spoken to the filing attorney. We also observed that none of the claim filing documents and supporting documentation were signed by applicant and that evidence established that applicant's only involvement with the claim had been to instruct that it be withdrawn after learning of the filing. (Decision, at pp. 9-10.) We noted the first evidence establishing compensable disability arising out of industrial exposures was the May 4, 2021 medical reporting of orthopedic physician Dr. Einbund. We thus identified May 4, 2021 as the section 5412 date of injury, and concluded that because the instant claim was not filed more than one year from the date of injury, compensation was not barred under section 5405. (Id. at p. 11.)

  The WCAB found that the applicant's date of injury was May 4, 2021, based on medical evidence, and that the 2004 claim filing did not establish knowledge of compensable disability to trigger the statute of limitations under section 5405.

• ADJ14305554 · 2026-06-09 · Santa Rosa District OfficeMedical treatment / UR / IMRapplicant prevailed

  Determinative passage · p.4II Section 4600(b) provides that "medical treatment that is reasonably required to cure or relieve the injured worker from the effects of the worker's injury means treatment that is based upon the guidelines adopted by the administrative director pursuant to Section 5307.27." (Lab. Code, § 4600(b).) Section 5307.27 specifies that these guidelines refer to the Medical Treatment Utilization Schedule (MTUS). (Lab. Code, § 5307.27(a).) The MTUS can be found in AD Rules 9792.20 through 9792.27.23 (Cal. Code Regs., tit. 8, § 9792.20-9792.27.23). The MTUS is presumptively correct on the extent and scope of treatment and is the primary source of guidance for physicians. (Lab. Code, § 4604.5(a); Cal. Code Regs., tit. 8, § 9792.21(c).) However, the MTUS may be rebutted, and treatment may be warranted based on recommendations outside the MTUS in limited situations. (Cal. Code Regs., tit. 8, § 9792.21(d); see also Lab. Code, § 4604.5(d).) If a UR decision is untimely, the determination of medical necessity must be made by the WCAB based on substantial medical evidence consistent with the MTUS. (Dubon II, supra, 79 Cal.Comp.Cases at 1300.)

  The Appeals Board found the December 3, 2024 UR determination was untimely under Labor Code section 4610 and former AD Rule 9792.9.1(f), requiring further development of the record with current medical evidence to determine medical necessity. The WCJ erred in dismissing the request as untimely without considering applicant's medical evidence.

  Official decision · page 4 →
• ADJ13797705 · 2026-06-09 · Santa Ana District OfficeJurisdiction / venuedeferred

  Determinative passage · p.1We granted reconsideration1 to further study the factual and legal issues in this case. Applicant sought reconsideration of the May 26, 2022 Findings and Order, wherein the workers' compensation administrative law judge (WCJ) found that the Workers' Compensation Appeals Board ("WCAB") cannot exercise subject matter jurisdiction over applicant's claim because he was not hired in California, did not regularly work here, and because California has no legitimate interest in his cumulative injury claim. Applicant contends that the WCJ erred because he was in fact hired in California and/or regularly employed here, thereby establishing subject matter jurisdiction pursuant to Labor Code section 3600.5, subdivisions (a). 2 We received an Answer. The WCJ prepared a Report and Recommendation on Petition for Reconsideration ("Report"), recommending that the Petition be denied. Subsequent to the grant of reconsideration, the Court of Appeal issued Atlanta Falcons v. Workers' Comp. Appeals Bd. (Gandy) (2025) 114 Cal.App.5th 1268 [90 Cal.Comp.Cases 997] ("Gandy"), a decision interpreting section 3600.5, subdivisions (c) and (d), and what constitutes "hire" in California for purposes of California workers' compensation proceedings more generally. Specifically, Gandy provided the following reasoning for rejecting the Appeals Board's interpretation of those subdivisions:

  The WCJ found no jurisdiction because applicant was not hired or regularly employed in California, but reconsideration was granted to consider the impact of the Court of Appeal decision Gandy (2025) which interprets 'hire' under section 3600.5 and favors a liberal construction to find California jurisdiction when a California-based team is involved.

  Official decision · page 1 →
• ADJ19384154 · 2026-06-04 · Santa Ana District OfficeJurisdiction / venueremanded

  Determinative passage · p.3(See Defendants' Trial Brief, at p. 1 ["It does appear there is personal jurisdiction over the Cardinals based on applicant's testimony that he worked in California briefly for the Cardinals in 2012."].) The matter went to trial on three issues: (1) subject matter jurisdiction over the case; (2) personal jurisdiction over each defendant; and (3) whether any defendant is exempt according to section 3600.5. (Minutes of Hearing / Summary of Evidence ("MOH/SOE"), 9/9/2025, at p. 2.) Applicant was the sole witness to testify. (MOH/SOE, 11/10/2025, at pp. 2§ 11.) The WCJ issued his F&O on March 2, 2026, finding as relevant to this Petition (1) personal jurisdiction over the Dodgers, and (2) that section 3600.5, subdivisions (c) and (d) do not bar applicant's claim. The appended Opinion on Decision makes clear that the WCJ based his finding on the rationale that the Dodgers, a California-based employer, employed applicant during the last year of his professional career. (Opinion on Decision, at pp. 6§ 8.) The F&O deferred the question of personal jurisdiction over the other defendants. (F&O, at p. 3.)

  The WCJ found personal jurisdiction over the Dodgers and that section 3600.5 subdivisions (c) and (d) do not bar the claim; however, the Appeals Board found concerns about substantial evidence on hire and work in California by the Dodgers, requiring further review.

  Official decision · page 3 →
• ADJ15615310 · 2026-06-01 · Santa Ana District OfficeApportionmentapplicant prevailed

  Determinative passage · p.15Dr. Mack's apportionment opinion fails to satisfy the requirements as set forth in Escobedo6. His analysis relies primarily on the timing of Applicant's employment and the existence of pre-existing conditions, without explaining "how and why" those conditions are causing permanent disability at the time of the evaluation. As explained in Escobedo, a medical opinion on apportionment must do more than state percentages. It must explain the causal relationship between the industrial injury and the permanent disability and separately explain how and why nonindustrial factors are responsible for a portion of that disability. Dr. Mack's reports do not provide this required analysis. The deficiency is also apparent with respect to the cubital tunnel syndrome. While Dr. Mack relates this condition to the elbow pathology, he does not explain why 50% of the resulting disability is attributable to nonindustrial factors or identify what those factors are. A mere medical relationship between conditions does not establish apportionment. Because Defendant bears the burden of proof on apportionment, and because the medical evidence offered does not constitute substantial evidence, the Court is not permitted to rely upon it. Accordingly, an unapportioned award is warranted.

  The Appeals Board found Dr. Mack's apportionment opinion was not substantial evidence as it lacked required detailed explanation and reasoning, thus denying apportionment and awarding an unapportioned permanent disability.

  Official decision · page 15 →
• ADJ13153374 · 2026-04-17 · Santa Ana District OfficeJurisdiction / venuedeferred

  Determinative passage · p.1We granted reconsideration1 to further study the factual and legal issues in this case. Applicant sought reconsideration of the May 12, 2021 Joint Findings of Fact, wherein the workers' compensation administrative law judge (WCJ) found no jurisdiction over applicant's specific and cumulative injury claims based upon findings that applicant was neither hired nor regularly employed in California. Applicant asserts that the WCJ erred because defendant is a California-based team that directed and controlled applicant's employment from California and that directed applicant to undergo surgery in this state for work-related injuries. We received an Answer. The WCJ prepared a Report and Recommendation on Petition for Reconsideration ("Report"), recommending that the Petition be denied. Subsequent to the grant of reconsideration, the Court of Appeal issued Atlanta Falcons v. Workers' Comp. Appeals Bd. (Gandy) (2025) 114 Cal.App.5th 1268 [90 Cal.Comp.Cases 997] ("Gandy"), a decision interpreting Labor Code2 section 3600.5, subdivisions (c) and (d), and what constitutes "hire" in California for purposes of California workers' compensation proceedings more generally. Of specific relevance to this case, Gandy provided the following reasoning for rejecting the Appeals Board's interpretation of those subdivisions:

  The WCJ found no jurisdiction because applicant was neither hired nor regularly employed in California, but the Appeals Board granted reconsideration to study the impact of the Gandy decision, which interprets the meaning of 'hire' in California workers' compensation law and favors a liberal construction to find California jurisdiction when the employer is California-based.

  Official decision · page 1 →
• ADJ10598940 · 2026-04-10 · Fresno District OfficeJurisdiction / venuedefendant prevailed

  Determinative passage · p.12III DISCUSSION I. The WCAB had no jurisdiction and therefore the Medical Unit had no jurisdiction for Gallagher Bassett to request panel # 7404253 on 4/9/21. The board has no jurisdiction over any aspect of a workers' compensation claim until an application for adjudication has been filed. This rule has been codified in Regulation 10450(b). The Medical Unit, which issues QME panels, operates under the authority of the WCAB. Since the WCAB has no jurisdiction until an application is filed, the Medical Unit cannot issue a QME panel without an underlying case that gives the WCAB jurisdiction. In this case, as of 4/9/21 ADJ16413854 did not exist. There was no petition for new and further disability filed in ADJ10598940. No jurisdiction had been established on 4/9/21 to request panel # 7404253. (Labor Code Section 5500, nor Regulation 10450(b).) Therefore, panel # 7404253 is an invalid panel. a. There is no legal basis to argue Panel #7404253 dated 4/9/21 was requested to enforce a stipulated medical award. Future medical awards are enforced pursuant to LC § 4610. Treating physicians submit requests for authorization (RFAs) for medical treatment. The RFAs are then subject to utilization review (UR). b.

  The WCAB lacked jurisdiction to issue QME Panel 7404253 on 4/9/21 because the underlying case ADJ16413854 did not exist at that time, and no petition for new and further disability was filed in ADJ10598940. Therefore, the panel was invalid and Dr. Graham's reports were excluded.

  Official decision · page 12 →
• ADJ13858864 · 2026-03-23 · Santa Ana District OfficeStatute of limitationsapplicant prevailed

  Determinative passage · p.2We have considered the allegations of the Petition for Reconsideration and the contents of the Report. Based on our review of the record, and for the reasons discussed below, we will grant reconsideration and affirm the F&O, except that we will amend it to find that the section 5412 date of injury was May 4, 2021 (Finding of Fact No. 2); that compensation is not barred by section 5405 (Finding of Fact No. 3); and that applicant is not estopped from claiming injury under the equitable doctrine of laches (Finding of Fact No. 5).

  The WCAB found the date of injury to be May 4, 2021, so the claim was filed within the one-year statute of limitations under section 5405, and the defendant failed to prove prejudice to support laches.

  Official decision · page 2 →
• ADJ10715566 · 2026-03-19 · Oakland District OfficePermanent disability ratingapplicant prevailed

  Determinative passage · p.1Applicant seeks reconsideration of the Findings & Award (F&A) issued on September 13, 2022, by the workers' compensation administrative law judge (WCJ). The WCJ found, in pertinent part, that applicant sustained industrial injury while employed by defendant on March 19, 2014 to her low back, resulting in 51% permanent disability.

  The WCAB found that the vocational expert opinion supporting 100% permanent disability was substantial evidence, while the apportionment opinion of PQME Dr. Anderson was speculative and legally insufficient, leading to an amendment of the permanent disability rating to 100%.

  Official decision · page 1 →
• ADJ12302753 · 2026-01-23 · Lodi District OfficeReopening / new and further disabilityapplicant prevailed

  Determinative passage · p.12Internal medicine PQME Dr. Mahmoudi also provides a substantial opinion regarding the worsening of applicant's hypertension. As noted in the WCJ's Report, Dr. Mahmoudi opined that applicant has industrial hypertension due to deconditioning and the cumulative effects of his injury. (See Applicant's Exhibit 4, Deposition of Dr. Mahmoudi, p. 8, lines 3-12). He felt that applicant had an increase in hypertension from stage 1 to stage 2 and that increase is industrial, especially given applicant's use of NSAIDs. (Id. at p. 9, lines 17-25). He confirmed that all the prior blood pressure measurements that he is using to find causations for the hypertension predate the stipulated award of October 31, 2022. (Id. at p. 16, lines 21-25). He also testified that applicant's first class 2 diagnosis for hypertension was on April 14, 2021. (Id. at p. 35, lines 6-16). The QME reaffirmed that he felt this was industrial due to the NSAIDs, weight gain, and total knee replacement, especially since NSAIDs can increase blood pressure. (Id. at pp.

  The WCJ found new and further disability of the left knee and hypertension based on substantial medical evidence, including unrebutted opinions of PQME Dr. Mahmoudi and Dr. Sclafani, and concluded the stipulated award was properly reopened under section 5410 and 5803.

  Official decision · page 12 →
• ADJ10222709 · 2026-01-16 · Van Nuys District OfficeAOE/COEremanded

  Determinative passage · p.2FACTUAL BACKGROUND On November 24, 2020, the matter proceeded to trial in ADJ10222709. In that case, applicant claims to have sustained injury AOE/COE while employed by UCLA as a hospital lab technician, during the period May 1, 2014 through November 11, 2015, to her bilateral upper extremities, bilateral wrists, bilateral hands, bilateral arms, neck, digestive system (stomach), fingers, both shoulders, elbows, internal, dental, nervous system, pulmonary and vision. The issues raised for determination were stated as follows: 1. Injury arising out of and in the course of employment. 2. Applicant attorney's motion to strike PQME Klassen is vigorously opposed by both defendants, including possible deposition unavailability. 3. Applicant's request for an additional panel in internal medicine is opposed by defendants. 4. Applicant's attorney objects to trial at this time and seeks further discovery.

  The WCJ failed to make findings on injury AOE/COE and improperly based denial solely on applicant's lack of credibility; the Appeals Board requires medical evidence for injury determination and remands for further proceedings.

  Official decision · page 2 →

Also recorded as

The same insurance carrier is printed several ways across the decisions, and all of them were counted as one. These are the twelve commonest of 35.

• ACE AMERICAN INSURANCE COMPANY
• ACE American Insurance Company
• ACE AMERICAN INSURANCE
• Ace American Insurance Company
• ACE American Insurance
• ACE AMERICAN
• ACE AMERICAN INSURANCE CO.
• Ace American Insurance
• ACE AMERICAN INSURANCE COMPANY/CHUBB
• ACE AMERICAN INSURANCE/CHUBB
• ACE USA
• ACE AMERICA INSURANCE COMPANY

Is this your company and something here is wrong? Tell us and we will fix it. Every figure on this page is a count of released decisions this insurance carrier is named in, and the decisions themselves are listed above with the passage each turned on.