Insurance Company of the West

What they litigate

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

Where they appear

• Van Nuys 22
• Los Angeles 15
• Santa Ana 12
• Marina del Rey 9
• Sacramento 8
• Riverside 6
• San Diego 6
• Oakland 5
• San Bernardino 5
• Santa Rosa 5
• Fresno 4
• Pomona 3

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.

• 62 for the defense
• 37 for the applicant
• 17 returned for more record

Counted over 108 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.

• ADJ18890787 · 2026-06-15 · San Diego District OfficeJurisdiction / venuedefendant prevailed

  Determinative passage · p.7We agree with the WCJ that the second case against Asset Protection is an attempt by applicant to relitigate the issues decided against him with finality in case number ADJ10622598 and as such, the case is precluded by the doctrine of res judicata. Furthermore, we agree that this case should be dismissed with prejudice as there is no new evidence in the record to support the contention that applicant should be allowed to proceed against defendants.

  The Appeals Board agreed with the WCJ that the second case ADJ18890787 is an attempt to relitigate issues decided with finality in ADJ10622598 and is precluded by res judicata, warranting dismissal with prejudice due to no new evidence supporting the claim.

  Official decision · page 7 →
• ADJ7940908 · 2026-06-01 · San Diego District OfficeDiscrimination under Labor Code §132adefendant prevailed

  Determinative passage · p.12Additionally, the WCJ weighed the witnesses' testimony and found them to be credible in their assertions. Realistically, there was not much differentiation between the testimony of the employer from Applicant's testimony. We accord this credibility determination great weight because the WCJ had the opportunity to observe the witnesses' demeanor while testifying at trial. (Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312, 318§ 319 [35 Cal.Comp.Cases 500].) Thus, applicant failed to prove either a prima facie case of discrimination in violation of section 132a, or an actual violation of that section by a preponderance of the evidence with respect to his termination or disciplinary actions.

  Applicant failed to prove a prima facie case of discrimination under Labor Code section 132a or an actual violation by a preponderance of the evidence regarding his termination or disciplinary actions. The WCJ found the employer's witnesses credible and the disciplinary actions consistent with company policy, not discriminatory.

  Official decision · page 12 →
• ADJ19532643 · 2026-05-18 · Marina del Rey District OfficeTemporary disabilityapplicant prevailed

  Determinative passage · p.7At trial, when the Applicant was presented with this deposition testimony, she explained that she may have misspoken at the deposition, and that it was more a desire to retire just from CVS, (MOH/SOE page 6, lines 12-14). She stated that she is planning to renew her pharmaceutical license, and that as of the date of trial, she was taking the necessary classes towards that end, (MOH/SOE page 5, lines 9-12). She further testified that a job in the pharmaceutical field was offered to her sometime in April or May of 2024, but due to her shoulder injury, she did not accept it, and that she does not [at this time] feel comfortable returning to the work force, (MOH/SOE page 5, lines 17-25). She is currently looking online for work opportunities, and testified that when she retired from CVS, she told management that she was intending to retire from that company only, (MOH/SOE page 6, lines 1-5). No witnesses from management at CVS provided testimony contradicting the last statement.

  The WCJ found applicant intended to retire only from the employer, not the labor market entirely, supported by credible trial testimony showing willingness to work post-retirement despite injury, and no contrary evidence from defendant.

  Official decision · page 7 →
• ADJ19984698 · 2026-04-14 · Marina del Rey District OfficeQME/AME processdefendant prevailed

  Determinative passage · p.1Defendant seeks removal of the Joint Findings of Fact and Order (F&O) issued on January 12, 2026 by the workers' compensation administrative law judge (WCJ). The F&O found, in pertinent part, that applicant validly requested a Replacement QME Panel on March 5, 2025 (to replace panel number 3593170). The WCJ ordered that replacement QME panel number 3622506 replace panel number 3593170, leaving, after the striking process previously performed by the parties, Kofi D. Agyeman, M.D., as the orthopedic surgery QME in these matters.

  The WCJ and Appeals Board found that the applicant validly requested a replacement QME panel due to Dr. Willoughby's unavailability to schedule within 120 days, and that the replacement panel and Dr. Agyeman as QME were properly appointed.

  Official decision · page 1 →
• ADJ8471459 · 2026-03-20 · Los Angeles District OfficeAOE/COEremanded

  Determinative passage · p.1The following Decision After Remittitur is issued pursuant to the Order issued on February 20, 2026 by the Second District Court of Appeal, Division 8 (Second District), in which the Court found good cause to grant the request of the Appeals Board to annul the Opinion and Decision after Reconsideration issued on December 10, 2024 (Decision), and remand the matter to the Appeals Board for further proceedings. This is our decision after remittitur and remand.

  The record lacked substantial evidence to support the denial of industrial causation due to missing contemporaneous witness statements not provided to medical evaluators, requiring further development of the record.

  Official decision · page 1 →
• ADJ20105844 · 2026-03-13 · Riverside District OfficeJurisdiction / venueapplicant prevailed

  Determinative passage · p.1Applicant seeks reconsideration or in the alternative removal of the "Findings and Order" (F&O) issued on January 5, 2026, by the workers' compensation administrative law judge (WCJ). The WCJ found that the Appeals Board did not have jurisdiction to act upon the disbursement of funds from a third-party settlement check.

  The Appeals Board does not have jurisdiction over the third party or the disbursement of third-party settlement funds absent an agreement approved by the WCAB; the issue of credit for third-party settlement funds is within WCAB jurisdiction and was deferred by the WCJ.

  Official decision · page 1 →
• ADJ18177050 · 2026-03-06 · San Jose District OfficePsyche AOE/COEapplicant prevailed

  Determinative passage · p.5Based on the evidence presented, applicant's injury was the result of a "sudden" employment condition, as described in section 3208.3(d). As he attempted to lower the scissor lift in order to exit the equipment, it suddenly and unexpectedly tipped over and fell. (Exhibit 5, applicant's offer of proof dated August 27, 2024, p. 1.) Because the employment condition that caused applicant's psychiatric injury was "sudden" within the meaning of section 3208.3(d), we turn to whether it was "extraordinary." In light of the legislative and judicial history, the reference to an "extraordinary" employment condition in section 3208.3(d) is an event that is not regular and routine, going beyond what is usual, regular, common, or customary. (Matea, supra, at 1448, quoting Webster's.)

  The evidence showed the scissor lift tipped over suddenly and unexpectedly, which was not a regular or routine employment event, meeting the criteria for a sudden and extraordinary employment condition under Labor Code section 3208.3(d). Defendant presented no contrary evidence.

  Official decision · page 5 →
• ADJ18421273 · 2026-03-03 · Van Nuys District OfficePermanent disability ratingremanded

  Determinative passage · p.1Applicant seeks reconsideration of two decisions issued concurrently by a workers' compensation administrative law judge (WCJ). In a Findings and Award of October 30, 2025 in case ADJ18421273, it was found that while employed as a water system technician on December 28, 2020, applicant sustained industrial injury to his right shoulder, causing permanent disability of 11% and the need for further medical treatment. In a Findings and Award of October 30, 2025 in cased ADJ18421294, it was found that while employed as a water system technician during a cumulative period ending July 7, 2021, applicant sustained industrial injury to his cervical and lumbar spine causing permanent disability of 23% and the need for further medical treatment, but that there was no cumulative injury to the shoulders, elbows, knees, or in the forms of hypertension or diabetes.

  The WCJ's permanent disability ratings and injury scope findings were based on incomplete medical evidence, particularly regarding left shoulder, elbows, knees, and internal medicine claims, requiring further development of the medical record.

  Official decision · page 1 →
• ADJ20892439 · 2026-02-09 · Van Nuys District OfficeEarnings / average weekly earningsapplicant prevailed

  Determinative passage · p.8The undersigned issued a Findings of Fact on 11/13/2025. For tips the undersigned found that the Applicant could assist as many as 20 guests per day to and from their accommodations. The undersigned noted that an estimate of more than 20 guests per day was not credible. The Applicant estimated his tips to be between $5 and $10 per guest.

  The WCJ found the applicant's testimony regarding tips credible and unrebutted by substantial evidence, supporting the average weekly wage calculation including tips.

  Official decision · page 8 →
• ADJ19406087 · 2026-02-03 · Santa Ana District OfficeMedical treatment / UR / IMRdefendant prevailed

  Determinative passage · p.1The WCJ found, in pertinent part, that applicant, while employed on May 23, 2024 as a driver, at Irvine, California, sustained injury arising out of in the course of employment (AOE/COE) to his left eye, left side of face, head, neck, left arm, chest, left shoulder, and injury in the form of a concussion with all other body parts deferred. The WCJ further found that the treatment request for continual care at Casa Colina is reasonable and necessary, and that defendant has not provided evidence of a change in applicant's condition or circumstances that show that applicant's treatment at Casa Colina is no longer reasonably required. Additionally, the WCJ found that applicant does not have the burden of being required to provide a new Request for Authorization (RFA), and that defendant failed to meet the requirements of Labor Code Section 4610(i)(4)(C)1 and Title 8, California Code of Regulations 9792.9.1(e)(6). Applicant was awarded further medical treatment at Casa Colina.

  The WCJ found the treatment request reasonable and necessary and that defendant failed to show a change in condition or meet statutory requirements for denial. The WCAB granted reconsideration to further review the merits and statutory law.

  Official decision · page 1 →
• ADJ19039281 · 2025-10-28 · San Bernardino District OfficeQME/AME processdefendant prevailed

  Determinative passage · p.6Additionally, the WCJ's decision to invalidate panel number 7774203 to the extent it was not properly served is consistent with WCAB Rule 10625, which states in relevant part:

  The panel number 7774203 was invalidated because the claim number used was incorrect and the panel was not properly served, consistent with regulatory requirements and precedent.

  Official decision · page 6 →
• ADJ12910087 · 2025-09-02 · Oakland District OfficeStatute of limitationsapplicant prevailed

  Determinative passage · p.1Applicant seeks reconsideration of the Findings of Fact (Findings) issued on May 14, 2025 by a workers' compensation administrative law judge (WCJ). The WCJ found that decedent the applicant sustained a specific injury arising out of and in the course of her employment to her lumbar spine on February 4, 2019; that claimed that decedent sustained a cumulative injury arising out of and in the course of her employment to "other body systems" resulting in death on January 20, 2023; the Application for Adjudication of Claim (Death Case) (death case Application) was filed on January 2, 2024 and dated December 29, 2023; the death case Application was filed within one year of the date of decedent's death, but was filed more than 240 weeks after decedent's date of injury; Based on these findings of fact, the WCJ found the death claim Application barred by Labor Code2 section 5406, subdivision (b) (section 5406(b)), and "[a]ll further proceedings, including medical-legal discovery," to be moot.3

  The WCJ erred in applying the specific injury date as the date of injury for the death claim; the date of injury for cumulative injury is the date the dependents knew or should have known the injury contributed to death, per Berkebile; lack of substantial medical evidence to determine cause of death requires further proceedings.

  Official decision · page 1 →

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 19.

• INSURANCE COMPANY OF THE WEST
• Insurance Company of the West
• INDEMNITY INSURANCE COMPANY OF NORTH AMERICA
• INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA
• Insurance Company of the State of Pennsylvania
• INSURANCE COMPANY OF THE STATE OF PA
• American Casualty Company of Reading, Pennsylvania
• Indemnity Insurance Company of North America
• INSURANCE COMPANY OF NORTH AMERICA
• INSURANCE CO. OF THE WEST
• American Casualty Company of Reading Pennsylvania
• AMERICAN CASUALTY COMPANY of Redding Pennsylvania

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.