National Liability and Fire Insurance Company

What they litigate

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

• Temporary disability3
• AOE/COE2
• Liens2
• Death benefits1
• Psyche AOE/COE1
• Jurisdiction / venue1
• Medical treatment / UR / IMR1
• Permanent disability rating1

Where they appear

• Redding 5
• Van Nuys 3
• Anaheim 1
• Long Beach 1
• Oakland 1
• Pomona 1
• San Luis Obispo 1
• Santa Rosa 1

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.

• 6 for the applicant
• 3 for the defense
• 3 returned for more record

Counted over 12 appealed decisions. Not this insurance carrier’s book of work.

Decisions

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

• ADJ18371631 · 2026-03-13 · Santa Rosa District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.3In addition to the analysis set forth in the WCJ's Report, we observe the following. The employee bears the burden of proving injury AOE/COE by a preponderance of the evidence. (South Coast Framing v. Workers' Comp. Appeals Bd. (Clark) (2015) 61 Cal.4th 291, 297-298, 302 [80 Cal.Comp.Cases 489]; Lab. Code, § 3600(a), 3202.5.) The Supreme Court of California has long held that an employee need only show that the "proof of industrial causation is reasonably probable, although not certain or `convincing.'" (McAllister v. Workmen's Comp. Appeals Bd. (1968) 69 Cal.2d 408, 413 [33 Cal.Comp.Cases 660].) "That burden manifestly does not require the applicant to prove causation by scientific certainty." (Rosas v. Workers' Comp. Appeals Bd. (1993) 16 Cal.App.4th 1692, 1701 [58 Cal.Comp.Cases 313].) Here, to find industrial injury AOE/COE to the low back, bilateral shoulders and bilateral knees, the WCJ relied on the medical evidence of global PQME, Adam J.

  The WCJ relied on substantial medical evidence from PQME Dr. Stoller and credible applicant testimony to find injury AOE/COE to the low back, bilateral shoulders and bilateral knees during the cumulative trauma period through June 30, 2017.

  Official decision · page 3 →
• ADJ11274250 · 2024-01-12 · Pomona District OfficeLiensremanded

  Determinative passage · p.3The NOI stated that the basis for dismissal was petitioner's "fail[ure] to appear for...conference/hearing on 09/26/2023"; however, upon review, there is nothing in the record to support this statement. The only evidence related to the September 26, 2023 lien conference consists of the Minutes of Hearing (MOH) issued that day; however, nowhere in the MOH did the WCJ note the alleged non-appearance by petitioner (or its representative). (Minutes of Hearing (MOH), September 26, 2023.) Absent an evidentiary basis for the NOI, the NOI was substantively defective and void ab initio, or from the start. Because the NOI was invalid, so was the resultant Order Dismissing.

  The NOI to dismiss was substantively defective and void because there was no evidence in the record to support the alleged non-appearance by petitioner, and due process requires notice and an opportunity to be heard before dismissal.

  Official decision · page 3 →
• ADJ12008723 · 2022-08-05 · Van Nuys District OfficeDeath benefitsapplicant prevailed

  Determinative passage · p.5First, the death certificate states the cause of death, and that is the starting point in order to determine causation. Dr. Borsada opines (to be more fully discussed below) that hypertension is a contributing factor towards arteriosclerosis, the condition that caused the applicant' death. The doctor then discusses the stressors that can lead to an aggravation of hypertension. After reviewing the evidence presented, the doctor concludes that the decedent's stressors at work aggravated his hypertension and his atherosclerotic cardiovascular disease that caused his death.

  The Board found substantial medical evidence based on reasonable medical probability that the decedent's job duties contributed to his death, supported by the PQME's opinion and circumstantial evidence, and rejected the defendant's arguments against industrial causation.

  Official decision · page 5 →
• ADJ10973875 · 2021-10-22 · Van Nuys District OfficePsyche AOE/COEapplicant prevailed

  Determinative passage · p.5Applicant was evaluated by David Reiss, M.D. as the psychiatric panel QME. Dr. Reiss diagnosed applicant with an adjustment disorder. (Applicant's Exhibit No. 3, Medical report of PQME David Reiss, M.D., January 21, 2020, p. 20.) This was considered predominantly caused "by the circumstances and medical sequelae of the applicant's industrially-related physical injury." (Id. at p. 19.) Dr. Reiss assigned applicant with a GAF score of 62, which translates to 12% WPI. (Id. at p. 21.) Apportionment was 75% to the injury and 25% to non-industrial causes. (Id. at p. 22.)

  The psychiatric QME Dr. Reiss concluded the psychiatric condition was predominantly caused by the industrial physical injury, supported by substantial medical evidence, establishing compensability of the psychiatric injury as a consequence of the physical injury.

  Official decision · page 5 →
• ADJ4383952 · 2021-04-09 · Van Nuys District OfficeLiensremanded

  Determinative passage · p.6Here, the WCJ found that Dr. Paul's March 10, 2009 Report satisfied lien claimants' burden of proof that their medical treatments were reasonable and necessary. Based on the record before us, it is not entirely clear if this report satisfies either lien claimant's burden of proof. A review of Dr. Paul's March 10, 2009 Report reveals no mention of the MTUS, and Dr. Paul did not present "a preponderance of scientific evidence" to justify a variance from treatment per the MTUS. Additionally, Dr. Paul did not review any medical records for his March 10, 2009 report, and he did not discuss any of applicant's prior medical treatment. Thus, it is unclear how Dr. Paul's March 10, 2009 report could be used to evaluate or justify applicant's medical treatment prior to March 10, 2009, as reasonable and necessary. Furthermore, it is unclear how Dr. Paul's report of March 10, 2009, may be the basis for the reasonableness and necessity of medical treatment

  The WCJ's reliance on Dr. Paul's March 10, 2009 report was insufficient to establish the reasonableness and necessity of the medical treatment under the MTUS or to rebut the MTUS by a preponderance of scientific evidence. The record did not clearly support the liens as reasonable and necessary, and further proceedings are required.

  Official decision · page 6 →
• ADJ10725201 · 2021-04-01 · Anaheim District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.1Defendant seeks reconsideration of the Findings and Award (F&A), issued by the workers' compensation administrative law judge (WCJ) on January 28, 2021, wherein the WCJ found in pertinent part that applicant sustained injury arising out of and occurring in the course of employment (AOE/COE) to her thoracolumbar spine, right shoulder, right elbow, right forearm/upper extremity in the form of radial tunnel syndrome, right wrist/hand in the form of carpal tunnel syndrome, and both knees; that applicant did not sustain injury to her left elbow; that applicant was temporarily totally disabled for the period from December 1, 2016, through February 9, 2018; that the injury caused 31% permanent disability; that applicant will require further medical treatment to cure or relieve from the effects of her injury; and that defendant unreasonably failed to pay temporary disability and permanent disability benefits, entitling applicant to a penalty on both benefits, pursuant to Labor Code section 5814.

  The WCJ found applicant sustained injury AOE/COE to multiple body parts based on credible testimony and substantial medical evidence, including QME Dr. Geiger's reports and deposition.

  Official decision · page 1 →
• ADJ1082010 · 2021-03-30 · Oakland District OfficeMedical treatment / UR / IMRdefendant prevailed

  Determinative passage · p.2Defendant filed an answer. We did not receive a Report and Recommendation from the WCJ. Based on our review of the record and applicable law, we conclude that the WCJ correctly found that applicant is not entitled to further reimbursement of medical mileage expenses in ADJ1082010 or ADJ1958378. We also note that the penalties assessed by the WCJ have not been challenged upon reconsideration. Therefore, we will affirm the WCJ's decision in its entirety. Reviewing applicant's petition for reconsideration as paginated in the Electronic Adjudication Management System (EAMS), applicant apparently alleges at pages five through eight that she is entitled to additional mileage for injury-related medical treatment visits she made to Fremont Urgent Care and to a Kaiser facility located in Milpitas. However, the WCJ explained in his Opinion on Decision that he did add up mileage for the Kaiser and Fremont Urgent Care visits, as set forth in applicant's exhibits 1 and 3 (admitted into evidence at trial on June 21, 2019). For the injuries in both case numbers, the WCJ even concluded that defendant actually paid more mileage than applicant was entitled to, and again this is according to applicant's own trial exhibits 1 and 3.

  The WCJ correctly found that applicant is not entitled to further reimbursement of medical mileage expenses based on the evidence and the lack of explanation for new evidence; the WCAB affirmed this finding.

  Official decision · page 2 →
• ADJ11353445 · 2023-08-01 · San Luis Obispo District OfficeReconsideration / removaldefendant prevailed

  Determinative passage · p.1Removal is an extraordinary remedy rarely exercised by the Appeals Board. (Cortez v. Workers' Comp. Appeals Bd. (2006) 136 Cal.App.4th 596, 599, fn. 5 [71 Cal.Comp.Cases 155]; Kleemann v. Workers' Comp. Appeals Bd. (2005) 127 Cal.App.4th 274, 280, fn. 2 [70 Cal.Comp.Cases 133].) The Appeals Board will grant removal only if the petitioner shows that substantial prejudice or irreparable harm will result if removal is not granted. (Cal. Code Regs., tit. 8, § 10955(a); see also Cortez, supra; Kleemann, supra.) Also, the petitioner must demonstrate that reconsideration will not be an adequate remedy if a final decision adverse to the petitioner ultimately issues. (Cal. Code Regs., tit. 8, § 10955(a).) Here, based upon the WCJ's analysis of the merits of petitioner's arguments, we are not persuaded that substantial prejudice or irreparable harm will result if removal is denied and/or that reconsideration will not be an adequate remedy if the matter ultimately proceeds to a final decision adverse to petitioner.

  Petitioner failed to show substantial prejudice or irreparable harm if removal was denied and failed to show reconsideration would be inadequate remedy.

  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. This is every spelling behind the figures above.

• NATIONAL LIABILITY FIRE INS. CO.
• NATIONAL LIABILITY & FIRE INSURANCE COMPANY
• National Liability and Fire Insurance Company
• NATIONAL LIABILITY AND FIRE INSURANCE COMPANY
• National Liability & Fire Insurance Company
• NATIONAL LIABILITY & FIRE INSURANCE

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.