North River Insurance Company

What they litigate

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

• AOE/COE5
• Jurisdiction / venue2
• Contribution / subrogation1
• Cumulative trauma1
• QME/AME process1
• Medical treatment / UR / IMR1
• Reopening / new and further disability1
• Sanctions under Labor Code §58131

Where they appear

• Santa Ana 5
• San Francisco 3
• Long Beach 1
• Los Angeles 1
• Los Angles 1
• Pomona 1
• Santa Rosa 1
• Van Nuys 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.

• 7 for the applicant
• 6 for the defense
• 1 returned for more record

Counted over 14 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.

• ADJ13002614 · 2026-01-05 · San Francisco District OfficeQME/AME processdefendant prevailed

  Determinative passage · p.1Applicant seeks reconsideration, or in the alternative, removal of the Findings and Order (F&O) issued on October 1, 2025, wherein the workers' compensation administrative law judge (WCJ) found, in relevant part, that while employed by defendant on January 11, 2020 as a rental leasing consultant, applicant sustained an injury arising out of and in the course of employment (AOE/COE) to the cervical spine, lumbar spine, bilateral shoulders, bilateral wrists (carpal tunnel syndrome), and psyche. The WCJ further held that panel 3448334 is valid; applicant's December 9, 2024 selection of Hosein Tahami, D.O. as the psyche panel Qualified Medical Evaluator (PQME) from said panel was premature; the parties April 3, 2024 agreement to continue use of Jeffrey Gould, M.D. as the psyche PQME was in effect until its termination on December 6, 2024; and the time frame during which the parties were to commence the striking process for panel number 3448334 was October 1, 2025--the date of service of the F&O.

  The WCJ found the applicant's selection of Dr. Tahami premature because the striking period for the QME panel started anew on December 6, 2024, and had not expired by December 9, 2024, when the applicant selected Dr. Tahami.

  Official decision · page 1 →
• ADJ19575926 · 2025-06-30 · Pomona District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.7This claim is straightforward. Though applicant was no longer "on the clock," he was performing the task for which he was hired by the defendant, caring for the patient, while still on the premises to which he was assigned by the employer. It is certainly anticipated by the employer that applicant should have continued to assist the patient, who struggled with balance, with walking to bed even though he had already clocked out for his shift. In fact, no testimony was elicited as to any policies the employer may have had for caretaking, clocking out, or even staying beyond one's shift. Given the nature of the employment, the employer could not have expected that applicant

  Applicant was performing a task for which he was hired, caring for the patient, while still on the employer's premises, and such activity was reasonably anticipated by the employer even though applicant had clocked out. No evidence showed applicant was acting inconsistently with his employment.

  Official decision · page 7 →
• ADJ8627409 · 2025-02-18 · Santa Ana District OfficeJurisdiction / venueapplicant prevailed

  Determinative passage · p.8Here, AIFSIF's attorneys filed a Notice of Appearance on behalf of Summit, the administrator, on April 12, 2021. This Notice of Appearance contains no indication that Summit and therefore AIFSIF was appearing specially to contest personal jurisdiction. Strictly speaking, it appears that this conduct was sufficient, standing alone, to waive any objection to personal jurisdiction, despite the attorney's assertion three days later of the personal jurisdiction objection at the first hearing the attorney attended.

  AIFSIF's conduct, including filing a Notice of Appearance without a special appearance and participating in the merits for nearly two years before seeking adjudication, constituted a waiver of personal jurisdiction objection.

  Official decision · page 8 →
• ADJ16473370 · 2025-01-21 · Van Nuys District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.12Hence the preponderance of the evidence shows that Command was the Applicant's employer on the date of injury.

  The preponderance of the evidence shows that Command International Security was the applicant's employer on the date of injury, based on applicant's testimony, corroborating testimony from the project manager, text messages, and lack of evidence of employment or payment by Prestige.

  Official decision · page 12 →
• ADJ13428207 · 2024-11-18 · Los Angeles District OfficeReopening / new and further disabilityremanded

  Determinative passage · p.6With respect to the finding that applicant's claim is barred by the five-year statute of limitations under section 5410, we note that the defense of statute of limitations is an affirmative one. Defendant bears the burden of proving same. (Lab. Code, § 5409; Kaiser Found. Hosps. Permanente Medical Group v. Workers' Comp. Appeals Bd. (1985) 39 Cal.3d 57, 67, fn. 8 [50 Cal.Comp.Cases 411] ["The running of the statute of limitations is an affirmative defense (§ 5409), and the burden of proving it has run, therefore, is on the party opposing the claim."].) On this existing record, it appears that the defendant has failed to prove that the filing of the petition to reopen is untimely.

  The record was insufficient to determine the date of injury or whether the petition to reopen was timely; the defense failed to meet its burden to prove untimeliness, so the matter was remanded for further record development.

  Official decision · page 6 →
• ADJ10808328 · 2024-11-15 · San Francisco District OfficeMedical treatment / UR / IMRdefendant prevailed

  Determinative passage · p.6As part of my August 16, 2024 Findings, Award and Order, I did order further development of the record on the issue of applicant's claim for reimbursement for self- procured medical expenses. Labor Code section 4600(e) provides for reasonable expenses for transportation, meals, and lodging incident to a medical- legal examination, along with payment for each day of lost wages in connection with the examination. To the extent that the transportation expenses are self- procured medical expenses, I have already ordered further development of the record on the issue.

  The issue of reimbursement for QME travel expenses was not raised at trial and no evidence was presented. Further development of the record on self-procured medical expenses was already ordered; reconsideration is not appropriate for a non-final order.

  Official decision · page 6 →
• ADJ10961161 · 2024-04-15 · Santa Rosa District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.1We have considered the allegations of the Petition for Reconsideration, the Answer, and the contents of the WCJ's Report. Based on our review of the record, as our Decision After Reconsideration we will rescind the WCJ's July 15, 2022 F&O, and in its place, we will substitute a new findings of fact that applicant sustained industrial injury to her mouth, which resulted in no permanent disability and no need for future medical treatment.

  The Board found that applicant sustained industrial injury to her mouth based on medical evidence and rejected the WCJ's prior finding to the contrary.

  Official decision · page 1 →
• ADJ7912629 · 2023-09-27 · Santa Ana District OfficeTemporary disabilitydeferred

  Determinative passage · p.23In summary, we have previously provided notice of intention to affirm our June 12, 2018 Opinion and Order Granting Petitions for Reconsideration and Decision after Reconsideration except to amend the March 20, 2018 Findings and Award, to find that the issue of applicant's Permanent and Stationary date is deferred (Finding of Fact No. 5); that the issues of permanent disability, apportionment, and attorney's fees are deferred (Findings of Fact Nos. 6, 7, 15); and that the issue of the applicable rating schedule is deferred (Finding of Fact No. 10). We have further provided notice of our intention to rescind the WCJ's April 12, 2019 Findings and Award, and substitute a new Findings and Award reflecting that applicant's date of injury was March 20, 2014 (Findings of Fact No. 1); that applicant's disability must be rated using the AMA Guides, pursuant to section 4660.1 (Finding of Fact No. 2); that applicant's Permanent and Stationary date is March 20, 2014 (Finding of Fact No. 5); and that the issues of permanent disability, COLA adjustment, and attorney fees are deferred (Findings of Fact Nos. 6 & 7). We continue to exercise our original jurisdiction because there has been no prior final award of compensation. We further conclude that

  The Board deferred the issues of permanent disability, apportionment, attorney fees, COLA adjustment, and other issues for further proceedings.

  Official decision · page 23 →
• ADJ13504941 · 2022-12-30 · Long Beach District OfficeAOE/COEdefendant prevailed

  Determinative passage · p.4Moreover, wherever else the Petition references medical reports or other assertions, there are no citations in support of the same. The Applicant did not meet his burden of proof on the issue of injury AOE/COE It is well established that a specific injury needs to cause disability or need for medical treatment.4 An Applicant has the burden of proof by a preponderance of the evidence to establish that an injury occurred.5 Moreover, it is well established that medical opinions must be based on substantial medical evidence.6 Part of substantiality includes the factual accuracy of what is presented therein, as well as the credible testimony of witnesses in support of said facts. The trial judge is afforded great latitude in credibility determination.7 Regarding the finding of no injury, the Petition takes issue finding that Dr. Haronian's opinions are not substantial. The Petition seeks to blame Applicant's prior attorney for the wrong

  The WCJ found the Applicant not credible and noted inconsistencies in medical reports and testimony, concluding the Applicant did not meet the burden of proof for injury AOE/COE.

  Official decision · page 4 →
• ADJ9069066 · 2022-08-29 · Santa Ana District OfficeCumulative traumaapplicant prevailed

  Determinative passage · p.1Defendant California Insurance Guarantee Association (CIGA) seeks reconsideration of a workers' compensation administrative law judge's (WCJ) Findings of Fact of January 27, 2022 wherein it was found that while employed as a professional gridiron football player applicant sustained two separate cumulative injuries. The WCJ found "The first cumulative trauma injury is for the period June 15, 1975 through November 10, 1979 while applicant was employed by the [Los Angeles] Rams and the second cumulative trauma injury is for the period April 29, 1983 through the 1984 season while applicant was employed by the Washington Federals and the Houston Gamblers." The only issue for adjudication at trial was whether applicant sustained one or two periods of cumulative injury. (Minutes of Hearing and Summary of Evidence of August 16, 2021 trial at p. 2.)

  Both reporting physicians opined that applicant sustained two separate cumulative injuries, and there was no medical evidence to rebut these uncontroverted opinions. The WCJ's factual findings on this issue were upheld.

  Official decision · page 1 →
• ADJ10885532 · 2025-04-11 · San Francisco District OfficeReconsideration / removaldefendant prevailed

  Determinative passage · p.1We have considered the allegations of the Petition for Removal and the contents of the report of the workers' compensation administrative law judge (WCJ) with respect thereto. Based on our review of the record1 and based upon the WCJ's analysis of the merits of petitioner's arguments in the WCJ's report, we will deny removal.

  The Appeals Board denied the petition because the petitioner did not show substantial prejudice or irreparable harm if removal was denied, nor that reconsideration would be inadequate.

  Official decision · page 1 →
• ADJ6785524 · 2023-07-19 · Santa Ana District OfficeReconsideration / removaldefendant prevailed

  Determinative passage · p.1On May 26, 2023, we issued our "Opinion and Notice of Intention to Dismiss" (Opinion), wherein we allowed lien claimant Beverly Hills Pharmacy 15 days to file proof that it had timely filed its petition for reconsideration of a F&O issued on June 21, 2022 by a workers' compensation administrative law judge (WCJ). In our Opinion, we gave notice to Beverly Hills Pharmacy that, unless it submitted proof of timely filing within the allotted 15 days, its petition for reconsideration would be dismissed.

  The petition for reconsideration was dismissed because Beverly Hills Pharmacy failed to timely file it within the jurisdictional time limit, depriving the Appeals Board of authority to consider it.

  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.

• NORTH RIVER INSURANCE COMPANY
• North River Insurance Company
• NORTH RIVER 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.