Document 4vVM7Omd4gq8EvLran25J86zj
FILE NAME: Metalclad (METC) DATE: 1966 DOC#: METC010 DOCUMENT DESCRIPTION: WC Claim - Crader [From J-M Archive]
File Name Contract Unit Claim File: Lo la J. Crader/ W illard R. C ra d er
Scanned ? y e s
Source
JM A: N S-JM
Start Year 1966
Stop Year
1981
Contents
claim
Notes
1
WORKERS' COMPENSATION APPEALS BOARD
2
STATE O F CALIFORNIA
3 LOLA. J. CEADEE
4 WILLARD E. CEADEE, SE.(DECEASED)
C ase N o . 64 POM 1939
5 Applicata
6 vs.
CERTIFICATION
7
8
9
Defendant
10
11
I hereby certify that the attached documents are true
12 and correct copies of the original documents filed in the records -
13 of this office in the above-entitled matter.
'
14
ATTEST my hand and the Seal of the Workers' Compensation
15 Appeals Board of the State of California.
16
17
18
19 20 Workers' Compensaosjudge
Workers' Compensation Appeals Board
21
22
23
24 Dated at San Francisco,
25 California, this 23 day
26 o March 1981 27
rDetAimWuCfAl
<N*W?)
DFAJrrMBKT O F INBWOTIUAI.
divisionor MovrnuAL
(t Wonfi's Cc*npsnii;c rmA\Pr"?r'-s*.C;s >' _ j
BEFORE THE INDUSTRIAL ACCIDENT COMMISSION OF THE STATE OF CALIFORNIA
POMONA
COMPROMISE AND RELEASE (Dependency Claim)
CASE N O . 6 4 POM 1 939
SOCIAL SECURITY NO _____________
LflLa J ----rR M ffiB . w if ln o f WTT.T.awn .
CRADER,SR., Deceased.
"""""
1Q6Q3 V a l e n r i a . RI nnw i BIWMMg
. Palif.
OfSNS-CORMIKO FIBREGLAS. et al.
(see attached sheet)
wu
5933 Teleqraah Rd.. l a . Calif.
AETNA CASUALTY & SURETY CO, a corp. 2404 Wilshire Blvd.. LA 54. Calif. et al. (see attached)
Tlx parti howto, for the purpose of compromio only, agree as follow:
The above-named applicaaL-- el.m S .L.. WIXiIA RD R . CRftDSR S R .
--
im am o r c iiP b o m
. whileemployed t
various locations in California
XXbetween January 1938 and 3 March 196
kr various employers (see attached)
,thenissuedastoworkmen'scompcnacoonKaMst
^ various carriers (see atached)
i r r s T e n * m b o r CASSIS * wHrTHKA
-stained injury arising o u of asd 0 tlx c a n of sac
employmentasfollow: it is alleged that exposure to irritants at work caused in
jury to the claimant's lungs and other parts of his body resulting in deat.
2. The death of said employee occurred m 1 March 1 9 6 6
, j s ____f u t ^ 0{ tht el.N w l injury.
3. The actual weekly wages o f the employee at the time of claimed injury were__i n dispute |,, b a * aTense n t y n p
(statutory)
4. Payments o f compensation to the employee in his lifetim e on account o f the claimed injury w * none
The applicant___herein claimS__ to have been dependent upon said employee at the time o f claimed injury, and statc-SL. the ages, relationship to . and the extent of dependency upon said deceased employee to have been as follows:
NAME
ASE
RELATIONSHIP
EXTENT OF DEPENDENCY
Lola J. Crader___________________adult_______ widow__________ total
The parties hereby agree to settle any and all claims of said dependent___on account of the claimed injury and the death o: ss.it
employee by payment of the sum of t 7 , 5 0 0 . 0 0
| payable as follows to__a p p l i c a n t j r . lu m p s u m , ___
less reasonable attorneys' fees, less lien claim of applicant's attorneys
$ 1 7 2 .1 0
r^WW ** A ACC t <*CV *4i
>.
c
14. The undersigned does hereby affirm and acknowledge that he has
2 * 2 ; '" " " 1**" l>.a it fully explained f0 S ? m " U j
appreciates the foregoing words, terms, and their
Y
effect, and that this is a full, final compromise, release and
settlement of all claims, demands, actions or causes of actions known
o r .u!?lt"own' euapeeted and unsuspected, and as a further consideration
and inducement for this compromise settlement the provisions of
Section 1542 of the Civil Code of the state of California, which reads as follows:
"A general release does not extend to claims
which the creditor does not know or suspect to exist in his favor at the time of executing of the release, which if known by him must have materially affected his settlement with the debtor,"
and hereby expressly waived by the undersigned, who does hereby expresslv
agree that this release shall extend and apply to all unknown, unsuspecte.
and unanticipated injuries and damages, as well as those which are now
disclosed, and the undersigned hereby affirms that he has affixed his
signature hereto voluntarily and of his own free will and accord.
'
15. This release contains the entire agreement between the parties hereto and the terms of this release are contractual and not merely a
Applicant
t
--
(
"
X
The parties hereby agree (if meb items ef expense be claimed) that medical, faoipital and burial ezpenee requued by ream, o f
alleged injury and the death of the employee d u ll be borne t i fallow- a l l s u c h e x p e n s e s b v a o p l i e a n - t -
. The name and addreu of applicant'! attorney (if a*!; L e v y , D e R o y , G e f f n e r & V a n B o u r a , P o m o n a . r -
wbo requests a fee of iJ L P O 0..00__ , Laving been prcrioualy paid t none______
9. Reason for enmpmmi serious dispute exists as to the applicant *s rights to any compensation. Defendants contend that the decedent's death was neither
caused nor aggravated by his employment. The death certificate indicates
that the cause of death was probably cerebral aneurism; defendants eaHt.BV
that this has nothing whatsoever to do with his employment or any a l l e g e
,, SSPPSttre.-- The outcome of litigation is therefore hazardous and uncertain
i _
.
V. The undersigned request that thit eomproaiae agreement and release be approved.
(over)
U . Upon approval of tbit compromise agreement by o tin of the Industrial Accident Commission, , panel thereof, a Commissioner
or a Referee, and payment in accordance with the provisions of told order of approval, uid applicants and each of them do berth-
release end forever discharge said employer and said insurance company of and from all claims, demands, actions or censes of actm>
Of every kind or nature whatsoever, on account of, Or by reason of the injury and death sustained at aforesaid by the employee
end tn particular of any, all and every claim or cause of action which the undersigned, heirs, executors, representatives, or admini
strators may have bad, now have, or shall hereafter have against said employer, said insurance carrier, and each ef them undr.
Division TV of Labor Code of the State of California.
12. It is agreed by all parties hereto that the filing of this document is the filing of an application on behalf of the applicant___, aac
that the commission may in it discretion tec the matter for hearing as a regular application, reserving to the parties the right u
put in issue any o f the facts admitted herein, and that if hearing is held with this document used as an application the defendants
shall have available to them all defenses that were available as o f the date of filing o f this document, end that the
^
thereafter either approve said Compromise Agreement and Release or disapprove the same and issue its If jo after hearing ha:
been held and the nutter regularly submitted.
W rnntss the signature hereof this
Jay nf.
___________ 1________ , et____ .___________________
< aw a k & - , / - t '/<>------
r
LEV1LdeRQY.g e f f w e b ;^
.wniren
-----
Attorneys for Applicant
(SEE ATTACHED)
WtTNBM
TW INJURED ARRUCANT* (N A T U R E HURT BE ATTESTED Y TWO OISINYSRCSTEO RCASON O R ACKNOWkCOOED OCROR A NOTARY RURUC.
STATE OF CALIFORNIA
dCeuatyo
Fe^v<3I-BPascS.rrv -
m t i - u i v.< -m C t t
O--n thii
-- --.... --......... -- ? 0 th ------ay0f ---------- A p r il_________A. D.
before me,
e Notary Public in end for the m.id
County end State, residing therein, duly commissioned and sworn, personally appeared
I.n1a...T. C-rnr'a r
known to me to be the person whose names____ is______ subscribed to the w ilen
instrument, and acknowledged to me that S he executed the tame.
In V ttnek V hereof,/have hereunto set my hand and affixed m y official seal the de\
and year in this Certificate first above written.
- . .
*
-<41/
-
tr i: - .-
S o e a r j fm odtr bo mod fm tald Cam nty a o l I n . a o f C*iii% m +a
r
(
The various itfirnce companies listed below and tSe various self insured employers \ist<*3 below, being the workmens ^mpensation carriers for Some o'f the named defendant employ ersNin'this case during some of the..peci'od alleged as the period oFinnury^in this
ment* S9ree t 0 *-- *e the following contribution!'t^ward%bis settle
*
-
PIAOT RU3BER & ASBESTOS WORKS, a corp. (self i n PABCO INSULATION CORP.(self insured)
PACIFIC EMPLOYERS INSURANCE CO.
GENERAL ACCIDENT,FIRE & LIFE ASSUR. CORP. LTD. EMPLOYERS MUTUAL LIABILITY INS. CO. OF WISCONSIN STATE COMPENSATION INSURANCE FUND
AMERICAN MOTORISTS INSURANCE CO. GUARANTEE INSURANCE CO.
INDUSTRIAL INDEMNITY CO. FIREMENS FUND INSURANCE CO.
EMPLOYERS LIABILITY ASSURANCE CORP. LTD. CALIFORNIA CASUALTY INDEMNITY EXCHANGE
.NATIONAL AUTOMOBILE A CASUALTY INSURANCE CO. FIDELITY & CASUALTY CO. OF NEW YORK RELIANCE INSURANCE CO.
AETNA CASUALTY & SURETY CO.
LIBERTY MUTUAL INSURANCE CO.
TRAVELERS INSURANCE CO.
Total
'
,7 \
s vu$ r'$44e.00d \ * 70.00 A.
1.175.00
150.00 '
225.00
20.00' ;
1.770.00
.
100.00
265.00 '
295'.OO'isY'
75.00
.vv-S.OO
, v 20>00
T`iV- . .2:oo
<" * 48.00
SO '.O Q
^O.OO
250.00
$7,500.00
WEINGAHD,KNDIG & STOCKWELL
L_ B y ____________________ ______________
Attorneys for Trailers Ins.'
Co., Aetna Casualty & Surety
Co., and Liberty Mut. Ins. Co.
r P "
/,
-... '1 n Q & lC V O A A stJo ^tiM s
orneys' fc^r Pacific E m p ^ y e r s
ins
EMPLOYERS MUTUAL INSURANCE CO.
B y _ .Z
i-
BROBECK, PHLEGER & HARRISON
y. L u c Q ,
Attorneys for Plant Rubber & Asbes: Works and Pabco Insulatioli Corp.
BRILL HUNT, DeBUYS & BURBY
By
Attefneys for Gen. Accident,Fire & Life Assur. Corp. Ltd.
STATE COMPENSATION. INSURANCE FUND
By <
)
JlV /
/BROP^Y'
/ /j
Attorneys for Amer. Motorists Ins. Co.
J A FFE E, MALLSRY, THOMP3 ON,
TALBOTT & LEMASTEP. ' , ' i ' ;
By - ~ "
^ y
'
Attorneys for Employers Liability
Assur. Corn. Ltd.
NATL. :.UT0::03ILE & CPS. INS. CO.
PARKES f t ,
Bv-- w1 C j Attorneys for Guarantee Ins. co., InpustriaI^lndemnity Co., and Firenen^fund Ins. Co. , and
MNITY EXCHP S
^ CLOPTON & PENNY
6c. e,- A/.V. a-
(Bjt, ,
' j
By__/fieri}-X *, ( V & Attorneys for Fidelity & Cas. Co. o
New York and Reliance Insurance Co..
ij
l
I
(
(
* .
1
WORKMEN'S COMPENSATION APPEALS BOARD
2
STATE OF CALIFORNIA
3
4
LOLA J. CRADER, Widow
(Willard R. Crader, Sr. Dec'd)
5 Applicant,
CASE NO. 64 POM 19
6
vs. 7
ORDER APPROVKG
ARMSTRONG CONTRACTING & SUPPLY CORP.;
8
ARMSTRONG CORK CO.j B & B ENGINEERING
COMPROMISES
& SUPPLY; CALIFORNIA HOME IMPROVEMENT
9
CO.; CALIFORNIA VERMICULITE CORP.;
C. F. BRAUN & CO.; CLARK B.-REECE of
10
REECE INSULATING CO.; COAST INSULATING
and RELEASES
PROD.; C.O. SPARKS & MUNDO ENGINEERING
11
CO.; DUTTON ASBESTOS & SUPPLY CO.;
LUSE STEVENSON CO.; HADDOCK ENGINEERS,
12
LTD; HENRY J. KAISER CO.; H.K. EDWARDS
GLOBE EXTERMINATING ENGINEERS; INDUS
13
TRIAL INSULATORS, INC.; J.A. CARTER CO.;
JOHNS-MANVILLE CORP.; J.S. BARRETT; J.S.
pomqna o m a BTOUSIWAl ACCIDENT COMMISSION
tTATi OP CAUFOMlA
14
THORPE, INC.; J.T. THORPE & SON, INC.;
KELLEY ASBESTOS PROD. CO.; LEE R. EKINS
AUG .17U67.
15
CO.; LOCKHEED AIRCRAFT CORP.; L.A. CORK
CO.; L.A. FOSTER CO.; L.A. RUBBER &
FUEL
16
ASBESTOS WORKS; LUHMAN BROTHERS; RODERICK
LYNCH, LYNCH ASBESTOS CO.; McNEIL STANLEY,
17
INC.; MACCO MoKITTRICK-MORRISON; M A C K E
ENGINE & SUPPLY CO.; METAL CLAD INSULATION
18
CO., INC.; OFFCCO CONSTRUCTION CO.,KC.;
OWENS-CORNKG FIBERGLASS CORP.; PABCO
19
INSULATION CORP.; THE PHILIP CAREY MFG.
CO.; PLANT ASBESTOS CO.; PLANT RUBBER &
20
ASBESTOS WORKS; STANDARD ASBESTOS MFG. &
INSULATING CO.; SYDNEY CARMINE; THORPE
'
21
KSULATION CO.; TOTMAN MORGAN CO.; UNITED
CORK COMPANY; FIBERGLASS E N G K E E R K G &
22
SUPPLY, a corporation; THE CALIFORNIA
CASUALTY INDEMNITY EXCHANGE, an inter-
`
23
insurance exchange; ASSOCIATED INDEMNITY '
CORP., a corporation; LIBERTY MUTUAL IN- '
24
SURANCE CO., a corporation; GENERAL
ACCIDENT,FIRE & LIFE ASSURANCE CORP., LTD.'
25
a corporation; THE TRAVELERS KSURANCE
COMPANY, a corporation; PACIFIC EMPLOYERS
26
KSURANCE COMPANY, a corporation; ARGONAUT
INSURANCE COMPANY, a corooration; EMPLOYER
27
LIABILITY ASSURANCE CORP, LTD.; AMERICAN
MOTORISTS INSURANCE COMPANY, a corooration
28
FIREMAN'S FUND KS U R A N C E COMPANY, a corpo
ration; INDUSTRIAL INDEMNITY COMPANY, a '
2?
corporation; GUARANTEE INSURANCE COMPANY, '
a corporation; STATE COMPENSATION K S U R - '
30
ANCF FUND;
-lj! UtlipJ - t B cj-s
1 '* 5 ,
THE AETNA CASUALTY & SURETY COMPANY *,,2r52ration-' W I T E D PACIFIC INSUR ANCE COMPANY, a corporation: NATIONAL AUTOMOBiLE & CASUALTY INSURANCEOTMA v H ,o ! i orporationi Re l i a n c e INSUR-
a corporation; FIDELITY & CASUALTY COMPANY OF NEW YORK, a corporation,
Defendants.
Applicant and the following defendants: PACIFIC EMPLOYERS INSURANCE COMPANY, a corporation; GENERAL ACCIDENT, FIRE & LIFE ASSURANCE CORPORATION, LTD.; EMPLOYERS MUTUAL LIABILITY INSURANCE COMPANY OF WISCONSIN, a corporation; STATE COMPENSATION INSURANCE FUND; AMERICAN MOTORISTS INSURANCE COMPANY, a corporation; QUARANTI INSURANCE COMPANY, a corporation; INDUSTRIAL INDEMNITY COMPANY, a corporation; FIREMAN'S FUND INSURANCE COMPANY, a corporation; EMPIOYERS LIABILITY ASSURANCE CORF. LTD.; CALIFORNIA CASUALTY m SB t NITY EXCHANGE, an inter-insurance exchange; NATIONAL AUTOMOBILE & CASUALTY INSURANCE COMPANY, a corporation; FIDELITY & CASUALTY COM PANY OF NEW YORK, a corporation; RELIANCE INSURANCE COMPANY, a corporation; THE AETNA CASUALTY & SURETY COMPANY, a corporation; LIBERTY MUTUAL INSURANCE COMPANY, a corporation; THE TRAVELERS INSURANCE COMPANY, a corporation; have filed Compromises and Re
leases herein on August 10, 1967, covering only that period of
alleged continuing trauma wherein the above named defendants had compensation insurance coverage for the following named defendant
employers during the period January, 1938 to March 3, 1964:
COAST INSULATING PROD.; J.T. THORPE, INC.; J.T. THORPE & SON, INC.; THE PHILIP CAREY MFG. CO.; LEE R. EKINS CO.; LOS ANGELES RUBBER & ASBESTOS WORKS; C. F. BRAUN CO.; HENRY j. KAISER CO.; METAL CLAD EMULATION CC. INC.; PLANT RUBBER & ASBESTOS 'WORKS; THORPE INSULATI CO.; LOCKHEED AIRCRAFT CORP.; LOS ANGELES CORK COMPANY; LUSE STEVEN SO.: CO.; ARMSTRONG CORK COMPANY; OWENS -CORN INC- FIBERGLASS CORP.;
c
X
CASE NO. 64 p o m 1939
1
2 3 4
5
6 7 8
9
10 11 12 13 14 15 16 17 18 19
'2 0
21 22 23 24 25 26 27 28 23
FIBERGLASS ENGINEERING & SUPPLY, a corporation; UNITED CORK CONPAI
a corporation; ARMSTRONG COKTMOiriG-& SUPPLY CORP. ; JOHNS-'^-yn.
CORP.; PA3C0 EMULATION CORP., self-insured, for the sunt of
"
$7,500.00, m addition to all sums which may have been oaid pre viously, and requesting that they be approved; and this Board
having considered the entire record, including said Compromises
and Releases, now finds that they should be approved;
,
IT IS ORDERED that said Compromises and Releases be and they are hereby approved.
AWARD is made in favor of:
Lola J. Crader, Widow of (Willard R. Crader, Sr., Deceased)
Against the following:
payable by:
THE TRAVELERS INSURANCE COMPANY, a corporation
TO: Lola j. Crader, Applicant Lesvy, DeRoy, Geffner & Van Bourg, fee and investigation expense advanced
$ 77.90
1 ,000.00
172.10 $1,250.00
PLACT r a g r a * BESJOS O R B , a o r p o r m . a
TO:
Lola J. Crader, Applicant
PABCO INSULATION CORP., self-insured
TO:
Lola J. Crader, Applicant
PACIFIC EMPIOYERS INSURANCE CO., a corporation
TO:
Lola J. Crader, Applicant
GEIERAL ACCIDENT, FIRE & LIFE ASSURANCE CORP. LTD.
TO:
Lola J. Crader, Applicant
MTjrjAL LIABILITY INSURANCE COMPANY OF -1Is^o.vSIN, a corporation
TO:
Lola J. Crader, Applicant
STATE CO.MPENSATION 'INSURANCE FUND
-0 :
Lola J, Crader, Applicant
- 3-
994.00 70.00
1,175.00 150.00
225.00
20.00
f .;
CASE KO. 64 POM 1939
1 AMERICAN MOTORISTS INSURANCE COMPANY, a corporation
2
TOi -Lola J. Crader, Applicant
3
GUARANTEE INSURANCE COMPANY, a corporation
$1,770.00
4
TO: . Lola J. Crader, Applicant
5
INDUSTRIAL INDEMNITY COMPANY, a corporation
100.00
6
TO:
Lola J. Crader, Applicant
7 FIREMAN'S FUND INSURANCE COMPANY, a corporation
265.00
8
TO:
Lola J. Crader, Applicant
9 EMPLOYERS LIABILITY ASSURANCE CORP., LTD.
295.00
10
T O : Lola J. Crader, Applicant
11 CALIFORNIA CASUALTY INDEMNITY EXCHANGE, an inter-insurance exchange
12
TO:
Lola J. Crader, Applicant
13
NATIONAL AUTOMOBILE & CASUALTY INSURANCE COMPANY
14 a corporation
*
75.00
15.00
15
TO:
Lola J. Crader, Applicant
16 FIDELITY & CASUALTY COMPANY OF NEW YORK, a corporation
17
TO:
Lola J. Crader, Applicant
18
RELIANCE INSURANCE COMPANY, a corporation 19
TO:
Lola J . Crader, Applicant
20
THE AETNA CASUALTY & SURETY COMPANY, a corporation 21
TO:
Lola J. Crader, Applicant
22
LI3ERTY MUTUAL INSURANCE COMPANY, a corporation 23
TO:
Lola J. Crader, Applicant
24
20.00 28.00 48.00 980.00 20.00
25
T O T A L ........ . $7,500.00
26 DATED AT POMONA, CALIF.
27
23 ! SERVED OK ALL PARTIES
2 ? ; AS LISTED ON OFFICIAL ,! ADDRESS RECORD
.;i BAyu_g_u_s_t_ F1.6,SzIa9lv>a7y --^ 1
Referee
G
WORKMEN'S COMPENSATION APPEALS BOARD
.I.V'IS
,i 1 6' J'?
5-eii