Document Mo0ZYJ0xOeNVVRQa1kBOxLzok
FILE NAME: Contract Unit Workers Comp Claims (WCC) DATE: 1966 DOC#: WCC058 DOCUMENT DESCRIPTION: Workers Comp File - Crader, William R
File Name Contract Unit Claim File: Lo la J. Crader/ W illard R. C rad er Scanned ? y es
Source
JM A: N S-JM
Start Year 1966
Stop Year
1981
Contents
claim
Notes
1
WORKERS' COMPENSATION APPEALS BOARD
2
STATE OF CALIFORNIA
3 LOLA. J. CRADER
4 WILLARD R. GRADER, SR.(DECEASED)
C ase No. 6 4 POM 1939
5 Applicant
6 vs.
CERTIFICATION
7
8
9
D efen dan t
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
21
22 23
24 Dated at San Francisco,
25 California, this 23 da7
26 of March 1981 27
FDtA W CA
orm ub
(NEW t?P)
AirrMBKT o r in b u o t h u i. b a s t i o n division o r M ovrnuA L aqcjbewti
( Wonfi's Cc*npsnii;c Appsais B;:rd ; ' 'r-'i
BEFORE THE INDUSTRIAL ACCIDENT COMMISSION OF THE STATE OF CALIFORNIA
POMONA
COMPROMISE AND RELEASE (Dependency Claim)
CASE N O . 6 4 POM 1 9 3 9
SOCIAL SECURITY NO ____________
LOM .7__ ffBADER. w irlm u n f WTT.T.tWn B . CRADER,SR., D e c e a s e d .
1Q6Q3 Valencia.
nrmnwgfcnn. Palif
0:7SNS-C0RNINS FIBREGLAS. et al.
(see attach ed sh eet)
u '
5933 Teleqraah Rd,, l a . Calif.
UBUM
AETNA CASUALTY & SURETY CO., a corp. 2404 Wilshire Blvd.. LA 54. Calif.
et al. (see attached) iMima**
AOQM1M
Tlx parties bento, for the purpose of compromise only, agree u follows:
The shore-named applicant claim s t W WILIARD R. CRADER, SR.___________
--v;l.oo^oyed i
IMAM o r C H P b O m
various locations in California_____ xxbetween January 1938 and 3 March 196
by------ y a r i o u s _ e m p l o y e r s ( s e e a t t a c h e d ) ___________,tbcam dMw M b-. , = Cabibr
by-- y a j i g y s - c a r r i e r s , ( s e e a t a c h e d ) ____________ ,,ned iojuiy irising out of and is tho count of vac
IT A T * MAMS o r A N M t* CM W N i n t U M B^4M U U V
employmentufollow*: 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
< 59___ _ s * result of the
injury.
3. The actual weekly wages of the employee at the time of claimed injury were_in dispute | irerage weekly wigt
(statutory)
4. Payments of compensacion to the employee in his lifetime on account of the claimed injury w none
The a p p lic a n t, herein claim_ to have been dependent upon said employee at the time of claimed injury, and statc-SL die name ages, relationship to, and the extent of dependency upon said deceased employee to have been as follows:
NAME
ASE
R E L A T IO N S H IP
EXTENT OF DEPENDENCY
Lola J. Crader___________________adult_______ widow__________ total_________
The parties hereby agree to settle any and all claims of said d e p e n d e n t, on account of the claimed injury and che death of sail
employee by payment of the sum of f ? . 5 0 0 . 0 0
, payable as follows to__applicant jr. luTOD sum,__
less reasonable attorneys' fees, less lien claim of applicant's attorneys
$ 1 7 2 .1 0
F' r aet 1 '*(v t*
14. The undersigned does hereby affirm and acknowledge that he has read the foregoing release or had it fully explained to him, and fully understands and appreciates the foregoing words, terms, and their effect, and that this is a full, final compromise, release and settlement of all claims, demands, actions or causes of actions known or unknown, suspected 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 expressly agree that this release shall extend and apply to all unknown, unsuspectei 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 recital.
Applicant
(
The parties hereby agree (if web items ef expense be claimed) that medical, hospital and burial expense required by reams of tx
alleged injury and the death of the employee 'hall be borne aa follow;__ all such expanses by applicant.
I. The name and address of applicant' attorney (if any)
43ft W. 4 th'
,G & fner & Van Bourq,Pomona .C;
who requests a fee of 1 0 0 0 0 0 , having been prcrioualy paid $ n o n e
. Reaaon for
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 vas probably cerebral aneurism; defendants conteric
that this has nothing whatsoever to do with his employment or any alleged
exposure. The outcome of litigation is therefore hazardous and uncertain (over)
V. The ondenigacd request that this compromise agreement and release be approved.
U . Upon approval o f tb it compromit* agreement by order of the Induitrial Accident Commission, a panel thereof, a Commissioner or a Referee, and payment in accordance with the proviuont o f aid order of approval, taid applicantt and each o f them do berthrelate and forever ditebargt told employer and taid insurance company o f and from all clahnt, demandt, actions or ceases of actm t o f every kind or nature whatsoever, on account of. Or by raton o f the infury and death tiulabted at aforetaid by the employee and in particular o f any, all and every clam or cote o f action which the undersigned, beirt, executors, repmentativet, or admini strators may bave bad, now hove, or shall berafter have against taid employer, taid insurance carrier, and each o f them undr. Division IV o f Labor Code o f the State o f California.
12. It is agreed by all partie hereto that the filing of this document it the filing of an application on behalf of the applicant__ _ aac that the commission may in its discretion set the matter for hearing as a regular application, reserving to the partie the right k put in issue any of the fact adsnitted herein, and that if hearing it held with this document used as an application the defendant: shall have available to them all defenses that were available as of the data of filing of this document, essd that the commission may thereafter cither approve said Compromise Agreement and Release or disapprove the same and issue its decision after hearing ha: been held and the matter regularly submitted.
wmeesn
THf INjgftCD APPLICANT'S (NATURE MUfT Vf ATTtfTtD PY TWO RltlNTtfttSTtO P U H N I O n ACKMOWLVOOVD VCPOR ANOTARYPWfUC.
STATE OF CALIFORNIA H.
jCnatyo
On th is
20th _ Aay nl
L. Stone
_
April __
A. T9&7_ before me, Notary Public in and for the said
County end State, residing therein, duly commissioned and sworn, personally appeared
T n l s - t, f-rflfjgr-
known to me to be the person whose ******
-< *
-- *uh*erilj*A to the witem
Instrument, and acknowledged to me that S he executed the same. In W itness W h e r e o f I have hereunto set my hand and affixed m y official seal the day
and year in this Certificate first above written.
tPaet^tiv-u*t3<1'.&P`m*Cscf2<orv -c
S o a r r j PmOntt tm mwd f t * aeid Comoty am J Sta .a o f C
4
4. J
I
(
The various ^jn'Surance companies listed below and tSe various self-
insured employers fisted below, being the workmens compensation
carriers for Some o'f"the named defendant employer&,in ctiis case
during some of' the..peei'od alleged as the period,of lyjurj^in this
case, agree tot,,make the following contributions'ia^ward%jhis settle
ment:
* '
~
v
* .> , -?94t< O 0
PLANT RUBBER & ASBESTOS WORKS, a corp (self insured) v$ '$44.00
PABCO INSULATION CORP.(self insured)
70.00
PACIFIC EMPLOYERS INSURANCE CO.
1 .1 7 5 .0 0
GENERAL ACCIDENT,FIRE & LIFE ASSUR. CORP. LTD.
1 5 0 .0 0 '
EMPLOYERS MUTUAL LIABILITY INS. CO. OF WISCONSIN
225.00
STATE COMPENSATION INSURANCE FUND
20.0 0 '
AMERICAN MOTORISTS INSURANCE CO. GUARANTEE INSURANCE CO.
1 .7 7 0 .0 0 100.00
INDUSTRIAL INDEMNITY CO.
265.00
FIREMENS FUND INSURANCE CO.
295 . OO'TSV-
EMPLOYERS LIABILITY ASSURANCE CORP. LTD.
75.00
CALIFORNIA CASUALTY INDEMNITY EXCHANGE
-V -5.00
.NATIONAL AUTOMOBILE A CASUALTY INSURANCE CO. FIDELITY A CASUALTY CO. OF NEW YORK
iOyoo
T?" ,i.2 :00
RELIANCE INSURANCE CO.
? 48,00
AETNA CASUALTY A SURETY CO.
RBOVOO
LIBERTY MUTUAL INSURANCE CO. TRAVELERS INSURANCE CO.
Total
.jgyio.oo
n . 250.00 $ 7 ,5 0 0 .0 0
WEING^D.KENDIG, A STOCKWELL
BROBECK, PHLEGER A HARRISON
1',
B y .__________________ _______________
iU c O il S
Attorneys for T r a c e r s Ins.
Attorneys for Plant Rubber A*sbes:
cs., Aetna Casualty A Surety
Works and Pabco insulatioA Corp.
Co., and Liberty Mut. Ins. Co.
BRILL HUNT, DeBUYS . BURBY
Emp^yc
bv
--
Attorneys for Gen. Accident,Fire e.
Life Assur. Corp. Ltd.
EMPLOYERS MUTUAL INSURANCE CO.
STATE COMPENSATION. INSURANCE FUND
By
Ai_
bv
jiV
PARKE :
Attorneys for Amer. Motorists Ins. Co.
By. Attorneys for Guarantee Ins. Co. Industrial_^Indemnity Co., and
Firemen^fujja Ins. Co. , and
JAFFEE,MALLSRY,THOMP3 O N ,
TALBOTT A LEMASTER
x
y < ` "V .
BV - " '
^ L-'>_____ "
Attorneys for Employers Liability
J \
.-.ssur. Corp. Ltd.
MKITY EXCHP
s
c A/.y.
NATL. :.UT0::03ILE A CPS. INS. CO. CLOPTON A PENNY
' I
J By
b i r K _____
( Attorneys for Fidelity & cas. Co. o
New York and Reliance Insurance Co..
1/
I
I
T
1
WORKMEN'S COMPENSATION APPEALS BOARD
2
STATE OF CALIFORNIA
3
4
LOLA J. CRADER, Widow
(Willard R. Crader, Sr. Dec'd)
5
Applicant,
3
6
vs.
3
7
ARMSTRONG CONTRACTING it SUPPLY CORP.;
j
8
ARMSTRONG CORK CO. ; B & B ENGINEERING
J
& SUPPLY; CALIFORNIA HOME IMPROVEMENT
3
9
CO.; CALIFORNIA VERMICOLITE CORP.;
3
C. F. BRAUN it CO.; CLARK B.-REECE of
3
10
REECE INSULATING CO.; COAST INSULATING
PROD.; C.O. SPARKS & MUNDO ENGINEERING
11
CO.; DUTTON ASBESTOS it 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.; J
JOHNS-MANVILLE CORP.; J.S. BARRETT; J.S. )
14
THORPE, INC.; J.T. THORPE it SON, INC.;
KELLEY ASBESTOS PROD. CO.; LEE R. EKINS
15
CO.; LOCKHEED AIRCRAFT CORP.; L.A. CORK
CO.; L.A. FOSTER CO.; L.A. RUBBER it
16
ASBESTOS WORKS; LUHMAN BROTHERS; RODERICK
LYNCH, LYNCH ASBESTOS CO.; McNEIL STANLEY,
17
INC.; MACCO McKITTRICK-MORRISON; MACINE
ENGINE & SUPPLY CO.; METAL CLAD INSULATION
18
CO., INC.; OFFCCO CONSTRUCTION CO.,INC.;
OWENS-CORNING FIBERGLASS CORP.; PABCO
19
INSULATION CORP.; THE PHILIP CAREY MFG.
CO.; PLANT ASBESTOS CO.; PLANT RUBBER & ,
20
ASBESTOS WORKS; STANDARD ASBESTOS MFG. it (
INSULATING CO.; SYDNEY CARMINE; THORPE
21
INSULATION CO.; TOTMAN MORGAN CO.} UNITED
CORK COMPANY; FIBERGLASS ENGINEERING &
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 INSURANCE
COMPANY, a corporation; PACIFIC EMPLOYERS
26
INSURANCE COMPANY, a corporation; ARGONAUT
INSURANCE COMPANY, a corporation; EMPLOYER
27
LIABILITY ASSURANCE CORP, LTD.; AMERICAN
MOTORISTS INSURANCE COMPANY, a corporation
28
FIREMAN'S FUND INSURANCE COMPANY, a corpo
ration; INDUSTRIAL INDEMNITY COMPANY, a
2?
corooratlon; GUARANTEE INSURANCE COMPANY,
a corporation; STATE COMPENSATION LiSUR
30
ANCE FUND;
I -1- il
i' *' Ajjifii a .f Aitss Boj-s
<1 ttn 5,
CASE NO. 64 POH 19
ORDER APPROVING COMPROMISES and RELEASES
Pomona orna obubrul AcciDSff cohmissoh
RATI 0 > CAMFOMlA
AUG -17W67. Ria 3 1
V
(
CASE NO. 64 POM 1939
1 THE AETNA CASUALTY & SURETY COMPANY,
a corporation; UNITED PACIFIC INSUR
2 ANCE COMPANY, a corporation; NATIONAL
AUTOMOBILE & CASUALTY INSURANCE COM
3 PANY, a corporation; RELIANCE INSUR
ANCE COMPANY, a corporation; FIDELITY
4
& CASUALTY COMPANY OF NEW YORK, a
corporation,
5
Defendants.
6
7
8
Applicant and the following defendants: PACIFIC EMPLOYERS
9
INSURANCE COMPANY, a corporation; GENERAL ACCIDENT, FIRE & LIFE
10 ASSURANCE CORPORATION, LTD.; EMPLOYERS MUTUAL LIABILITY INSURANCE
11 COMPANY OF WISCONSIN, a corporation; STATE COMPENSATION INSURANCE
12 FUND; AMERICAN MOTORISTS INSURANCE COMPANY, a corporation; GUARANTI
13
INSURANCE COMPANY, a corporation; INDUSTRIAL INDEMNITY COMPANY, a
14
corporation; FIREMAN'S FUND INSURANCE COMPANY, a corporation;
15 EMPLOYERS LIABILITY ASSURANCE CORP. LTD.; CALIFORNIA CASUALTY INDEI>
16 NITY EXCHANGE, an inter-insurance exchange; NATIONAL AUTOMOBILE &
17
CASUALTY INSURANCE COMPANY, a corporation; FIDELITY & CASUALTY COM
1.8 PANY OF NEW YORK, a corporation; RELIANCE INSURANCE COMPANY, a
19
corporation; THE AETNA CASUALTY & SURETY COMPANY, a corporation;
20 LIBERTY MUTUAL INSURANCE COMPANY, a corporation; THE TRAVELERS
21
INSURANCE COMPANY, a corporation; have filed Compromises and Re
22
leases herein on August 10, 1967, covering only that period of
23
alleged continuing trauma wherein the above named defendants had
24 ; compensation insurance coverage for the following named defendant
25 | employers during the period January, 1938 to March 3, 1964:
26 | COAST INSULATING PROD.; J.T. THORPE, INC.; J.T. THORPE 8: SON, INC.;
27 ! THE PHILIP CAREY MFC. CO.; LEE R. EKINS CO.; LOS ANGELES RUBBER &
2s ;j ASBESTOS WORKS; C. F. BRAUN CO.; HENRY J. KAISER CO.,* METAL CLAD
29
INSULATION CC. INC.; PLANT RUBBER & ASBESTOS WORKS; THORPE INSULAEI j
30 \ CO.; LOCKHEED AIRCRAFT CORP.; LOS ANGELES CORK COMPANY; LUSE STEVEN
so:: co.; Ar m s t r o n g c o r k c o m p a n y ; o w e n s -c o r n i n g f i b e r g l a s s c o r p .;
;i (Rh $*>
c
c
CASE NO. 64 p o m 1939
1 FIBERGLASS ENGINEERING & SUPPLY, a corporation; UNITED CORK COMPAQ
a corporation; ARMSTRONG CONTRACTING & SUPPLY CORP.; JOHNS-MAN7TL. 2
CORP.; PABCO INSULATION CORP., self-insured, for the sum of
3
$7 ,500.00, in addition to all sums which may have been paid pre
4
viously, and requesting that they be approved; and this Board
5
having considered the entire record, including said Compromises
6
and Releases, now finds that they should be approved;
,
7
IT IS ORDERED that said Compromises and Releases be'and they 8
are hereby approved.
9
10
AWARD is made in favor of: Lola J. Crader, Widow of
(Willard R. Crader, Sr., Deceased)
11
12
Against the following:
payable by:
13 THE TRAVELERS INSURANCE COMPANY, a corporation
14
TO: Lola J. Crader, Applicant
$ 77.90
Levy, DeRoy, Geffner & Van Bourg, fee
1,000.00
15
and investigation expense advanced
172.10
$1 ,250.00
16
17
PLANT RUBBER & AS3EST0S WORKS, a corporation
self-insured
18
TO:
Lola J. Crader, Applicant
19
PABCO INSULATION CORP., self-insured
'20
TO:
Lola J. Crader, Applicant
21
PACIFIC EMPLOYERS INSURANCE CO., a corporation
22
TO:
Lola J. Crader, Applicant
23 GENERAL ACCIDENT, FIRE & LIFE ASSURANCE CORP. LTD.
24
TO:
Lola J. Crader, Applicant
25 EMPLOYERS MUTUAL LIABILITY INSURANCE COMPANY OF
26 WISCONSIN, a corporation
27
TO:
Lola J. Crader, Applicant
994.00 70.00
1,175.00 150.00 225.00
28 STATE COMPENSATION 'INSURANCE FUND
23 i
TO:
Lola J. Crader, Applicant
20.00
`i
-3-
:i
f .:
n
~v C
CASE NO. 64 POM 1939
1
AMERICAN MOTORISTS INSURANCE COMPANY, a corporation
2
TO:
-Lola J. Crader, Applicant
$1,770.00
3
GUARANTEE INSURANCE COMPANY, a corporation
4
TO: . Lola J. Crader, Applicant
103.00
5
INDUSTRIAL INDEMNITY COMPANY, a corporation
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.
10
TO:- 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
295.00 75.00 15.00
15
TO:
Lola J. Crader, Applicant
20.00
16 FIDELITY & CASUALTY COMPANY OF NEW YORK,
a corporation
17
TO:
Lola J. Crader, Applicant
18
RELIANCE INSURANCE COMPANY, a corporation
28.00
19
TO:
Lola J. Crader, Applicant
20 THE AETNA CASUALTY it SURETY COMPANY, a corporation
48.00
21
TO:
Lola J. Crader, Applicant
22 LI3ERTY MUTUAL INSURANCE COMPANY, a corporation
98O.OO
23
TO:
Lola J. Crader, Applicant
20.00
24
T O T A L .......... $7,500.00 25
26 ! DATED AT POMONA, CALIF.
27 ,|
28 ! SERVED ON ALL PARTIES
2 ? AS LISTED ON OFFICIAL J ADDRESS RECORD August IS, 1967 --' , ,By_____F. Ssalay "
'
Referee WORKMEN'S COMPENSATION APPEALS BOARD
-4-
;.i 1fe'4' * S-iii