Document a4pby0oye725QvqgGyykrgoMb

FILE NAME Insulators Workers Comp Claims IWC DATE 1966 DOC IWC058 DOCUMENT DESCRIPTION Claimant - Crader Willard R. & Lola J. From M Archive File Name Contract Unit Claim File Lola J. Crader Willard R. Crader Scanned ? yes Source JMA NS Start Year 1966 Stop Year 1981 Contents claim Notes Sod WORKERS COMPENSATION APPEALS BOARD STATE OF CALIFORNIA <. WILLARD R. CRADER SR DECEASED no Applicant VS. ) CERTIFICATION i Ln: Defendant 111 1213 14 152 15 16 17 I hereby certify that the attached documents are true and correct copies of the original documents filed in the records of this office in the entitled matter ATTEST my hand and the Seal of the Workers Compensation Appeals Board of the State of California 22218 222 222 Appeals Workers Compensation Workers Compensation Board Dated at San Francisco 2 California this 23 of March 1981 day DIA WCAS FOR 15 NEW 1-781 BEY CR DEPARTMENT OF INDUSTRIAL RELATIONS OF 7 ne eet Workmen's Workmen's Workmen's WorkmenWorkmen's's Workmen's CompensatioCompensaCtioompensatio Compensatio Board - - Appeals Board _ POMONA BEFORE THE INDUSTRIAL ACCIDENT COMMISSION OF THE STATE OF CALIFORNIA : COMPROMISE AND RELEASE Dependency Claim CASE NO.6 19394 SOCIAL SECURITY NO CRADER Decessed APPLICANT 10603 Valencia Bloomington ADDARES Calif CORNING FIBREGLAS et al 5933 Telegraph Rd LA Calif see attached sheet EMPLOTEA ADDRESS : AETNA CASUALTY & SURETY CO ^ corp et al see attached INBURANCE GARRIER 2404 Wilshire Blvd. LA ADORESS 54 Calif Calif The parties heret for the purpose of compromise only agros as follows The named applicant claim that WILLARDCRR . ADER SR while employed s 4 OF EMPLEO MPY LOE YE E E various locations in California xybetween January 1938 and 3 March 196 by various employers see attached then insured as to workmen's compensation liabil~-r see atached various carriers STATE NAME OF atached sustained injury arising out of and in the course of me employasmfeolnlotws it is allegedthat 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 employees on March 1966 as a result of the claimed injury 3. The actual weekly wages of the employer at the time of chimed injury were in dispute ~ while sverage weekly wage ( statutory were 4. Payments of compensation to the employer in his lifetime on account of the claimed injury were none The applican herein claims to have been dependent upon said employee at the time of claimed injury and state_5_ the name ages relationship to and the extent of dependency upon said deceased employee to have been as follows NAME Lola J. Crader AGE adult RELATIONSHIP widow EXTENT OF DEPENDENCY total The parties hereby agree to settle any and all claims of said dependent on account of the claimed injury and the death of su ' employer by payment of the sum of 7,500.00 , payable as follows to applicant in lump sum 145s reasonable attorneys fees less lien claim of applicant's attorneys 172.11 72.0 10 Crew S* DR MeGe lt reEy 18 ear 14. The undersigned does hereby affirm and acknowledge that he has read the foregoing release or had it fully explained to him and understands and appreciates the foregoing words terms fully 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 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 between 15. This release contains the entire agreement hereto and the terms of this release are contractual recital the parties and not merely a Grades Lola Lola : Grades Grades * Lola Lola Applicant . oye . a e . ae . The parties hereby agree if such items of expense be claimed that medical hospital and burial expense required by reason of tr alleged injury and the death of the employee shall be borne as follows all such expenses by applicant ; 43 W. 4th 8. The name and add usof applicant's attorney if any Levy DeRoy Geffner & Van Bourg Pomona Ca who request a fee of 1,000.0,0 having been previously paid _none 9. Reason for compromise 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 indicates The death certificate that the cause of death was probably c^'rebral aneurism defendants contend that this has nothing whatsoever t do with his employment or any alleged exposure The outcome of litigation is therefore hazardous and uncertain over \. The undersigned request that this compromise agreement and release be approved demends actions 11. Upon approval of this compromise agreement by order of the Industrial Accident Commission a panel thereof a Commissioner or a Referee and payment in accordance with the provisions of said order of approval said applicants and each of them do bereb velzese and forever discharge said employer and said insurance company of and from all claims or causes of action of every kind or nature whatsoever on secount of or by reason of the injury and deeth sustained as aforesaid by the employer and in particular of any all and every claim or cause of action which the undersigned heirs executors representatives or admini- strators may have bed now have or shall bereafter have against said employer said insurance carrier and each of them undr Division IV of Labor Code of the State of Californis 12. It is agreed by all parties hereco that the filing of this document is the filing of an application on behalf of the applicant and that the commismasyiinoints discretion set the matter for beaars airengulgar application reserving to the parties the right to put in issue any of the facts admitted herein and that if hearing is held with this document used as an application the defendants shall have thereafter avati o tl hemaalb l del fene ses that were availablaes of the date of filing of this documenantd that the commission may either approve saidCompromise Compromise Agreement and Release or disapprove the same and issue its decision after hearing has been held and the matter regularly submitted Wirness the signature bereof this . __day of_ + 19__., at Appli~ an^'Appli~ an^' - x ater Appli~ an^' GREENERIE GRE NERIE GREENERIE x By Attorneys for Applicant . SEE ATTACHED SSES APLICANTS THE INJURED APPLICANTS SIGNATURE MUST BE ATTESTED BY TWO BEFORE AISINTERESTED OR ACENOWLEDGED PUBLIC STATE OF CALIFORNIA 83 _County of San Bernardino On this 20th Geneva L. Stone _day of_ April __A D. 1967 before me Notery Public in and for the said County and State residing therein duly commissioned and sworn personally appeared Crader known to me to be the person whose names he is excented subscribed subscribed subscribed subscribed to the wit^m band . Instrument and acknowledged to me that 5 he excented the soTTP of icial . IN WITNESS WHEREOF I have bereunto set my band and efixed my official seal the day and year in this Certificate first above written 2 @eun 291.9 Pace ares os ca. ~ gene saveartza tree HO coe . . . we ed 4 far Jury Ser to and for weld Copery sad Sieve of Calif Sree eter oe . C4 8 NY emt - A Reems oe eee . ee ee, a insurance ha this of The various insured insurance companies listed below and the various self- employers listed below being the workmens compensation carriers for some of the named defendant employers case during some of the period alleged as the period injury this case agree hizk^the following contributions settle- ward ment ward insured ae PLANT RUBBER & ASBESTOS WORKS a corp PABCO INSULATION CORP insured PACIFIC EMPLOYERS INSURANCE CO self insured GENERAL ACCIDENT & LIFE ASSUR CORP LTD 499400 499400 -544.00- 70.00 924 4 1,175.00 ' 150.00 .' EMPLOYERS MUTUAL LIABILITY INS CO OF WISCONSIN 225.00 STATE COMPENSATION INSURANCE FUND 20.00 AMERICAN MOTORISTS INSURANCE CO 1,770.00 GUARANTEE INSURANCE CO 100.00 INDUSTRIAL INDEMNITY CO : 265.00 FIREMENS FUND INSURANCE CO EMPLOYERS LIABILITY ASSURANCE CORP LTD CALIFORNIA CASUALITY INDEMNITY EXCHANGE NATIONAL AUTOMOBILE & CASUALTY INSURANCE FIDELITY & CASUALTY CO OF NEW YORK RELIANCE INSURANCE CO AETNA CASUALTY & SURETY CO CO 295.007 a. . 75.00 a i 5.00 * os oe 20,00 ee 28200 ' A A 48.00 00 LIBERTY MUTUAL INSURANCE CO TRAVELERS INSURANCE CO SEC SEC 250.00 Total 7,500.00 WEINGAND Attorneys for Trawlers Ins Co. Aetna Casualty & Surety Co. and Liberty Mut Ins Co. BROBECK PHLEGER & By Ria HARRISON Sun Attorneys for Plant Rubber & Asbest Works and Pabco Insulation Corp. Attorneys Ins Co. Employers Pacific Employers EMPLOYERS MUTUAL INSURANCE CO Tha Tha Tha b Dozerer BRILL HUNT DeBUYS & BURBY Res BY Res Res Res Attorneys for Gen. Accident & Life Assur Corp. Ltd. STATE COMPENSATION Vernie By Vernie 0 Vv INSURANCE INSURANCE FUND batt battana HAUNA Amell Attorneys for Amer Motorists Ins Co. At orneys By / Attorneys G4 for Guarantee Ins Co Industrial Indemnity Co. and Fund Ins Co. and JAFFEE MALLERY THOMPSON TALBOTT & LEMASTER ~~ Py ve Attorneys for Employers Assur Corp. Ltd. Liamity NATL LUTOMOBILE & CAS INS CO QUALIQTUAYLITY TEPEMNITY EXCHA Fidelity Reliance Casuality Co. of N.Y. CLOPTON & PENNY Most Clopton By Clopton Attorneys for Fidelity & Cas Co. 2 New York and Reliance Insurance Co. - wes 3 Pe OH 6 7 Oo o 10 111 12 1313 14 14 15 15 16 17 18 222 222 222 N. N. 23 24 | 25 28 2727 28 | | UNN ! WORKMEN'S COMPENSATION APPEALS BOARD STATE OF CALIFORNIA , LOLA J. CRADER Widow Willard R. Crader Sr. Dec'd Applicant CASE NO 64 POM 19 VS. ARMSTRONG CONTRACTING & SUPPLY CORP ARMSTRONG CORK CO B & B ENGINEERING & SUPPLY CALIFORNIA HOME IMPROVEMENT .; co CALIFORNIA VERMICULITE CORP REECE C. F. BRAUN & CO CLARK B. of REECE INSULATING CO COAST INSULATING PROD C.O. SPARKS & MUNDO ENGINEERING .; CO DUTTON ASBESTOS & SUPPLY CO LUSE STEVENSON CO HADDOCK ENGINEERS GLOBE EXTERMINATING ENGINEERS EDWARDS ; INDUS- } TRIAL INSULATORS INC J.A. CARTER CO MANVILLE CORP J.S. BARRETT J.S. THORPE INC J.T. THORPE & SON INC KELLEY ASBESTOS PROD CO LEE R. EKINS CO LOCKHEED AIRCRAFT CORP L.A. CORK CO L.A. FOSTER CO L.A. RUBBER & ASBESTOS WORKS LUHMAN BROTHERS RODERICK LYNCH LYNCH ASBESTOS CO MCNEIL STANLEY .; INC MACCO McKITTRICK MACINE ENGINE & SUPPLY CO METAL CLAD INSULATION CO INC OFFCCO CONSTRUCTION INC CORNING FIBERGLASS CORP PABCO INSULATION CORP THE PHILIP CAREY MFG CO PLANT ASBESTOS CO PLANT RUBBER & ASBESTOS WORKS STANDARD ASBESTOS MFG & INSULATING CO SYDNEY CARMINE THORPE INSULATION CO TOTMAN MORGAN CO UNITED CORK COMPANY FIBERGLASS ENGINEERING & SUPPLY a corporation THE CALIFORNIA CASUALTY INDEMNITY EXCHANGE an inter- insurance exchange ASSOCIATED INDEMNITY CORP a corporation LIBERTY MUTUAL IN- SURANCE CO a corporation GENERAL ACCIDENT FIRE & LIFE ASSURANCE CORP LTD a corporation THE TRAVELERS INSURANCE COMPANY a corporation PACIFIC EMPLOYERS INSURANCE COMPANY a corporation ARGONAUT INSURANCE COMPANY a corporation EMPLOYER LIABILITY ASSURANCE CORP LTD AMERICAN MOTORISTS INSURANCE COMPANY a corporation FIREMAN'S FUND INSURANCE COMPANY a corpo- ration INDUSTRIAL INDEMNITY COMPANY a corporation GUARANTEE DISURANCE COMPANY a corporation STATE COMPENSATION INSUR- ORDER APPROVING COMPROMISES and RELEASES POMONA OFFICE INDUSTRIAL ACCIDENT COMMISSION AUG 17 1967 , FLED we _,; * | Dott $C 3 3 Relasieta et Mb Teaders 4: ator Asset's Qea-e M<er 5-46 136 -1- INe a i ' soe oe CASE NO 64 POM 1939 I 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 hk & CASUALTY COMPANY OF NEW YORK a corporation 5 FO Defendants YF 8 o 10 13 : 14 15 16 1417 19 20 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 GUARANTE INSURANCE COMPANY a corporation INDUSTRIAL INDEMNITY COMPANY a corporation FIREMAN'S FUND INSURANCE COMPANY a corporation EMPLOYERS LIABILITY ASSURANCE CORP LTD .; CALIFORNIA CASUALTY INDER NITY EXCHANGE an 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 22 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 24 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 SON THE PHILIP CAREY MFG CO LEE R. EKINS CO LOS ANGELES RUBBER & ASBESTOS WORKS C. P. BRAUN CO HENRY J. KAISER CO METAL CLAD INSULATION CO INC PLANT RUBBER & ASBESTOS WORKS THORPE INSULATI - CO LOCKHEED AIRCRAFT CORP LOS ANGELES CORK COMPANY LUSE STEVEN " SON Sega 24 **** CO ARMSTRONG CORK COMPANY CORNING -2- FIBERGLASS CORP .; ' ALS -- 41 "me tse de ke 5.65 7 CASE NO 64 POM 1939 1 FIBERGLASS ENGINEERING & SUPPLY a corporation UNITED CORK COMPA wD a corporation ARMSTRONG CONTRACTING & SUPPLY CORP MANVI MANVIL L | 3 CORP PABCO INSULATION CORP insured for the sum of 4 7,500.00 in addition to all sums which may have been paid pre- 5 viously and requesting that they be approved and this Board 6 having considered the entire record including said Compromises 7 and Releases now finds that they should be approved 8 IT IS ORDERED that said Compromises and Releases be and they are hereby approved 9 11 AWARD is made in favor of Lola J. Crader Widow of Willard R. Crader Sr. Deceased ) 13 15 17 ee 2019 N. N 28 Against the following payable by THE TRAVELERS INSURANCE COMPANY a corporation TO Lola J. Crader Applicant Levy DeRoy Geffner & Van Bourg fee and investigation expense advanced PLANT RUBBER & ASBESTOS WORKS a corporation insured TO Lola J. Crader Applicant PABCO INSULATION CORP insured ; TO Lola J. Crader Applicant PACIFIC EMPLOYERS INSURANCE CO a corporation TO Lola J. Crader Applicant GENERAL ACCIDENT FIRE & LIFE ASSURANCE CORP LTD TO Lola J. Crader Applicant EMPLOYERS MUTUAL LIABILITY INSURANCE COMPANY OF WISCONSIN a corporation 70 Lola J. Crader Applicant 1 STA~ E COMPENSATION INSURANCE FUID $ 77.90 1,000.00 172.10 1,250.00 1,250.00 994.00 70.00 1,175.00 150.00 225.00 00 Lola J. Crader Applicant 20.00 -3- : CASE NO 64 POM 1939 & AMERICAN MOTORISTS INSURANCE COMPANY a corporation 2 TO -Lola J. Crader Applicant 3 GUARANTEE INSURANCE COMPANY a corporation - 1,770.00 Fe TO . Lola J. Crader Applicant 5 INDUSTRIAL INDEMNITY COMPANY a corporation 100.00 o2 TO Lola J. Crader Applicant 7 FIREMAN'S FUND INSURANCE COMPANY a corporation 8 TO Lola J. Crader Applicant 265.00 295.00 9 EMPLOYERS LIABILITY ASSURANCE CORP LTD 10 TO Lola J. Crader Applicant 11 CALIFORNIA CASUALEY INDEMNITY EXCHANGE an insurance exchange 75.00 TO Lola J. Crader Applicant NATIONAL AUTOMOBILE & CASUALTY INSURANCE COMPANY 14 a corporation 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 19 TO Lola J. Crader Applicant N THE AETNA CASUALTY & SURETY COMPANY a corporation NN TO Lola J. Crader Applicant NN LIBERTY MUTUAL INSURANCE COMPANY a corporation N TO Lola J. Crader Applicant 28.00 48.00 980.00 20.00 IS ! TOTAL 4 7,500.00 26 i DATED AT POMONA CALIF , SERVED ON ALL PARTIES 23 = AS LISTED ON OFFICIAL | ADDRESS RECORD : August 18 1967 = 4 i By - F. Szalay 4, t is Frations Fe Frations **** **** Azues i Bran ba 5.661 eR Jestone WORKEN'S COMPENSATION APPEALS BOARD -4-