Document aDDE2gvRXE8LjjOyxkjGjGaKa

FILE NAME Manville JMA DATE 1966-1981 DOC JMA156 DOCUMENT DESCRIPTION Contract Unit Claim File Lola J. Willard R. Crader I WORKERS COMPENSATION APPEALS BOARD 2 LOLA J. CRADER | &fi WILLARD CRADER STATE OF CALIFORNIA SR DECEASED CASE No. 64 POM 1939 5 Applicant OD VS. ) CERTIFICATION 7 fi 1100 Defendant 1111 1122 13 13 14 1155 1616 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 Appeals Board of the State of California Compensation 17 1818 19 1920 Workers Compensation Appeals Workers ' Compensation Board 2121 2323 24 Dated at San Francisco 25 California this 23 26 of March 1981 27 day DIA WEAB FORM 115 NEW 9.79 COCONN T DT UP DEPARTMENT OF INDUSTRIAL RELATIONS OF BEFORE ACCIDENT CALIFORNIA THE INDUSTRIAL OF THE STATE OF COMPROMISE AND RELEASE Dependency Claim COMMISSION CASE NO.64 POMONAPOMONA . POM 1939 SOCIAL SECURITY NO LOLA CRADER widow of WILLARD R. CRADER Decessed APPLICANT 10603 valencia Bloomington ADORESS Calif OWENS CORNING FIBREGLAS et al see attached sheet EMPLOYER 5933 Telegraph Rd LA Calif ADDRESS CASUALTY AETNA et al & SURETY CO a corp see attached INSURANCE CARRIER 2404 Wilshire Blvd. LA 54 ADDRESS The parties hereto for the purpose of compromiss only agres as follows Calif while employed The named applicant claim 5 that WILLARD R. CRADER SR R . ~ various locations in California a NAME OF EMPLOYEE xxbetween January 1938 and 3 March 196 by various employers see attached , then insured as to workmen's compensation compensation liabilir see atached various carriers STATE NAME OF sustained injury arising our of and in the course of me employasmfeolnlot ws alleged is 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 March 1966 19_as a result of the claimed injury 3. The actusi weekly wages of the employee at the time of claimed injury were dispute while average weekly wage statutory were 4. Paymentosf compensation to the employeirn his lifetime on of account the claimed injury were none claimed the names The applicant herein claimto have been dependent upon said employee at the time of injury injury and state 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 of the claimed injury and the death of szic employee by payment of the sum of 7,500.00 less reasonable attorneys fees payable as followws applicant in lump sum less lien claim of applicant's attorneys 172o. f 11 72.0 10 free 27 PAGE DEV 17.461 ful y 14 The undersigned does hereby affirm and ruenaddersttheandfsoraengdoing release or had it fully exapclkanionweldedgteo appreciates the foregoing words that him he has and fully effect and that this is a terms and their full final compromise release and settlement of all claims demands actions or or unknown suspected and unsuspected and causes of actions known and inducement for this as a further consideration compromise settlement the provisions of Section 1542 of the Civil Code of the State of as follows California which reads 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 and hereby expressly waived by the undersigned who does agree that this release shall extend and apply to all hereby unknown expressly and unanticipated injuries and damages as well as unsuspecte those which disclosed and the undersigned hereby affirms that he has are now signature hereto voluntarily and of his own free will and aafcfcioxredd his between 15. This release contains the entire agreement hereto and the terms of this release are contractual recital the parties and not merely a , : * Lola Lola Lola : Craber Craber Craber Applicant { ( . . vO " The parties hereby agree if such items of expense be claimed that medical hospital and burial expense required by reason of th alleged injury and the death of the employee shabelblorne as follows such expenses by applicant 8. The name and address of applicant's attorney if any Geffner . Levy DeRoy 43 W. 4th & Van Bourg Pomona C - who requests a fee of 1,000.00 having been previously paid none 9. Resson 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 that the cause of death was indicates employment The death certificate probably c^'rebralaneurism defendants conten^' exposure that this has nothing whatsoever t with his employment or any alleged : The outcome of litigation is therefore hazardous and uncertain \. > The undersigned request that this compromise agreement and release be approved over 11. Upon approval of this compromise agreement by order of the Industrial Accident or a Referee and payment in accordance with the Commission a panel thereof a Commissioner release and forever discharge seid employer and provisions said of said order of approval said applicants and each of them do berebr of every kind or nature insurance company of end from all claims demands actions or causes of action and in particular of wahllatasnodever on account of or by reason of the injury and death sustained as aforesaid by the employee any every claim or cause of action which the undersigned beirs executors admini- strators may have had now have or shall hereafter have against said employer said insurance representatives or Division IV of Labor Code of the State of Californis carrier and each of them unde . 12. It is agreed by all parties hereto that the filing of this document is the filing of an application on behalf of the | in its set the as a that the commission may discretimaottn er for hearing application applicant and right . . . _day of 19, af Applicant a, BY Attorneys LE, for - Applicant SEE ATTACHED THE DISINTERESTED : INJURED WITHESISS APLICANTS APPLICANTS SIGNATURE MUST OR ACENOWLEASED BE ATTESTED BY TWO A NOTART PUBLIC STATE OF CALIFORNIA . $ County San Bernardino . Fery 431. PAGPAGEE 32903-658 16 tu FFX_15 cap FFX_15 84 . , ~ . this day On 20th of Geneva L. Stone April _A D. 1967 before me Notary Publie in and for the said County end State residing therein duly commissioned and sworn personally appeared Lola Crader known to me to be the person whose names is subscribed to the wit^m Instrument and acknowledged to me that s be IN WITNESS executed the same of icial and year in thWisHCEeRrtEifOiFcatIehfaivrset baebroevuentworistettemny bend end offixed my official seal the day ce Cf ng ne to ye a t STE fase gf Nesory Papics to and for sold County red Scans of songs at insurance the this employers insuracnompcaneies The various companies listed below and insured employers listed below being various the workmens workmens Compensation self- carriers for some of the named defendant defendant Compensation during some of the period alleged alleged as the case of case agree tomakemake the followingfolowing contribpuetiroinsod injury this ! toward ment settle- , Ly PLANT RUBBER & ASBESTOS WORKS a corp PABCO INSULATION CORP insured PACIFIC EMPLOYERS INSURANCE CO self insured GENERAL ACCIDENT & LIFE ASSUR EMPLOYERS MUTUAL LIABILITY INS CO STATE COMPENSATION INSURANCE FUND CORP LTD OF WISCONSIN AMERICAN MOTORISTS INSURANCE CO GUARANTEE INSURANCE CO yy KN $44.0070.00 si."s: 1,175.00 |. 150.00 3. | 225.00 - 20.00 .*- 1,770.00 21.2 > INDUSTRIAL INDEMNITY CO FIREMENS FUND INSURANCE CO EMPLOYERS LIABILITY ASSURANCE CORP LTD CALIFORNIA CASUALTY INDEMNITY EXCHANGE NATIONAL AUTOMOBILE & CASUALTY INSURANCE FIDELITY & CA UALTYCO OF NEW YORK RELIANCE INSURANCE CO CO 100.00 265.00 = 7 295.00 75.00 ~ 15.00 5928200 20,00 5928200 we 5928200 AETNA CASUALTY & SURETY CO LIBERTY MUTUAL INSURANCE CO TRAVELERS INSURANCE CO at 48.00 SEC 00 SEC SEC 250.00 Total Total 7,500.00 WEINGAND KENDIG & STOCKWELL By Attorneys for Trawlers Ins Co. Aetna Casualty & Surety Co. and Liberty Mut Ins Co. Attorneys for Ins Co. Pacific EmplEmpoloyyersers EMPLOYERS es By f MUTUAL INSURANCE et hoot CO HANNA BY BROPHY 7) Attorneys for Amer Motorists Ins Co. JAFFEE MALLERY THOMPSON TALBOTT . & LEMASTER . . - By ~ \; i f Employers . - . Attorneys for Employers Liability Assur Corp. Ltd. NATL LUTOMOBILE & CAS INS CO .- BROBECK PHLEGER & HARRISON BY une Attorneys Works and TOON for Plant Rubber & Asbest Pabco Insulation Corp. BRILL HUNT DEBUYS & BUREY A By At orneys M Attorneys for Gen. Accident & Life Assur Corp. Ltd. STATE COMPENSATION INSURANCE FUND BY Verna Verna att t ah ee a e Attorneys for Guarantee Ins Co. Industrial Firemens Indemnity Co. and Fund Ins Co. and 2 QA Fidelity & Casualty of N.Y. CRLeOlPTiOaNnc&ePEINNnYmance Co. Mort Clopton BY Clopton Attorneys for Fidelity & Cas Co. o New York and Reliance Insurance Co. 4 . ~ " . we we 1 2 3 & BR ' 7 o 2 10 11 2 12 21313 14 15 WORKMEN'S COMPENSATION APPEALS BOARD STATE OF CALIFORNIA LOLA J. CRADER Widow Willard R. Crader Sr. Dec'd Applicant 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 LUSE LTD DUTTON ASBESTOS & SUPPLY CO STEVENSON CO HADDOCK ENGINEERS HENRY J. KAISER CO H.K. EDWARDS GLOBE EXTERMINATING ENGINEERS 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 EKINS CORP CO LOCKHEED AIRCRAFT 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 .; CO INC OFFCCO CONSTRUCTION CORNING FIBERGLASS CORP PABCO INSULATION CORP THE PHILIP CAREY MFG PLANT CO ASBESTOS CO PLANT RUBBER & ASBESTOS WORKS STANDARD ASBESTOS MFG & INSULATING CO SYDNEY CARMINE THORPE INSULATION 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 LED a corporation THE TRAVELERS INSURANCE COMPANY a corporation PACIFIC EMPLOYERS INSURANCE COMPANY a corporation ARGONAUT INSURANCE COMPANY a corporation EMPLOYER LIABILITY MOTORISTS FIREMAN'S ASSURANCE CORP LTD AMERICAN INSURANCE COMPANY a corporation FUND INSURANCE COMPANY a corpo- ration INDUSTRIAL INDEMNITY COMPANY a corporation GUARANTEE INSURANCE COMPANY a ANCcEorpFoUrNaDtion ; STATE COMPENSATION INSUR- CASE NO 64 POM 19 ORDER APPROVING COMPROMISES and RELEASES POMONA OFFICE INDUSTRIAL ACCIDENT COMMISSION STATE OF CALIFORNIA AUG 17 1967 | | -1- 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 BW Defendants 9 7 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 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 INDEN 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 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.3 LOS ANGELES RUBBER & ASBESTOS WORKS C. F. BRAUN CO HENRY J. KAISER CO METAL CLAD DNSULATION CO INC PLANT RUBBER & ASBESTOS WORKS THORPE INSULATI 1 CO LOCKHEED AIRCRAFT CORP .; LOS ANGELES CORK COMPANY LUSE STEVEN 4 SON CO ARMSTRONG CORK COMPANY CORMING FIBERGLASS CORP -2- - CASE NO 64 POM 1939 | FIBERGLASS ENGINEERING & SUPPLY a corporation UNITED CORK COMPAN .; a corporation ARMSTRONG | CONTRACTING & SUPPLY CORP JOHNS MANVILI MANVILI CORP.; PABCO INSULATION CORP insured for the sum of 7,500.00 in addition to all sums which may have been paid pre- viously and requesting that having considered the entire they be record approved including and said this Board Compromises approved and Releases now finds that they should be * are IT IS ORDERED that hereby approved said Compromises and Releases be and they AWARD is made in favor of Lola J. Crader Widow of Willard R. Crader Sr. Deceased Against the following payable by THE COMPANY TRAVELERS INSURANCE a corporation TO Lola J. Crader Applicant Leavnyd DeRoy Geffner & Van Bourg fee investigation expense advanced $ 77.90 1,000.00 172.10 1,250.00 1,250.00 1,250.00 PLANT RiUn BBsERur & eASdBESTOS WORKS a corporation 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 TO Lola FIRE & LIFE ASSURANCE J. Crader Applicant CORP LTD EMPLOYERS MUTUAL LIABILITY INSURANCE COMPANY | WISCONSIN a corporation OF 994.00 70.00 | 1,175.00 150.00 TO Lola J. Crader Applicant I STATE COMPENSATION INSURANCE FUND 0 Lola J. Crader Applicant 225.00 20.00 -3- | : . : C ; ; CASE NO 64 POM 1939 1 AMERICAN MOTORISTS INSURANCE COMPANY a corporation 2 TO -Lola J. Crader Applicant 3 | GUARANTEE INSURANCE COMPANY a corporation 4 TO | Lola J. Crader Applicant 5 | INDUSTRIAL INDEMNITY COMPANY a corporation 6 TO Lola J. Crader Applicant 7 FIREMAN'S FUND INSURANCE COMPANY a corporation 1,770.00 100.00 265.00 | : 8 TO Lola J. Crader Applicant 9 EMPLOYERS LIABILITY ASSURANCE CORP LTD 295.00 10 TO Lola J. Crader Applicant oe 11 CALIFORNIA CASUALTY INDEMNITY EXCHANGE an insurance exchange 12 TO Lola J. Crader Applicant 13 | 14 NaATcIoOrNpoArLatAiUoTnOMOBILE & CASUALTY INSURANCE COMPANY 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 19 28.00 . TO Lola J. Crader Applicant 20 THE AETNA CASUALTY & SURETY COMPANY a corporation 21 TO Lola J. Crader Applicant 22 LIBERTY MUTUAL INSURANCE COMPANY a corporation 23 TO Lola J. Crader Applicant - 48.00 980.00 20.00 25 TOTAL . . . 7,500.00 26 DATED AT POMONA CALIF . 27 28 23 | SERVED ON ALL PARTIES AS LISTED ON OFFICIAL ADDRESS RECORD gestone WORKDEN'S COMPENSATION APPEALS BOARD f 24-