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FILE NAME Mundet Cork MCK DATE 1962 DOC MCK138 DOCUMENT DESCRIPTION WC Claim of Wyss Pt 2 fi Sduf gifial'accident of KalaionsKalaions ' (Pp ARTCEIVED 1 0 of # 2 wane Cae ad er cme BEET EB ray : ae LOT ater de met : mma Woe wrens Wt ee mbemnnnes ge sey oa oR tA aS NE ST ' st ye. Sdugifial'accident Cir mission ARTCEIVED JA1 N 96 STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION DeparInt dustm rialent IndustIr nduistaril al Accidarts FILED * | Oakland Office APPLICATION JA 11 1N 962 PALE SIGNED ORIGINAL AND SIX COPIES PLEASE PRINT OR TYPE NAMES AND ADDRESSES ; CASE NO Oakland Office DOAK DOAK DOAK 7422 __ JOHN WYSS YS Mundet Cork Co. and many others APPLICAN- 507 Capp Street oo APPLICANT S ADDRESS San Francisco California Social Security No. 558-01-3502 | cesta 440 Brannan Street San Francisco California Aetna Casualty & Surety Co. EMPLOTER'S INSURANCE GAARIKE 220 San MontgomeryStreet INSURANCE INSURANCE CARRIERS CARRIERS ADDRESS Francisco California . JOHN WYSS HANE OF EXPLOTES ; 10/14/99 alleges that while employed on _ Nov. 10 19.61 19.61 DATE OF DIETN DATE OF INJURY asbestos worker as |... OCCUPATION AT TIME OF INJURY ato... various .. CITY TOWN OR PLACE WHERE tee eeeeeeeey INJURY OCCURRED California by Mundet Cork Co. .. WW __. -_.., .... sustained injury arising out of andin the course of the employment as follows MAKE OF EMPLOYER Exposurd e ust foreign substances over many.pars many.pars EXPLAIN NOW INJURY WAS RECEIVED ee resulting in chest disability eset ote oon STATE WHAT PARTS OF BODY WERE INJURED AND SUBSEQUENT RESULTE smene 2. Aetna Casualty & Surety Co. Aetna was the employer's employer's insurance carrier on date ofinjiury njury RANE OF INSURANCE COMPANY OR IP EMPLOYER WAS NOT INSURED STATE WHETHER INSURED ON UNINSURED 3. Novemb1e0r pre tospe ren set nt PERIODS OF WORK DUE TO THE INJURY oo . DATE INJURED RETURNED TO WORK _.. DATE LAST MEDICAL FURNISHED 4. Was compensation paid no YES OR NO $ TOTAL PAID ~ $ ceegeee eeeeemeetuceance, WEEKLY RATE 0 eegeeene nee DATE ae OF LAST . PATMENT 5. Earnings at time of injury $ MAX @ sce sssess MONTH OR WEEE seme The basis of STATE pay was PAY PERIOD OF HOURLY ZATE HOURS & DAY AND DAYS A WELL 6. Was medical treatment needed yes YES ON NO Who furnished treatment '. self self oo le eeee cece en eee GIVE RADES OF DOCTORS WHO TREATED THE INJURY AND STATE WHO PAID THEIR BILLE 7. This application is filed to determine liability for a Temporary disabiliyteys YES OR NO b Permanent disability yesc Medical treatment .. yes YES OR NO YES OF HO d Medical costs eee TES OR NO e Litigation expense TES OR NO a f STATE ANY OTHER REASON 59 K 1345 LIST CASE KUNNERS OF ANY OTHER APPLICATIONS FILED a WHEREFORE it is requested that a time proper under the Workmen's Compensation and place be fixed for hearing and Laws of California Dated at Oakland , that an award be made granting such relief as may be -- John Californi.a.Januar 19y 62 __ Hearing requested at Oakland CITY Number of witnesses fy ee ee time of Estimat tre ia d l TodToa day y Today ! SMITH PARRISHPAD&UCC LANK CY Pinancial Center Building CaklandCakland12 California . SACUMEN SACUM SACE UMN EN NO TELEPHONE TELEPHONE my St er em mm em garding the various listed employers Coen Company - No Record ke Mundet Cork Corp. - No record prior to Aetna Casualty & Surety Co. th 12-31-39 Policy Policy Folicy Policy Policy Policy Policy Policy Policy 10-110500 12-31-39 10-10000 12-31-40 20200 12-31-45 C32100 12-31-46 C44800 12-31-47 C44800 12-31-48 1-070600 12-31-49 C6720 12-31-52 C23413 12-31-60 Plant Rubber & Asbestos Works ~ No Record R. W. Giddings Supply Co. - No Record Bay Cities Asbestos Co. Ltd. - No Record Western Asbestos Co. State Compensation Ins Fund Folicy 93224 1937 through 1968 A Standard Asbestos Co. -- No Record Warren & Bailey Co. - No Record ' . |e POR PRE e f Thorpe & Son Inc. Pacific Employers Ins Co. Policy C 59886 9-30-38 Policy 70781 10-1-39 Industrial Indemnity Co. Policy 100021 1-1-55 Plant Asbestos Company - No record prior to 10-1-39 Pacific Employers Ins Co. Policy 70782 10-1-39 Industrial 11 11 Indemnity Co. Policy 71790 10-1-40 41 Policy 76945 1-1-48 50 Policy 51378 1-1-49 1-1-56 57 Policy 100654 1-1-56 Policy 608056 1-1-59 Lish Corp. No Record E. B. Badger & Sons Co. - No Record Harry A. Dutton Jr. Dutton Asbestos Co. - No Record Van Arsdale Harris Lumber Co. Inc. - No Record Richmond Shipbuilding Corp. - No Record Western Precipitation - No Record Permanent Hotels Corp. - No Record G. R. Dutton & C. A. Leighton et al Western Fiberglass Supply Ltd. - No Record Lorentzen Co. - No Record Asbestos Supply Co. of Beattle - No Record Racoma Asbestos Co. Charles R. Brower & E. E. Saberhagen - No Record Motel Clad Insulation Co. Inc. - No Record Janar & Olkan Co. - No Record . Saberhagen rest Chas R. Brower & Co. E. E. The E. J. Bartells Co. - No Record 1 Hardware Mutual Casualty Co. , Charles Ayers Co. - No Record 224680 Policy 10-1-5210-1-1520-1-52 tot die QUTUN your 1 ao Fiberglass Engineering & Supply Co. of the Northwest Inc Not California Korthwest Cork & Asbestos Inc. - Ho Record Armstrong Cork Co. 638141-1-5770 Travelers Insurance Co. Policy Policy RUB 638141-1-5770 1-1-54 1-1-55 638141-1-5770 Sead At Tig ete Le thines Gane vinta Vere eee Coast Insulating Products A Corp. Argonaut Insurance Co. ... Policy 86736 Policy 95792 5-1-55 5-1-56 Pacific Employers Ins Co. Policy 15163 5-1-57 Insulation & Asbestos Industry Works or North Fund Local No. 16 - No Record California Vacation Trust Muldoon Company Industrial Indemnity Co. Policy 503004 7-1-56 Owens Corning Fiberglass Aetna Casualty " Corp. & Surety Co. " Policy Policy Policy 822 879 926 9-1-56 9-1-57 9-1-58 Wm Thomas Tuck - No Record Dan Caw : Industrial Indemnity Co. || Policy 208831 Policy 216623 4-21-57 4-21-58 . Thos C. Douglass Jr. Douglass Insulation Co. U.S.Fidelity & Guaranty Co. Policy 1065 6-19-57 Armstrong Contracting & Supply Co. Travelers Insurance Co. " Policy 7226992 Policy 7768159 1-1-58 1-1-59 Harold G. Lorentzen Lorentzen Co. . 1-1-60 Industrial Indemnity Co. Policy 600054 Argonaut Insurance Co. Policy 53569 1-1-59 " Policy 6879 1-1-61 pers ae W.HofeTrh > a ow WORKMEN'S COMPENSATION APPEALS BOARD STATE OF CALIFORNIA . 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 JOHN WYSS VS (ol. \~ 7 Applicant Applicant 7 MUNDET CORK COMPANY and AETNA CASUALTY & SURETY COMPANY et al Defendants CASE NO 62 OAK 7422 OPINION and ORDER Compromise Approving Compromise Compromise Release Reconsideration was granted herein and returned to the calendar for further hearing on the issue of proper parties defendant A hearing was held and thereafter the parties filed a proposed settlement agreement providing for a lump sum payment to applicant in the sum of 6,500.00 less attorneys fees and costs and further providing that applicant shall assume unpaid and future medical and hospital expense We find from the record and the settlement agreement that no part of the proposed settlement sum is attributab.lteo temporary disability indemnity It is the opinion of the Workmen's Compensation Appeals Board that the Compromise and Release Agreement is adequate and in the best interests of the parties and therefore should be approved Applicant's attorneys have rendered services herein of the reasonable value of 650.00 and have advanced litigation costs in the sum of 47.00 on behalf of applicant For the foregoing reasons IT IS ORDERED that the Compromise and Release Agreement filed herein on March 8 1966 be and the same hereby is APPROVED payable in the manner and by the named parties as follows 1AC FOR 309 55413-9541.55 55413-9541.55 024 OSP ears NO 2 Be 2 3 4 10 6 10 11 12 13 14 a To Surety sum of 2,499.55 2,499.55 applicant John Wyss Company the sum of Aetna Casualty & 2,499.55 less the 697.00 payable to Smith Parrish Paduck & Clancy for attorneys fees and costs veveres 2,499.55 b To applicant John Wyss by the following State Compensation Insurance Fund .... ceee sence .1,2 429.34 429.34 Plant Rubber & Asbestos Works , a corporation . .790.09 Pacific Employers Insurance Company wee .158.01 Industrial Indemnity Company bon eeeeev ones .215.48 .215.48 .215.48 Argonaut Insurance Company ve aeeseeveses .581.80 Fireman's Fund Insurance Company coerce ..129.29 ..129 .29 ..129.29 Travelers Insurance Company bce ee eee 6 .603.34 Ocean Accident & Guarantee Corp. Ltd.cece ese .43.10 .43.10 United States Fidelity & Guaranty Company ..25.00 Employers Mutual Liability Insurance Company of Wisconsin coer eevee eee svase we ee .25.00 15 TOTAL 6,500.00 16 17 18 WORKMEN'S COMPENSATION A, PPEALS BOARD Zo ad 19 CVA 2 6 20 21 G.B. Boardman 22 G.B. Boardman Boardman Boardman 23 Calis 24 Dated at San Francisco Calis 25 26 Lug 26 27 Service by mail to all parties as shown on Official Address Record WYSS 28 620AK7422 Opn & Ord |! Appr & 30 IAC FORM 339 55413-3029.65 55413-3029.65 M aS OSP Ky 2 Lb ens, COMPENSATION APPEALS BOARD -WORKMEN'S 1 STATE OF CALIFORNIA 0 a | f ^' 3 . ra / a ( : CASE NO 4 | JOHN WYSS / Applicant / 5 , f VS 6 CORK COMPANY and AETNA 7 MUNDET COMPANY et al CASUALTY & SURETY 8 9 10 Defendants ; . / 62 OAK 7422 11 12 13 12/66 case 14 15 16 17 18 19 2 2 2 2 24 25 26 to returned was granted herein and the case Reconsideration hearing on the issue of proper parties the calendar for further filed a A hearing was held and thereafter the parties defendant for a lump sum payment to providing proposed settlement agreement fees and costs in the sum of 6,500.00 6,500.00 less attorneys 6,500.00 applicant shall assume unpaid and future applicant and further providing that record the and We find from the medical and hospital expense sum settlement that no part of the proposed settlement agreement disability indemnity is attributable to temporary Board of the Workmen's Compensation Appeals It is the opinion is adequate and in the and Release Agreement that the Compromise should be approved of the parties and therefore best interests herein of the have rendered services Applicant's attorneys litigation costs in reasonable advanced value of 650.00 and have the sum of 47.00 on behalf of applicant 27 28 29 30 For the foregoing reasons 3 and Release Agreement filed | IT IS ORDERED that the Compromise be and the same hereby is APPROVED herein on March 8 1966 named parties as follows in the manner and by the payable FORM 339 339 1AC att? wuaty CSP re | 1 1 2 3 4 07 10 11 12 13 14 15 16 @mers Aentnoat a To applicant John Wyss Casualty & 2,499.55 2,499.55 Parrish Surety Company the sum of 2,49.25 ,499.55 Smith less the Paduck sum of 697.00 payable to fees and costs .. eees wee ee & Clancy for attorneys 2,499.55 b To applicant John Wyss by the following State Compensation Insurance Fund .1,429.34 Plant Rubber & Asbestos Works a corporation 790.09 Pacific Employers Insurance Company wo .158.01 .158.01 Industrial Indemnity ..215.48 Company weeneee cote ..215.48 .581.80 Argonaut Insurance Company cee ee ee Fireman's Fund Insurance Company son Armstrong Paveles only Travelers Insurance Company woes Ocean Accident & Guarantee Corp. ~ Ltd. . .43.10 United States Fidelity & Guaranty Company ..25.00 Employers Mutual Liability Insurance Company of Wisconsin cec Compant y ..25.00 ..25.00 a - TOTAL -6,-500.00 17 18 WORKMEN'S COMPENSATION APPEALS BOARD 22 Cva i Mg o ' 20 21 Schvin Jemelly 2 2 G.Schvin Boardman 2 2 pCaarltifioersnia 26 Dated at San Francisco 26 APR APR Service by mail to all as shown on Official Address Record 27 28 620AK7422 620AK7422 Opn & Ord Appr R 30 JAC FORM 339 53413-502 9-43 43M CSP at i aye i Claimant ou. John Wyss Wyss MundetCork mie . Plant Rubber and Asbestos : _ ArmstrongCork - _ Owens OwensCorninCgorning Corning . 0 pe NL a Ae RAR EE me California Date 1/10/62 1/10/621/10/62 ae ec ce NN Jc cE TO ~ ndusifialArcidunt C mission RECEIVED RECEIVED vs JA 1 0 1 N 96 Oakland OffiOfcfiece pieatlspao e EERIE CT EEE . STATE OF CALIFORNIA INDUSTRIAL ACCIDENT COMMISSION APPLICATION Relations Department of Industrial Relations Relations Division of Industrial Accidents FILED JAN 11 1962 FILE SIGNED ORIGINAL AND SIX COPIES PLEASE PRINT OR TYPE NAMES AND ADDRESSES CASE NO Oakland Office DCAK DCAK 7422 _ JOHN WYSS -- -- ------<--fl--- VS. Mundet Cork Co. and many others Aetna Casualty & Surety Co. 507 Capp Street ow APPLICANT SANDOES36 SANDOES36 San Francisco California . Social Security No. _558-01-3502 __440 Brannan Street0 San Francisco California 220 Montgomery Street San Francisco California JOHN WYSS 1 NAME OF EMPLOYER 10/14/99 1961 10 Nov. , alleges that while employed on . * DATE OF INJURT DATE OF BIST asbestos worker 11 OCCUPATION AT TIME OF INJURY at. places variousplaces CITY TOWN OR WHERE INJURY OCCURRED , California by Mundet Cork Co. ..... NAME OF EMPLOYER he sustainedinjury arising out of andin the course of the employment as follows ., - -- Exposure dust foreign many pars to substances EXPLAIN NOW INJURY WAS RECEIVED -- - resul- t- ing in - chest disability STATE WHAT PARTS OF BODY WERE INJURED AND SUBSEQUENT REBULTS Aetna Casualty SuretyCo. 2 WHETHER INSURED NANE OF INSURANCE COMPANY OR IF & EMPLOYER EMPLOYER WAS NOT INSURED STATE WHETHER a. was SELP OR UNINSURED the employer's insurance carrier on date of injury Nov1e 0 1m 961b to e presr ent 3. PERIODS OFF WORK DUE TO THE INJURY DATE INJURED RETURNED TO WORE DATE LAST NEDICAL FURNISHED 4. Was compensation paid 5. Earnings at time ofinjury no TED OR KO $ TOTAL PAID .. m ax_ @ ne eee MONTH OR WEEK ee $ WEEKLY RATE an DATE OF LAST PATMIRY The basis of STATE pay was a PAY PERIOD OR HOURLY RATE HOURS & DAY AND DAYS & WILK 6. Was medical treatment needed JesJes YES OR NO Who furnished treatment --- self self ee GIVE MARKS OF DOCTORS WHO TREATED THE INJURY AND STATE WHO PAIN THEIR BILLS 7. This application is filed to determine liability for a Temporary disability yes TES OR MO disability b Permanent YES OR RO Medical treatment ... yes YES OR NO d Medical costs a=: YES OR NO e Litigation expense f YES OR NO STATE ANY OTHER REASON 59 13CA4SE5 I. OAK LIST NUMBERS OF ANY OTHER APPLICATIONS FILED WHEREFORE it is requested that a time and place be fixed for hearing and that an awerd be California Oakland proper under the Workmen's Compensation Compensation Laws of Dated at_ Oakland -_, California CITY 7 made granting such relief as may be 1962 January .._ DATE CITT Number of witnesses Today Today Today Estimated time of trial Today Today Today Today . , A. APPLICANTS APPLICANTS SREATURK PARRISH, PADUCK & CLANCY Oakland California Financial Center Oakland 12 a Tatas waAcbeh es os IPHONE IPHONE Building garding various the listed TTT TT employers eee mee Coen Company - No Record me Mundet Cork Corp. - No record prior to Aetna Casualty & Surety Co. " It 11 1 tt ... + 12-31-39 Folicy 10-110500 12-31-39 Policy 10-10000 12-31-40 Policy 20200 12-31-45 Policy 1-032100 12-31-46 Policy 1-044800 12-31-47 Policy 1-044800 12-31-45 Policy C70600 12-31-49 Policy C6720 12-31-52 Policy C23413 12-31-60 Plant Rubber & Asbestos Works - No Record R. W. Giddings Supply Co. - No Record Bay Cities Asbestos Co. Ltd. - No Record Western Asbestos Co. State Compensation Ins Fund Standard Asbestos Co. - No Record Folicy 93224 1937 through 1962 #3 Warren & Bailey Co. - No Record J. T. Thorpe & Son Employers Pacific Inc. " Ins Co. ; Policy 59886 Policy 70781 9-30-38 39 10-1-39 10-1-39 Industrial Indemnity Co. Policy 100021 1-1-55 Plant Asbestos Company - No Pacific Employers " record prior to 10-1-39 Ins Co. Policy 70782 Policy 71790 10-1-39 10-1-40 It Policy 76945 1-1-48 " Policy 51378 1-1-49 Industrial Indemnity Co. Policy 100654 1-1-56 " Policy 608056 1-1-59 Lish Corp. - No Record E. B. Badger & Sons Co. - No Record Harry A. Dutton Jr. Dutton Asbestos Co. - Ho Record Van Arsdale Harris Lumber Co. Inc. - No Record Richmond Shipbuilding Corp. - No Record Western Precipitation - No Record Permanent ctals Corp. - No Record G. R. Dutton & C. A. Leighton et al Western Fiberglass Supply Ltd. - No Record Lorentzen Co. - No Record Asbestos Supply Co. of Seattle - No Record Racoma Asbestos Co. Charles R. Brower & E. E. Saberhagen - No Record Metal Clad Insulation Co. Inc. - No Record Jamar & Olman Co. - No Record Forest Chas R. Brower & Co. E. E. Saberhagen & E. \ - No Record The E. J. Bartells Co. Partelle Cutual Casualty Co. Charles Ayers Co. - Eo Record Policy 224680 224680 Policy tg tte Ve 10-1-52 10-1-52 ' gare wT AEST - 1. Fiberglass Engineering & Supply Co. of the Northwest , Inc Not California Northwest Cork & Asbestos Inc. - No Record Armstrong Cork Co. Trevelers Insurance " 1 Co. Policy Policy ro. 318-643814 3386210 4490459 3183-18-6643814433188-61438414 ' 1-1-54 1-1-53 1-3-57 1-3-57 Oakland California Coast Insulating Products A Corp. Insurance Co. Policy 86736 5-1-55 5-1-56 Argonaut 11 Policy 95792 Yee Ins Co. Policy 15163 5-1-57 Pacific Employers & Asbestos Industry Works or North Insulation Fund Local No. 16 - No Record California Vacation Trust Muldoon ComIpnadnuystrial Indemnity Co. Policy 503004 7-1-56 Owens Corning Fiberglass Corp. Aetna Casualty & Surety Co. ... Policy Policy Policy 822 879 926 9-1-56 9-1-57 9-1-58 Wm Thomas Tuck - No Record Dan Cav Indemnity Industrial Co. Policy 208831 Policy 216623 4-21-57 4-21-58 Thos C. DoU.uSg.lFaisdselJ itry. &DoGuugalraasnstyIC nsou.laPtoilonicyCo.1065 6-19-57 Armstrong Contracting & Supply Co. Travelers Insurance Co. 11 Policy 7226992 Policy 7768159 1-1-58 1-1-59 Harold G. : Lorentzen Lorentzen Co. Industrial Indemnity Co. Policy 600054 1-1-59 Insurance Co. Policy 53565 1-1-60 Argonaut " Policy 6879 1-1-61 nwa ee < " & as ? vg Bae ered % APPEALS BOARD COMPENSATION r WORKMEN'S WORKMEN'S COMPENSATION COMPENSATION on 62 OAK 7422 SASE NO. 3 4 ^' f : WYSS JOHN | 4 JOHN a , Applicant CASE 62 OAK 5 ve / 7 6 , and MUNDET CORK CCOMPANY OMPANY AETNA AETNA 7 8 CASUALCCATSUAYLTAY SUALTY Compromise . 3 Defendants ge 9 ; APR / . | | \ r \ 10 requrned to and the case herein 121 Reconsideration granted case returned to Reconsideration the issue | 5/2/66 defendant calendar further hearing on thereafter proper parties parties a, \ 5/2/66 14 held and to i filed ae was A hearing @ parties parties co r el4 proposed for agreement providing payment costs, payment settlement 15 applicant 6,500.00 less attorneys \ future further the sum of $ 6,500.00 shall unpaid and costs future 16 and that applicantapplicant and future 17 18 medical hospital the record We find sum the settlement agreement expense proposed proposed 18 settlement no part the that attributable 19 attributable disability indemnity poard the opinion temporary Appeats Compensation 20 is the Workmen's Workmen's Board Board the the the Compromise Compromise adequate and Agreement 21 parties Release approved the + best interests interests approved therefore 22 therefore attorneys have the of the attorneys pest Applicant's herein rendered in 23 650.00 nave costs costs reasonable advanced litigation 24 and behalf 47.00 on applicant 25 the of foregoing reasons For the foregoing 26 the Compromise Compromise ORDERED that filed Release Agreement filed IT i)ooy 1966 be and same APPROVED APPROVED APPROVED, 28 on March by the named the hereby follows follows: in manner manner parties follows 29 and by the payable an the manner 30 payable i \ i |339, IAG FORM | wate 57 i pa ose ae - 1 - 1 2 3 4 6 8 10 11 12 13 14 curs curs . 7 not not 2,499.55 John Wyss Aetna Casualty & a To applicant Surety Company the sum of 2,499.55 2,499.55 less the to Smith Parrish Paduck sum of 697.00 payable & Clancy for attorneys fees and costs eseeeceeeee 2+ 2,499.55 . b To applicant John Wyss by the following State Compensation Insurance Fund 1,429.34 Plant Rubber & Asbestos Works , a corporation .158.01 Pacific Employers Insurance Company Industrial Indemnity Company ..215.48 eee cececc cece ..215.48 ..215.48 Argonaut Insurance Company epee cence .581.80 Fireman's Fund Insurance Company 42 .129.29 | Travelers Insurance Company ..603.34 ..603.34 frutting frutting Ocean Accident & Guarantee Corp. Ltd. .43.10 United States Fidelity & Guaranty Company ..25.00 Employers Mutual Liability Insurance Company of WiscoMn utuas l ec i ern ensecsever seer eeeenee .25.00 .25.00 .25.00 15 TOTAL 6,500.00 16 17 18 19 - 20 COMPENSATION APPEALS BOARD WORKMEN'S 21 22 23 24 25 26 27 Dated at San Francisco California APR 4 Service by mail to all parties shown on Official Address Record WYSS 28 620AK7422 Opn & @rd Appr R 30 IAC FORM 339 5413.902 5413.902 9-63 63H oar 5413.902 ! ^'~ oS , PDL | 1 WORKMEN'S COMPENSATION APPEALS BOARD 2 STATE OF CALIFORNIA 3 4 5 i? | JOHN WYSS . So Q Applicant 6 VS . . 7 MUNDET CORK COMPANY and AETNA CASUALTY & SURETY COMPANY et al . 8 9 Defendants . CASE NO 62 OAK 7422 OPINION and ORDER Compromise Approving Compromise Release 10 11 12 13 14 15 16 17 18 19 2 2 22 23 24 25 N NN 28 29 30 Reconsideration was granted herein and returned to the calendar for further hearing on the issue of proper defendant A hearing was held and thereafter the parties filed a proposed settlement agreement providing for a lump sum payment to costs applicant in the sum of 6,500.00 less attorneys fees and and further providing that applicant shall assume unpaid and future medical and hospital expense We find from the record and the settlement agreement that no part of the proposed settlement sum is attributablteo temporary disability indemnity that It is the opinion of the Workmen's Compensation Appeals the Compromise and Release Agreement is adequate and in Board the best interests of the parties and therefore should be approved Applicant's reasonable value attorneys have of 650.00 and rendered services herein have advanced litigation of the costs in the sum of 47.00 on behalf of applicant For the foregoing reasons IT IS ORDERED that the Compromise and Release Agreement filed herein on March 8 1966 be and the same hereby is APPROVED payable in the manner and by the named parties as follows IAC FORM 329 55413.327-63 55413.327-63 CS4 OSP ers oa MAY S F 1 3 Pe 5 6 7 10 11 12 13 14 15 16 2,499.25,5499.55 a To applicant John Wyss the sum of Aetna Casualty & 2,499.55 less the Surety Company to Smith Parrish Paduck sum of 697.00 payable and costs 2,499.55 & Clancy for attorneys fees b To applicant John Wyss by the following State Compensation Insurance Fund wee 1,429.34 1,429.34 Plant Rubber & Asbestos Works a corporation Pacific Employers Insurance Company eeae Industrial Indemnity Company 158.01 . 215.48 Argonaut Insurance Company ce cceeeeseeeecccee . 581.80 Fireman's Fund Insurance Company woe eee Travelers Insurance Company beeen es Ocean Accident & Guarantee Corp. Ltd. + ..129.29 .603.34 .43.10 United States Fidelity & Guaranty Company . ..25.00 ..25.00 Employers Mutual Liability Insurance Company of Wisconsin cseeeree- sneer enenenee ae neee ... .25.00 TOTAL 6,500.00 17 18 WORKMEN'S WORKMEN'S COMPENSATION APPEALS BOARD 19 20 21 22 23 26 24 Dated at San Francisco CalCaliforinia fo> rnia 25 t 26 27 Service by mail to all parties WYSS 28 620AK7422 Opn & ord Appr & 30 /As shown on Official Address Record 1AC FORM 339 43.32 9-45 63M et 037 pet an Wey SM eu tem oe tab 2 BEFORE THE INDUSTRIAL ACCIDENT COMMISSION OF THE STATE OF CALIFORNIA CLAIM NO 62 OAK 7422 ee Mah lH No ee et ee ee . . , N MITTYEN MITTYEN YEAR YEAR YEAR ONE ONE NOTICE NOTICE ALS ALS PPAARRTTIIE ES S You You buy harby nood'ied harby nood'ied that that that furthering furthering furthering in tho entitled action p furthering furthering furthering i i be be held held held State Building Jason Street Californiae QAMOQNESPERATION QAMOQNQAMOQNESPRATIONEQASMOQNESPERATPION QAEMOQNESRPERATIAON TQAIMOQNEOSPERNATION Ref.no 9:00 AM Befo ( ALL DAY 8 at lu Tahtend A 2 IND WAT ACCID GER Cao - A RD P1 OCT 22 1965 JOIN JOINJOIN JOIN WYS5WYS5 WYS5 t CasCe ase Case Case No. No. 6262 CCAKAK 2 yar 01. 01. 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San FranciscForancisco ate 94104 3 A . wes BEFORE THE INDUSTRIAL ACCIDENT COMMISSION OF THE STATE OF CALIFORNIA CLAIM NO 62 OAK 7422 rot NOTICE NOTICE NOTICE TO TO ALL P PA AR RT TI IE ES S * heraby heraby ores : sae Poe a <4 oe Oe ee ~ eat - haling - furthai furthai haling si't si't be held held held Austt ~ December 1965 my ak DELITION DELITION DELITION DELITION DELITION Ve , Bee sd hot ' ra ( ALL DAY 2 - y ty \ a a 9 ey R t All 107 : 1220 . of} OCT 22 1965 FinancialHighlands Highlands leke Blog.Dakland Blog.DaklandBlog.Dakland Blog.Dakland HighlandsHighlands Highlands leke County County P P Financial Center Blog.Dakland Blog.Dakland Blog.Dakland Blog..DaklandBlog..DakBlalndog..Dakland ae w t rish rish racuck racuck racuck Financial Finacial Francisco Francisco Francisco Company Company Co. Iranan Montgomery Montgomery Stret Blog.Daklnd Blog.Daklnd Stret SanSan Company Company Company Company Irannan Irannan Irannan Irannan Street Co. Co. , San Montgomery Montgomery Montgomery Street , Francisco FranciFsrcoanciscoFranciscForancisco FranciscoFrancisco Francisco 220old 100 MontgomeryMontgomery Strst Stret Aeons 100 Bush Strst ntold 100 Strst Strst Strst > S Sodge Sansome SansomeSansome San Pine Strel Sansome Strel Strel Indust Pine Strel Strel Francisco Francisco San Franciscu Pecific Franciscu Franciscu Franciscu Franciscu Golden Gato Golden 525 GoldenGolden Franciscu Stret Stret San Francisco Montgomery Montgomery Montgomery Street Street Francisco Francisco Francisco Francisco Francisco Francisco Francisco Montgomery 315 Ltd. Ltd. Ltd. Francisu 7217217 Francisco Francisco Wisconsin SanSan Francisco Francisco Francisco Wisconi Box San Franciscs 132 PinePine Stre tStreet Street San San Strau Street Caland Caland FranciscsFranciscsFranciscs FranciFscrsanciscsFranciscs Franciscs Franciscs StretPine Caland Francisco Street Francisco Stret CaliSftorrneiaFtrancisc Francisc Rar Rar - Suter Francisco Rar Stre t ArcnuAercnue Street Sutter , California CaliforniaOakland Francisc StreetStreetStreet Oakland Francisc Francisc Street Can CanCan FrenkisesFrenkisesFrenkisFersenkises Frenkises Frenkises FrenkiFsers enkises San Francisco Francisco Francisco Francisco Francisco Francisco Francisco Francisco Francisco 537 537 TownsendTownsend Asbestos Stre t Asbestos Bal er Bryant Second Baller Ocean 64th 64th Pitts Achaston Achaston Achaston Achaston etal etal etal etal , dha Western Western Western Western Francisco Francisco Francisco Francisco NorthweNstorthwest Inc. Northwest Inc. Inc. , of NorthwestNorthwest Oregon Oregon Portland Oregon Oregon Strects Strects Strects , Strects Strects Strects Lancast Lancast Lancast Lancast vy vt G Tid Tid Tid .. PenPnennPenn , i wt FilippiFilippi , wo f 31546 2257 2257 fee o aoe . 315 Montgomery Street SanSan San Francisco Francisco FranciscoFranciscForanciscFroancisco Francisco tt FO 8 av t. . 4 ' cm ae --ryWe 94104 94104 94104 94104 sern me Temsme fl a * _ ' . fl fl . x fl \ } fl fl ' CCIDENT CCIDENTCCIDECNCTIDENTCCIDCENCTIDENTCCIDENT OC OC MISSION MISSION MISSION MISSION MISION MISSION MISIONMISSION OF OF THE THE THE THE THE STATE STATE STATE STATE STATE OF CALIFORNIA CALIFORNIA CALIFORNIA CALIFORNCIA LIFORNIA CALIFORNIA CALIFORNIA GIAIY GIAIY GIAIYGIAIY GIAIY NCNC NAK NAK NAK NAK NAK 7 nt NAK Appl^r Appl^r : so . a Nt434 aoa|ai ey ~ i j . . eo te r : a. sed PHIT PHIT PHIT . . . an a . otTread uwtany Re ~ ~ = 2 ~ 7 t i. Pore) ao : +~ : : 7.0 : : . * saan-~ fo - - . - . - 2 ~~ SetoF en fe o 4 oe G O - . _ : tes . . 4 4 t *. oa ve . ; os ae July July July 28th 28th 1955 1955 JOHN WYSS - Cast No. 62 OAK 7422 Box John Wyss P. O. Box 913 Clear Lake Highlands Lake County Smith Parrish Paduck & Clancy Financial Center Oakland 94612 Mundet Cork Company 440 Brannan Street San Francisco Aetna Casualty & Surety 220 Montgomery Street San Francisco Sedgwick Detert & Arnold Bush Street San Francisco Industrial Indemnity Company Sansome Street San Francisco Pacific Employers Insurance Co. 244 Pine Street San Francisco State Compensation Insurance Fund Colden Gate Avenue San Francisco Ocean Accident & Guaranty Inc. Litd Montgomery Street Francisco Mutual Liab.Ins Co. Wisconsin 7847 San Francisco Employers Fireman's Fund Insurance Company 332 Pine Street San Francisco Travelers Insurance Co. 1956 Webster Street Oakland Argonaut Insurance Co. 550 California Street San Francisco U.S. Fidelity & Guaranty Co. 444 California Street San Francisco Base & Broby 3540 San Pablo Avenue Oakland Taylor Ersbeck State Plant Souson Street Ser Precisco Harrison 113 Employment Sutter Street San Francisco Box Rincon Annex Francisco Astaston Works 537 Brannan Street San Francisco Bay Westorn Westorn Standard Standard Standard Westorn Standard Warren & Asbestos Co. Ltd. o Western Asbestos Co. Company 675 Townsend Street San Francisco Asbestos Company 450 Bryant Street San Francisco Bailey Co. 193 Second Street Sar Francisco J. T. Thorpe & Son Inc. 1351 Ocean Avenue Emeryville Plant Asbestos Company 1300 - 64th Street Emeryville E. B. Badger & Sons Company Pitts Street Boston Massachusetts Harry A. Dutton Jr. Dutton Asbestos Co. Natoma Street Francisco Van Arsdale Harris Lumber Inc. & Brannan Streets Francisco Coast Insulating Products 2016 San Fernando Road Los Angeles Richmond Shipbuilding Corp. Box 1072 Richmond Western Frecipitation 1016 W. Ninth Street LosAngeles Permanent Metals Corp. Box 1072 Richmond G. .. Dutton & C.A.Leighton Western Fiberglass Supply Ltd. 739 Bryant Street San Francisco Charles Ayers Co. 698 Minnesota Street San Francisco Fiberglass Engineering & Supply Co.of the Northwest Inc. 416 Northwest Glison Street Portland Oregon Armstrong Corl Company Liberty & Charlotte Streets Lancaster Penn 89 Muldoon Company 1537 Thesta Fresno Owens Corning Fiberglass Corp. Box 89 Santa Clara Dan Caw dta Caw Insulations 3600 * 20th Avenue San Francisco Thomas C. Douglass Jr. dha Douglars Insulation 337 Irwink Strect San Francisco Armstrong Contracting & Supply Co. Lox 1540 Lancaster Harold G. Lorentzen 2257 Market Street Oakland Penn a COMISSION COMISSION COMISSION COMISSION COMISSION COMISION COMISION COMISSION OF OF THE THE THE STATESTATESTATE STATE STATE OF CALIFORNIA CALIFORNIA CALIFORNIA CALIFORNIA erd pa pe oy we ids Building Building Building 6 mee wires roa 4 we JOHN WYSS - Dest No. 62 OAK 7422 John Wyss P. O. Box 913 Clear Lake Highlands Lake County 94612 Parrish Paduck & Clancy Financial Center Oakland Mundet Cork Company 440 Brannan Street San Francisco Aetna Casualty & Surety 220 Montgomery Street San Francisco Sedgwick Detert & Arnold Bush Street San Francisco Industrial Indemnity Company Sansome Streat San Francisco Pacific Employers Insurance Co. 244 Pine Street San Francisco Francisco State Compensation Insurance Fund Golden Gate Avenue San Francisco Ocean Accident & Guaranty Inc.Co. Montgomery Street Francisco Employers Mutual Liab.Inc.Co.of Wisconsin 332 Pine Box 7647 San Francisco Street San Francisco Fireman's Fund Insurance Company Travelers Insurance Co 1956 Webster Street Cakland Insurance Co. 550 California Street San FrancisFrancisonon Argonaut U.S. Fidelity & Guaranty Co. 444 California Street San FrancF isco rancisco Hanne & Brophy 1540 San Pablo Avenue Cakland Taylor & Porter 233 Sansome Street San Francisco Phleger & Harrison 111 Sutter Street San Francisco State Department of Employment Box Rincon Annex San Francisco Plant Rubber & Asbestos Works 537 Brannan Street San Francisco Bay Cities Asbestos Co. Ltd. / Western Asbestos Co. Western Asbestos Company 675 Townsend Street San Francisco Standard Asbestos Company 450 Bryant Street San Francisco Warren & Bailey Co. 198 Second Street San Francisco J. T. Plant Thorpe & Asbestos Son Inc. 1351 Company 1300 - Ocean Avenue Emeryville 64th Street Encryville E. B. Badger & Sons Company Pitts Street Massachusetts Harry A. Dutton Dutton Asbestos 532 Natoma Street Francisco Van Arsdale Harris Lumber Inc. & Brannan Streets Francisco Coast Insulating Products 2316 San Fernando Road Los Angeles Richmond Shipbuilding Corp. Box 1072 Richmond Western Precipitation 1016 W. Ninth Street LosAngeles Permanent Metals Corp. Box 1072 Richmond G. R. Dutton & C.A.Leighton etal Western Fiberglass Supply Ltd 739 Bryant Street San Francisco Charles Ayers Co. 698 Minnesota Street San Francisco Fiberglass Engineering & Supply Co.of the Northwest Inc. 416 Northwest Glison Street Portland Oregon Armstrong Cork Company Liberty & Charlotte Streets Lancaster Penn Muldoon Company 1537 Thesta Fresno Owens Corning Fiberglass Corp. Box Dan Caw dba Caw Insulations 3600 = 9 Santa Clara 20th Avenue San Francisco Thomas C. Douglass Jr. dba Douglass Insulation 337 San Francisco Armstrong Contracting & Supply Co .. Box 1548 Lancaster Harold G. Lorentzen 2257 Market Street Oakland- Lancaster Penn INDUSTRIAL ACCIDENT COMMISSION STATE OF CALIFORNIA WBH. WBH JOHN WYS3 oo _ 7 ; \ fi Applicant VS. MUNDET CORK COMPANY and AETNA CASUALTY & SURETY COMPANY at al W.L.H. DEC 3 1962 NOTICE OF HEARING Defendan_t* You are hereby notified that an application for compensation 1 copy of which is attached bereto has been filad with the Industrial Accident Commission of the State of California You are further notified that said application has been set for bearing at 3000 STATE BUILDING December 18th 1111 JACKSON STREET OAKLAND CALIFORNIA 9:00 A.M. ALL DAY Before Huff and that at mid time and place the Industrial Accident Commission of the State of California will proceed to hear and dirpoes of the mid application in the manner prescribed by kw Nors The parties are anyecsed to subasit s^besar in outreverry for dreisina at this hosting thereforalel mommary vitnasts vitnasts evidno document Dated OAKLAND CALIFORNIA oo INDUSTRIAL ACCIDENT COMMISSION By Assistant Secretary The undersigned certifies that as an employee of the Industrial Accident Commission she served the foregoing notice on the parties hereinafter mentioned at the time set opposite their respective names by depositing a copy of said notice artached to a copy of the application therein mentioned in a sealed envelope in the United States mail on said day at Oakland California with the postage thereon fully prepaid and addressed to the said parties at their last known places of business of romi as d fola lown s tc o we it NAME AND ADDRESS OF PERSONS SERVED DATE ALL PARTIES LISTED IN ATTACHED APPLICATION ee ere BEFORE THE INDUSTRIAL ACCIDENT COMMISSION OF THE STATE OF CALIFORNIA Cese No. 62 OAK 7422 JOHN AYDE Applicent MINLFT CORK COMPANY anj AETNA CASUALTY AND SURETY CONANY CONANY etal - Order Joining Party Defendant Defendants Good Cause Appearing Therefor IT IS HEREBY ORDERED THAT ALL PARTIES LISTED IN ATTACHED APPLICATION be joined as a party defendant in the above entitled cause Referee Cley , Huff INDUSTRIAL ACCIDENT COMMISSION oo 4 ATLANTA BALTIMORE CHICAGO CLARKSBURG LOS ANGELES MIAMI MONTREAL NEWARK NEW ORLEANS NEW YORK PHILADELPHIA PITTSBURGH SAN FRANCISCO ST LOUIS TORONTO TULSA ALEXANDER & ALEXANDER INCORPORATED INSURANCE AVERAGE ADJUSTERS CONSULTING ACTUARIES 2225 NORTH CHARLES STREET BALTIMORE MD 21218 February 25th 1964 TELEPHONE TUXEDO 9-4304 CABLE ADDRESS ALEXBLUE \ \ / * i Insurance Department Armstrong Cork Company develops f NG A . Lancaster Pennsylvania Gentlemen re / Joan Wyss B9850928 & B 9850941 Steve Gilivich B B 9850942 and 9850927 WORKMEN'S COMPENSATION the two enclose We have received a status report in connection with captioned cases from the Travelers Insurance Company and herewith two copies of their letter of February 18th 1964 which will be found self explanatory Letter filed filed filed under . under Gilivich It would appear that the Steve ready to be closed out closing report from the We will advise Travelers you Gilivich case is about when we have a final States Gilivich no in in Sincerely developments ALEXANDER & ALEXANDER INC Wyss Wyss LC. Flick Flick in G.. H. Finlay GENERAL ADJUSTER Before the Industrial Accident Commission of the State of California Case OAK 7422 JOHN WYSS Applicant vs MUNDET CORK COMPANY and AFTNA CASUALTY & SURETY COMPANY et al ORDER TAKING OFF CALENDAR 12/20/82 12/20/82 Defendant B Inasmuch as the applicant's pleading was not proper and and the case 23 not ready for presentation GOOD CAUSE APPRATING THETFOR IT IS HEREBY ORDERED That the above entitled matter bx and the same hereby is taken off calendar and all further action on the matters now pending herein suspended subject to being react after notice upon request of any of the parties hereta OLH ty ACCIDENT Sheol dM Sie NUFA LLB INDUSTRIAALCCIDENT COMM^ SI^COMNM^ SI^ N SEAL DATE FILED AND SEAVED ON ALL PARTIES AS SHOWN ON ATTACKED LIST 12-20-t6v2 JOHN WYSS - Case No. 62 OAK 7422 - ORDER TAKING OFF CALENDAR John Wyss 507 Capp Street San Francisco Calif Smith Parrish Paduck & Clancy Oakland 12 Calif 315 Financial Center Building Munde--- Cork Company 440 Brannan Street San Francisco Calif Aetna Casualty & Surety Co. 220 Montgomery St. San Francisco Calif Sedgwick Detert Moran & Arnold 100 Bush St. San Francisco Calif Industrial Indemnity Company 300 Grand Ave. Oakland 10 Calif Pacific Employers Insurance Co. 244 Pine St. San Francisco Calif State Compensation Insurance Fund San Francisco Calif 525 Golden Gate Ave. Ocean Accident & Guaranty 315 Montgomery St. San Francisco Calif Employers Mutual Liability 114 Sansome St. Insurance Company of Wisconsin San Francisco Calif Hardware Mutual Casualty Co. 20 Battery St. San Francisco Calif Travelers Insurance Co. 1956 Webster St. Oakland Calif Argonaut Insurance Co. 550 California St. SannFrancisco Calif U. S. Fidelity & Guaranty Co. 444 California St. San Francisco Calif Hanna and Brophy 1540 San Pablo Ave. Oakland 12 Calif Brobeck Phleger & Harrison 111 Sutter St. San Francisco Calif State Department of Employment P. O. Box 3534 Rincon Annex San Francisco 19 Calif Coen Company 915 Bryant Street San Francisco Calif Mundet Cork Corp. 7101 Tonnelle Ave. North Bergen New Jersey Plant Rubber & Asbestos Works 537 Brannan St. San Francisco Calif Plant Rubber & Asbestos Works 1300 - 64th St. Emeryville Calif Bay Cities Asbestos Co. Ltd. / Western Asbestos 675 Townsend St. San Francisco 3 Calif Company Western Asbestos Company 675 Townsend St. San Francisco 3 Calif Western Asbestos Company J. T. Thorpe & Son Inc. P. O. Box 3784 Rinoon Annex San Francisco 1351 Ocean Ave. Emeryville Calif Plant Asbestos Company 1300 - 64th Emeryville 8 Calif E. B. Badger & Sons Company 75 Pitts St. Boston Massachusetts Harry A. Dutton Jr. Dutton Asbestos .San Francisco Calif Co. 532 Natoma Street wo. h rt YM - n Ba Sg Ee hoe NT NE NE DAY DAY of Soe FE wit RE TAKING TAKINTAG KING PPHHA A PHA INDAY INDAY yee TY o Ne MPern Seo wt lp mae? Rat lo oy, 201 Sw Nooan . neh atl, 5 Anvels Call Call Astest PORT RAS AMC ToL. Bayan Bayan Bayan Bayan Metal Metal Metal Metal AL. ~ aoap Western . Western Western Western byn byn , -- O27 10. tme oars AlmarAlmar teny he 1. Paty Grower Grower 114 Virginia and and and th .. Virginia 8. 8. vey ~ Toe Fad nae RC, ^> orth Hardin Ave Onicato pL Tab 19 b . attle attle ) Washington PePhineat PePhineat PePhineat PePhineat Ave. Ave. South South South Beattle Beattle Beattle Beat le Beattle 8, aunt ton eet es Aye Company Minnesota San Francisge leS Rtesn way eS pore q kia ti. erk La we 207 207 a. Norn T po we u gs t va eb y 3.18 3.18 as many many . th,, of of Northwest the Northwest Portland Oregon Oregon Oregon Nreieor y ow hoa wessr Jork Jork juodona Ave. juodona Ave. ") Cabin, nc ee Tancat er Tancatter 6 Nort Cjerreni Cjerreni : . sor re ' Sana oa am. ote . Thick Ue, bye Ney Thick Tuck's Tuck's , Sappej oe at . . . Tuck's Tuck's Sappej co... Son 1 letra, a COW COW Sew Sew Insulations Insulations Insulations Insulations ) ) - gh gh ARG en - Mas : : . rs rea cof Via. ~ tra Uy ret, * oa + ee ; Before the 61 inaustrial inaustrial Accident Accident Commission Commission the State of California California sce TENNe Apbiti Apbiti ant STARTY COMPANY Laj Laj Le ESE Defaminat one tm 12/20/62 12/20/62 12/20/62 Blasmuch as The The with Heading * TOMER SO aye : lar, nut SINE 41 uns F * AUNG AFREAKING AFREAKING THERING THERING THERING . Last yee ... we mkar mkar That the abov entitied master the and the same hereby the matters matters cae pending pending beren beren enjenrod enjenrod enjenrod tanke sequenot sequenot sequenot sequenot sequenot shy shy on the pa beteta beteta lake ) can ' to.^' c r alae Gg LGD / Salad TATS FILE AND SERVEN ON ALU ALU a 1 ee ee ne ed John Wyss 507 Capp Street San Francisco Calif Smith Parrish Paduck & Clancy Oakland 12 Calif 315 Pinancial Center Building Mundes Cork Company 440 Brannan Street San Francisco Calif Aetna Casualty & Surety Co. 220 Montgomery St. San Francisco Calif Sedgwick Detert Moran & Arnold 100 Bush St. San Francisco Calir Industrial Indemnity Company 300 Grand Ave. Oakland 10 Calif Pacific Employers Insurance Co. 244 Pine St. San Francisco Calif State Compensation Insurance Fund San Francisco Calif 525 Golden Gate Ave. Ocean Accident & Quaranty 315 Montgomery St. San Francisco Calif Employers Mutual Liability Insurance Company of Wisconsin 114 Sansome St. San Francisco Calif Hardware Mutual Casualty Co. 20 Battery St. San Francisco Calif Travelers Insurance Co. 1956 Webster St. Oakland Calif Argonaut Insurance Co. 550 California St. Francisco Calif U. S. Fidelity & Quaranty Co. 444 California St. San Francisco Calif Hanna and Brophy 1540 San Pablo Ave. Cakland 12 Calif Brobeck Phleger & Harrison 111 Sutter St. San Francisco Calif State Department of Employment P. O. Box 3534 Rincon Annex San Francisco 19 Calif Coen Company 915 Bryant Street San Francisco Calif Mundet Cork Corp. 7101 Tonnelle Ave. North Bergen New Jersey Flant Rubber & Asbestos Works 537 Brannan St. San Francisco Calif Plant Rubber & Asbestos Works 1300 - 64th St. Emeryville Calif Bay Cities Asbestos Co. Ltd. / Western Asbestos Company 675 Townsend St. San Francisco 3 Calif Western Asbestos Company 675 Townsend St. San Francisco 3 Calif Western Asbestos Company P. O. Box 3784 Rincon Annex San Francisco J. T. Thorpe & Son Inc. 1351 Ocean Ave. Emeryville Calif Plant Asbestos Company 1300 - 64th Emeryville 8 Calir E. B. Badger & Sons Company 75 Pitts St. Boston Massachusetts Harry A. Dutton Jr. Dutton Asbestos Co. San Francisco Calif 532 Natoma Street ypAYG Came Re OP 86 7422 = 05 ER TAKING TAKING OFF CALENDAR ft tert fal) eperr Teectporestor., 01- W. Ninth orl, cs Angeles Calif , te oe een Sy, poy Mewar ep Toy tem, F 31 teer Piberglass Piberglass lap Pranctoo , Calif Supply , . Asbests Asbests Supply Company tatale k of leathite, teen 25 First Ave. South oma Acb stos Com y, (etrie S ul wot wit ; te, , er & E. shingto Saberhagen Metal Clad insulati Ca.. one... : ., treme, Calif thar and Olman Company 320 North Harding sth Inlenge dy rrtoe Is hs R. -power and 5.,. 2. 114 VingirVii ngiri The ^" Rantells Co. 1212 Sixth AVL Nouth Seattle 4 Washington 53 Ayans ondary 400 Minnesota Sr., San Francifcc " Calif FiberglFaibersglas Engineering s 40 Northwest Pronly Clison Company of the Northwest St. Portland 7, Cres: Inc. Norinwest Norinwest Tork and Asbestos Inc 3615 Premont Ave. eattle 3 War Armstrong Donk Co. Liberty & Charlotte Sts Lancaster Pennsylvanta Insultation and - Trust Ascestos Industry Fund Local Number Works of North alifornia 5 200 Guerrent Un l. an Vacation Pranc doon Company 1537 Thesta Presno Calif Owens Corning Fiberglas Corporation F.G Box 29. Santa Clara Cal Wm Thomas Tuck Tuck's Supply fl. 469 Tunen'ne bane Fone Nevala Dan Caw Caw Insulations 3000 - 20th Ave. Sacramento v alt?, Thes . Douglass " ouglass insulation San Francisco , Calif o,, 47 iretn Street strong Contracting and spoly Langster Langster Pennsp Combaby P. Mew Univ, BALTIMORE NEW YORK CLARKSBURG TULSA ST LOUIS LOUIS CHICAGO LOS ANGELES ATLANTA PITTSBURGH SAN FRANCISCO NEW ORLEANS MIAMI PHILADELPHIA ALEXANDER & ALEXANDER INCORPORATED INSURANCE AVERAGE ADJUSTERS CONSULTING ACTUARIES 2225 NORTH CHARLES STREET BALTIMORE 18 MD September 11th 1962 TELEPHONE TUXEDO 9-4304 BELL SYSTEM TELETYPE BA 582 CABLE ADDRESS ALEXBLUE 9/12/22 Mr. Wallace B. Hofferth ty Assistant General Manager Insurance Department Armstrong Cork Company Lancaster Pennsylvania Dear Mr. Hofferth Wyss John Wyss Applicant v Mundet Cork Company 3/31/54 and Aetna Casualty and Surety Company Supplementing our letter of August 31st acknow- ledging we have receipt of papers in connection with the above case now received a letter from the Oakland California Office of the Travelers dated September 6th 1962 which reads as follows This is to acknowledge receipt of the Petition to Join Further Parties in the case of Armstrong Cork Company and Armstrong Contracting and Supply Corporation regarding files on these claims Mr. and John will Wyss We are now establishing proceed to protect your insured interests The above is for your information and file Sincerely ALEXANDER & ALEXANDER INC ' GENERAL ADJUSTER BALTIMORE NEW YORK CLARKSBURG TULSA ST LOUIS CHICAGO LOS ANGELES ATLANTA PITTSBURGH SAN FRANCISCO NEW ORLEANS MIAM PHILADELPHIA ALEXANDER & ALEXANDER INCORPORATED INSURANCE AVERAGE ADJUSTERS CONSULTING ACTUARIES 2225 NORTH CHARLES STREET BALTIMORE 18 MD August 31st 1962 WBH TELEPHONE TUXEDO 9-4304 BELL SYSTEM TELETYPE BA 582 CABLE ADDRESS ALEXBLUE 1862 Mr. Wallace B. Hofferth Assistant General Manager Insurance Department Armstrong Cork Company Lancaster Pennsylvania .L . aa . . t. Dear Mr. Hofferth John Wyss Applicant v Mundet Cork Company and Casualty & Surety Company Aetna We acknowledge your letter of August 29th 1962 enclosing Petition to Join Further Parties naming Armstrong Cork and Armstrong Contracting & Supply Corporation in connection with the above California We Office have forwarded the papers to the Oakland of the Travelers Insurance Company for necessary handling Sincerely ALEXANDER & ALEXANDER INC GH z GENERAL ADJUSTER August 29 1962 Mr. G. H. Finlay Alexander & Alexander 2225 N. Charles Street Baltimore 18 Maryland Inc. Dear Mr. Finlay . ~ , VT ~ . a Subject John Wyss Applicant v Mundet Cork Company and Aetna Casualty and Surety Company Defendants The enclosed Petition to Join Further Company and Armstrong Contracting and tional defendants in Claim No. 62 QAK Parties names Armstrong Cork Supply Corporation as addi- 7422 to be heard before the Industrial refer this Accident Petition Commission of the State of California Please to the appropriate office of The Travelers for handling and protection of both companies interests Very truly yours Enclosures MEB Wallace B. Hofferth Assistant General Manager Insurance Department .. .. a7 a . | 14 o7 7 4 2 ' ~ 3| UNSAFE ACT oe 2. 1 COMPANY aw a t . EMPLOYEE 7 4 2 UNSAFE PRES FACTOR fn A 19 Plant Rubber i nt 1 COMPANY Hip ye 2 DIVISION & Abestos 2.DIVISION AGE Head (eTs)miH ee= fan i iit " 4 ApperQIACORU ApperQIACORU ApperQIACORU ApperQIACORU = 3.EMPLOYEE L Office Office SEX M FM CLAIM NO YEARS 7009 EMPLOYED ~ 7 " - - 9 mm > ACCIDENT ne TYPE @ ACCIDENT 1 ACCIDENT : |; OCCUPATION DATE OF Wyss Wyss John Abestosos TIME OF 7.LENGTH OF TIME ON THIS JOB YRS A.M. | LOST TIME . MOS TEMP 8.DEPT DATE CASE CLOSED m= - - ' ~ a am -~ m < COND Lied COND UNSAFE UNSAFE ACCIDENT INJURY SUSTAINED Exposure PART OF BODY INJURED us us ENA gr IP ne PRIOR ACCIDENTS to dust & foreign substances over many years EXTENT OF INJURY AGENCY Chest Disability AGENCY PART UNSAFE MECH 14 UNSAFE MECHANICAL CONDITION TYPE OF _ ACCIDENT FM - SEX SEX 6 < OCUPATION 7 OCCUPATION OCCUPATION OC UPATION OCUPATION Bb OCCUPATION @ o < ' a as 1 TA: 62- OAK 7422- 2 UNSAFE ACT 0/0 12-20-62 + fi 12-20-62 12-20-62 0/0 12-20-62 UNSAFE PERSONAL FACTOR ~-L . 7. TIME ft TIME AGENCY 1 AGENCY AGENCY 13 13 4 2 y mPa m1 FIBREBOARD PRODUCTS COMPENSATION COMC PENSATION LAIMS MEDIA 373 =: Fe "fi " MONEY 2 AQ 1 Zz vy A Aaah er Bp 2 z v 1 1 fa] 20 11 A 06 OF 06 2 Ain 06 L 01 01 be & A fo L Bala fal 1 . 339,519 ENGINE ANTIns . ASNCNIE pt A # < 1 z z Aa Aad fal 5 ON 7 JOB = PENTING OTM795 FRANCISCO CALIF women e N ? . i a |e a i[a zz DATE Wyss John EMPLOYEE MEDICAL PLANT OUTSIDE 5/14 5/14 9/65 > HOSPITAL EXPENSE DISTRIBUTION 7009 RAY OTHER EXPENSE EXPLANATION | 450 ~ 450 Legal Freas _| 397 Legal LEGAL | > oTIT 449 5015005 .003 1ya.a oe TOTAL [ EX GRATIA PAYMENTS | | COMPEN SATION f | _ t TOTAL COSTS Zz ; 450 450 RESERVE 500.00 4955 4955 ype M@ Dy prbosar s Pr er ir 6101A01A as S F r Pre Ee REP e nneina h aalrna tPnanhaa tPaR AMRn Onin FINKEBOARGIRODUCTS FIa) NKEBOARGI... iR.OD| UCTS 373 8