AIG Claims, INC.

What they litigate

Disputed issues across the decisions this insurance carrier is named in. Every row opens the decisions it counts.

Where they appear

• Los Angeles 8
• Van Nuys 8
• San Jose 5
• Marina del Rey 4
• San Diego 3
• Anaheim 2
• Oakland 2
• Bakersfield 1
• Fresno 1
• Sacramento 1
• San Bernardino 1
• San Francisco 1

How the appealed decisions came out

These are decisions that were appealed and published — the tail of a system that mostly settles. Most claims end in a compromise and release or a stipulation and never reach a panel, so nothing below describes how this insurance carrier does its work. It describes how a set of appealed disputes came out.

• 17 for the defense
• 13 for the applicant
• 6 returned for more record

Counted over 36 appealed decisions. Not this insurance carrier’s book of work.

Decisions

Newest decisions this insurance carrier is named in, each with the passage the panel turned on and a link to the official PDF.

• ADJ19403295 · 2026-06-08 · San Francisco District OfficeStatute of limitationsremanded

  Determinative passage · p.10Accordingly, the record is not fully developed and the WCJ's decision was not based on substantial evidence. We grant KForce's Petition as one seeking reconsideration, rescind the March 2, 2026 Findings of Fact, and return this matter to the trial level for further proceedings consistent with this decision.

  The WCJ's March 2, 2026 Findings of Fact on date of injury and statute of limitations were rescinded due to insufficient substantial evidence and incomplete record development.

  Official decision · page 10 →
• ADJ4433060 · 2024-08-28 · Marina del Rey District OfficeJurisdiction / venueapplicant prevailed

  Determinative passage · p.4While the WCA issued the Report on August 4, 2021, filing of the arbitration file in EAMS was not completed as required by WCAB Rule 10995, as the record does not include a summary of evidence and/or minutes of the arbitration proceedings, as well as proper identification of the evidence and exhibits.

  The record was incomplete, lacking summary of evidence, minutes, and proper identification of exhibits, preventing meaningful review. Due process requires a complete record for substantial justice. The decision was rescinded and the matter returned to trial level for further proceedings.

  Official decision · page 4 →
• ADJ13873540 · 2024-08-02 · Los Angeles District OfficePenalties under Labor Code §5814defendant prevailed

  Determinative passage · p.7Here, applicant asserts that she is owed penalties in connection with this settlement; applicant does not otherwise seek to set aside any other terms of the agreement. However, section 5814(c) makes clear that if pending claims for penalties are not specifically excluded in the C&R, then an injured worker is not entitled to them. Applicant's Petition for Penalties was outstanding at the time of the settlement and was not excluded by the terms of the settlement. Thus, once the WCJ approved the C&R, it is presumed that the Petition for Penalties was resolved.

  Section 5814(c) presumes that any accrued claims for penalty are resolved by approval of a C&R unless expressly excluded; applicant's penalty claim was not excluded in the C&R, so it is deemed resolved and not recoverable.

  Official decision · page 7 →
• ADJ16497715 · 2024-07-08 · Los Angeles District OfficeLiensdefendant prevailed

  Determinative passage · p.6We will not disturb the WCJ's finding that lien claimant is not entitled to reimbursement for medical treatment services because lien claimant did not prove that applicant sustained compensable industrial injury. We note that lien claimant did not challenge or address the finding as to AOE/COE in the Petition. (Lab. Code, § 5904 [Petitioner is deemed to have waived an issue that is not raised in the petition for reconsideration].)

  Lien claimant did not prove that applicant sustained compensable industrial injury; no challenge to AOE/COE finding in the Petition.

  Official decision · page 6 →
• ADJ11949488 · 2024-05-21 · Oakland District OfficePermanent disability ratingremanded

  Determinative passage · p.31257.) An employee may also be entitled to a higher occupational group number if the activity (or activities) which generates the higher occupational group is an integral part of the occupation. (National Kinney v. Workers' Comp. Appeals Bd. (Casillas) (1980) 113 Cal.App.3d 203, 215-216 [45 Cal.Comp.Cases 1266].)

  There is insufficient evidence to determine the correct occupational group number; the matter is remanded for further development of the record to ensure due process and accurate permanent disability rating.

  Official decision · page 3 →
• ADJ13081250 · 2024-05-07 · Van Nuys District OfficeMedical treatment / UR / IMRapplicant prevailed

  Determinative passage · p.1Applicant seeks reconsideration of the February 14, 2024 Findings and Award ("F&A"), wherein the workers' compensation administrative law judge (WCJ) found applicant sustained a work-related injury to his back on March 13, 2017, but that applicant sustained no permanent disability as a result of the injury, that he did not require any further medical treatment, and that applicant was therefore due no further compensation. (F&A, at pp. 1§ 2.)1 Applicant asserts that the WCJ erred in basing her conclusions on the reporting of Panel Qualified Medical Examiner ("QME") Ronald Wolfson, M.D. because the reports are not substantial medical evidence.

  The WCJ failed to address the merits of the applicant's contention that the QME report was not substantial evidence, which is required by law; the WCAB granted reconsideration and remanded for further proceedings to consider this issue.

  Official decision · page 1 →
• ADJ11248992 · 2024-04-29 · Van Nuys District OfficePsyche AOE/COEapplicant prevailed

  Determinative passage · p.3Here, we agree with applicant that the WCJ erred in finding the date of injury to be February 18, 2020. Section 5412 requires proof of two elements: disability, and the injured worker's knowledge that the disability was related to the injury. The QME Report of July 18, 2017 finds that applicant sustained a "5% whole person impairment to the left wrist." (Ex. 1, at p. 22.) With regard to causation, the same report states: "Regarding his bilateral hands and wrists... it is my opinion, with reasonable medical probability, that the applicant's duties as a plumber were sufficient repetitive... to have caused an injury arising out of and in the course of his employment[.]" (Id., at p. 21.) In our view, these findings are sufficient to establish a July 18, 2017 date of injury pursuant to section 5412.

  The WCAB found that the July 18, 2017 QME report established disability and knowledge of industrial causation, satisfying section 5412 requirements, and that the WCJ erred in fixing the date of injury as February 18, 2020 based on section 5500.5 which governs liability, not date of injury.

  Official decision · page 3 →
• ADJ14445198 · 2024-04-15 · Santa Ana District OfficeMedical treatment / UR / IMRapplicant prevailed

  Determinative passage · p.3Lien Claimant filed a Petition for Reconsideration, alleging that the undersigned was incorrect and that the charges were valid medical-legal services for which the defendant remains liable. After review of the Petition, the undersigned determined that the original Findings, Order, and Opinion on Decision that issued contained an overly rigid analysis of Labor Code section 4060 and whether or not Dr. Michaels was Applicant's primary treating physician. Furthermore, the undersigned's analysis conflicted with 8 CCR 9793 and Labor Code 4604.

  The WCJ found that Dr. Michaels was properly elected as Applicant's Primary Treating Physician and that his report was a valid med-legal report, rejecting defendant's arguments to the contrary based on case law and procedural facts.

  Official decision · page 3 →
• ADJ13012543 · 2024-02-22 · Los Angeles District OfficePsyche AOE/COEremanded

  Determinative passage · p.1Applicant seeks reconsideration of the New and Amended Joint Findings and Order (F&O) issued by the workers' compensation administrative law judge (WCJ) on November 30, 2023, wherein the WCJ found that applicant did not sustain a psychiatric injury arising out of and occurring in the course of employment (AOE/COE) while employed by defendant during the period from August 26, 2015, through August 26, 2016 (ADJ13404851); and that applicant did not sustain a psychiatric injury AOE/COE while employed by defendant during the period from March 17, 2000, through February 21, 2020 (ADJ13012543); the WCJ ordered that applicant take nothing by way of her injury claims.

  The WCJ's denial of compensability was based on a finding that the medical opinion was not supported by substantial evidence due to an inaccurate history; the WCAB found the medical record insufficient and remanded for further development.

  Official decision · page 1 →
• ADJ13282654 · 2023-12-21 · Van Nuys District OfficeQME/AME processapplicant prevailed

  Determinative passage · p.1Defendant seeks reconsideration of the October 10, 2023 Findings of Fact and Order (F&O), wherein the workers' compensation administrative law judge (WCJ) found that applicant, while employed as a medical assistant on July 18, 2019, sustained industrial injury to the lumbar spine and right wrist. The WCJ found good cause to replace Qualified Medical Evaluator (QME) Moshe Wilker, M.D.

  The WCJ found that Dr. Wilker's reports lacked substantial medical evidence due to deficient medical history analysis and incomplete clinical examination, and that the QME's testimony showed bias and unwillingness to reconsider his opinions, justifying replacement.

  Official decision · page 1 →
• ADJ10586171 · 2023-12-15 · San Jose District OfficeAOE/COEremanded

  Determinative passage · p.7Here, as set forth by the WCJ in his Report, the record regarding applicant's claimed injury to his left eye is not sufficient. Thus, as a matter of due process, further development of the record is appropriate. Applicant is admonished that he should obtain the additional evidence forthwith.

  The record was found insufficient to establish injury to the left eye; further development was ordered but applicant did not timely object to the specialist's report or timely file the petition for reconsideration.

  Official decision · page 7 →
• ADJ16819991 · 2023-11-09 · Van Nuys District OfficeAOE/COEremanded

  Determinative passage · p.1Applicant seeks reconsideration of the Findings and Order (F&O)1 issued by the workers' compensation administrative law judge (WCJ) on August 22, 2023, wherein the WCJ found that applicant did not sustain an injury arising out of and occurring in the course of employment (AOE/COE) to his back on May 25, 2021; and the WCJ ordered that applicant take nothing.

  The WCJ's original decision was based on a finding that the injury date was inconsistent and that the QME's opinion was not based on an accurate history due to incomplete medical records. The WCAB found the record lacked substantial evidence and ordered further development of the record and a supplemental QME report.

  Official decision · page 1 →

Also recorded as

The same insurance carrier is printed several ways across the decisions, and all of them were counted as one. These are the twelve commonest of 15.

• AIG
• AIG CLAIMS
• AIG CLAIMS SERVICES
• AIG CLAIMS, INC.
• AIG INSURANCE
• AIG CLAIMS/THIRD PARTY ADMINISTRATOR
• AIG/NEW HAMPSHIRE INSURANCE COMPANY
• AIG AMERICAN HOME ASSURANCE
• AIG CLAIMS SERVICES, INC.
• AIG/GALLAGHER BASSETT
• AIG CLAIMS MANAGEMENT
• AIG CLAIM SERVICES

Is this your company and something here is wrong? Tell us and we will fix it. Every figure on this page is a count of released decisions this insurance carrier is named in, and the decisions themselves are listed above with the passage each turned on.