XL Specialty Insurance Company

What they litigate

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

Where they appear

• Anaheim 6
• Los Angeles 6
• Marina del Rey 5
• Riverside 5
• Van Nuys 5
• Long Beach 4
• Pomona 4
• Oakland 3
• Redding 3
• Sacramento 3
• Lodi 2
• Oxnard 2

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.

• 30 for the defense
• 21 for the applicant
• 8 returned for more record

Counted over 54 appealed decisions. Not this insurance carrier’s book of work. A decision that went one way on one issue and the other way on another is counted in both columns, so the figures add up to more than the total.

Decisions

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

• ADJ11754124 · 2026-05-26 · Pomona District OfficeReopening / new and further disabilityapplicant prevailed

  Determinative passage · p.1Applicant seeks reconsideration of the "Findings and Order" (F&O) issued on February 20, 2026, by the workers' compensation administrative law judge (WCJ). The WCJ found, in pertinent part, that applicant's internal injury complaints are barred by Labor Code1 section 5410 because applicant failed to obtain substantial medical evidence establishing internal injury within five years from his date of injury.

  The WCJ's finding that applicant's internal injury complaints were barred by Labor Code section 5410 was unsupported due to lack of substantial medical evidence; applicant timely filed petition to reopen; record development needed; thus, reconsideration granted and matter remanded for further proceedings.

  Official decision · page 1 →
• ADJ12788201 · 2026-05-01 · Long Beach District OfficeSerious and willful misconductdefendant prevailed

  Determinative passage · p.1Defendant CVS Health Corporation1 seeks reconsideration of a workers' compensation administrative law judge's (WCJ) Findings of Fact and Order of January 23, 2026, wherein it was found, "Pursuant to Labor Code § 4553, the applicant was injured as a result of the serious and willful misconduct of her manager." (Finding No. 3.) In this matter, while employed on November 14, 2019 as an assistant store manager, applicant sustained admitted injury to the right forearm, right wrist, right fingers, right shoulder, right hand, and psyche. However, "the nature and extent of Applicant's injuries are all deferred pending further discovery."

  Applicant did not carry burden to show serious and willful misconduct was proximate cause of injury; manager's act of grabbing tote bag was inappropriate but not done with intent or reckless disregard likely to cause serious injury.

  Official decision · page 1 →
• ADJ11078504 · 2026-03-09 · San Francisco District OfficeTemporary disabilitydefendant prevailed

  Determinative passage · p.10Discussion 1. Applicant did not rebut the level of disability through vocational evidence. Applicant did not meet her burden of proof in rebutting the permanent disability rating of the AMEs in this case through vocational evidence. I found that the reporting of applicant's expert, Eugene Van de Bittener, was not substantial evidence. At the time of trial, the applicant was working full time as a teacher in a modified capacity. (Summary of Evidence, 13:3-6.) The vocational evidence shows that the applicant consistently remained employed by a variety of employers in her chosen profession as a special education teacher. Following her employment with defendant, applicant worked as a special education teacher for St Vincent's School for Boys from June, 2013 to November 2015, and then for Petaluma City Schools from November 2015 to November 30, 2018. (Applicant's exhibit 3, page 54.) Following her 2017 surgery, she worked part time as a substitute special education teacher for San Rafael City Schools from October 2020 to June 6, 2021, then from January, 2021 to June 6, 2021 as a guest support teach/aide for Ross Valley Schools, and then for the summer session she worked from June 14 to July 9, 2021. (Id. at page 70.) She also worked as a part time special education teacher in a long time substitute position, and then from August 2022 to June 2023 she worked as

  Applicant did not meet burden to rebut permanent disability rating with vocational evidence; applicant was working full time in modified capacity, so vocational expert's opinion was not substantial evidence.

  Official decision · page 10 →
• ADJ16384093 · 2026-01-20 · Marina del Rey District OfficePenalties under Labor Code §5814defendant prevailed

  Determinative passage · p.31. Applicant's Petition for Penalties, Costs, and Attorney fees based on the untimely issuance of authorization for right hip replacement surgery. 2. The statutory limit for temporary total disability benefits according to Labor Code section 4656(c). 3. The transition, at the time of termination of temporary disability benefits, to permanent disability benefits. (MOH, July 16, 2025, 2:23-3:2.) The WCJ issued an F&O on October 7, 2025 finding, in relevant part, that defendant had not violated sections 5814 and 5813 by delaying or denying medical treatment or temporary disability benefits. (F&), 10/7/2025, p. 3.) The WCJ noted:

  The defendant had a reasonable legal basis to deny surgery due to ongoing litigation and a genuine dispute over medical necessity, so no bad faith or unreasonable delay was found to justify penalties or sanctions.

  Official decision · page 3 →
• ADJ16445262 · 2026-01-05 · Pomona District OfficeSubstantial evidence / credibilityremanded

  Determinative passage · p.1Applicant seeks reconsideration of a workers' compensation administrative law judge's (WCJ) Joint Findings and Order of October 3, 2025, wherein it was found that applicant did not sustain industrial injury to her head, brain and neck while employed on June 28, 2022 as a licensed vocational nurse in case ADJ18616858. It was also found that applicant did not sustain industrial injury to the right arm, right wrist, right fingers, back, right shoulder, hips, legs, knees, feet, right ankle, brain, and psyche during a cumulative period from February 1, 2022 through July 7, 2022 in case ADJ16445262. However, the issue of cumulative injury to the circulatory system in case ADJ16445262 was deferred pending further development of the medical record. With regard to the allegation of cumulative injury to the psyche, it was found that applicant's claim was barred pursuant to Labor Code section 3208.3(d) because applicant's employment lasted less than the requisite six months. In finding no industrial injury in the specific injury case (ADJ18616858), the WCJ found that applicant's claim that she fell backwards and hit her head against the wall while at work was not credible.

  The WCJ found applicant's testimony not credible due to failure to report injury, inconsistent accounts, and lack of contemporaneous medical records; the WCAB found the record needed further development and analysis, including husband's testimony and medical reports.

  Official decision · page 1 →
• ADJ18434613 · 2025-07-25 · Riverside District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.6Petitioner contends that the WCALJ erred in finding that the Applicant's injury arose out of and occurred in the course of her employment. The undersigned maintains that the facts, medical evidence and law supports a finding of AOE/COE on the following grounds:

  The WCJ found the applicant's testimony credible and the QME deferred industrial causation to the trier of fact, supporting the finding of injury arising out of and in the course of employment.

  Official decision · page 6 →
• ADJ16909714 · 2025-04-25 · Sacramento District OfficeJurisdiction / venuedefendant prevailed

  Determinative passage · p.8II. Defendant first contends that the WCJ erroneously failed to consolidate case number ADJ16909714 with case number ADJ20101471, which was filed by defendant. As stated in the Report, the record lacks evidence that applicant has been employed by the entity against which defendant asserted the claim in ADJ20101471 or was injured at any time after January 13, 2018. It follows that the record is without grounds for consolidation of the cases. Defendant next contends that the WCJ erroneously found that applicant sustained injury to the cervical spine resulting in permanent disability of 18%. As stated in the Report, PQME Dr. Ryan adequately explained the grounds on which she found that applicant sustained a fracture of the C-6 vertebrae injury and rated the resulting disability. It follows that the argument that the record lacked substantial medical evidence to support the finding that applicant sustained injury to the cervical spine is without merit. Defendant next contends that the WCJ erroneously declined to admit exhibits in evidence. As stated in the Report, defendant failed to timely file exhibits for trial and failed to establish grounds for applicant's deposition transcript to be admitted in evidence notwithstanding that he appeared as a witness at trial.

  Defendant failed to timely file exhibits and did not establish grounds for admission, so the WCJ did not err in declining to admit them.

  Official decision · page 8 →
• ADJ17886767 · 2025-04-15 · Oakland District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.1Defendant seeks reconsideration of a workers' compensation administrative law judge's (WCJ) Findings and Orders of December 9, 2024, wherein it was found that while employed on March 16, 2023 as an activity assistant, applicant sustained industrial injury to her right wrist and right hand causing the need for further medical treatment to those body parts. Applicant also claims injury to the head, neck, right arm, right shoulder, right hip and lumbar spine as a result of the March 16, 2023 incident, but the issue of injury to those body parts was deferred.

  The WCJ and WCAB found that applicant was injured in the course of employment while performing usual and customary duties benefiting the employer, even though she was not scheduled to work that day, supported by credible testimony and legal precedent.

  Official decision · page 1 →
• ADJ17195883 · 2024-12-02 · Oakland District OfficeStatute of limitationsapplicant prevailed

  Determinative passage · p.3It is undisputed that "since no benefits have been provided to applicant, the only applicable limitation is one year from the May 4, 2021 claimed date of the injury." (F&O, Opinion on Decision, p. 10 citing Lab. Code, § 5405(a).) Applicant filed his claim on January 18, 2023. (Application for Adjudication, January 18, 2023.) Therefore, applicant's claim was filed more than one year from the May 4, 2021 claimed date of injury.

  The WCJ's decision to bar the claim based on the statute of limitations was not supported by substantial evidence because the defendant failed to provide sufficient proof that the DWC-1 claim form and notice were properly mailed and received by the applicant. New evidence showed returned mail to the applicant's address, undermining the presumption of proper service.

  Official decision · page 3 →
• ADJ10452116 · 2024-10-07 · Los Angeles District OfficePsyche AOE/COEapplicant prevailed

  Determinative passage · p.3We agree with the WCJ that the opinions of Thomas Curtis, M.D., Judith Schwafel, Ph.D., and Gayle Windman, Ph.D., are substantial medical evidence upon which the WCJ properly relied in finding applicant's psychiatric injury was predominantly caused by the industrial injury and thus compensable. It is well-established that the relevant and considered opinion of one physician may constitute substantial evidence, even if inconsistent with other medical opinions. (Place v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 372, 378-379 [35 Cal.Comp.Cases 525].) In order to constitute substantial evidence, a medical opinion must be predicated on reasonable medical probability and it must set forth the reasoning in support of its conclusions. (Escobedo v. Marshalls (2005) 70 Cal. Comp. Cases 604, 621.) A medical opinion is not substantial evidence when based on incorrect facts, history or legal theory, or surmise, speculation, conjecture or guess. (Place v. Workers' Comp Appeals Bd. (Place) (1970) 3 Cal.3d 372, 378 [35 Cal.Comp.Cases 525]; Escobedo v. Marshalls (Escobedo) (2005) 70 Cal.Comp.Cases 604, 620-621.)

  The WCJ and WCAB found the reports and deposition testimony of Drs. Curtis, Schwafel, and Windman constitute substantial medical evidence establishing compensability of the psychiatric injury as predominantly caused by employment events, rejecting Dr. Cohen's contrary apportionment opinion as vague and unsupported.

  Official decision · page 3 →
• ADJ16511003 · 2024-08-02 · San Bernadino District OfficeMedical treatment / UR / IMRdefendant prevailed

  Determinative passage · p.3We 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. As noted above, 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 meet burden to prove compensable industrial injury (AOE/COE) and did not challenge this finding in the petition, so reimbursement for medical treatment services was denied.

  Official decision · page 3 →
• ADJ17453317 · 2024-06-10 · Van Nuys District OfficeAOE/COEapplicant prevailed

  Determinative passage · p.4Injury aoe/coe It was found by the undersigned that Applicant sustained a work-related injury to his right foot and shin as he described.

  The evidence including medical records, photos, and credible testimony supported the finding of industrial injury to the right foot and shin on 1/23/2023, rejecting the employer's alternative theory.

  Official decision · page 4 →

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 24.

• XL Specialty Insurance Company
• XL SPECIALTY INSURANCE COMPANY
• XL INSURANCE AMERICA, INC.
• XL INSURANCE
• XL INSURANCE AMERICA
• XL INSURANCE COMPANY
• XL INSURANCE OF AMERICA
• XL Insurance of America
• XL Specialty Insurance
• XL SPECIALTY INSURANCE
• XL SPECIALITY INSURANCE COMPANY, ADMIN. BY ESIS
• XL SPECIALTY INSURANCE by GALLAGHER BASSETT

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.