Adir International v. The Travelers Indemnity CA2/7

CourtCalifornia Court of Appeal
DecidedDecember 31, 2020
DocketB293415
StatusUnpublished

This text of Adir International v. The Travelers Indemnity CA2/7 (Adir International v. The Travelers Indemnity CA2/7) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Adir International v. The Travelers Indemnity CA2/7, (Cal. Ct. App. 2020).

Opinion

Filed 12/30/20 Adir International v. The Travelers Indemnity CA2/7 NOT TO BE PUBLISHED IN THE OFFICIAL REPORTS

California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication or ordered published for purposes of rule 8.1115.

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA

SECOND APPELLATE DISTRICT

DIVISION SEVEN

ADIR INTERNATIONAL, LLC, B293415

Plaintiff and Respondent, (Los Angeles County Super. Ct. No. BC575513) v.

THE TRAVELERS INDEMNITY CO.,

Defendant and Appellant.

APPEAL from an order of the Superior Court of Los Angeles County, Lisa Hart Cole, Judge. Affirmed. Gordon & Rees, Asim K. Desai, Margaret M. Drugan; Gibson, Dunn & Crutcher, Theodore J. Boutrous, Jr., Blaine H. Evanson, and Samuel Eckman for Defendant and Appellant. Klapach & Klapach and Joseph S. Klapach for Plaintiff and Respondent.

_______________________ INTRODUCTION The Travelers Indemnity Co. appeals from an order granting a motion for reconsideration and declaring arbitration provisions unenforceable and void. Travelers argues the trial court did not have jurisdiction under Code of Civil Procedure section 1008, subdivision (b), to reconsider its prior ruling because case law cited in the motion was not “new” law. Travelers also argues the trial court erred in ruling that the Insurance Code required Travelers to file the arbitration provisions with the Insurance Commissioner (Commissioner) for the arbitration provisions to be effective and that, if California required invalidation of the arbitration provisions, the Federal Arbitration Act (FAA) preempted California law. We affirm. FACTUAL AND PROCEDURAL HISTORY A. Workers’ Compensation Insurance 1. The Policy Adir International, LLC operates the Curacao chain of retail department stores. From 2004 to 2011, on eight occasions, Travelers issued a workers’ compensation insurance policy (the policy) to Adir.1 The policy was a “guaranteed cost” policy with standard language approved by the Commissioner.2 The policy

1 The policies contained substantially similar terms and conditions. 2 According to the Commissioner, “Most California employers receive workers’ compensation insurance coverage through guaranteed cost policies. Under a guaranteed cost policy, the insured pays a fixed annual premium for the policy term, regardless of subsequent loss experience. The fixed premium is the sum of the average losses and certain fees. Average losses

2 contained the rates it would charge Adir. In the policy, Travelers warranted that the policy would apply to a single uniform loss experience rating plan. Before issuing the policy to Adir, in accordance with Insurance Code section 11658,3 Travelers filed the policy with the Workers’ Compensation Insurance Rating Bureau (Rating Bureau) for the Commissioner’s review.4 The Commissioner did not object to the policy.

take into account the base rate for each classification assigned to the policy and the employer’s experience modification factor. The fees are the estimated costs of providing the insurance; that is sales, underwriting, profit and other fixed costs. Thus, a company with average losses of $500,000, may be charged $750,000 in premium; $500,000 to cover expected loss payments and $250,000 in fees.” (Matter of Adir International, LLC (Nov. 20, 2018) Cal. Insurance Commissioner, No. AHB-WCA-16-14, pp. 7-8, fn. omitted (Matter of Adir).) 3 Undesignated statutory references are to the Insurance Code. 4 Section 11658, subdivision (a), provides: “A workers’ compensation insurance policy or endorsement shall not be issued by an insurer to any person in this state unless the insurer files a copy of the form or endorsement with the [Rating Bureau] pursuant to subdivision (e) of Section 11750.3 and 30 days have expired from the date the form or endorsement is received by the commissioner from the [Rating Bureau] without notice from the commissioner, unless the commissioner gives written approval of the form or endorsement prior to that time.” After performing an initial review, the Rating Bureau transmits the policy or endorsement to the Department of Insurance (Department) for the Commissioner’s review. (See § 11750.3, subd. (e); Cal. Code Regs., tit. 10, §§ 2218, 2509.30.)

3 With regard to dispute resolution, the policy provided, in a section titled “Actions Against Us”: “There will be no right of action against us under this insurance unless: . . . The amount you owe has been determined with our consent or by actual trial and final judgment.” The policy did not contain an arbitration provision. The policy documents also included a “Policyholder Notice” that contained information regarding sections 11737 and 11753.1. The notice provided that, pursuant to sections 11737 and 11753.1, an insured aggrieved by Travelers’ “decision adopting a change in a classification assignment that results in increased premium, or by the application of [Traveler’s] rating system to [an insured’s] workers’ compensation insurance” could send Travelers a written complaint, and if “dissatisfied” with Travelers’ decision upon review, an insured may appeal to the Commissioner. The policy also contained an endorsement titled “Retrospective Rating Plan Premium Endorsement - Large Risk Alternative Rating Option.” The Retrospective Rating Plan Endorsement provided: “This endorsement is issued because you chose to have the cost of the insurance rated retrospectively. This endorsement applies only to workers compensation and employers liability insurance when rated under the provisions of the Large Risk Alternative Rating Option that we have negotiated with you.” The endorsement did not set forth its premium calculation, definitions, terms, rates, or the parties’ obligations under the alternative rating option.5 The guaranteed

5 As described by the Commissioner, “A retrospective rating plan, or loss sensitive plan, varies the premium an employer will pay based on the employer’s actual losses during the coverage period. A minimum program cost, or premium, covers the

4 cost rates were the only rates in the policy. 2. The Unfiled Agreement As an annual condition for issuing the policy, Adir executed a separate agreement with Travelers that contained the terms and conditions for the Retrospective Rating Plan Endorsement.6 The agreement provided that Travelers issued the policy “based upon [Adir’s] compliance with the terms and conditions set forth in the [agreement].” Thus, the agreement set forth the manner by which Travelers would retrospectively calculate the premium and other charges for the policy based on Adir’s “incurred losses” and “claims handling charges.” In addition, the agreement introduced a requirement that Adir post collateral, permitted Travelers to collect attorneys’ fees, altered the policy’s cancellation terms, and required the binding arbitration of disputes. If the terms of the policy and the agreement conflicted, the agreement’s terms prevailed. Regarding dispute resolution, the agreement stated: “The parties recognize that disputes may arise between them . . . about the parties’ rights and duties relative to payment of premium and

program’s basic costs. The premium then increases linearly with respect to actual losses until it reaches a maximum plateau. A large risk deductible option varies the program calculation even further. Under most workers’ compensation insurance policies, the insurer is statutorily obligated to pay an employee’s entire claim, from the ‘first dollar’ to the last. With a large risk deductible plan, the employer agrees to reimburse the insurer for claim costs up to an agreed-upon amount.” (Matter of Adir, supra, at pp. 10-11, fns.

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Adir International v. The Travelers Indemnity CA2/7, Counsel Stack Legal Research, https://law.counselstack.com/opinion/adir-international-v-the-travelers-indemnity-ca27-calctapp-2020.