Allen v. Lenape Lure Co.

2002 OK CIV APP 74, 50 P.3d 1153, 73 O.B.A.J. 2138, 2002 Okla. Civ. App. LEXIS 52, 2002 WL 1553822
CourtCourt of Civil Appeals of Oklahoma
DecidedApril 26, 2002
Docket97,084
StatusPublished
Cited by2 cases

This text of 2002 OK CIV APP 74 (Allen v. Lenape Lure Co.) is published on Counsel Stack Legal Research, covering Court of Civil Appeals of Oklahoma primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Allen v. Lenape Lure Co., 2002 OK CIV APP 74, 50 P.3d 1153, 73 O.B.A.J. 2138, 2002 Okla. Civ. App. LEXIS 52, 2002 WL 1553822 (Okla. Ct. App. 2002).

Opinion

Opinion by

CAROL M. HANSEN, Presiding Judge:

T1 In seeking review of the Workers' Compensation Court's order denying his claim, Petitioner, John Allen (Claimant), contends the court misinterpreted 85 0.8.1991 §§ 65.2 and 65.8, which together are referred to as the "estoppel act." Section 65.2 provides:

*1155 Every employer and every insurance carrier who schedules any employee as a person employed by the employer for the purpose of paying or collecting insurance premiums on a Workmen's Compensation insurance policy or who pays, receives or collects any premiums upon any insurance policy covering the liability of such employer under the Workmen's Compensation law by reason of or upon the basis of the employment of any such employee shall be estopped to deny that such employee was employed by the employer in a hazardous employment subject to and covered by the Workmen's compensation law if such person receives an accidental personal injury arising out of and in the course of his employment, during the period for which such premium was so received, regardless of the type of business in which the employer was engaged or the type of employment in which the employee was engaged at the time of such injury.

¶ 2 Where, as here, the issues presented turn on interpretation of statutes, such issues are questions of law, and we will examine the Workers' Compensation Court's ruling independently with no deference given to that ruling. Fink v. State ex rel. Department of Public Safety, 1992 OK CIV APP 169, 852 P.2d 774.

¶ 3 The facts here are essentially undisputed. Claimant was an employee of the Le-nape Lure Company, one of the names under which the Delaware Tribe of Oklahoma (the Tribe) does business. On January 11, 2001, while employed by the Tribe and on its premises, Claimant slipped on some ice and was injured. From the date of injury to February 22, 2001, the Tribe, paid Claimant "wages in excess of $1,500.00", although he was off work with the injury at the time. From the latter date, the Tribe's insurance carrier, First Nations Compensation Plan (First Nations), paid Claimant four "additional" weeks temporary total disability compensation totaling $672.00.

¶ 4 In response to Claimant's Form 8, the Tribe filed its answer admitting Claimant was its employee, but denying injury and coverage under the Workers' Compensation Act, The Tribe asserted non-compensability due to "neutral risk", and lack of jurisdiction, alleging tribal sovereign immunity. After filing its answer, the Tribe moved to dismiss, both as to itself and First Nations.

¶ 5 After presentation of evidence, the trial court entered its order finding Claimant's injury, which occurred while he was returning from the restroom on a direct route back to his duty station, arose out of and in the course of his employment. The trial court found at the time of injury the Tribe had in foree a workers' compensation insurance policy from First Nations 1 . The trial court further found while the Tribe is a sovereign Indian nation immune from Oklahoma workers' compensation liability, First Nations was estopped in accordance with 85 ©.8.1991 §§ 65.2 and 65.3 from denying liability. The trial court dismissed the Tribe, but ordered First Nations to pay compensation to Claimant.

¶ 6 First Nations filed an appeal to a three-judge panel of the Workers' Compensation Court,. The three-judge panel, with one judge dissenting, vacated the order of the trial court. Citing Dominic v. Creek Nation, 1997 OK 41, 986 P.2d 985, 2 the panel found Claimant had failed to satisfy his burden of establishing First Nations' insurance premiums were calculated in part upon Claimant's salary. Claimant seeks review of the order of the three-judge panel. 3

¶ 7 In Dominic, the State Insurance Fund carried the tribe's workers' compensation insurance, basing its premiums on the salaries of the tribe's employees. The Oklahoma Supreme Court reversed the trial court and the three-judge panel and vacated the Court of *1156 Civil Appeal's opinion, all of which had found the claimant was not covered because the tribe was not an "employer" under the Workers' Compensation Act.

¶ 8 The Dominic Court held the State Insurance Fund was "statutorily estopped" to deny the tribe's "cover-employed status" pursuant to §§ 65.2 and 65.3. The Court stated the purpose of statutory estoppel is to prevent both an employer's and an employee's ensnarement in the false belief that compensation had been provided, only later to discover the protection to be unavailable.

¶ 9 Noting the tribe's claim of sovereign immunity was not at issue, Justice Opala, writing for the Court, focused on the rights of the injured claimant against the tribe's insurer. These rights, he stated, were statutory rather than contractual. The decision held that the claimant who relies upon estop-pel must show (1) an injury that occurred during the time his employer maintained a compensation liability policy, (2) the insured employer's payment of premiums based the claimant's salary, and (8) the claimant's injury occurred in and arose out of her employment with the insured employer. "This proof brings the insurer under the estoppel act's compensation liability."

¶ 10 First Nations claims the second element above is missing in Claimant's case. In fact, in its brief, it acknowledges it "specifically modified the method by which it caleu-lated premiums and charged its customers" to avoid coverage under Dominic. "Rather than calculate those premiums based on the wages of salaries of particular tribal employees, First Nations instead calculated premiums based on the number of employees and their various job classifications."

¶ 11 The effect of First Nations formulation, whether intended or not, allows it to use its insured's immunity to deny Workers' Compensation coverage to any or all of the Tribe's employees, notwithstanding that it admittedly had collected premiums based on each of those employees. We find this result contrary to the letter and spirit of the estop-pel act. We do not believe either the Legislature or the Supreme Court designed or interpreted the statutes to provide an "out" for a tribe's insurance carrier.

¶ 12We agree with the trial court that Dominic and related cases are good law, but the formalistic distinction drawn by First Nations is irrelevant. As the trial court noted, "Itlhe fundamental basis for estoppel is that the premium paid for coverage is based upon the fact of claimant's employment and the activities performed." The result would be different if First Nations, as did the State Insurance Fund in Dominic, computed its premiums based on salaries of its employees, and Claimant's salary was not included.

¶ 13 If a carrier does set its premiums for a tribe, or any other employer, according to wages of its employees, then certainly the criteria set out in Dominic would apply. Whereas here, when the carrier bases its premiums on the number of employees and the types of job duties in which those employees, including Claimant, are engaged, the statutory provisions for estoppel will nevertheless apply. This clearly falls within the intent and unambiguous language of the es-toppel act.

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Bluebook (online)
2002 OK CIV APP 74, 50 P.3d 1153, 73 O.B.A.J. 2138, 2002 Okla. Civ. App. LEXIS 52, 2002 WL 1553822, Counsel Stack Legal Research, https://law.counselstack.com/opinion/allen-v-lenape-lure-co-oklacivapp-2002.