Allen v. Reynolds

186 P.3d 663, 145 Idaho 807, 2008 Ida. LEXIS 109
CourtIdaho Supreme Court
DecidedJune 6, 2008
Docket34369
StatusPublished
Cited by8 cases

This text of 186 P.3d 663 (Allen v. Reynolds) is published on Counsel Stack Legal Research, covering Idaho Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Allen v. Reynolds, 186 P.3d 663, 145 Idaho 807, 2008 Ida. LEXIS 109 (Idaho 2008).

Opinion

J. JONES, Justice.

In 2004, Christina Allen, an employee of Why Worry Ranch, LLC, (‘WWR”) lost her thumb when it was caught in a rope while she was tying a horse. Allen submitted a worker’s compensation claim to the Idaho State Insurance Fund (“SIF”). SIF refused to cover Allen’s injury, asserting that WWR was not covered by worker’s compensation insurance at the time of her injury. Anne Reynolds, the owner of WWR, contends a policy was or should have been in effect at the time of the injury. However, a referee for the Idaho Industrial Commission disagreed, finding that neither Reynolds nor WWR had worker’s compensation coverage on July 14, 2004, when the accident occurred. The referee’s findings were adopted by the Industrial Commission. Reynolds appealed to this Court, and we affirm.

I.

Since 1983, Reynolds has owned and operated a horse ranch in Elmore County, named Why Worry Ranch. In 2000, the operation was changed from a sole proprietorship to a limited liability company, with Reynolds being the only member. Since that time employees worked for and were paid by WWR. From 2000 to 2004, Reynolds had a worker’s compensation insurance policy issued by Western Community Insurance Company. She got the insurance through a local agent, Tom Hart, who in turn found it through Farm Insurance Brokerage (“FIB”). 1 In 2003, Western Community ceased writing worker’s compensation insurance in Idaho and began transferring its insureds to SIF.

Hart received pre-printed application forms from a subsidiary of FIB to forward to SIF in order to transfer Reynolds’ insurance. These forms stated the applicant’s name was “Anne M. Reynolds” and the type of business was “individual.” Reynolds’ worker’s compensation insurance for the prior four years had been issued in Reynolds’ name, as sole proprietor, not in the name of her ranch, WWR.

On February 4, 2004, Dixie Black, Hart’s assistant, visited Reynolds at her ranch. Together, they completed the application while Reynolds sat atop a horse. Reynolds admitted she probably did not read everything on the application and did not notice that WWR was not mentioned anywhere on it.

FIB submitted the application to SIF. An underwriter at SIF sent Reynolds a quote for a premium deposit of $1177.00. The quote listed “Anne M. Reynolds” as the insured and described her as “Exempt — sole proprietor.” Reynolds sent a check drawn on the WWR bank account to pay the deposit. A SIF underwriter noticed the discrepancy and called FIB to find out whether WWR should be on the policy. FIB told the underwriter that the agent was gone for two weeks, so the underwriter wrote coverage for Reynolds as sole proprietor and noted the “dba” could be changed if necessary.

On March 18, 2004, an SIF underwriter sent FIB a coverage advisory form. The form asked Reynolds to acknowledge that SIF covered only Reynolds, individually, and not WWR. Reynolds refused to sign the *810 form, telling Black, “I am WWR.” SIF again sent a form on April 18, 2004. Reynolds again refused to sign and return the form. However, Reynolds never communicated her refusal to sign to SIF. She testified that she directed her bookkeeper, Sue Cenarrusa, to change the policy. Cenarrusa testified Reynolds never told her to change the policy.

Meanwhile, SIF was also dealing with an issue of payroll reporting. SIF requires insureds to inform it of the actual payroll of the insured entity in order to calculate the correct premium. On March 28, 2004, SIF sent Reynolds a payroll report form with a self-addressed return envelope. The form, specific to Reynolds (not WWR), required that Reynolds fill out a few numbers and return it to SIF. The form stated at the top, “Cancellation may be initiated if report is not received by the due date.” The form also had an identification number that SIF automatically scans into the computer upon return of the form, thus preventing any reminder letters or notices of cancellation from being generated. Reynolds did not return the report. SIF sent Reynolds a reminder letter on April 26, 2004. She still failed to return the report, even though she testified she was “concerned” about it.

SIF sent Reynolds a Notice of Cancellation on May 11, 2004, indicating the policy would be cancelled effective May 31 due to her failure to file a payroll report. Reynolds’ husband signed the certified mail receipt for the notice on May 14. SIF cancelled the policy, as per the warning, on May 31, 2004.

Before the policy was cancelled, SIF indicated to Reynolds and her agent that it might be possible to assign the policy from Reynolds to WWR without lapse. However, since Reynolds failed to provide the necessary payroll report, SIF cancelled the policy instead of assigning it. SIF underwriters have discretion to reinstate a policy without lapse if a person remedies the problem that caused her policy to lapse — here, the delinquent payroll report. Thus, if Reynolds had submitted a payroll report within 30 days of cancellation, her policy could have been reinstated and then assigned to WWR. However, the 30-day deadline apparently was not communicated to Reynolds, although the SIF underwriter indicated to the Farmers Insurance broker on June 1 that it needed to be submitted “right away” and “as soon as possible.” Reynolds’ bookkeeper, Cenarrusa, sent SIF a spreadsheet purporting to be a “payroll summary” on June 13. However, Cenarrusa failed to use the payroll report form or self-addressed envelope provided by SIF, nor did she include the employee codes required by SIF. She also apparently misaddressed the document, because SIF did not receive it until two weeks later, on July 1-31 days after the policy was cancelled.

SIF made a final effort to help Reynolds reinstate coverage. On July 2, SIF asked Reynolds for a letter certifying that she had not had any worker’s compensation claims and for a new application naming WWR as the insured. SIF gave Reynolds only a few days to submit the letter and application, requesting she complete and return them by July 6. Reynolds failed to meet the deadline, even though the SIF underwriter gave her until July 8 to comply.

On July 14, Christina Allen, an employee of WWR, severely injured her thumb while tying a horse. The thumb was later amputated. That day, Reynolds called Cenarrusa to confirm that the worker’s compensation problem had been addressed. Cenarrusa assured her it had been. However, Cenarrusa lied. Hours later, Cenarrusa faxed the application and the certification of no claims to SIF. She pre-dated the application to state July 10, so that it appeared as though she sent it before Allen’s accident occurred. However, the fax machine’s print-out revealed Cenarrusa’s deception. Further, Cenarrusa failed to fax the documents to the correct entity. Instead of sending them to SIF, she faxed them to the Industrial Commission. The documents were routed to SIF on July 16.

About one month later, Reynolds discovered that Cenarrusa had embezzled around $350,000 from her over the previous five years. On September 10, Reynolds wrote a letter to SIF explaining what had occurred and expressing remorse for Cenarrusa’s failure to provide SIF with the correct documents. However, Reynolds has asserted throughout this litigation that SIF received *811 the payroll report, or Cenarrusa’s spreadsheet, in a timely manner.

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Cite This Page — Counsel Stack

Bluebook (online)
186 P.3d 663, 145 Idaho 807, 2008 Ida. LEXIS 109, Counsel Stack Legal Research, https://law.counselstack.com/opinion/allen-v-reynolds-idaho-2008.