American Compensation Insurance Company v. Hector Ruiz, Doing Business As Los Primoz Construction; Raul Aparacio; Jesco, Incorporated; and Appalachian Underwriters, Incorporated

Mississippi Supreme Court·Decided June 27, 2024·No. 2023-FC-01160-SCT·Published

Opinion

IN THE SUPREME COURT OF MISSISSIPPI NO. 2023-FC-01160-SCT

AMERICAN COMPENSATION INSURANCE COMPANY

v.

HECTOR RUIZ, DOING BUSINESS AS LOS PRIMOZ CONSTRUCTION; RAUL APARACIO; JESCO, INCORPORATED; AND APPALACHIAN UNDERWRITERS, INCORPORATED

DATE OF JUDGMENT: 10/12/2023 TRIAL COURT ATTORNEYS: CHRISTOPHER HAILEY CORKERN LAWRENCE MATTHEW QUINLIVAN MICHAEL WAYNE BAXTER

MICHAEL MADISON TAYLOR, JR.

GEORGE E. DENT

EDWARD P. CONNELL, JR

ROBERT P. THOMPSON

PAUL PACIFIC BLAKE

ATTORNEYS FOR APPELLANT: ROBERT P. THOMPSON PAUL PACIFIC BLAKE

ATTORNEYS FOR APPELLEES: GEORGE E. DENT MICHAEL WAYNE BAXTER

SEAN PATRICK MOUNT

MICHAEL MADISON TAYLOR, JR.

PHILLIP MARTIN LEMERE

NATURE OF THE CASE: CIVIL - FEDERALLY CERTIFIED QUESTION

DISPOSITION: CERTIFIED QUESTION ANSWERED -

06/27/2024

MOTION FOR REHEARING FILED:

BEFORE KITCHENS, P.J., MAXWELL AND CHAMBERLIN, JJ.

MAXWELL, JUSTICE, FOR THE COURT:

¶1. The United States Court of Appeals for the Fifth Circuit has certified the following question to this Court:

Does the Mississippi Workers’ Compensation Act (MWCA) allow an insurer to void ab initio a workers’ compensation policy based on a material misrepresentation?

The MWCA is silent. The statutory contractor (who will be on the hook if the subcontractor’s insurer is permitted to void the policy) argues that, because the MWCA does not provide for rescission—only cancellation and nonrenewal—then rescission is not an available remedy. The insurer (who will be on the hook for millions of dollars if not permitted to void the policy) argues that, because the legislature opted not to address rescission in the MWCA, the common law remedy of voiding the policy ab initio is available.

¶2. The insurer filed for a declaratory judgment in federal court. The federal district judge made an Erie guess1 that Mississippi’s workers’ compensation law does not permit an insurer to rescind a workers’ compensation policy. So it dismissed the insurer’s lawsuit to have the policy declared void. The insurer appealed to the Fifth Circuit. Instead of making its own Erie guess, the Fifth Circuit certified the determinative question to this Court.

¶3. As the Fifth Circuit rightly observed, there is no Mississippi statute or case addressing this exact issue. There is, as the insurer points out, case law permitting other types of

1 Taking its name from Erie Railroad v. Tompkins, 304 U.S. 64, 58 S. Ct. 817, 82 L. Ed. 1188 (1938), an Erie guess occurs when, in the absence of a state statute or caselaw on point, a “federal court must divine and enforce the rule that it believes this [C]ourt would choose if the case were pending here.” Peoples Bank & Tr. Co. v. L & T Devs., Inc., 434 So. 2d 699, 712 n.9 (Miss. 1983) (citing Mason v. Am. Emery Wheel Works, 241 F.2d 906 (1st Cir. 1957); Green v. Amerada-Hess Corp., 612 F.2d 212, 214 (5th Cir. 1980); Wright, Law of Federal Courts 375 (4th ed. 1983)), judgment corrected, 437 So. 2d 7 (Miss. 1983).

insurance policies to be voided ab initio if a material misrepresentation is made by the insured when applying for the policy. But a workers’ compensation policy is different. Not only is it governed exclusively by statute, but also it exists to pay benefits to the injured worker.2 And in this case, the injured worker did not make any material misrepresentation—his employer allegedly did.

¶4. Because the MWCA makes no provision for an insurer to void a workers’ compensation policy based on a material misrepresentation and because the MWCA exists to ensure injured workers are compensated, we conclude that the MWCA does not allow insurers to void ab initio a workers’ compensation policy based on an employer’s material misrepresentation.

Background Facts & Procedural History

¶5. Our answer to the certified question is not driven by the underlying facts. The Fifth Circuit has not tasked this Court with determining if the employer made a material misrepresentation in obtaining a workers’ compensation policy. Neither has the federal district or appellate court reached any conclusions about the insurer’s allegations of a material misrepresentation. Instead, the district court dismissed the insurer’s complaint because it concluded, as a matter of Mississippi law, a workers’ compensation policy could not be rescinded based on a material misrepresentation. Still, the facts—and certainly the procedural history—do provide necessary context for how the certified question landed in this Court and help frame the parties’ competing arguments.

2 Miss. Code Ann. § 71-3-1(3) (Rev. 2021).

I. The Declaratory Action

¶6. The employer is Hector Ruiz, doing business as Los Primoz Construction. Ruiz was performing work as a subcontractor for contractor Jesco, Incorporated, when his employee Raul Aparacio fell more than fifteen feet and severely injured himself.

¶7. Ruiz had a workers’ compensation insurance policy with the American Compensation Insurance Company (ACIC). ACIC immediately began paying benefits to Aparacio. But when ACIC’s payouts surpassed the quarter-million-dollar mark, ACIC initiated a declaratory action in federal court seeking to retroactively void the policy. ACIC alleged that Ruiz materially misrepresented in his application that his company did not perform work more than fifteen feet above ground. ACIC asserted that, had Ruiz been truthful, ACIC would not have issued the policy.

¶8. Again, while this Court is not tasked with weighing the merits of ACIC’s claim, we do observe that the facts appear to be more nuanced than ACIC has alleged in its complaint. Apparently, Ruiz’s former policy did take into account and charge additionally for the fact his employees worked at heights above fifteen feet. So when ACIC received the application for the policy year at issue, ACIC questioned why the application answered negatively about working above ground. Ruiz’s insurance agent assured ACIC the application was correct.3 So ACIC issued the policy and only charged for not working more than fifteen feet above ground. But ACIC included the work-above-ground code in the description of what the policy covered. After Aparacio fell, ACIC initially retroactively increased its premium to

3 Ruiz contends his agent was the one to make the misrepresentation, asserting that the agent filed the application without his authorization.

cover work more than fifteen feet above ground. But then ACIC later filed the declaratory action against Ruiz and Jesco—Aparacio’s statutory employer should the subcontractor’s workers’ compensation policy be declared void.

¶9. Jesco moved for summary judgment. Jesco asserted that ACIC was not entitled to void the policy because Mississippi’s workers’ compensation statutes do not provide for rescission as a remedy for an employer’s material misrepresentation. Jesco argued that the MWCA replaced all common law rights and remedies. And while Mississippi Code Section 71-3-77(1) (Rev. 2021) allows for cancellation and nonrenewal if certain conditions are met, the MWCA makes no provision for rescission. ACIC countered that, because Section 71-3- 77(1) is silent about rescission, it has the common law right to void the policy.

II. The Federal District Court’s Decision

¶10. The federal district judge sided with Jesco. Am. Comp. Ins. Co. v. Ruiz, No. 1:18- CV-213-DMB-DAS, 2022 WL 4468619 (N.D. Miss. Sept. 26, 2022). The judge looked to the MWCA, emphasizing that it exclusively governs workers’ compensation insurance policies, is in derogation of the common law, and exists to provide benefits to injured employees. Id. at *5-6. Looking specifically at Section 71-3-77(1), the judge noted this Court has held the statute’s purpose is to ensure employees are protected. Id. at *6 n.27 (quoting Cooper v. Marathon Freight Lines, Inc., 635 So. 2d 855, 858 (Miss. 1994)). So to allow post-injury rescission of a policy would go against this purpose. Id. at *6-7.

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American Compensation Insurance Company v. Hector Ruiz, Doing Business As Los Primoz Construction; Raul Aparacio; Jesco, Incorporated; and Appalachian Underwriters, Incorporated, (Mich. 2024).

American Compensation Insurance Company v. Hector Ruiz, Doing Business As Los Primoz Construction; Raul Aparacio; Jesco, Incorporated; and Appalachian Underwriters, Incorporated (American Compensation Insurance Company v. Hector Ruiz, Doing Business As Los Primoz Construction; Raul Aparacio; Jesco, Incorporated; and Appalachian Underwriters, Incorporated) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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