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

CourtMississippi Supreme Court
DecidedJune 27, 2024
Docket2023-FC-01160-SCT
StatusPublished

This text of 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) is published on Counsel Stack Legal Research, covering Mississippi Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

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

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).

2 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).

3 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.

4 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,

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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, Counsel Stack Legal Research, https://law.counselstack.com/opinion/american-compensation-insurance-company-v-hector-ruiz-doing-business-as-miss-2024.