Atlas Reserve Temporaries, Inc. v. Vanliner Insurance Co.

51 S.W.3d 83, 2001 Mo. App. LEXIS 643, 2001 WL 376387
CourtMissouri Court of Appeals
DecidedApril 17, 2001
DocketWD 58425, WD 58477
StatusPublished
Cited by19 cases

This text of 51 S.W.3d 83 (Atlas Reserve Temporaries, Inc. v. Vanliner Insurance Co.) is published on Counsel Stack Legal Research, covering Missouri Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Atlas Reserve Temporaries, Inc. v. Vanliner Insurance Co., 51 S.W.3d 83, 2001 Mo. App. LEXIS 643, 2001 WL 376387 (Mo. Ct. App. 2001).

Opinion

ULRICH, Judge.

Plaintiffs-Appellants [hereinafter “Plaintiffs”] appeal the summary judgment of the circuit court in favor of the Defendants Respondents, sixteen servicing insurance carriers who provided workers’ compensation insurance policies to Plaintiffs [hereinafter “Insurance Carriers”] and the National Counsel on Compensation Insurance [hereinafter “NCCI”], on their claims for breach of contract against Insurance Carriers, and negligence against NCCI. Plaintiffs contend that the trial court erred in granting Defendants’ Motions for Summary Judgment in that Defendants were not entitled to judgment as a matter of law because the surcharge provisions in Plaintiffs’ contracts with the Insurance Carriers were not ambiguous in their language or application, and the plain language of these contractual provisions recited an “additive” calculation of the surcharges as alleged by Plaintiffs in their petition. The judgment of the trial court is reversed, and the case is remanded to the trial court for further proceedings.

I. Facts

Plaintiffs are Missouri employers who purchased workers’ compensation insurance from Missouri’s involuntary market 1 between September 1, 1991 and December 31, 1993. Plaintiffs could not otherwise obtain coverage in Missouri’s voluntary market, but since workers’ compensation insurance was mandatory for all Missouri employers with more than five employees, they were forced into the involuntary market. Insurance Carriers are the sixteen servicing insurance carriers who provided workers’ compensation insurance policies to Plaintiffs through the involuntary market. NCCI is a not-for-profit corporation and licensed rating organization responsible for administering Missouri’s involuntary market.

The Missouri Division of Insurance [hereinafter “MDI”] is vested with the sole authority to set and adjust workers’ compensation rates, premiums, and surcharges. The approval of new workers’ compensation rates is a multi-step process. As the rating organization, NCCI is responsible for collecting information concerning the policies, premiums, and losses of the workers’ compensation insurance *85 carriers. Using this data, NCCI then prepares and submits a proposal to revise the workers’ compensation rates to the MDI. Upon the filing of a proposal made by NCCI, the MDI holds a public hearing to discuss the proposal. After a hearing, the MDI will issue an order accepting, rejecting, or modifying NCCI’s proposal to revise rates.

Once a new rate is authorized by a MDI rate order, it still must be implemented into the existing employers’ workers’ compensation insurance policies. These new rates are put into effect through the use of endorsements, written by the NCCI and approved by the MDI, that attach to and become a part of the existing policies of the insureds.

The MDI authorized the addition of two surcharges to policies obtained through the involuntary market. In a rate order issued May 29, 1990, the MDI approved NCCI’s proposal to surcharge experience rated risks in the involuntary market when an employer’s actual losses exceed their modified expected losses, as determined using values from the experience rating modification calculation. This surcharge was called the Assigned Risk Adjustment Program Surcharge [hereinafter “ARAP surcharge”]. The 1990 rate order that approved the ARAP surcharge provided, in pertinent part:

2. The Assigned Risk Adjustment Program is approved as proposed by the NCCI to be effective September 1, 1990, and thereafter on new and renewal business except that the maximum surcharge shall be limited to 25%.

In a second rate order issued August 1, 1991, the MDI approved a modified version of NCCI’s proposal to impose a 20% surcharge on all risks in the involuntary market [hereinafter "20% surcharge”]. This rate order modified NCCI’s proposal by limiting the surcharge to only those risks in the involuntary market with an experience modification factor greater than 1.20. The 1991 rate order that approved the 20% surcharge provided, in pertinent part:

11. The NCCI proposal to implement a surcharge of +20% on all risks insured by the assigned risk pool is unfair and unreasonable. By reason of Finding of Fact No. 9 a surcharge of +20% to any risk in the assigned risk pool with an experience modification factor of 1.20 or greater is fair and reasonable as a method to encourage those risks in the pool which are experiencing significantly higher-than-expected losses to take steps to reduce such losses in the future, while at the same time, avoiding the implementation of a surcharge on those risks which are placed in the pool for reasons unrelated to loss experience.

In order for these two surcharges to take effect, they must have been made a part of the contracts between Plaintiffs and Insurance Carriers through endorsements approved by the MDI, which attached to the existing policies. NCCI submitted to the MDI drafts of proposed endorsements for both surcharges. The MDI approved the NCCI authored endorsements without alteration. The ARAP surcharge endorsement was approved by the MDI on March 16, 1992, but this approval was made retroactive to September 1, 1990. The endorsement that implemented the 20% surcharge was also approved by the MDI on March 16, 1992, but this approval was made retroactive to September 1,1991.

Once these two surcharges became effective, Insurance Carriers calculated the employers’ surcharged premiums by applying the first surcharge to the employers’ total modified premium, and then the second surcharge was calculated by applying the second surcharge to this new value, *86 the sum of the total modified premium plus the first surcharge. 2 Plaintiffs believe that this “multiplicative” method of calculation was contrary to the rate orders and ensuing endorsements approved by the MDI, and, thus, this calculation ultimately resulted in Insurance Carriers breach of contract. 3 Plaintiffs, therefore, filed a petition in the Circuit Court of Cole County on February 20, 1997. In their action for damages, Plaintiffs alleged that Insurance Carriers did not use the proper calculation method for the two workers’ compensation surcharges forcing Plaintiffs to overpay the total premium owed. Plaintiffs further alleged that NCCI was negligent in its administration of the involuntary market in that it allowed Insurance Carriers to calculate and assess premiums in violation of the laws of the State of Missouri.

In July 1999, NCCI moved for summary judgment. Shortly thereafter, Insurance Carriers followed suit and filed its motion for summary judgment in August 1999. After written discovery and depositions, the parties submitted briefs, and oral argument was heard on the motions on November 10, 1999. On March 9, 2000, the circuit court granted summary judgment in favor of NCCI and Insurance Carriers and against Plaintiffs, holding that the “multiplicative” approach was the proper method for calculating Plaintiffs’ premiums. This appeal followed.

II. Standard of Review

An appellate court’s standard of review of a summary judgment is essentially de novo. Lewis v. Snow Creek, Inc.,

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Bluebook (online)
51 S.W.3d 83, 2001 Mo. App. LEXIS 643, 2001 WL 376387, Counsel Stack Legal Research, https://law.counselstack.com/opinion/atlas-reserve-temporaries-inc-v-vanliner-insurance-co-moctapp-2001.