Brickstreet Mutual Insurance Co. v. Zurich American Insurance Co.

813 S.E.2d 67
CourtWest Virginia Supreme Court
DecidedApril 5, 2018
Docket17-0592
StatusPublished
Cited by7 cases

This text of 813 S.E.2d 67 (Brickstreet Mutual Insurance Co. v. Zurich American Insurance Co.) is published on Counsel Stack Legal Research, covering West Virginia Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Brickstreet Mutual Insurance Co. v. Zurich American Insurance Co., 813 S.E.2d 67 (W. Va. 2018).

Opinion

Davis, Justice:

This Court is herein presented with three certified questions from the United States Court of Appeals for the Fourth Circuit. The underlying action is a dispute between two insurance companies, petitioner BrickStreet Mutual Insurance Company ("BrickStreet") and respondent Zurich American Insurance Company ("Zurich"), over whether both companies should contribute to the payment of workers' compensation benefits arising from a single uncontested work-related injury. The subject injury was to an employee who had been hired by BrickStreet's insured, Employers' Innovative Network, LLC ("EIN"), a professional employer organization ("PEO"), and assigned by EIN to work for Zurich's *70 insured, Taggart Site Services Group ("Taggart"). Our resolution of this matter necessitates that we answer only two of the questions certified: 1

(1) Does jurisdiction lie exclusively with the West Virginia Workers' Compensation Office of Judges to hear disputes between insurance carriers regarding whether one or both carriers are responsible for contributing toward payment of an employee's workers' compensation benefits?
(2) West Virginia Code § 33-46A-7(a) requires that parties to a professional employer agreement designate "either" the professional employer organization (PEO) "or" the client-employer as responsible for obtaining workers' compensation insurance coverage for covered employees ...; and under subsection (b) of the statute, if the PEO is the designated party, the client-employer "shall at all times remain ultimately liable" to provide workers' compensation coverage for covered employees. Do these statutory provisions mandate the designated party's workers' compensation policy as the primary policy over coverage provided by the other party, precluding the PEO and client-employer from agreeing to provide shared coverage? And, if the PEO is designated as the responsible party to obtain workers' compensation coverage, does the term "ultimately" trigger liability by the client-employer for such coverage only if the PEO, or its carrier, defaults?

(Footnote defining "covered employee" omitted).

We reformulate the first question and answer it in the negative, finding that the Workers' Compensation Office of Judges does not have jurisdiction over a declaratory judgment action such as the one underlying the instant proceeding. We answer the second question in the affirmative, and conclude that, pursuant to W. Va. Code § 33 -46A-7(a) (2008) (Repl. Vol. 2011), parties to a professional employer agreement must designate either the professional employer organization or the client-employer as the responsible party for obtaining workers' compensation insurance coverage for covered employees. Moreover, pursuant to W. Va. Code § 33 -46A-7(b), and W. Va. C.S.R. § 85-31-6.3, when parties to a professional employer agreement designate the PEO as the responsible party for obtaining workers' compensation insurance coverage for covered employees, the policy obtained by the PEO is primary over a policy obtained by a client-employer. Therefore, coverage under a workers' compensation policy purchased by the client-employer is triggered only if the PEO or its carrier default on their obligation to provide workers' compensation coverage. 2

I.

FACTUAL AND PROCEDURAL HISTORY

In 2010, EIN executed a professional employer agreement (sometimes referred to as a "PEO agreement") with Taggart "to provide professional employer organization services at [Taggart's] workplace(s) through the assignment to [Taggart's] workplace(s) of qualified EIN employees ('Worksite Employees'), including supervisory personnel." (Emphasis added). 3

*71 EIN and other PEOs in this State are governed by W. Va. Code § 33 -46A-1 et seq . With respect to workers' compensation, the West Virginia Code requires, in relevant part:

(a) The responsibility to obtain workers' compensation coverage for covered employees in compliance with all applicable law shall be specifically allocated in the professional employer agreement to either the client-employer or the PEO .
(b) If the responsibility is allocated to the PEO under the agreement:
(1) The agreement shall require that the PEO maintain and provide workers' compensation coverage for the covered employees from a carrier authorized to do business in this state: Provided, That the provisions of section seven [§ 23-2-7], article two, chapter twenty-three of this chapter [ 4 ] may not be abrogated by a PEO agreement and the client-employer shall at all times remain ultimately liable under chapter twenty-three of this code to provide workers' compensation coverage for its covered employees [ 5 ] ;

W. Va. Code § 33 -46A-7 (footnotes and emphasis added). Accordingly, and of particular relevance to the instant dispute, the professional employer agreement between EIN and Taggart expressly required that "EIN shall obtain and maintain workers' compensation coverage on all Worksite Employees assigned to [Taggart's] workplace(s) and shall administer all related workers' compensation claims. [Taggart] shall, however, maintain its status as a complying employer with its current insurance carrier. ..."

In compliance with the foregoing agreement, EIN secured workers' compensation coverage through a multiple coordinated policy issued by BrickStreet. 6 The BrickStreet policy names Taggart as an insured and provides that BrickStreet "will pay promptly when due the benefits required of you by the workers [sic] compensation law."

Likewise, Taggart had workers' compensation coverage through a policy issued by Zurich. The policy was issued to Taggart's parent company and listed Taggart as a named insured. Thus, by virtue of this policy, Taggart complied with both its obligation imposed by W. Va. Code § 33 -46A-7 to "remain ultimately liable under chapter twenty-three [§ 23-1-1 et seq.] of this code to provide workers' compensation coverage for its covered employees," and its obligation under the professional employer agreement with EIN to "maintain its status as a complying employer with its current insurance carrier. ..."

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Bluebook (online)
813 S.E.2d 67, Counsel Stack Legal Research, https://law.counselstack.com/opinion/brickstreet-mutual-insurance-co-v-zurich-american-insurance-co-wva-2018.