Commissioners of the State Insurance Fund v. Photocircuits Corp.

2 Misc. 3d 300, 773 N.Y.S.2d 190, 2003 N.Y. Misc. LEXIS 1388
CourtNew York Supreme Court
DecidedOctober 3, 2003
StatusPublished

This text of 2 Misc. 3d 300 (Commissioners of the State Insurance Fund v. Photocircuits Corp.) is published on Counsel Stack Legal Research, covering New York Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Commissioners of the State Insurance Fund v. Photocircuits Corp., 2 Misc. 3d 300, 773 N.Y.S.2d 190, 2003 N.Y. Misc. LEXIS 1388 (N.Y. Super. Ct. 2003).

Opinion

[301]*301OPINION OF THE COURT

Carol R. Edmead, J.

In this action to recover premiums due under an insurance policy, plaintiff moves for an order (1) striking defendant’s answer and affirmative defenses and granting plaintiff summary judgment against the defendant for $466,100, plus costs pursuant to State Finance Law § 18 (5), or (2) prohibiting defendant from conducting discovery or introducing at trial that plaintiff improperly handled the defense of the workers’ compensation claims filed by defendant’s employees, and (3) for costs and disbursements.

In response, defendant cross-moves for summary judgment to dismiss the complaint on grounds that plaintiffs claims (1) are barred due to the absence of a contract with a valid and binding retrospective premium endorsement; (2) are barred due to plaintiffs breach of the terms of the proffered agreement and endorsements; (3) are untimely under CPLR 213 (2); and (4) to the extent plaintiffs claims are predicated upon an unexecuted and/or postdated retrospective premium agreement and endorsement, such claims are barred by General Obligations Law § 5-701 (a) and CPLR 213 (2).1

In support of plaintiffs motion, plaintiff submits, among other things, the following: defendant’s application for workers’ compensation insurance, the workers’ compensation insurance policy that was issued to defendant (the policy), an “Information Page New Policy” form dated “11/98” pertaining to said policy (the 11/98 endorsement), an audit dated October 31, 1993, an “earned Premium Bill” dated January 20, 1994, the first, second, third, fourth and fifth “Not Final” accounting statements, dated November 1994, June 1995, July 1996, June 1997, and April 2000, respectively, the sixth “Final” accounting statement, dated March 2001, six earned premium bills dated December 1994, August 1995, July 1996, February 1998, April 2000 and April 2001, and the statement of account showing the balance due. Plaintiff also submits an affidavit of director of underwriting Vincent Troianiello (the Vincent affidavit), and an [302]*302affirmation of director of actuarial services Reuben Epstein (the Epstein affirmation).2

According to the Vincent affidavit, plaintiff issued the policy to defendant for the period October 1, 1992 to October 1, 1993. As part of each “Information Page” is the special endorsement for the “One Year L.B. (Low Basic) Retrospective Rating Plan,” which plaintiff issued to defendant (the endorsement). The endorsement, combined with the policy, sets forth the terms and conditions of the policy and the manner in which plaintiff computed the premiums.

The Vincent affidavit continues, by explaining, among other things, the method of calculation of premium charges under the retrospective plan selected by defendant. A retrospective premium plan permits an insurer to recover additional premiums after the end of a policy period based on the insured’s actual claims experience for claims arising during the policy period. In pertinent part, the indicated retrospective premium is the sum of the basic premium and incurred losses, within the range of the maximum and minimum retrospective premium. The affidavit continues:

“For the first year of each policy period, the defendant’s Indicated Retrospective Premium is calculated, and if monies were then due a bill sent, and if a credit results, a refund issued. In any subsequent year, the Indicated Retrospective Premium is calculated by determining if the Incurred Losses have increased or decreased as compared to the prior year’s accounting of Incurred Losses. If the Incurred Losses have increased over and above those incurred in the prior accounting for that same year, an additional premium is due to [plaintiff] ... In each subsequent or retrospective accounting, the increases and/or decreases in the Incurred Losses for each claim are totaled, offset against each other, and then the net result of the Incurred Losses is then compared to the Incurred Losses for the prior Retrospective Accounting for that same period.”

According to the Vincent affidavit, this either increased or decreased the retrospective premium yearly. “The sums claimed to be due in this action to SIF [plaintiff] are because the [303]*303Indicated Retrospective Premium, the sum of the Basic Premium and the Incurred Losses, exceeded the sums paid by defendant to SIF [plaintiff].” According to the Vincent affidavit, after applying credits and debits to the payments made, defendant is indebted to plaintiff for $466,100.

Plaintiff argues that the submissions establish its entitlement to summary judgment. Furthermore, defendant cannot claim that plaintiff mishandled workers’ compensation claims or that it breached its covenant of good faith and dealing, since plaintiff has the right to negotiate and settle claims as it deems appropriate. Further, as the legislative intent is to allow a state agency to collect up to an additional 22% to cover collection costs without establishing whether such amount is reasonable, and plaintiffs costs of collection are 14% $65,254 should be awarded to plaintiff.

Plaintiff further argues that defendant’s affirmative defenses should be stricken, given that defendant’s affirmative defenses (a) of failure to state a cause of action lacks merit; (b) that the action is barred by documentary evidence lacks merit as no such documentary evidence exists; (c) that the action is barred by plaintiffs negligence lacks merit; (d) that the action is barred by the doctrine of unclean hands (fourth), estoppel (fifth), and waiver (sixth) are insufficiently pleaded; (e) that the action is barred by laches lacks merit since laches cannot be asserted as a defense to an action at law; (f) that the action is untimely lacks merit as this action to recover monies due, akin to a claim for installment payments due under a note, was commenced within the six-year statute of limitations; and (g) that the action is barred by the terms of the policy lacks merit as no such terms exist. Defendant’s tenth affirmative defense seeking to preserve the right to assert additional affirmative defenses lacks merits, since no such defenses have been asserted.

Defendant opposes plaintiffs summary judgment motion and cross-moves for summary relief pursuant to CPLR 3212 (b). Defendant contends that plaintiff failed to establish the existence of the very contract and endorsement forming the basis of the demanded relief. Defendant contends that plaintiff’s claim is supported by the “11/98 endorsement,” which according to the deposition of Mr. Chali,3 was a form “probably” issued in 1998. Therefore, since plaintiffs claim, based on a postdated endorsement, could not have been part of the policy issued for 1992-[304]*3041993, plaintiff failed to establish the terms of the agreement. Defendant also argues that assuming plaintiff has established a valid and binding agreement, plaintiff failed to establish the undisputed terms of such agreement. The “One Year L.B.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

American Insurance Co. v. Midwest Motor Express, Inc.
554 N.W.2d 182 (North Dakota Supreme Court, 1996)
Brookshire Grocery Co. v. Bomer
959 S.W.2d 673 (Court of Appeals of Texas, 1997)
Hartford Accident & Indemnity Co. v. Costal Dry Dock & Repair Corp.
467 N.E.2d 894 (New York Court of Appeals, 1984)
John J. Kassner & Co. v. City of New York
389 N.E.2d 99 (New York Court of Appeals, 1979)
Edlux Construction Corporation v. State
14 N.E.2d 197 (New York Court of Appeals, 1938)
Edlux Construction Corp. v. State
252 A.D. 373 (Appellate Division of the Supreme Court of New York, 1937)
Zuckerman v. City of New York
404 N.E.2d 718 (New York Court of Appeals, 1980)
Phoenix Acquisition Corp. v. Campcore, Inc.
612 N.E.2d 1219 (New York Court of Appeals, 1993)
Ely-Cruikshank Co. v. Bank of Montreal
615 N.E.2d 985 (New York Court of Appeals, 1993)
Vigilant Insurance of America v. Housing Authority of El Paso
660 N.E.2d 1121 (New York Court of Appeals, 1995)
3092 Realty Corp. v. Callaway
691 N.E.2d 626 (New York Court of Appeals, 1997)
Hartford Accident & Indemnity Co. v. Coastal Dry Dock & Repair Corp.
97 A.D.2d 724 (Appellate Division of the Supreme Court of New York, 1983)
Bentivegna v. Meenan Oil Co.
126 A.D.2d 506 (Appellate Division of the Supreme Court of New York, 1987)
Paz v. Singer Co.
151 A.D.2d 234 (Appellate Division of the Supreme Court of New York, 1989)
Dayton Towers Corp. v. Leon D. DeMatteis & Sons, Inc.
212 A.D.2d 396 (Appellate Division of the Supreme Court of New York, 1995)
County of Rockland v. Homicki
227 A.D.2d 477 (Appellate Division of the Supreme Court of New York, 1996)
Robbins v. Growney
229 A.D.2d 356 (Appellate Division of the Supreme Court of New York, 1996)
Commissioners of the State Insurance Fund v. Gem Steel Erectors Inc.
237 A.D.2d 213 (Appellate Division of the Supreme Court of New York, 1997)
Loiacono v. Goldberg
240 A.D.2d 476 (Appellate Division of the Supreme Court of New York, 1997)
Commissioners of the State Insurance Fund v. Netti Wholesale Beverage Co.
245 A.D.2d 48 (Appellate Division of the Supreme Court of New York, 1997)

Cite This Page — Counsel Stack

Bluebook (online)
2 Misc. 3d 300, 773 N.Y.S.2d 190, 2003 N.Y. Misc. LEXIS 1388, Counsel Stack Legal Research, https://law.counselstack.com/opinion/commissioners-of-the-state-insurance-fund-v-photocircuits-corp-nysupct-2003.