Curran v. INDUSTRIAL COM'N OF ARIZONA

752 P.2d 523, 156 Ariz. 434, 5 Ariz. Adv. Rep. 16, 1988 Ariz. App. LEXIS 66
CourtCourt of Appeals of Arizona
DecidedMarch 29, 1988
Docket1 CA-IC 3772
StatusPublished
Cited by22 cases

This text of 752 P.2d 523 (Curran v. INDUSTRIAL COM'N OF ARIZONA) is published on Counsel Stack Legal Research, covering Court of Appeals of Arizona primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Curran v. INDUSTRIAL COM'N OF ARIZONA, 752 P.2d 523, 156 Ariz. 434, 5 Ariz. Adv. Rep. 16, 1988 Ariz. App. LEXIS 66 (Ark. Ct. App. 1988).

Opinion

OPINION

FROEB, Presiding Judge.

This is a special action review of an Industrial Commission award for noncompensable claims. Compensability was denied because the applicable workers’ compensation insurance covered claims against but not by the insured, a sole proprietor. The central issue on review is whether the insured has a remedy against the compensation carrier for the alleged negligence or deceit of the sub-agent who prepared the application for insurance. We hold that the insured is not entitled to relief against the carrier, and we affirm the award.

The petitioner filed two compensation claims for work-related injuries. By notices of claim status, the respondent carrier (Fremont) denied both claims. The second of these notices of claim status specified that “[sjole proprietor is excluded from policy.” The claimant protested both denials, and the claims were consolidated for hearing.

The sole dispute concerned coverage. The parties stipulated that the claimant had suffered two work-related injuries that would be compensable if covered. Furthermore, Fremont’s defense was purely legal. It produced no evidence to controvert the petitioner’s factual claims. It did, however, produce evidence regarding its underwriting practices.

*435 We turn now to the facts. The claimant testified that in November, 1985 he was a licensed air conditioning and heating contractor doing business as Absolute Air Conditioning and Refrigeration (Absolute), a sole proprietorship. He did not then employ other workers and considered himself to be the sole employee of Absolute. He had won a City of Phoenix contract, which required the petitioner to provide workers’ compensation and other insurance coverage. He contacted several insurance agencies, but only one, Corroon & Black of Arizona, Inc., could get the petitioner the required coverage in time.

The plaintiff dealt personally with “an agent representing Corroon & Black. He was an employee.” According to. the claimant, he showed this agent the City of Phoenix specifications for required insurance coverage, informed him that he was the only employee of Absolute, and reviewed his personal medical history with the agent. In addition, the petitioner provided an estimated payroll, but the record is unclear whether he specifically told the agent that the estimation was based exclusively on the petitioner’s own salary. Based on this information, the agent himself completed the application for workers’ compensation insurance. The agent never identified Fremont as the potential carrier. When the application was complete, the petitioner paid an estimated premium but did not read or sign the application. The claimant believed that he was then insured and that the insurance covered him personally.

The agent personally delivered a standard form application to Fremont. The applicant is identified as the petitioner, doing business as Absolute. The proposed effective date is the date of delivery, November 20,1985. This application indicated that the applicant had two employees and a payroll of $36,000, but the employees were not otherwise identified. The application specifically excluded coverage for the petitioner. The agent alone had signed the application in the space provided for the “producer’s signature.”

The claimant subsequently received a standard form certificate of insurance concerning workers’ compensation coverage and also giving information about general liability coverage with another carrier. It identified Fremont as the workers’ compensation carrier, Corroon & Black as the producer, and the petitioner, doing business as Absolute, as the “insured.” The claimant interpreted this to mean that he was covered personally. He also received an information page, which included nothing to indicate that the petitioner was personally excluded from coverage. He never received the policy or any endorsements. Believing that he was covered, the petitioner allowed other insurance to lapse. Although he acknowledged a problem confirming his coverage in January, 1986, after the first injury, the petitioner testified that the first disclosure of the coverage problem was the June, 1986 notice of claim status.

Fremont’s underwriting manager confirmed that the application it had received excluded coverage for the petitioner. Fremont accordingly never issued an endorsement extending personal coverage to him. Furthermore, the carrier’s underwriting policy prohibited this coverage, and Fremont would have rejected an application for this coverage. The manager did not know, however, if Corroon & Black’s agent knew of this policy. Finally, the manager conceded that nothing in the policy itself would have notified the petitioner that he was not personally covered.

The standard form policy included an integration provision:

The only agreements relating to this insurance are stated in this policy. The terms of this policy may not be changed or waived except by endorsement issued by us to be part of this policy.

It also identified who is insured under the policy as follows:

You are insured if you are an employer named in item 1 [the insured] of the Information Page. If that employer is a partnership, and if you are one of its partners, you are insured, but only in your capacity as an employer of the partnership’s employees.

*436 The policy did not otherwise identify whose injuries were covered. It merely stated that the insurer “will pay promptly when due the benefits required of you by the workers compensation law.”

Based on this evidence, the administrative law judge issued the award for noncompensable claims. He concluded that Fremont’s policy did not cover the petitioner personally, relying on A.R.S. § 23-901(5)(i). Furthermore, he concluded that Fremont was not responsible for the alleged misconduct of the agent and his employer, Corroon & Black. After affirmance on administrative review, this special action followed.

On review, the petitioner concedes the technical accuracy of the administrative law judge’s first conclusion. However, he disputes the second conclusion, asserting that the insurance agent was Fremont’s agent and, therefore, that his misconduct is imputable to Fremont.

COVERAGE OF SOLE PROPRIETORS

We begin our analysis with the general coverage problem. The policy insures the insured against compensation liability. Coverage for particular claims, therefore, depends on the scope of compensation liability. This liability requires an employer-employee relationship. See A.R.S. §§ 23-901(5)(b), -1021(A); accord 1C A. Larson, Workmen’s Compensation Law § 43.10 (1986). The traditional rule required employer and employee to have separate identities. For this reason, partners could not be employees of the partnership. See 1C A. Larson, supra, § 54.31. Similarly, a sole proprietor could not be his own employee. See, e.g., Dunwoody v. Industrial Comm’n, 22 Ariz.App.

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Bluebook (online)
752 P.2d 523, 156 Ariz. 434, 5 Ariz. Adv. Rep. 16, 1988 Ariz. App. LEXIS 66, Counsel Stack Legal Research, https://law.counselstack.com/opinion/curran-v-industrial-comn-of-arizona-arizctapp-1988.