Delka v. Continental Casualty Co.

2008 SD 28, 748 N.W.2d 140, 2008 S.D. LEXIS 26, 2008 WL 902928
CourtSouth Dakota Supreme Court
DecidedApril 2, 2008
Docket24288
StatusPublished
Cited by7 cases

This text of 2008 SD 28 (Delka v. Continental Casualty Co.) is published on Counsel Stack Legal Research, covering South Dakota Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Delka v. Continental Casualty Co., 2008 SD 28, 748 N.W.2d 140, 2008 S.D. LEXIS 26, 2008 WL 902928 (S.D. 2008).

Opinion

ZINTER, Justice.

[¶ 1.] Following an occupational disability, Ted E. Delka commenced this action against Greentree Transportation Company (Greentree); one of Greentree’s employees, Charlene Burd (Burd); and Continental Casualty Company (CCC). Delka pleaded nine causes of action arising out of his enrollment under Greentree’s group occupational accident insurance policy that Greentree had purchased from CCC for Greentree’s employees and independent contractors. The circuit court granted summary judgment dismissing CCC. Del-ka appeals. We affirm.

[¶ 2.] In 1999, Delka, a trucker residing in South Dakota, began working as an independent contractor for Greentree, a Pennsylvania company. Greentree required its independent contractors to have workers’ compensation insurance or occupational accident insurance (OAI) as a condition of employment. Burd advised Del-ka that group OAI was available through Greentree, and allegedly stated that it was “just like” workers’ compensation insurance. Delka did not have either type of insurance, and he enrolled under Green-tree’s group OAI policy with CCC. Upon enrollment, Delka received an insurance card, but alleges that he received no other information about the policy.

[¶ 3.] CCC is in the business of providing OAI. CCC employed Ameriplan Benefit Corporation (Ameriplan) as CCC’s underwriting manager. Greentree had applied to CCC for a group OAI policy. Southern States Insurance Agency (Southern States) acted as Greentree’s in *143 surance agent or broker in the transaction. CCC issued the group policy to Greentree as the policyholder. Greentree purchased and received delivery of the policy in Pennsylvania. Therefore, the parties agree that Pennsylvania law governs the relationship between CCC as the insurer, Greentree as the policyholder, and Delka as an insured under the group policy. The parties further agree that, pursuant to their employment agreement, Pennsylvania law governs the relationship between Greentree and Delka.

[¶ 4.] Greentree’s contract of insurance with CCC required Greentree, not Delka, to pay the monthly premiums for the OAI. The premium was based upon the total number of independent contractors covered each month. Greentree’s cost of insurance for Delka was $92 per month. Greentree, however, deducted $125 per month from Delka’s checks, which was $38 per month (a total of $396) more than Greentree’s cost of OAI during the time Delka was employed. Allegedly, $18 of the monthly excess was deducted for a “contingent liability policy” that covered Greentree, and $15 was deducted for “Greentree’s losses” on independent contractor insurance. Delka contends that he had no knowledge of these additional premium deductions and alleges that he was being overcharged. 1

[¶ 5.] In 2000, Delka was involved in a work-related accident that rendered him unemployable. After his accident, Delka had his first contact with CCC: Delka received copies of his application and CCC’s policy. CCC subsequently paid Delka all disability and medical benefits afforded under Greentree’s OAI policy. Although there is no dispute that CCC fully complied with the terms of the group policy, the policy benefits were limited to five years, and Delka alleges that he is permanently disabled and will need further medical care for the rest of his life. Delka therefore contends that the OAI is insufficient to cover his disability and that Greentree and CCC are liable for misleading him in believing that OAI was just like workers’ compensation insurance.

[¶ 6.] Delka brought this suit on causes of action alleging deceit, bad faith, violation of South Dakota’s Unfair Trade Practices Act, violation of Pennsylvania’s Unfair Insurance Practices Act, negligent misrepresentation, breach of fiduciary duty, conversion, fraud and concealment, and negligence. The gravamen of all claims is that the OAI was misrepresented as being “just like” workers’ compensation insurance and Delka was overcharged. With respect to CCC and vicarious liability, Delka alleges that Greentree was CCC’s agent in the group insurance transactions and therefore, CCC is vicariously liable for Greentree’s acts and omissions. With respect to direct liability, Delka alleges that CCC misrepresented certain facts to Delka, had knowledge of overcharging for OAI, and breached duties it owed to Delka arising from obligations independent of the group insurance contract.

[¶ 7.] The circuit court granted summary judgment dismissing CCC on all claims. With respect to vicarious liability, the circuit court concluded that Greentree and Burd could not, as a matter of Pennsylvania law, be deemed CCC’s agents in enrollment and premium transactions involving group insurance. With respect to direct liability, the circuit court observed that Delka failed to assert that CCC made any representations to Delka prior to his *144 accident. The court also concluded that CCC owed Delka no duty independent of its obligations under the group insurance contract. 2

[¶ 8.] Delka appeals raising the following issues:

1. Whether Greentree was CCC’s agent in the OAI group insurance transactions.
2. Whether CCC made misrepresentations or owed any duties to Delka independent of CCC’s obligations under the policy.

We review these issues under our familiar standard of review:

Summary judgment is authorized if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact, and that the moving party is entitled to judgment as a matter of law. We will affirm only when there are no genuine issues of material fact and the legal questions have been correctly decided. All reasonable inferences drawn from the facts must be viewed in favor of the non-moving party. The burden is on the moving party to clearly show an absence of any genuine issue of material fact and an entitlement to judgment as a matter of law. Summary judgment will be affirmed if there exists any basis which would support the trial court’s ruling.

Schwaiger v. Avera Queen of Peace Health Serv., 2006 SD 44, ¶7, 714 N.W.2d 874,

Agency

[¶ 9.] Delka contends that Green-tree acted as CCC’s agent in the marketing and servicing of the group insurance and therefore CCC is vicariously liable for Greentree’s alleged overcharging and misrepresentations. Pennsylvania’s law on agency with regard to group insurance is well settled. The United States Supreme Court, applying Pennsylvania law, concluded:

When procuring [a group] policy, obtaining applications of employees, taking payroll deduction orders, reporting changes in the insured group, paying premiums, and, generally, in doing whatever may serve to obtain and keep the insurance in force, employers [such as Greentree] act not as agents of the insurer [such as CCC], but for their employees [such as Delka] or for themselves.

Boseman v. Connecticut Gen. Life Ins. Co., 301 U.S. 196, 204-05, 57 S.Ct. 686, 690, 81 L.Ed. 1036 (1937) (citations omitted).

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Cite This Page — Counsel Stack

Bluebook (online)
2008 SD 28, 748 N.W.2d 140, 2008 S.D. LEXIS 26, 2008 WL 902928, Counsel Stack Legal Research, https://law.counselstack.com/opinion/delka-v-continental-casualty-co-sd-2008.