Eastern Air Lines, Inc. v. Insurance Co.

85 F.3d 992
CourtCourt of Appeals for the Second Circuit
DecidedJune 5, 1996
DocketNo. 956, Docket 95-5038
StatusPublished
Cited by8 cases

This text of 85 F.3d 992 (Eastern Air Lines, Inc. v. Insurance Co.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Second Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Eastern Air Lines, Inc. v. Insurance Co., 85 F.3d 992 (2d Cir. 1996).

Opinion

KEARSE, Circuit Judge:

Plaintiff Eastern Air Lines, Inc. (“Eastern”), appeals from a final judgment of the United States District Court for the Southern District of New York, John E. Sprizzo, Judge, affirming an order of the bankruptcy court that dismissed Eastern’s complaint against defendant The Insurance Company of the State of Pennsylvania (“ISOP”) for the immediate refund of a premium overpayment under the terms of an insurance contract and of an additional amount of premium that allegedly exceeded the rate permitted by the State of Florida. The district court affirmed the bankruptcy court’s grant of summary judgment in favor of ISOP dismissing the complaint on the grounds that the insurance contract (a) was enforceable and (b) did not require ISOP to refund Eastern’s premium overpayment prior to January 31, 1994. On appeal, Eastern contends that it was entitled to judgment in its favor principally on the ground that the challenged premium term of the contract was invalid because ISOP failed to obtain Eastern’s consent to that term as required by Florida law and failed to file the contract with the pertinent Florida regulatory agency. For the reasons that follow, we disagree and affirm the judgment of the district court.

I. BACKGROUND

The present controversy centers on workers’ compensation insurance needed by Eastern in order to comply with various state laws and with provisions of its labor con[994]*994tracts. The relevant events are not in dispute.

A. The Negotiations and the Insurance Contract

In January 1989, Eastern’s insurance broker solicited from a number of insurance companies proposals for a nationwide worker’s compensation insurance policy to become effective upon the expiration of Eastern’s existing policy some three weeks thence. At that time it was common knowledge that Eastern was facing mounting labor and financial difficulties, and no insurance carrier was willing to issue to Eastern a “guaranteed cost” plan under which premium payments would be established chiefly on a prospective basis without regard to actual losses incurred. Instead, each carrier proposed a loss-sensitive plan, under which the premium would be calculated largely retrospectively by reference to Eastern’s actual loss claims.

ISOP proposed a loss-sensitive plan calling for Eastern to pay at the beginning of the coverage period a premium deposit, in cash and by letter of credit, totaling approximately $23 million, which approximated Eastern’s anticipated covered losses (including associated expenses). If it turned out that actual covered losses were significantly below the amount deposited, Eastern would be entitled to a partial refund. If, instead, it turned out that such losses significantly exceeded the initial deposit, Eastern would be required to pay additional premium; however, regardless of actual loss experience, the proposed plan set a ceiling, expected to be approximately $28 million, on Eastern’s premium (the “maximum premium”). The maximum premium was to be computed retrospectively essentially by multiplying Eastern’s actual payroll by two factors: (a) ISOP’s “filed rates,” and (b) a “maximum premium factor” of 1.6. Filed rates are, basically, multipliers that states require an insurer to file with state regulatory agencies; the insurer then multiplies the applicable filed rates by the insured’s payroll to yield a figure known as “standard audited premium.” Thus, ISOP’s proposed policy provided in essence that the formula for calculating Eastern’s maximum premium would be {Eastern’s actual payroll} x {ISOP’s filed rates} x 1.6; i.e., the maximum premium would be 160% of ISOP’s “standard audited premium.”

Eastern was amenable to ISOP’s proposal, except that it could not obtain a sufficiently large letter of credit to make an immediate deposit of $23 million. Following negotiations, ISOP agreed to accommodate Eastern’s financial condition by lowering the initial deposit amount, spreading deposit payments over a 10-month period, and forgoing any requirement that Eastern post collateral. In return for these concessions, Eastern agreed that if it were eventually entitled to a refund, ISOP would not be required to refund the paid-in premium, at least up to the amount of the maximum premium, prior to January 31, 1994.

Accordingly, Eastern and ISOP entered into a contract entitled “THE INSURANCE COMPANY OF THE STATE OF PENNSYLVANIA WORKERS COMPENSATION DIVIDEND PLAN RATING AGREEMENT” (the “Plan” or “ISOP-Eastem Plan”), under which ISOP agreed to provide Eastern with nationwide workers’ compensation coverage for the period February 1, 1989, to February 1, 1990. With respect to Eastern’s premium deposit, the Plan provided that the “Expected Total Premium” was “$21,000,000” (Plan Addendum No. 1, at 1), of which $3,500,000 was to be paid by Eastern on February 1, 1989, with the remaining $17,500,000 paid in 10 equal monthly installments beginning on March 1, 1989. The Plan stated that the “Maximum Premium Factor” was “1.60.” (Plan at 1.)

With respect to the retrospective calculations of loss and the final premium amount payable by Eastern, the Plan provided, in pertinent part, as follows:

4. PREMIUM ADJUSTMENT PROCEDURES
After the initial twelve (12) months, losses will be examined quarterly. Ultimate loss levels will be estimated using the Table of Loss Development Factors indicated below. Final Premium and Dividend (if any) will be calculated and recorded. If at anytime, [sic ] the Final Premium indicated by these calculations exceeds the Paid-in Premium, the additional premium will [995]*995be immediately billed, subject to Maximum Premium Limitations. All billings will be due and payable within thirty (30) days.
5. PLAN TERM
The term of this plan is five (5) years. At the expiration of the term, the reported incurred losses will be adjusted to ultimate level using the appropriate Loss Development Factor, and will be considered final.
6. PLAN TERMINATION
Upon receipt of the January 31, 1994 Loss Report, the calculation of final premium and dividend (if any) will be made according to the formula contained in this plan. Any additional premium, subject to maximum premium limitation, will be immediately due and payable. Any dividend or return of paid-in premium will be immediately credited and the account will be closed.

(Plan Addendum No. 1, at 1-2.)

B. The Florida Statute

The largest portion of the risk covered under the Plan was in Florida, as the covered Florida residents outnumbered the covered residents of all other states combined. Florida has an elaborate insurance regulatory scheme, see generally Fla.Stat.Ann. § 627.011, et. seq., designed chiefly “to protect policyholders and the public against the adverse effects of excessive, inadequate, or unfairly discriminatory insurance rates,” id. § 627.031(2). To this end, each insurance company doing business in Florida and providing workers’ compensation coverage for residents of Florida is required to, inter alia, file with the Florida Department of Insurance (“FDOI” or the “Department”) every rating plan

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85 F.3d 992, Counsel Stack Legal Research, https://law.counselstack.com/opinion/eastern-air-lines-inc-v-insurance-co-ca2-1996.