Esposito v. Simkins Industries, Inc.

943 A.2d 456, 286 Conn. 319, 2008 Conn. LEXIS 100
CourtSupreme Court of Connecticut
DecidedApril 1, 2008
DocketSC 18019
StatusPublished
Cited by5 cases

This text of 943 A.2d 456 (Esposito v. Simkins Industries, Inc.) is published on Counsel Stack Legal Research, covering Supreme Court of Connecticut primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Esposito v. Simkins Industries, Inc., 943 A.2d 456, 286 Conn. 319, 2008 Conn. LEXIS 100 (Colo. 2008).

Opinion

Opinion

KATZ, J.

The principal issue on appeal is whether, under the Connecticut Insurance Guaranty Association Act (guaranty act), General Statutes §§ 38a-836 through 38a-853, a self-insured employer that initially is liable for a workers’ compensation claim as the last insurer on the risk is permitted to seek apportionment, pursuant to General Statutes § 31-299b, 1 against the defendant Connecticut Insurance Guaranty Association (association), 2 for an insolvent insurance carrier’s share of *322 workers’ compensation benefits. The association appeals from the decision of the workers’ compensation review board (board) affirming the decision of the workers’ compensation commissioner for the eighth district (commissioner), ordering the association to reimburse the named defendant, Simkins Industries, Inc. (Simkins), for the portion of the benefits that Simkins otherwise would have been able to obtain from an insolvent insurer. We affirm the board’s decision.

The record discloses the following undisputed facts and procedural history. The named plaintiff, Nicholas Esposito (decedent), began working for Simkins in 1948, and continued in that employment relationship until May 16,1984. In February, 1999, he filed a claim for workers’ compensation benefits, pursuant to General Statutes § 31-294c, alleging that he had sustained an occupational disease, including asbestosis, which arose out of and in the course of his employment with Simkins. The decedent died in 2000, and Angelina Esposito, the decedent’s wife and executrix of his estate, was substituted as claimant in the underlying action.

Throughout the decedent’s employment history with Simkins, Simkins either fully insured its workers’ compensation risk or self-insured that risk pursuant to General Statutes § 31-284. Simkins was self-insured, however, during the last period of the decedent’s employment, from April 1,1965, through May 16,1984.* * 3 *323 On the basis of the varied insurance coverage during the course of the decedent’s employment history, the commissioner apportioned responsibility for the decedent’s occupational disease amongst Simkins’ insurers, including Simkins itself as a self-insurer. 4 One of those insurers, American Mutual Liability Insurance Company (American Mutual), had declared bankruptcy and no longer was in business.

In accordance with § 31-299b, as the last insurer on the risk, Simkins administered the claim, but retained the right to pursue a claim against prior insurance carriers for an apportionment of liability and recovery of benefits expended on the claim. In its role administering the claim pursuant to § 31-299b, Simkins had reached a settlement with the parties that resolved all issues regarding the decedent’s claim, except that of apportionment. Angelina Esposito received a $200,000 settlement to resolve her claim against Simkins and its insurers. The insurers, together with the association, had agreed to resolve the issue of apportionment of liability subsequent to settlement, and all parties agreed to the reasonableness of the settlement figure. In accordance with the percentages of responsibility allocated by the commissioner, Simkins then sought reimbursement as follows: $63,400 from the association, on behalf of American Mutual; $21,000 from Liberty Mutual Insurance Company; $2400 from American Employers Insurance Company; and $400 from Employers’ Liability Assurance Corporation.

*324 In the proceedings before the commissioner, the association acknowledged that workers’ compensation claims that previously had been the responsibility of American Mutual were being administered by the association pursuant to General Statutes § 38a-841. 5 The association contended, however, that it was not obligated to reimburse Simkins for American Mutual’s proportionate share of the settlement because Simkins’ claim was not a “covered claim” under § 38a-841 (1), as that term is defined by General Statutes § 38a-838 (5). 6 Specifically, the association contended that the *325 claim fell within the exception to the definition of a covered claim of “any claim by or for the benefit of any . . . insurer ... as subrogation recoveries or otherwise . . . .” General Statutes § 38a-838 (5). The association also claimed that Simkins could not seek apportionment because it had failed to exhaust its administrative remedies prior to making its claim for apportionment pursuant to § 31-299b. The commissioner rejected the association’s contentions and ordered the insurers and the association to reimburse Simkins for their respective apportionment shares. The association appealed from that decision to the board, which affirmed the decision on the ground that the decision is controlled by Connecticut Ins. Guaranty Assn. v. State, 278 Conn. 77, 896 A.2d 747 (2006), and Doucette v. Pomes, 247 Conn. 442, 724 A.2d 481 (1999). This appeal followed. 7

On appeal, the association renews the two claims that it made before the commissioner: (1) Simkins is not entitled to seek apportionment; and (2) even if it were, it is precluded from doing so in the present case because it failed to exhaust its administrative remedies. The association further contends that this case is not controlled by Doucette and its progeny because those cases did not involve apportionment under § 31-299b. We reject the association’s claims.

I

It is undisputed that, under the exception to covered claims in § 38a-838 (5), insurers are not entitled to *326 obtain reimbursement under the guaranty act. The first issue we must decide, therefore, is whether Simkins, as a self-insurer, is an insurer for purposes of the guaranty act and, consequently, is precluded from recovering from the association.

At the outset, we set forth the applicable standard of review. Because the facts are undisputed, the question before us solely is one of statutory interpretation. Accordingly, “our review is plenary and we must determine whether the trial court’s conclusions of law are legally and logically correct and find support in the stipulated facts.” (Internal quotation marks omitted.) Doucette v. Pomes, supra, 247 Conn. 453. “Cases that present pure questions of law . . . invoke a broader standard of review than is ordinarily involved in deciding whether, in light of the evidence, the agency has acted unreasonably, arbitrarily, illegally or in abuse of its discretion. . . . We have determined, therefore, that the traditional deference accorded to an agency’s interpretation of a statutory term is unwarranted when the construction of a statute . . .

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Cite This Page — Counsel Stack

Bluebook (online)
943 A.2d 456, 286 Conn. 319, 2008 Conn. LEXIS 100, Counsel Stack Legal Research, https://law.counselstack.com/opinion/esposito-v-simkins-industries-inc-conn-2008.