Grimaud v. Pennsylvania Insurance Department

995 A.2d 391, 2010 Pa. Commw. LEXIS 216, 2010 WL 1688485
CourtCommonwealth Court of Pennsylvania
DecidedApril 28, 2010
Docket1683 C.D. 2009
StatusPublished
Cited by8 cases

This text of 995 A.2d 391 (Grimaud v. Pennsylvania Insurance Department) is published on Counsel Stack Legal Research, covering Commonwealth Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Grimaud v. Pennsylvania Insurance Department, 995 A.2d 391, 2010 Pa. Commw. LEXIS 216, 2010 WL 1688485 (Pa. Ct. App. 2010).

Opinion

OPINION BY

Judge BROBSON.

I. INTRODUCTION

Petitioner Gerald P. Grimaud d/b/a Beaver Logging (Beaver Logging) petitions for review of an Adjudication and Order of the Insurance Commissioner of the Commonwealth of Pennsylvania (Commissioner). In his Adjudication and Order, the Commissioner affirmed a determination by the Appeals Subcommittee of the Pennsylvania Compensation Rating Bureau (PCRB), denying Beaver Logging’s challenge to its business’s classification for purposes of calculating its workers’ compensation insurance premium. For the reasons that follow, we affirm.

*394 II. BACKGROUND 1

Beaver Logging is a Pennsylvania sole proprietorship whose business includes purchasing timber, harvesting timber (cutting/felling trees by chain saw), and hauling and marketing logs. Beaver Logging has its own log truck, a tractor trailer, which Beaver Logging principally uses to haul its logs from its staging areas to saw mills and pulp mills. Transportation of logs cut/felled by logging businesses is integral to such businesses.

Historically, either Gerald P. Grimaud (Owner), Beaver Logging’s owner, or a Beaver Logging employee drives the log truck. During the period relevant to this case, Beaver logging had only one employee — a part-time truck driver. Beaver Logging employees who operate the logging truck historically have not performed any other logging or logging-related activities, such as using chain saws. Instead, they have been employed for the sole purpose of loading, unloading, driving, and mechanical work. 2

The parties agree, and the Commissioner found, that the skills required of a person acting as a logger and those of a truck driver are markedly different. Loggers require skills such as the operation and repair of dangerous equipment (e.g., cable, chain saws, power saws) and wear safety equipment (e.g., hard hats with earmuffs and screen, chaps and gloves and long johns, heavy shirt, coat and rain gear for cold weather, snow, mud and water). Truck drivers, by contrast, require the skills commensurate with obtaining a commercial drivers license and operate generally within the confines of a heated truck cab.

Beaver Logging must compete with other logging businesses and different businesses in hiring and retaining qualified truck drivers. Beaver Logging believes that sawmills with log trucks, and log hauling companies whose sole business is hauling logs, pay wages to their drivers that Beaver Logging itself cannot afford to pay for this work. Since purchasing its log truck on September 9, 2004, Beaver Logging has hired eight drivers and has lost seven drivers. Beaver Logging estimates that those drivers have together worked a total of 12 to 14 weeks, with its current driver working part-time since July 2007.

The PCRB is a nongovernmental rating organization of private insurers. Pennsylvania Ass’n of Home Health Agencies v. Commonwealth, Ins. Dep’t, 119 Pa. Cmwlth. 495, 547 A.2d 824, 825 (1988). Pursuant to Section 654 of the Insurance Company Law of 1921 (Law), 3 the PCRB is required to file with the Commissioner for his review and amendment, modification, or approval a system of classifications of risks, underwriting rules, premium rates, and schedule or merit rating plans for workers’ compensation insurance in Pennsylvania. Under Section 707 of the Workers Compensation Act (Act), 4 every workers’ compensation insurer is required *395 to be a member of a rating organization and must adhere to the uniform classification system of the rating organization to which it belongs. Member insurers, however, may develop subclassifications to the uniform classification system of its rating organization. 77 P.S. § 1035.7(b)(2). The PCRB filing at issue in this case is the “Pennsylvania Workers Compensation Manual of Rates, Classifications and Rating Values for Workers Compensation and for Employers Liability Insurance” with an effective date of April 1, 2007 (Manual). 5

The Act defines “classification” and “classification system” as “the plan, system or arrangement for recognizing differences in exposure to hazards among industries, occupations or operations of insurance policyholders.” Id. § 1035.3. The PCRB uses numerical codes in its approved classification system. In Graduate Health Systems, Inc. v. Pennsylvania Insurance Department, 674 A.2d 367 (Pa.Cmwlth.1996), this Court described the PCRB’s classification system as follows:

The general provisions of the manual governing classifications provide that the objective of the classification system is to group insureds into classifications so that the rate for each classification reflects the exposures common to such distinct business enterprise. Subject to certain exceptions, it is the business of the insured within Pennsylvania that is classified, not the separate employments, occupations or operations within the business. All classifications in the manual are basic classifications; however, some occupations are common to so many businesses that special classifications, known as standard exception classifications, have been established for them. Two such standard exception classifications are clerical office employees or Code 953 and salespersons, collectors or messengers-Outside or Code 951....
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The manual provides further, with respect to the assignment of classifications, that the object is to assign the one basic classification which best describes each distinct business enterprise of the insured within Pennsylvania. Each classification includes all the various types of labor found in a distinct enterprise. Each classification is presumed to describe an entire business enterprise.

Graduate Health, 674 A.2d at 370-71 (citations omitted).

The Manual provides, as a general rule, that separate operations within a single business are to be considered a “single enterprise” for purposes of classification:

Single Enterprise. If a risk consists of a single operation or a number of separate operations which normally occur in the business described by a single manual classification, or separate operations which are an integral part of or incidental to the main business, that single classification which most accurately describes the entire enterprise shall be applied. The separate operations so covered may not be assigned to another classification even though such operation may be specifically described by some other classification or may be conducted at a separate location.

*396 Manual Rule § 1, IV.C.2.b.

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Bluebook (online)
995 A.2d 391, 2010 Pa. Commw. LEXIS 216, 2010 WL 1688485, Counsel Stack Legal Research, https://law.counselstack.com/opinion/grimaud-v-pennsylvania-insurance-department-pacommwct-2010.