Key System Transit Lines v. Pacific Employers Insurance Co.

345 P.2d 257, 52 Cal. 2d 800, 1959 Cal. LEXIS 250
CourtCalifornia Supreme Court
DecidedOctober 27, 1959
DocketS. F. 19858
StatusPublished
Cited by9 cases

This text of 345 P.2d 257 (Key System Transit Lines v. Pacific Employers Insurance Co.) is published on Counsel Stack Legal Research, covering California Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Key System Transit Lines v. Pacific Employers Insurance Co., 345 P.2d 257, 52 Cal. 2d 800, 1959 Cal. LEXIS 250 (Cal. 1959).

Opinion

SPENCE, J.

Plaintiffs sought reformation of a policy of workmen’s compensation insurance issued by the defendant insurance company, and also damages for alleged breach of the terms of the policy as reformed. Defendants successfully interposed the defense of illegality to defeat such reformation and enforcement. From the judgment accordingly entered, plaintiffs appeal.

The main question to be determined is whether the policy, in the event of its reformation, would have been illegal and therefore unenforceable. Our review of the pertinent statutes leads us to the conclusion that the trial court properly so held, and that the judgment should be affirmed.

Plaintiffs alleged that in May, 1950, they entered into a workmen’s compensation insurance contract with defendants. The policy was to be effective for one year, May 14, 1950, to May 14, 1951. A “Participation Endorsement” was attached to the policy and incorporated as a part thereof. The material portion of that endorsement reads as follows:

“After the expiration of this Policy, this Employer shall be entitled to a refund payable from any surplus of premiums derived from all compensation insurance policies insuring Employers and Employees under the Workmen’s Compensation Insurance and Safety Laws of the State of California, and which has accrued after adequate provision has been made for all losses, loss expenses, reserves, taxes and other charges. Such refund, if any, shall be computed as follows: From the amount of the entire premium earned and paid to the Company under this Policy, there shall be deducted amounts equal to the cost of incurred losses, including reserves *803 on open claims, and incurred loss and other expenses chargeable to this Policy. The amount of the balance, if any, shall be payable to this policyholder as may be provided in the authorized refund plan of the Company in effect and applicable to this Policy.”

Plaintiffs further alleged that as an inducement to plaintiffs, defendants had represented that there was to be included, as part of the policy, a participation plan under which the agreed advance premium was to be returned to plaintiffs to the extent that the premium exceeded the sum of (1) the total amount of losses under the policy, including open reserves, and (2) 25.5 percent of the premium, as administration fees. Calculation of this amount would be made 18 months after the expiration date of the policy, the period allowed for final settlement of all claims between the parties. Plaintiffs entered into the contract with defendants in reliance on these oral representations; but through the mutual mistake of the parties, or mistake of plaintiffs and fraud of defendants, the policy contained only the quoted “Participation Endorsement” and omitted the provisions of the oral agreement.

Plaintiffs finally alleged facts indicating that under the participation plan set forth in the oral agreement, they were entitled to a refund of $21,703.67 and that defendants had an accumulated surplus of premiums derived from California compensation business to pay such refund but they had only paid plaintiffs $2,665 of the amount owing. Accordingly, plaintiffs prayed that the contract be reformed to include the oral agreement and that the reformed policy be enforced, with damages to them in the amount of $19,038.67.

Defendants’ answer denied most of the allegations of plaintiffs’ complaint but admitted the execution and delivery of the policy, and the payment of $2,665 as a “participating policy holders’ dividend.” Their answer also raised certain special defenses, including that of illegality if the contract were reformed as plaintiffs prayed. On defendants' motion, there was a trial of the special defenses (Code Civ. Proc., § 597), and for the purpose of the trial on such limited issues, the court accepted the allegations of the complaint as true. It found that the reformed agreement would be illegal and unenforceable as calling for “a rebate” and resulting in “the charging of a premium less than that established by” state *804 law. Accordingly, it concluded that the defense of illegality constituted a bar to plaintiffs’ action.

On this appeal, plaintiffs take the position (1) that reformation was “unnecessary” and that they are entitled to enforcement of the policy as issued through ‘‘ interpretation and explanation of its terms” in the light of the oral agreement between the parties and (2) that in any event, they are entitled to reformation and enforcement, as the reformed policy would not provide for a rebate in violation of the minimum rating law (Ins. Code, §§ 11730-11742) but merely for a participating dividend as permitted by sections 763 and 11738 of the Insurance Code. On the other hand, defendants contend that plaintiffs have stated no cause of action under the policy as issued, and that the enforcement of the reformed policy would violate the minimum rating and antirebate provisions of the Insurance Code. The Insurance Commissioner as amicus curiae joins defendants in these contentions.

Defendants rely heavily upon the decision of this court in Contractor’s Safety Assn. v. California Comp. Ins. Co., 48 Cal.2d 71 [307 P.2d 626], in which a collateral agreement, not appearing in the policy, was held illegal. The purpose of the minimum rating law was there discussed at pages 74 and 75 as follows:

“The minimum rating law (now Ins. Code, §§ 11730-11742) was enacted in 1915 to eliminate irresponsible premium policies which developed in response to competitive conditions in the insurance field. The purpose of this law was to require a premium rate which would assure adequate reserves to meet claims as they matured. Obviously, the purpose of the law would be frustrated if collateral agreements could effect a reduction of the premium. For this reason agreements affecting the premium were brought within the scope of statutory and administrative regulation.”

Plaintiffs seek to distinguish the Contractor’s Safety Association ease by reference to the language of that decision where it was said at page 76 : “If the insurance policy which was not pleaded included the agreement and the agreement otherwise conformed to the requirements of the Insurance Code, a different situation would have been presented.” They contend that the instant ease presents a “different situation” in that the oral agreement was to have been included in the policy as pleaded, and that said oral agreement “otherwise conformed to the requirements of the Insurance Code.”

*805 We may assume, without deciding, that even in the field of workmen’s compensation insurance, the presumption that the parties’ entire agreement is embodied in the policy as written (Ins. Code, § 751; rule III, Manual of Rules, Classifications and Basic Rates for Workmen’s Compensation Insurance, promulgated March 1, 1950; Contractor’s Safety Assn. v. California Comp. Ins. Co., supra, 48 Cal.2d 71, 75) would not preclude the reformation of the policy where “through fraud of one and mistake of the other, or mutual mistake ... it does not embody therein the actual contract intended, or fully set forth the same.” (6 Couch, Cyclopedia of Insurance Law, § 1391, p.

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Cite This Page — Counsel Stack

Bluebook (online)
345 P.2d 257, 52 Cal. 2d 800, 1959 Cal. LEXIS 250, Counsel Stack Legal Research, https://law.counselstack.com/opinion/key-system-transit-lines-v-pacific-employers-insurance-co-cal-1959.