Nielsen Contracting, Inc. v. Applied Underwriters, Inc.

CourtCalifornia Court of Appeal
DecidedMay 3, 2018
DocketD072393
StatusPublished

This text of Nielsen Contracting, Inc. v. Applied Underwriters, Inc. (Nielsen Contracting, Inc. v. Applied Underwriters, Inc.) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Nielsen Contracting, Inc. v. Applied Underwriters, Inc., (Cal. Ct. App. 2018).

Opinion

Filed 5/3/18 CERTIFIED FOR PUBLICATION

COURT OF APPEAL, FOURTH APPELLATE DISTRICT

DIVISION ONE

STATE OF CALIFORNIA

NIELSEN CONTRACTING, INC. et al., D072393

Plaintiffs and Respondents,

v. (Super. Ct. No. 37-2017-00001814-CU-CO-CTL) APPLIED UNDERWRITERS, INC. et al.,

Defendants and Appellants.

APPEAL from a judgment of the Superior Court of San Diego County, Gregory

W. Pollack, Judge. Affirmed.

Hinshaw & Culbertson, Spencer Y. Kook and Travis Wall for Defendants and

Appellants.

Larry J. Lichtenegger for Plaintiffs and Respondents.

Nielsen Contracting, Inc. and T&M Framing, Inc. (collectively Nielsen) sued

several entities (defendants) alleging these entities fraudulently provided workers'

compensation policies to Nielsen that were illegal and contained unconscionable terms.

Defendants moved to compel arbitration and stay the litigation under an arbitration provision in one defendant's contract, titled Reinsurance Participation Agreement

(RPA). Nielsen opposed the motion, asserting the arbitration provision and the

provision's delegation clause were unlawful and void. After briefing and a hearing, the

trial court agreed and denied defendants' motion.

Defendants appeal. They contend: (1) the arbitrator, and not the court, should

decide the validity of the RPA's arbitration agreement under the agreement's delegation

clause; and (2) if the court properly determined it was the appropriate entity to decide

the validity of the delegation and arbitration provisions, the court erred in concluding

these provisions are not enforceable. We reject these contentions and affirm.

FACTUAL AND PROCEDURAL SUMMARY

We summarize the facts based on the complaint's allegations, and the materials

submitted in support of and opposition to the motion to compel arbitration. We describe

only those facts necessary to resolve the issues pertaining to the arbitration issue, and

make no attempt to discuss all of the facts relevant to Nielsen's substantive allegations

against defendants.

Background

In 2012, Applied Underwriters, Inc. (Applied) provided quotes to Nielsen for

Applied's patented workers' compensation program known as "EquityComp." Based on

Applied's representations about the program's low cost and profit-sharing benefits,

Nielsen signed a "Request to Bind" with Applied. Under this agreement, Nielsen was

2 initially issued a guaranteed-cost workers' compensation policy by California Insurance

Company (CIC), one of Applied's subsidiaries.

The Request to Bind also required Nielsen to sign a separate agreement (the

RPA) with another one of Applied's subsidiaries, Applied Underwriters Captive Risk

Assurance Company, Inc. (AUCRA). Nielsen and AUCRA signed the RPA in

December 2012. The RPA had a three-year term.

The RPA modified and supplanted many of the CIC policy terms, including

adding an arbitration provision. As discussed in more detail below, this provision

required arbitration of "[a]ny dispute or controversy" in the British Virgin Islands before

"disinterested officials of insurance or reinsurance companies." The arbitration

provision delegated to the arbitrator the authority to rule on disputes concerning the

enforceability of the arbitration provision. This is known as a "delegation clause."

Complaint

In January 2017, Nielsen filed a complaint against Applied and its two

subsidiaries (AUCRA and CIC) (collectively defendants). Nielsen sought a declaration

that the RPA is void and its provisions are unconscionable, and sought damages for

defendants' misrepresentations and breach of the implied covenant of good faith and fair

dealing. Nielsen alleged the RPA is an adhesion contract with unfair and

unconscionable terms; the RPA was written and structured to purposely mislead Nielsen

and to intentionally avoid and circumvent California insurance laws; and the RPA is an

illegal contract because it was not filed with or approved by the California Department

3 of Insurance (Insurance Department), as required by Insurance Code section 11658 and

title 10 of the California Code of Regulations section 2268.1 Nielsen alleged

"EquityComp is the brainchild of Applied," which caused CIC to issue an approved

guaranteed-cost workers' compensation insurance policy "to give the appearance of

compliance with the California insurance regulations, although CIC is never responsible

for making payment on claims using its own money."

Several months before this complaint was filed, in June 2016, the California

Insurance Commissioner (Insurance Commissioner) issued an administrative decision in

a case involving a different insured (Shasta Linen Supply, Inc.) that had challenged the

same EquityComp insurance program offered by these same defendants. (Matter of

Shasta Linen Supply, Inc., Decision & Order, dated June 20, 2016, File No. AHB-

WCA-14-31 (Shasta Linen).) In the 70-page decision, the Insurance Commissioner

found the RPA to be unlawful and void as a matter of law for various reasons, including

that it had not been filed and approved by the Insurance Department before it was

issued. (Ibid.) In reaching this conclusion, the Insurance Commissioner also found the

governing administrative regulations require workers' compensation insurers to obtain

approvals for "side agreements," including arbitration provisions that differ from the

1 Further unspecified statutory references are to the Insurance Code. Further references to Regulations sections are to title 10 of the California Code of Regulations. Unless otherwise stated, all references to Regulations section 2268 are to the version existing in 2012 when the parties signed the RPA.

4 dispute resolution provisions in a previously approved insurance policy. (Id. at p. 43;

See Regs., § 2268.)

Two months after the Shasta Linen administrative decision was issued, the

Insurance Department entered into a stipulated cease-and-desist order with Applied,

CIC, and AUCRA. In this stipulation, defendants stated they disagreed with the Shasta

Linen administrative decision, but acknowledged the decision "was made precedential"

under Government Code section 11425.60, subdivision (b).2 Defendants also agreed it

would not issue any new RPA or renew any existing RPA unless the policy is filed with

and approved by the Insurance Department.3

Motion to Compel Arbitration

In response to Nielsen's complaint, AUCRA moved to compel arbitration under

the RPA's lengthy arbitration provision. Of relevance here, the provision states:

"(A) It is the express intention of the parties to resolve any disputes arising under this Agreement without resort to litigation in order to protect the confidentiality of their relationship and their respective business and affairs. Any dispute or controversy . . . arising out of

2 This code section permits an administrative agency to designate a decision as "precedent" if the decision "contains a significant legal or policy determination of general application that is likely to recur." (Gov. Code, § 11425.60, subd. (b).) An administrative decision so designated can be relied upon by the agency in later cases. (Id., subd. (a).)

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