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

California Court of Appeal·Decided May 3, 2018·No. D072393·Published

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

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

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.

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).)

3 We deny Nielsen's request that we take judicial notice of a later settlement agreement between defendants and the Insurance Department in which defendants agreed to dismiss their superior court writ petition challenging the Shasta Linen decision. This settlement agreement was not before the trial court, and therefore it is not properly before this court. (See Vons Companies, Inc. v. Seabest Foods, Inc. (1996) 14 Cal.4th 434, 444, fn. 3.)

or related to this Agreement shall be fully determined in the British Virgin Islands under the provisions of the American Arbitration Association [AAA].

Free access — add to your briefcase to read the full text and ask questions with AI

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

Nielsen Contracting, Inc. v. Applied Underwriters, Inc. (Nielsen Contracting, Inc. v. Applied Underwriters, Inc.) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

Related

Prima Paint Corp. v. Flood & Conklin Mfg. Co.
388 U.S. 395 (Supreme Court, 1967)
First Options of Chicago, Inc. v. Kaplan
514 U.S. 938 (Supreme Court, 1995)
Buckeye Check Cashing, Inc. v. Cardegna
546 U.S. 440 (Supreme Court, 2006)
Preston v. Ferrer
552 U.S. 346 (Supreme Court, 2008)
McCullough Transfer Co. v. Virginia Surety Co., Inc
213 F.2d 440 (Sixth Circuit, 1954)
Peng v. First Republic Bank CA1/1
219 Cal. App. 4th 1462 (California Court of Appeal, 2013)
Vons Companies, Inc. v. Seabest Foods, Inc.
926 P.2d 1085 (California Supreme Court, 1996)
Ritter v. Shotwell
388 P.2d 527 (Washington Supreme Court, 1964)
Yamaha Corp. of America v. State Board of Equalization
960 P.2d 1031 (California Supreme Court, 1998)
Lewis & Queen v. N. M. Ball Sons
308 P.2d 713 (California Supreme Court, 1957)
Gonzales v. Concord Gardens Mobile Home Park, Ltd.
90 Cal. App. 3d 871 (California Court of Appeal, 1979)
Mission National Insurance v. Coachella Valley Water District
210 Cal. App. 3d 484 (California Court of Appeal, 1989)
Frontier Oil Corp. v. RLI Insurance
63 Cal. Rptr. 3d 816 (California Court of Appeal, 2007)
Malek v. Blue Cross of California
16 Cal. Rptr. 3d 687 (California Court of Appeal, 2004)
J.A. Jones Construction Co. v. Superior Court
27 Cal. App. 4th 1568 (California Court of Appeal, 1994)
Microsoft Corp. v. Franchise Tax Board
139 P.3d 1169 (California Supreme Court, 2006)
Carmona v. Lincoln Millennium Car Wash CA2/8
226 Cal. App. 4th 74 (California Court of Appeal, 2014)
Malone v. Superior Court
226 Cal. App. 4th 1551 (California Court of Appeal, 2014)
Pinela v. Neiman Marcus Group, Inc.
238 Cal. App. 4th 227 (California Court of Appeal, 2015)