Prate Roofing and Installations, LLC v. Liberty Mutual Insurance Corp.

2022 IL 127140
CourtIllinois Supreme Court
DecidedMay 19, 2022
Docket127140
StatusPublished
Cited by3 cases

This text of 2022 IL 127140 (Prate Roofing and Installations, LLC v. Liberty Mutual Insurance Corp.) is published on Counsel Stack Legal Research, covering Illinois Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Prate Roofing and Installations, LLC v. Liberty Mutual Insurance Corp., 2022 IL 127140 (Ill. 2022).

Opinion

2022 IL 127140

IN THE SUPREME COURT OF THE STATE OF ILLINOIS

(Docket No. 127140)

PRATE ROOFING AND INSTALLATIONS, LLC, Appellee, v. LIBERTY MUTUAL INSURANCE CORPORATION, Appellant.

Opinion filed May 19, 2022.

JUSTICE MICHAEL J. BURKE delivered the judgment of the court, with opinion.

Chief Justice Anne M. Burke and Justices Garman, Theis, Neville, Overstreet, and Carter concurred in the judgment and opinion.

OPINION

¶1 At issue is whether the Department of Insurance (DOI) had the authority to resolve this dispute between Prate Roofing and Installations, LLC (Prate), and Liberty Mutual Insurance Corporation (Liberty) over whether Prate owed additional premiums on its workers’ compensation policy. The appellate court held that under its recent decision in CAT Express, Inc. v. Muriel, 2019 IL App (1st) 181851, the Department of Insurance (DOI) did not have the authority to resolve the dispute and thus vacated the DOI’s final order and the order of the circuit court affirming it. 2021 IL App (1st) 191842-U. We allowed Liberty’s petition for leave to appeal. Ill. S. Ct. R. 315 (eff. Oct. 1, 2020). For the reasons that follow, we disagree with the appellate court’s conclusion and hold that the DOI had the authority to resolve the dispute under section 462 of the Illinois Insurance Code (215 ILCS 5/462 (West 2018)).

¶2 BACKGROUND

¶3 A complete statement of facts may be found in the appellate court’s order. 2021 IL App (1st) 191842-U, ¶¶ 5-29. We summarize here only those facts necessary for an understanding of the sole issue that we address.

¶4 Plaintiff, Prate Roofing and Installations, LLC, is a roofing and construction installations contractor. In 2013, Prate sought workers’ compensation coverage through the Illinois Assigned Risk Plan, which provides workers’ compensation insurance coverage through a risk pool administered by the National Council on Compensation Insurance (NCCI). Liberty was assigned as Prate’s carrier. Prate renewed the policy from October 2014 to June 2015. During that period Liberty audited Prate’s records and determined that one of Prate’s subcontractors, ARW Roofing, LLC (ARW), did not have workers’ compensation insurance. Liberty determined that the omission had exposed it to more liability than it had bargained for and assessed Prate an additional premium of $127,305.

¶5 Prate filed an appeal with the Illinois Workers’ Compensation Appeals Board (Board), which provides dispute resolution services for the NCCI. The Board later informed the parties by letter that it did not have sufficient information to resolve the dispute. Specifically, the Board explained that it had not been given copies of the relevant policy forms and could not confirm or deny whether coverage existed for ARW during the policy period. The Board could also not determine whether ARW was “an LLC or an Inc.” when work was performed and whether that had a bearing on the dispute. The Board suggested that Prate refile its dispute with the DOI along with a copy of the letter explaining why the Board declined to rule.

-2- ¶6 Prate then appealed to the DOI under section 462 of the Insurance Code. The parties waived their right to an in-person hearing and requested that the issues be determined by written submissions and exhibits. Liberty argued that it was entitled to the additional premium because Prate had been making payments to an uninsured subcontractor, ARW. Liberty explained that Prate had a certificate of insurance for another subcontractor, Reliable Trade Services, Inc. (RTS), but that certificate did not cover ARW. Because ARW was an uninsured subcontractor, it created a potential exposure for Liberty, entitling Liberty to an additional premium. Liberty cited Section C.2. of its policy with Prate, which provided:

“All other persons engaged in work that could make us liable under Part One Workers Compensation Insurance of this policy. If you do not have payroll records for these persons, the contract price for their services and materials may be used as the premium basis. This paragraph 2 will not apply if you give us proof that the employers of these persons lawfully secured their workers compensation obligations.”

Liberty also relied on (1) section 1(a)(3) of the Workers’ Compensation Act (820 ILCS 305/1(a)(3) (West 2018)), which provides that employers who engage a subcontractor are

“liable to pay compensation to the employees of any such contractor or sub- contractor unless such contractor or sub-contractor has insured, in any company or association authorized under the laws of this State to insure the liability to pay compensation under this Act, or guaranteed his liability to pay such compensation”

and (2) rule 2-H of the basic manual of the Illinois Assigned Risk Plan, which states that, “For each subcontractor not providing such evidence of workers compensation insurance, additional premium must be charged on the contractor’s policy for the uninsured subcontractor’s employees according to Subcontractor Table 1 and 2 below.” Prate had argued that all the payments it made to ARW were passed through to RTS, but Liberty contended that it was impossible to verify this. Liberty also pointed out that payments were being made to both entities throughout the policy period.

-3- ¶7 Liberty explained in an exhibit that it had calculated the additional premium using the default method provided in manual rule 2-H, tables 1 and 2, as Prate had failed to provide “any invoices to allow [Liberty] to determine the jobs involved, cost breakdowns, or the timeframe for the jobs in which payment is in question.” Accordingly, Liberty assessed the additional premium as 90% of the total paid to ARW. This is the amount specified for situations where a subcontractor fails to furnish adequate documentation and the job involves “labor only.”

¶8 Prate’s position was that Liberty had failed to establish that Prate was bound by the NCCI basic manual or subject to an additional premium for uninsured subcontractors. Assuming arguendo that Prate was subject to the terms of the manual, Prate argued that no additional premium was warranted because ARW did not have any employees. Prate noted that NCCI manual rule 2-H refers to “employees of uninsured subcontractors” and the “uninsured subcontractor’s employees.” Prate explained that all work on Prate projects was performed by employees of RTS and that RTS had workers’ compensation insurance during the relevant time period. Thus, Liberty was not entitled to an additional premium because it had not assumed any risk for workers’ compensation claims involving ARW. Alternatively, Prate claimed that the amount of the additional premium should be only $20,304.52, as Prate had provided evidence that the actual cost of labor for ARW jobs was $44,140.25. Prate contended that this amount should have been multiplied by the workers’ compensation premium rate of $46/100, for a maximum audit premium of $20,304.52.

¶9 The DOI’s hearing officer issued his findings of fact and conclusions of law, agreeing with Liberty on all of the issues. First, the hearing officer concluded that ARW did not have a workers’ compensation insurance policy of its own during the relevant period. Moreover, he concluded that the RTS policy did not provide coverage to ARW. Second, the hearing officer concluded that ARW had employees during the relevant policy period. Key to this determination was an admission by Prate’s president that RTS and ARW would complete contracts for one another. The hearing officer did not see how ARW could complete projects for RTS without employees of its own.

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2022 IL 127140, Counsel Stack Legal Research, https://law.counselstack.com/opinion/prate-roofing-and-installations-llc-v-liberty-mutual-insurance-corp-ill-2022.