State Compensation Insurance Fund v. McConnell

294 P.2d 440, 46 Cal. 2d 330, 1956 Cal. LEXIS 188
CourtCalifornia Supreme Court
DecidedMarch 2, 1956
DocketS. F. 19164
StatusPublished
Cited by27 cases

This text of 294 P.2d 440 (State Compensation Insurance Fund v. McConnell) 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
State Compensation Insurance Fund v. McConnell, 294 P.2d 440, 46 Cal. 2d 330, 1956 Cal. LEXIS 188 (Cal. 1956).

Opinions

McCOMB, J.

Plaintiffs (State Compensation Insurance Fund and six California insurance companies) filed an action against defendant (the California Insurance Commissioner) for declaratory relief, injunction and mandamus, to prevent a certain order changing the present system of rating workmen’s compensation insurance premiums from becoming effective.

[335]*335Another California insurance company, Industrial Indemnity Company, intervened as plaintiff.

From a judgment sustaining the validity of the order, all plaintiffs appeal.

Questions

First: Did the defendant Insurance Commissioner have the power to promulgate and adopt Ruling 67 changing the method of rating premiums for workmen’s compensation insurance f

Yes. Reduced to its bare rudiments, Ruling 67 provides for two new rating systems: (1) the “Retrospective” plans, and (2) a “Premium Discount Plan.” Within the general retrospective scheme there are three separate plans, “D,” “A” and “B.” Thus, we have four plans to consider.

1. The Retrospective Plans:

All three retrospective plans have this in common: Final determination of premium cost is delayed, being computed retrospectively after the expiration of the insurance and on the basis of paid and actual loss experience during the insurance period. Bach insured’s premium is determined on an individual basis, without reference to other employers or to particular fields or occupations. (However, in each retrospective plan, a sort of ‘tentative ’ ’ premium is paid initially, and then adjusted at the end of the insurance period to the actual premium.)

Plan D: Plan D provides for retrospective determination of premium for employers who produce $5,000 or more in annual premium from operations in all states. Determination may be on an annual or three-year basis. The unique feature of Plan D is that the employer may combine premiums from other lines of liability insurance with his workmen’s compensation premium in order to become eligible for this plan. (This multiline provision is not in either Plan A or B.) In brief, Plan D may be chosen if annual premium is over $5,000, based on premiums from all states, including other types of liability insurance. (Test: $5,000 total, multistate, multiline.)

Plan A: Plan A provides for retrospective determination of premium for employers who produce $1,000 or more in workmen’s compensation premium in all states. (Workmen’s compensation only; not a multiline plan.) The standard (or tentative) premium in Plan A is always the maximum pre[336]*336mium, and the minimum premium is higher than in Plan B. (Test: $1,000 total, multistate, workmen’s compensation only.)

Plan B: Plan B provides for retrospective determination of premium for employers who produce $1,000 or more in workmen’s compensation premium in all states. (Workmen’s compensation only; not a multiline plan.) In this plan, the standard (tentative premium) is lower than the maximum, and the minimum premium is lower, correspondingly, than the minimum, premium in Plan A. These maximum-minimum levels are the chief differences between Plans A and B. (Test: $1,000 total, multistate, workmen’s compensation only.)

How retrospective plans work: Retrospective rating is defined in Appendix B to Ruling 67 as “a plan or method which permits adjustment of the final premium for a Risk on the basis of its own loss experience subject to Maximum and Minimum limits.” In tabular plans A and B, the maximum and minimum premiums are fixed in relation to the standard (tentative) premium, which in Plan A is the maximum and in Plan B is much lower. In Plan D, the selection of maximum and minimum limits is left (within limits) to agreement between the buyer and seller. Within the limits of the maximum and minium, Ruling 67 provides formulae reflecting loss experience and costs used in determining the final cost of the insurance. The appropriate formula is applied at the end of the insurance period, and the result is an adjustment of the standard premium to reflect the actual loss and cost experience during the insurance period. This adjustment results in the retrospective rate.

2. Premium Discount Plan:

This plan provides for graduated expense loading determined through a scale of discounts graduated according to the annual amount of the employer’s premium. To qualify for this plan, the employer must have premiums from workmen’s compensation in excess of $1,000. This total may include premiums paid in all states to one insurer, but may not include other lines of liability insurance. (Multistate, but not multiline.) Then, the discount is applied to the California portion of the premium. This discount is received no matter how small the California portion may be; that is, the California portion need not be over $1,000. Furthermore, the discount is granted irrespective of loss experience.

“The California portion of the total workmen’s compensation standard premium of the policy or group of policies com[337]*337bined in accordance with this Rule shall be subject to the following discounts:

Total Workmen's Compensation Standard Premium

First $ 1,000

Next 4,000

Next 95,000

Over 100,000

Discounts Applicable to California Portion

None

7.1%

12.2%

13.7%

“The foregoing premium discounts shall not be applicable to any standard premium subject to. retrospective rating.” (Rule YII (2) Underwriting and Auditing Procedure of the California State Insurance Commissioner.)

In Statutes 1913, chapter 176, a compulsory workmen’s compensation system and the State Compensation Insurance Fund were established by the Legislature, without any express constitutional authority therefor. To give legality to an already accomplished fact, article XX, section 21, California Constitution, authorizing the Legislature to “create, and enforce a complete system of workmen’s compensation,” was adopted in 1918. Pursuant thereto, we now have Insurance Code, sections 11730 to 11742, covering “State Rate Supervision.”1

By Ruling 67, the commissioner seeks to modify existing minimum workmen’s compensation premium rates by putting [338]*338into effect two new rating plans, one of them called the “Premium Discount Plan” and the other the “Retrospective Rating Plan.”

The purpose of both rating plans is to introduce into the California workmen’s compensation insurance minimum rate structure the principle of ‘expense graduation by size of risk” as a means of reflecting in premium rates the commissioner’s finding that an insurance company’s expense involved in handling individual risks represents a smaller percentage of the premium in the case of larger risks than in the case of smaller risks.

The present system, under which minimum premium rates are loaded by the commissioner for expense on a flat percentage basis without reference to possible variation of expense by size of risk, involves a redundancy of the expense item in the ease of the larger risks.

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

Related

Allied Interstate Inc. v. Sessions Payroll Management, Inc.
203 Cal. App. 4th 808 (California Court of Appeal, 2012)
Arteaga v. Brink's, Inc.
163 Cal. App. 4th 327 (California Court of Appeal, 2008)
Satey v. JPMorgan Chase & Co.
521 F.3d 1087 (Ninth Circuit, 2008)
Simi Corporation v. Garamendi
1 Cal. Rptr. 3d 207 (California Court of Appeal, 2003)
20th Century Insurance v. Garamendi
878 P.2d 566 (California Supreme Court, 1994)
P. W. Stephens, Inc. v. State Compensation Insurance Fund
21 Cal. App. 4th 1833 (California Court of Appeal, 1994)
Maxon Industries, Inc. v. State Compensation Insurance Fund
16 Cal. App. 4th 1387 (California Court of Appeal, 1993)
Courtesy Ambulance Service v. Superior Court
8 Cal. App. 4th 1504 (California Court of Appeal, 1992)
R. J. Reynolds Co. v. California Insurance Guarantee Ass'n
235 Cal. App. 3d 595 (California Court of Appeal, 1991)
American International Group, Inc. v. Superior Court
234 Cal. App. 3d 749 (California Court of Appeal, 1991)
Winzler & Kelly v. Department of Industrial Relations
121 Cal. App. 3d 120 (California Court of Appeal, 1981)
Kreisberg v. Commissioner
1979 T.C. Memo. 420 (U.S. Tax Court, 1979)
Gordon H. Ball, Inc. v. State ex rel. Department of Public Works
26 Cal. App. 3d 162 (California Court of Appeal, 1972)
People v. Curtis
450 P.2d 33 (California Supreme Court, 1969)
Bituminous Casualty Corp. v. Lewis Crane Service, Inc.
173 So. 2d 715 (District Court of Appeal of Florida, 1965)
Bituminous Casualty Corporation v. Swartout
133 N.W.2d 32 (Supreme Court of Minnesota, 1965)
State Insurance Commissioner v. Allstate Insurance
351 P.2d 433 (Oregon Supreme Court, 1960)

Cite This Page — Counsel Stack

Bluebook (online)
294 P.2d 440, 46 Cal. 2d 330, 1956 Cal. LEXIS 188, Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-compensation-insurance-fund-v-mcconnell-cal-1956.