Texas Workers' Compensation Insurance Facility v. Comptroller of Public Accounts and the Attorney General of the State of Texas

CourtCourt of Appeals of Texas
DecidedJanuary 10, 2002
Docket03-01-00371-CV
StatusPublished

This text of Texas Workers' Compensation Insurance Facility v. Comptroller of Public Accounts and the Attorney General of the State of Texas (Texas Workers' Compensation Insurance Facility v. Comptroller of Public Accounts and the Attorney General of the State of Texas) is published on Counsel Stack Legal Research, covering Court of Appeals of Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Texas Workers' Compensation Insurance Facility v. Comptroller of Public Accounts and the Attorney General of the State of Texas, (Tex. Ct. App. 2002).

Opinion

TEXAS COURT OF APPEALS, THIRD DISTRICT, AT AUSTIN


NO. 03-01-00371-CV
Texas Workers' Compensation Insurance Facility, Appellant


v.



Comptroller of Public Accounts and The Attorney General of the State of Texas, (1) Appellees



FROM THE DISTRICT COURT OF TRAVIS COUNTY, 126TH JUDICIAL DISTRICT

NO. 97-03602, HONORABLE PAUL DAVIS, JUDGE PRESIDING

Appellant Texas Workers' Compensation Insurance Facility (the Facility) seeks a refund of roughly $24,000,000 from the Comptroller for taxes it claims it paid. The tax at issue is the maintenance tax surcharge paid by insurance companies that write workers' compensation insurance policies. See Tex. Ins. Code Ann. art. 5.76-5, § 10(a)(1) (West Supp. 2002). Although the Facility was an association of workers' compensation insurance companies, it was not an insurance company itself and thus was not subject to the tax. See id. § 10(a). It was, however, required to reimburse its member companies for the taxes they paid. See 28 Tex. Admin. Code § 1.411 (1993) (repealed) ("Rule 1.411"). (2) The Facility asserts that it is entitled to a refund because: (1) it effectively paid the tax by reimbursing the member companies even though it was not subject to the tax; and (2) the Department of Insurance exceeded its authority by adopting Rule 1.411, which required the Facility to reimburse the companies for the tax when the Facility was not itself subject to the tax under article 5.76-5, section 10(a). See Tex. Ins. Code Ann. art. 5.76-5, § 10(a) (West Supp. 2002).

We hold that: (1) the member insurance companies, not the Facility, paid the tax; (2) Rule 1.411 is valid and the Facility's reimbursement obligation was a lawful component of the legislative scheme under which the Facility operated; (3) the Facility's role in reimbursing its servicing companies does not convert the Facility into a taxpayer; and (4) the Facility has not met the statutory prerequisite for a tax refund. We therefore reject the Facility's claim for a tax refund and affirm the judgment of the trial court.



The Involuntary Market

Under the Texas Workers' Compensation Act, an employer may obtain workers' compensation insurance coverage through a licensed insurance company or, in certain instances, through self-insurance. See Tex. Labor Code Ann. § 406.003 (West 1996). Many employers who are unable to purchase insurance in the private voluntary market also are ineligible to self-insure. Since 1953, the Texas legislature has prescribed a variety of "residual" or "involuntary" market mechanisms to afford coverage to these "rejected risks," that is, those employers who are unable to obtain workers' compensation insurance through ordinary methods in the voluntary market. See Act of May 14, 1953, 53d Leg., R.S., ch. 279, § 1, 1953 Tex. Gen. Laws 716, 716-18, repealed by Act of Dec. 11, 1989, 71st Leg., 2d C.S., ch. 1, § 16.01(21), 1989 Tex. Gen. Laws 1, 114-15.

The legislative scheme has changed over the years. The coverage was initially provided by the Texas Workers' Compensation Assigned Risk Pool, (3) then by the Facility, (4) and currently by the Texas Mutual Insurance Company, (5) which was initially established as the Texas Workers' Compensation Insurance Fund. (6) From the beginning, the legislative design has remained constant in one regard: The cost of providing involuntary coverage was placed on all insurance companies that write workers' compensation policies as a proportional cost of their business in the state, (7) not on taxpayers generally. Indeed, the legislature has expressly prohibited the expenditure of public funds for costs associated with providing involuntary insurance. (8)



The Facility

The Facility, which was responsible for providing involuntary insurance from 1991 through 1993, was a non-profit association that all independent insurance companies licensed to write workers' compensation insurance in Texas were required to join. See Act of Dec. 11, 1989, 71st Leg., 2d C.S., ch. 1, § 13.11, 1989 Tex. Gen. Laws 1, 89-97 (amended 1991, repealed 1997) (formerly codified as Texas Insurance Code art. 5.76-2) (hereafter art. 5.76-2). More than three hundred such insurance companies were authorized by the Board of Insurance as eligible "servicing companies" of the Facility. See art. 5.76-2, §§ 1.01(11), 4.08. After determining that a company was entitled to involuntary coverage, the Facility would contract with one of its servicing companies, who in turn issued and serviced the policy, including auditing and collecting premiums, on its behalf. See art. 5.76-2, §§ 1.01(11), 4.02(b); see also All Star Metal & Roofing, Inc. v. Texas Dep't of Ins., 935 S.W.2d 186, 187, n.2 (Tex. App.--Austin 1996, no writ). The Facility ceased writing workers' compensation insurance on December 31, 1993, and the Fund replaced it as the insurer of last resort. (9) Although the legislature terminated the Facility in favor of the Fund, it maintained the statutory scheme of making insurance companies responsible for the cost of the involuntary market. In 1991, it enacted a law requiring the Texas Public Finance Authority to issue revenue bonds to finance the creation of the Fund. See Act of Aug. 25, 1991, 72d Leg., 2d C.S., ch. 12, § 18.19, Tex. Gen. Laws 252, 358 (currently codified at Tex. Ins. Code Ann. art. 5.76-5 (West Supp. 2002)). (10) All insurance companies collecting workers' compensation premiums must pay a proportionate share of the cost of servicing the bonds by paying a maintenance tax surcharge based on their correctly reported gross premiums. See Tex. Ins. Code Ann. arts. 5.76-5, § 10(b), 5.68 (West Supp. 2002). (11)

These provisions were in effect during the final years of the Facility's existence. The servicing companies paid the surcharge and the Facility was required to reimburse them. See Rule 1.411(d)(1). Likewise, the Facility was entitled to recoup the reimbursed amounts from policy holders by setting premium rates to reflect the surcharge. See Tex. Ins. Code Ann. art. 5.76-5, § 10(d) (West Supp. 2002) (authorizing insurance companies to pass the cost of the surcharge through to their policy holders); Rule 1.411(d)(2) (mandating that insurance companies that are also servicing companies of the Facility must implement the section 10(d) pass-through procedure and remit all funds received to the Facility). In the last year of its operation, the Facility decided to impose a recoupment rate of three percent on policy holders even though this was inadequate to cover surcharge costs and a shortfall resulted. (12)

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