Tilbury Constructors, Inc. v. State Compensation Insurance Fund

40 Cal. Rptr. 3d 392, 137 Cal. App. 4th 466, 2006 Cal. Daily Op. Serv. 2026, 2006 Daily Journal DAR 2795, 71 Cal. Comp. Cases 393, 2006 Cal. App. LEXIS 310
CourtCalifornia Court of Appeal
DecidedMarch 7, 2006
DocketC049150
StatusPublished
Cited by62 cases

This text of 40 Cal. Rptr. 3d 392 (Tilbury Constructors, Inc. v. State Compensation Insurance Fund) 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
Tilbury Constructors, Inc. v. State Compensation Insurance Fund, 40 Cal. Rptr. 3d 392, 137 Cal. App. 4th 466, 2006 Cal. Daily Op. Serv. 2026, 2006 Daily Journal DAR 2795, 71 Cal. Comp. Cases 393, 2006 Cal. App. LEXIS 310 (Cal. Ct. App. 2006).

Opinion

Opinion

ROBIE, J.

Plaintiff Tilbury Constructors, Inc., sued its workers’ compensation insurance carrier, State Compensation Insurance Fund (State Fund), asserting causes of action for breach of contract, breach of the implied covenant of good faith and fair dealing, and three other claims. Tilbury’s complaint is primarily based on the contention that State Fund “performed an incompetent investigation into the responsibility for an accident suffered by one of Tilbury’s employees, and, as a result, [State Fund] unreasonably settled a third-party claim for less than one-fiftieth of the value of the employee’s claim. Because [State Fund] obtained almost no setoff from the responsible party, Tilbury’s premiums skyrocketed.” We shall conclude State Fund’s conduct does not give rise to a cause of action for breach of the insurance contract or a cause of action for the tortious breach of the covenant *471 of good faith and fair dealing. We shall affirm the judgment dismissing the action after the trial court sustained State Fund’s demurrer without leave to amend. 1

FACTUAL AND PROCEDURAL BACKGROUND

Our review of the trial court’s actions in sustaining State Fund’s demurrer without leave to amend is governed by well-settled principles. “ 1 “We treat the demurrer as admitting all material facts properly pleaded, but not contentions, deductions or conclusions of fact or law. [Citation.] We also consider matters which may be judicially noticed.” [Citation.] Further, we give the complaint a reasonable interpretation, reading it as a whole and its parts in their context. [Citation.] When a demurrer is sustained, we determine whether the complaint states facts sufficient to constitute a cause of action. [Citation.] And when it is sustained without leave to amend, we decide whether there is a reasonable possibility that the defect can be cured by amendment: if it can be, the trial court has abused its discretion and we reverse; if not, there has been no abuse of discretion and we affirm. [Citations.] The burden of proving such reasonable possibility is squarely on the plaintiff.’ ” (Zelig v. County of Los Angeles (2002) 27 Cal.4th 1112, 1126 [119 Cal.Rptr.2d 709, 45 P.3d 1171], quoting Blank v. Kirwan (1985) 39 Cal.3d 311, 318 [216 Cal.Rptr. 718, 703 P.2d 58].) Our review of the legal sufficiency of the complaint is de novo, “i.e., we exercise our independent judgment about whether the complaint states a cause of action as a matter of law. [Citation.]” (Montclair Parkowners Assn. v. City of Montclair (1999) 76 Cal.App.4th 784, 790 [90 Cal.Rptr.2d 598].)

Applying this standard of review here, Tilbury’s complaint alleges the following:

Tilbury entered into an insurance contract for workers’ compensation insurance with State Fund on April 1, 2000.

In September 2000, Tilbury was working on the expansion of California Dairies Inc.’s facilities in Turlock, California. Tilbury worked as a subcontractor for Golden State Steel Company, Inc., which in turn was a subcontractor to the general contractor on the project, Harris Company, Inc.

Most of Tilbury’s work took place in the creamery silo. Harris employees ordered Tilbury employees not to use Tilbury ladders in the silo. In fact, a *472 Harris employee installed its own portable metal extension ladder in the silo to provide access to the catwalk inside the silo. The Harris employee, however, failed to properly secure that ladder.

On September 25, 2000, Gary Alfrey, one of Tilbury’s employees, was working in the silo. A Harris employee directed Alfrey to climb to the catwalk and erect a safety line. Alfrey used Harris’s ladder to ascend to the catwalk when the ladder slipped out from under him and he fell 12 feet to the ground. Alfrey suffered severe injuries to his right leg and foot. His foot will never completely heal.

The California Department of Industrial Relations, Division of Occupational Safety and Health issued a citation to Tilbury for violating worker safety rules regarding unsecured ladders. Subsequently, that citation was deleted by the department for lack of evidence.

Alfrey sued Harris for his injuries. During that litigation, the Harris employee who placed the ladder and failed to secure it testified in his deposition that the ladder was not in place prior to the accident nor did he enter the silo in the days immediately prior to the accident. At trial, the employee recanted this testimony and claimed that he had lied during his deposition to avoid being blamed for the accident.

State Fund paid out workers’ compensation benefits to Alfrey in the amount of $219,387.90 and estimated his compensable future losses would amount to $282,512. State Fund has subrogation rights under the law and its policy is to recover these sums from third parties who caused the accident. State Fund investigated whether to pursue subrogation and ultimately decided to pursue a subrogation claim against Harris.

Ten days prior to the scheduled trial date, State Fund sold its subrogation rights to Harris for $10,000. Tilbury alleges that State Fund relied on three documents in its decision to settle the action: (1) a notice from the Division of Occupational Safety and Health that it decided not to cite Harris; (2) a citation against Tilbury for violation of the regulation requiring ladders to be safely secured (the primary charge in this citation had been deleted nine months prior); and (3) a mediation brief submitted by Harris’s attorneys to the superior court. Tilbury alleged that State Fund failed to take any steps to determine that the Occupational Safety and Health Appeals Board had deleted the accident-related determination in the citation issued against Tilbury. Before settling its subrogation claim with Harris, State Fund did not speak with any employees of Tilbury, including Alfrey, Tilbury’s general manager, or any employees on the job site the day of the accident. Further, State Fund *473 did not obtain any of the documents filed by Alfrey’s attorneys in the action. State Fund did not inform Tilbury of its decision to sell the lien to Harris until 30 days later.

At trial, Harris settled Alfrey’s legal claims against it for $1.2 million. To date, State Fund has paid and held in reserve at least $522,894 on behalf of Alfrey and received only $10,000 as an offset of that amount.

Tilbury’s workers’ compensation premiums are affected by its experience modification rating. Tilbury alleges as a result of State Fund’s conduct of failing to investigate and obtain a fair settlement from Harris, Tilbury’s experience modification factor has increased. In turn, its workers’ compensation insurance premiums have increased in the amount of $42,000 for the year April 1, 2002, through April 1, 2003, and will increase in an unknown amount in the following year. Other employers will also suffer an increase in premium periods as well.

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40 Cal. Rptr. 3d 392, 137 Cal. App. 4th 466, 2006 Cal. Daily Op. Serv. 2026, 2006 Daily Journal DAR 2795, 71 Cal. Comp. Cases 393, 2006 Cal. App. LEXIS 310, Counsel Stack Legal Research, https://law.counselstack.com/opinion/tilbury-constructors-inc-v-state-compensation-insurance-fund-calctapp-2006.