Travelers Insurance v. Paolino Material & Supply, Inc.

903 F. Supp. 865, 1995 U.S. Dist. LEXIS 16488, 1995 WL 656636
CourtDistrict Court, E.D. Pennsylvania
DecidedNovember 6, 1995
DocketNo. 94-CV-2501
StatusPublished

This text of 903 F. Supp. 865 (Travelers Insurance v. Paolino Material & Supply, Inc.) is published on Counsel Stack Legal Research, covering District Court, E.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Travelers Insurance v. Paolino Material & Supply, Inc., 903 F. Supp. 865, 1995 U.S. Dist. LEXIS 16488, 1995 WL 656636 (E.D. Pa. 1995).

Opinion

DECISION

JOYNER, District Judge.

This diversity case was tried before this Court in a non-jury trial on April 27, 1995. The plaintiff is the Travelers Insurance Company (the “Travelers”), a Connecticut corporation seeking to recover a judgment of over $500,000 in unpaid premiums and interest from the defendants, Paolino Paving & Supply, Inc. and Joseph Paolino & Sons, Inc. (collectively, the “Paolinos”), two related Pennsylvania companies engaged in the construction business. For their part, the Paoli-nos have brought a counterclaim sounding in contract. The parties have submitted their proposed findings of fact and conclusions of law and the matter is now ripe for decision. Accordingly, we now issue the following factual findings and conclusions of law, pursuant to Fed.R.Civ.P. 52.

FINDINGS OF FACT

1. The Paolinos are engaged in the business of building and resurfacing roads and bridges. (Stip. Facts, p. 1-2).

2. The Paolinos are required by law to maintain worker’s compensation insurance. (Stip. Facts, p. 2).

3. In the three years prior to the years relevant to this lawsuit, the paolinos had paid annual premiums ranging from $235,359 to $458,553 for worker’s compensation insurance. (Tr., pp. 118-19).

4. After a number of unsuccessful attempts to secure worker’s compensation insurance in the voluntary market, the Paoli-nos applied to the Pennsylvania Compensation Rating Bureau (the “PCRB”) for involuntary worker’s compensation insurance on October 9, 1990. (Stip. Facts, p. 2).

5. In their application, the Paolinos estimated that their premium would be $198,665, using an experience modification factor (“EMF”) of 1.687. (Defendants’ Ex. 2).

6. The EMF is an underwriting, actuarial figure computed by the PCRB that considers the insured’s claims history and affects the amount of the premium. (Stip. Facts, p. 3).

7. In the three years prior to the years relevant to this lawsuit, the worker’s compensation policies the Paolinos held contained EMFs ranging from 1.017 to 2.186. (Tr., pp. 113-15).

8. The Paolinos used an EMF of 1.687 because they knew that the new EMF, to become effective on October 15,1990, had yet to be promulgated. The Paolinos were also aware that their premium would be adjusted once the actual EMF was published. (Defendants’ Ex. 3).

[867]*8679. The PCRB assigned the Paolinos’ risk to the Travelers. The Travelers then issued a policy of involuntary worker’s compensation insurance to the Paolinos. (Stip. Facts, p. 3).

10. The term of the policy ran from October 15, 1990 to October 15, 1991. The policy was renewed for a one-year term on October 15, 1991. (Stip. Facts, p. 3; Tr., p. 4-6).

11. The second policy provided coverage until it was canceled on January 16, 1992. (Tr., p. 20).

12. The policies contained the following language:

E. Final Premium
The premium shown on the Information Page, schedules, and endorsements is an estimate. The final premium will be determined after this policy ends by using the actual, not the estimated, premium basis and the proper classifications and rates that lawfully apply to the business and work covered by this policy. If the final premium is more than the premium you paid to us, you must pay the balance. If it is less, we will refund the balance to you. The final premium will not be less than the highest minimum premium for the classification covered by this policy.
G. Audit
You will let us examine and audit all your records that relate to this policy. These records include ledgers, journals, registers, vouchers, contracts, tax reports, payroll and disbursement records, and programs for storing and retrieving data. We may conduct the audits during regular business hours during the policy period and within three years after the policy period ends. Information developed by the audit will be used to determine the final premium. Insurance rate service organizations have the same rights we have under this provision.

(Plaintiff’s Ex. 6).

13. The total estimated premium for the first policy was $100,587. This figure was well below the amount the Paolinos anticipated because the Travelers inadvertently neglected to include the EMF in the estimate. (Defendants’ Ex. 9; Stip. Facts, p. 3).

14. By October 17, 1990, two days into the initial policy period, the Paolinos realized, or should have realized, that the EMF for the 1990-91 policy would be 2.357. On that day, the Paolinos addressed a letter to the PCRB, as follows: “Please forward our Loss History File used to promulgate our 1990 mod of 2.357 to our insurance agent_” (Plaintiff’s Ex. 24).

15. On June 14, 1991, the Travelers received notice from the PCRB that the Paoli-nos’ EMF for the 1990-91 policy was 2.357. (Stip. Facts, p. 3; Plaintiffs Ex. 7).

16. The Travelers endorsed the policy and added the EMF to the policy on July 19, 1991. Thus, the Paolinos’ premium was $464,772 for the initial policy period. (Stip. Facts, pp. 3-4; Plaintiffs Ex. 8; Tr., p. 61).

17. The Paolinos objected in writing to the application of the EMF. (Stip. Facts, p. 4).

18. On October 3, 1991, the Travelers sent a quotation for the 1991-92 period to the Paolinos. The estimate contained an EMF of 2.357. (Stip. Facts, p. 4; Plaintiffs Ex. 9).

19. On October 15, 1991, the policy was renewed for one year. The estimated premium for the 1991-92 policy was $149,673. (Stip. Facts, p. 4; Plaintiffs Ex. 10).

20. On November 12, 1991, the Travelers conducted an audit of the Paolinos’ records pursuant to the policy. The audit resulted in a credit to the Paolinos’ account for the first policy in the amount of $9,765. Thus, the total premium for the initial policy period was $455,007. (Stip. Facts, p. 4; Tr., p. 59).

21. The Paolinos made premium payments totalling $185,741 on the first policy. (Plaintiffs Ex. 12).

22. The Paolinos refused to make further premium payments in light of their dispute with the Travelers over the application of the 2.357 EMF to the first policy. (Defendants’ Ex. 11).

23. Thus, the Travelers canceled the policy for non-payment of the premium, effective January 16, 1992. The notice of cancellation [868]*868assured the Paolinos that “[a]ny premium adjustment required by the policy will be made.” (Defendants’ Ex. 10).

DISCUSSION

The Travelers contends that it is entitled to damages in the amount of $269,266 (the $465,007 earned premium minus the $185,741 in payments made by the Paolinos) arising from the first policy, plus $149,678 under the 1991-92 policy. Further, the Travelers asserts that it is entitled to 6 percent interest on the sum in the amount of $81,693.11, for a total of $500,632.11. The Paolinos, on the other hand, argue that they justifiably relied on the premium estimate figure of $100,587, and that the Travelers is estopped from asserting a higher premium amount. The Pao-linos have also set forth a counterclaim, in which they contend that they are entitled to a rebate for the premium payments collected in excess of the premium estimate, or $85,-154.

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Cite This Page — Counsel Stack

Bluebook (online)
903 F. Supp. 865, 1995 U.S. Dist. LEXIS 16488, 1995 WL 656636, Counsel Stack Legal Research, https://law.counselstack.com/opinion/travelers-insurance-v-paolino-material-supply-inc-paed-1995.