United States Life v. Superior National

CourtCourt of Appeals for the Ninth Circuit
DecidedJanuary 4, 2010
Docket07-55938
StatusPublished

This text of United States Life v. Superior National (United States Life v. Superior National) is published on Counsel Stack Legal Research, covering Court of Appeals for the Ninth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
United States Life v. Superior National, (9th Cir. 2010).

Opinion

FOR PUBLICATION UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT

UNITED STATES LIFE INSURANCE  CO., Petitioner-Appellant, v. No. 07-55938 D.C. No. SUPERIOR NATIONAL INSURANCE CO., SUPERIOR PACIFIC CASUALTY CO.,  CV-07-00850-VBF CALIFORNIA COMPENSATION (JTL) INSURANCE CO., COMMERCIAL OPINION COMPENSATION INSURANCE CO., and COMBINED BENEFITS INSURANCE CO., Respondents-Appellees.  Appeal from the United States District Court for the Central District of California Valerie Baker Fairbank, District Judge, Presiding

Argued and Submitted November 19, 2008—Pasadena, California

Filed January 4, 2010

Before: Susan P. Graber and Richard R. Clifton, Circuit Judges, and Edward F. Shea,* District Judge.

Opinion by Judge Shea

*The Honorable Edward F. Shea, United States District Judge for the Eastern District of Washington, sitting by designation.

83 UNITED STATES LIFE v. SUPERIOR NAT’L INS. 87 COUNSEL

Andrew S. Amer and Deborah Lynn Stein, Simpson, Thatcher & Bartlett LLP. Kathleen M. Sullivan (argued), Quinn Eman- uel Urquhart Oliver & Hedges LLP, Redwood Shores, Cali- fornia, for the petitioner-appellant.

Margaret M. Grignon (argued), Reed Smith LLP, Los Ange- les, California; and Joseph K. Hegedus, Lewis Brisbois Bis- gaard & Smith LLP, Los Angeles, California, for the respondents-appellees.

OPINION

E. SHEA, District Judge:

We are asked to determine whether an arbitration panel violated the Federal Arbitration Act (FAA), 9 U.S.C. §§ 2-16. The process employed by the arbitration panel, which included an ex parte meeting with panel-retained workers’ compensation experts, was unusual; however, after deferen- tially reviewing the panel’s award, we determine that the arbi- tration process provided the parties with a fundamentally fair arbitration and that the arbitration award rested on a plausible interpretation of the governing arbitration documents. Accordingly, we affirm the arbitration award in favor of Superior National Insurance Companies in Liquidation (SNI- CIL).

BACKGROUND

U.S. Life contractually agreed to reinsure the workers’ compensation risks insured by five California insurers between May 1, 1998, and January 1, 2003. This reinsurance contract contained an arbitration provision. These California insurers later declared bankruptcy and will be referred to as 88 UNITED STATES LIFE v. SUPERIOR NAT’L INS. SNICIL. The California Insurance Commissioner became SNICIL’s statutory liquidator.

Ten years ago, on November 29, 1999, U.S. Life requested arbitration, seeking: 1) rescission or reformation of the rein- surance contract because SNICIL misrepresented the reserves during the underwriting process and 2) damages for SNICIL’s bad-faith performance. SNICIL agreed to arbitrate, seeking a declaration that the reinsurance contract was valid, a ruling that U.S. Life was to perform its contractual obligations, and damages. The panel, which consisted of an arbitrator appointed by each party and a neutral arbitrator selected by the parties’ arbitrators, bifurcated the arbitration proceeding into two phases.1

Phase I addressed rescission and reformation claims. After holding extensive hearings, the panel entered a Final Interim Award that found no basis for rescission. The panel, however, reformed the reinsurance contract so that U.S. Life became liable for only 90% of the risks insured by SNICIL’s underly- ing policies because of SNICIL’s failure to be forthright dur- ing the contract formation period. The panel awarded SNICIL interest on this 90% amount “at a rate equal to the average of the 2 and 5 Year Treasury Notes as posted in the Wall Street Journal.”

U.S. Life sought vacatur of the Final Interim Award. The 1 At oral argument, the parties acknowledged that, before the submission of the parties’ pre-hearing briefs on February 21, 2006, each party had ex parte contact with its party arbitrator. This is customary in tripartite arbi- tration panels. See American Arbitration Association, Commercial Arbi- tration Rules and Mediation Procedures, Rule 18, available at http:// www.adr.org/sp.asp?id=22440&printable=true#18 (last checked on Dec. 21, 2009); JAMS, Arbitrators Ethics Guidelines, art. X, available at http:// www.jamsadr.com/arbitration-ethics/ (last checked on Dec. 21, 2009); American Bar Association, The Code of Ethics for Arbitrators in Commer- cial Disputes, canons III(B) & X(c), available at http://www.abanet.org/ dispute/commercial_disputes.pdf (last checked on Dec. 21, 2009). UNITED STATES LIFE v. SUPERIOR NAT’L INS. 89 district court denied U.S. Life’s petition; this court affirmed the district court’s decision. U.S. Life Ins. Co. v. Ins. Comm’r, 160 Fed. App’x 559 (9th Cir. 2005).

Phase II proceeded to determine whether SNICIL engaged in improper claims handling that resulted in bills to U.S. Life in excess of the amounts due under the reinsurance agree- ment. A Phase II organizational meeting was held on April 14, 2005. Rather than review each of the 98,901 June 30, 2004 claims, U.S. Life’s expert selected 500 of the 12,604 contested claims files for an audit. SNICIL’s expert used this same sample to conduct its audit.

Prior to Phase II’s evidentiary hearings, SNICIL’s party arbitrator advised the parties that he had terminal cancer, but that he wished to continue as an arbitrator. The parties elected to continue with the arbitration proceeding with SNICIL appointing an alternate arbitrator to observe and potentially replace SNICIL’s party arbitrator. The parties agreed that Phase II would be governed by Protocols Governing the Pre- sentation of Evidence (“the protocols”). The panel approved the protocols.

In March 2005, the panel listened to the parties’ Phase II evidence and arguments for approximately thirteen days.2 After the hearings, the panel advised the parties that it was unable to reach a decision regarding the quality of SNICIL’s claims handling and, more pointedly, U.S. Life’s reinsurance contract obligations given the parties’ divergent expert opin- ions. To rectify this “stalemate,” the panel advised that it would retain two workers’ compensation claims-handling experts (“the reviewers”) to review the submitted bills.

The panel and the parties exchanged correspondence dis- 2 On March 21, 2006, during the Phase II hearings, the health condition of SNICIL’s party arbitrator forced him to resign. He was replaced by the designated alternate SNICIL party arbitrator. 90 UNITED STATES LIFE v. SUPERIOR NAT’L INS. cussing what review process to use. Ultimately, the panel3 determined that the following review process would be used: 1) the reviewers would review 162 of the 500-claim sample of the June 30, 2004 claims; 2) the reviewers would meet with the panel for three days (hereinafter, “the ex parte meeting”) and no transcript would be prepared of the ex parte meeting; 3) the reviewers would provide their conclusions in writing to the panel and the parties; 4) the parties could submit briefs responding to the reviewers’ conclusions; 5) a two-day hear- ing would be held during which the parties could question the reviewers, under oath, for five hours each as to their qualifica- tions and the reasons for their conclusions, but not as to the ex parte meeting; and 6) the parties could submit post-hearing briefs to the panel. This procedure was used.

On December 6, 2006, the panel issued its Phase II Interim Award, finding that all amounts billed prior to June 30, 2004, were properly due.4 The panel determined, in addition to the Phase I Final Interim Award interest requirement, that U.S. Life was to disgorge its actual investment earnings on all monies due under the reinsurance agreement as of June 30, 2004. The panel also required U.S.

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