BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2490
                                                                  Page  1

          Date of Hearing:   April 21, 2010

                           ASSEMBLY COMMITTEE ON INSURANCE
                                 Jose Solorio, Chair
                     AB 2490 (Jones) - As Amended:  April 6, 2010
           
          SUBJECT  :   Workers' compensation: arbitration clauses

           SUMMARY  :   Requires dispute resolution clauses entered into  
          between an employer and a workers' compensation insurer to  
          specify that California law applies and the venue is to be in  
          California.  Specifically,  this bill  :  

          1)Provides that any agreement between an employer and a workers'  
            compensation insurer concerning dispute resolution, including  
            an arbitration clause, shall

             a)   Contain a choice of law provision that selects  
               California law as the law to be applied to any dispute;

             b)   Contain a forum selection clause that identifies  
               California as the proper venue for any proceedings arising  
               out of a dispute; and

             c)   Be submitted to the Insurance Commissioner (IC) as part  
               of the policy form filing that is required of workers'  
               compensation insurers for workers' compensation policies.

          2)Specifies that a failure to comply with the above requirements  
            renders the dispute resolution agreement void and  
            unenforceable.

          3)Contains Legislative findings and declarations to the effect  
            that requiring California employers to be subject to the law  
            of other states, and to conduct dispute resolution proceedings  
            in other states, is a burden on these employers.

           EXISTING LAW  :

          1)Provides for a comprehensive system of workers' compensation  
            benefits to be paid to employees who are injured on the job.

          2)Requires every employer in the state to obtain a policy of  
            workers' compensation insurance from an insurer licensed to  
            transact this insurance in the state, or obtain a certificate  








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            of self-insurance from the Department of Industrial Relations.

          3)Authorizes employers to purchase "high-deductible" workers'  
            compensation insurance policies, subject to certain  
            conditions, whereby the employer is effectively self-insured  
            below the deductible, but the insurer is ultimately  
            responsible to guarantee payment of benefits.

          4)Requires workers' compensation insurers to file their policy  
            forms with the IC for approval, but does not specifically  
            require side agreements such as dispute resolution agreements  
            to be part of that filing.


           FISCAL EFFECT  :   Undetermined impact on the Department of  
          Insurance to review and approve the newly mandated elements of a  
          workers' compensation insurance policy filing.

           COMMENTS  :   

           1)Purpose  .  According to the author, as evidenced by an  
            unpublished Court of Appeal decision (  Ceradyne, Inc. v.  
            Argonaut Insurance Company, 4th Dist., Div. 3, case No.  
            G039873  ), the courts have held that arbitration clauses  
            relating to workers' compensation insurance policies that have  
            not been submitted to the IC for approval are unenforceable.   
            However, the author argues that it is expensive and unfair to  
            California employers to force them to litigate this issue.   
            Instead, the rules should be clear that these agreements ought  
            to be part of the policy form filed with the IC, and that  
            California law and California venue ought to be the rule for  
            resolving disputes that arise in California concerning  
            California employers.

          2)Drafting issues  .  In informal discussions with some insurers,  
            drafting concerns were raised.  It was noted that the bill's  
            broad language "concerning resolution of disputes" could  
            require settlement documents resolving a dispute prepared  
            between an insurer and employer to be filed with the IC.  An  
            additional drafting concern is that the language does not  
            strictly limit its application to disputes arising in  
            California.  Typically, these agreements are associated with  
            large employers, and often involve multi-state operations, and  
            the language might be read to suggest that California venue  
            and law would apply whenever the policy covers California  








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            risks, even if the particular matter at issue arose elsewhere.

           3)Support  .  Pacific Hospital of Long Beach writes in support  
            because, with respect to its workers' compensation policies,  
            it was not aware of arbitration clauses until after disputes  
            arose.  In Pacific Hospital's matters, it was advised that  
            side agreements required reliance on New York law to resolve a  
            purely California dispute.

          Roxborough, Pomerance, Nye, & Adriani, and employer's rights law  
            firm that handles many cases like  Ceradyne  and the Pacific  
            Hospital situation, writes that the late delivery of these  
            side agreements is increasingly common.  In litigating the  
            cases, they win some and lose some, but always at great  
            expense to the employer.

           4)Opposition  .  The American Insurance Association (AIA) writes  
            in opposition to the bill that these agreements are typically  
            between insurers and large (sophisticated) employers, and the  
            bill impedes the right to freely contract for provisions that  
            are beneficial to both sides.  AIA argues that there are valid  
            business reasons why an employer might want broader freedom to  
            negotiate the issues covered by the bill than is allowed.  In  
            this regard, it points out that the current workers'  
            compensation insurance market is competitive, and if an  
            employer does not like the conditions being offered by an  
            insurer, it has market alternatives.  With respect to the case  
            cited by the author, AIA suggests that it was an unusual  
            situation where the employer was unaware of the "agreement"  
            until a substantial period of time after the policy was  
            purchased.

          In addition, AIA argues that these side agreements are not  
            standard form contracts like the insurance policy itself.   
            They are agreements negotiated between two sophisticated  
            parties, and the form changes from party to party, making it  
            impractical to have been previously filed by the insurer when  
            each agreement is reached with an employer.
           
           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          Pacific Hospital of Long Beach
          Nick Roxborough, Esq., Roxborough, Pomerance, Nye, & Adriani,  








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          counsel for Ceradyne

           Opposition 
           
          American Insurance Association
           
          Analysis Prepared by  :    Mark Rakich / INS. / (916) 319-2086