BILL ANALYSIS                                                                                                                                                                                                    






                             SENATE JUDICIARY COMMITTEE
                           Senator Ellen M. Corbett, Chair
                              2009-2010 Regular Session


          AB 2490 (Jones)
          As Amended May 20, 2010
          Hearing Date: June 29, 2010
          Fiscal: Yes
          Urgency: No
          TW:jd
                    

                                        SUBJECT
                                           
               Workers' Compensation Insurance:  Dispute Resolution:   
                                 Arbitration Clauses

                                      DESCRIPTION  

          This bill would regulate agreements concerning dispute  
          resolution, other than settlement agreements resolving  
          particular disputes, made between an employer and a workers'  
          compensation insurer by requiring choice of law and forum  
          selection provisions providing for California law.

                                      BACKGROUND  

          California employers are required to provide workers'  
          compensation benefits to their employees.  These benefits are  
          used by employees for medical services related to on-the-job  
          injuries or illnesses.  Although workers' compensation is  
          required by the state, the state does not pay employers for this  
          program; rather, employers typically maintain insurance policies  
          to cover workers' compensation benefits.  Workers' compensation  
          insurance policies are highly regulated, and each policy must be  
          submitted to the California Insurance Commissioner for approval  
          before the policy can be issued.  Subsequent agreements  
          regarding the insurance policy, referred to as insurance program  
          agreements (IPAs), may be reached between the insurer and  
          employer; these agreements are not required to be submitted to  
          the Insurance Commissioner for approval.

          This bill would require a dispute resolution agreement, other  
          than a settlement agreement resolving a particular dispute,  
          between an employer and insurer related to workers' compensation  
                                                                (more)



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          insurance to include choice of law and forum selection  
          provisions providing for California law. 

                                CHANGES TO EXISTING LAW
           
           Existing law  requires employers to maintain workers'  
          compensation insurance.  (Lab. Code Sec. 3700.)
           
          Existing law  requires that a workers' compensation insurance  
          policy or endorsement proposed to be issued in California must  
          be filed with the insurance rating organization; the policy  
          cannot be issued until either 30 days from receipt of the policy  
          or endorsement by the ratings organization and no notice has  
          been issued by the insurance commissioner or upon written  
          approval of the form or endorsement issued by the insurance  
          commissioner.  (Ins. Code Sec. 11658.)

           Existing law  provides that a limited workers' compensation  
          policy may be issued insuring either in the whole or any part of  
          the liability of any employer for compensation, as long as the  
          policy is previously approved as to substance and form by the  
          insurance commissioner; subject to these restrictions, the  
          policy can restrict or limit the insurance in any manner.  (Ins.  
          Code Sec. 11657.)

           Existing law  provides that a limited insurance policy cannot  
          otherwise be limited unless an endorsement is attached in a form  
          prescribed by the insurance commissioner or in accordance with  
          rules adopted by the insurance commissioner.  (Ins. Code Sec.  
          11659.)

           This bill  would require, as between an employer and a worker's  
          compensation insurer, any agreement concerning dispute  
          resolution, other than settlement agreements, to conform to the  
          following:

             1.   be filed with the insurance rating organization and  
               subject to approval by the insurance commissioner;
             2.   contain a choice of law provision that identifies  
               California as the law to be used to resolve any disputes  
               that arise in California; and
             3.   contain a forum selection clause identifying California  
               as the proper venue for any proceeding regarding a dispute  
               that arises in California.

                                        COMMENT
                                                                      



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           1.Stated need for the bill  
          
          The author writes:
          
            Despite the requirement that the commissioner approve the form  
            and substance of all workers' compensation plans, some  
            workers' compensation carriers issue unapproved separate or  
            side agreements, sometimes called Insurance Program Agreements  
            (IPAs) that require arbitration of any disputes between the  
            employer and the carrier concerning the approved workers'  
            compensation plan.  These IPAs are not provided to the  
            employer until after the policy or plan is accepted, and lack  
            the approval of the commissioner.

            These IPAs, which are unapproved, often choose a foreign  
            jurisdiction's law to interpret the plan and resolve disputes,  
            and choose a state other than California as the location or  
            venue to conduct arbitrations.  This subjects Californians to  
            another state's laws and forces them to travel outside this  
            state to conduct dispute resolution proceedings, resulting in  
            significant cost burdens.  Over time, these arbitration  
            clauses have become complex and expensive, and have diminished  
            the rights of the parties in the arbitration proceedings.

            Because these IPAs have not been approved by the Insurance  
            Commissioner, Courts have held that the IPA, at least with  
            respect to the arbitration clause, to be invalid.  [Citation  
            omitted.]  Even so, California employers should not have to  
            bring litigation to invalidate a side-agreement that should  
            have been submitted to the Insurance Commissioner for  
            approval.  Additionally, California businesses are not in a  
            position to negotiate the choice of law and venue issues of  
            these agreements, particularly when they circumvent Department  
            of Insurance oversight.

            Moreover, California has a compelling state interest in  
            ensuring that workers' compensation policies and plans are  
            enforced under California law and not subject to  
            interpretation by other jurisdictions, and that any dispute  
            resolution proceedings are conducted within its borders.
          
           2.California's interest in workers' compensation insurance  
            contracts  

          This bill would restrict dispute resolution agreements between  
                                                                      



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          an employer and a workers' compensation insurer by requiring  
          IPAs to be filed with the Insurance Commissioner and providing  
          for California forum selection and choice-of-law provisions.   
          The California Chamber of Commerce, an opponent of the bill,  
          argues that "AB 2490 (Jones) governs secondary contractual  
          relationships between very sophisticated parties, large  
          employers and their insurance companies, who have many sound  
          business reasons for choosing forums and legal jurisdictions  
          outside of California for resolving their disputes.  There is no  
          justification for interfering with the right of two such parties  
          to contract freely, as their selections have no impact on  
          California employees."

          The author cites to the case of Ceradyne, Inc. v. Argonaut  
          Insurance Company (2009) 74 Cal.Comp.Cas 702, which demonstrates  
          the need for this bill.  In Ceradyne, the plaintiff/employer was  
          a Delaware corporation doing business all over the world.  The  
          plaintiff entered into four large deductible policies that  
          covered workers' compensation claims made against it throughout  
          the United States.  (Id. at pg. 704.)   Cases such as Ceradyne  
          illustrate that out-of-state insurers and out-of-state  
          businesses enter into contracts which directly concern  
          California employees.  Although both the employer and insurer  
          were out-of-state companies, the pivotal issue is that the  
          original claims giving rise to the dispute began in California.

          The Legislature has, at times, enacted laws that restricted  
          choice of law and forum selection between contracting parties in  
          order to protect its residents.  (See AB 2781 (Leno, Ch. 797,  
          Stats. 2006) child support collection choice of law agreements;  
          SB 586 (Sher, Ch. 194, Stats. 1997) Uniform Interstate Family  
          Support Act choice of law.)  In these cases, a sufficient nexus  
          was drawn between California's desire to protect its citizens  
          and the nature of the contract between the parties.  

          Similarly, California has a legitimate interest in protecting  
          its citizens from unconscionable contracts that would overly  
          burden the resident by litigating a claim arising in California  
          but arbitrated in a different state.  The court in America  
          Online, Inc. v. Superior Court (2001) 90 Cal.App.4th 1 addressed  
          forum selection clauses and held that "[o]ur law favors forum  
          selection agreements only so long as they are procured freely  
          and voluntarily, with the place chosen having some logical nexus  
          to one of the parties or the dispute, and so long as California  
          consumers will not find their substantial legal rights  
          significantly impaired by their enforcement."  (Id. at pg. 21.)   
                                                                      



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          The IPAs, the author argues, are not procured freely and  
          voluntarily.  In most instances, employers are presented with  
          the IPA from the insurer after the insurance policy has been  
          issued.  The IPA contains material provisions of the insurance  
          contract, in addition to arbitration clauses, conflict of law  
          provisions, and forum selection clauses.  By the time the  
          employer receives the IPA, the employer has already paid money  
          toward the insurance policy.  Further, as in Ceradyne, the IPA  
          also may contain language such as "[t]he terms of this policy  
          may not be changed or waived except by endorsement issued by us  
          to part of this policy."  (Ceradyne, Inc. v. Argonaut Ins. Co.,  
          74 Cal.Comp.Cas at pg. 705.)  The author argues that employers  
          entering into these side agreements do so based on the belief  
          that they are unable to negotiate the terms of these agreements  
          since the policy has already been issued and the side agreements  
          indicate that they are non-negotiable.  

          California has a substantial nexus to the dispute resolution  
          agreements between an employer and insurer providing workers'  
          compensation insurance to California employees.  First, from the  
          experiences described by employers, the IPAs do not appear to be  
          procured freely and voluntarily.  Second, since the initial  
          worker's claim instigates the subsequent dispute between the  
          employer and insurer, using California law in these disputes is  
          logical.  Lastly, California requires its employers to provide  
          workers' compensation to employees injured on the job, so the  
          initial policy is written by the insurer because of state  
          requirements and regulations.  

           3.Freedom of parties to contract  

          This bill would require a workers' compensation insurance  
          agreement issued for the benefit of California employees to  
          contain California choice of law and forum selection provisions.  
           The author argues that restricting the contract provisions  
          between the insurers and employers will protect California  
          businesses, which "are not in a position to negotiate the choice  
          of law and venue issues of these agreements."  On the other  
          hand, the Civil Justice Association of California (CJAC), an  
          opponent of the bill, argues that "[c]ontractual relationships  
          tend to differ from situation to situation, and certain  
          situations may be best served by a choice of law other than  
          California's.  This bill would affect employers and workers'  
          compensation insurers, both relatively sophisticated parties who  
                                                                      



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          may have good reasons for negotiating specific provisions in a  
          contract."

          The author argues that arbitration clauses in IPAs have been  
          held invalid by California courts because they have not been  
          approved by the Insurance Commissioner.  The author points to  
          the case of Ceradyne, a Delaware corporation doing business in  
          California, which entered into an IPA agreement containing an  
          arbitration clause specifying Connecticut jurisdiction with a  
          determination on the final arbitration award to be decided by  
          New York courts.  (Id. at pgs. 704-706.)  Ceradyne, Inc.  
          executed the IPA nine months after the initial policy, submitted  
          to and approved by the California Insurance Commissioner, was  
          issued.  (Id at pg. 705.)  The IPA specified that it was  
          retroactive to the effective date of the policy, March 1, 2003.   
          (Id.)  The court held that the arbitration clause was void  
          because the IPA itself, an agreement containing material terms  
          related to the insurance policy, had not been approved by the  
          Insurance Commissioner as required by California statute.  (Id.  
          at p. 37.)  This bill would codify this ruling by requiring the  
          IPA to be filed with the Insurance Commissioner, as is already  
          required of the insurance policy under Insurance Code Section  
          11658. 
           
          4.Federal Arbitration Act (FAA)


           This bill would regulate arbitration agreements between  
          contracting parties.  The FAA, 9 U.S.C. Sec. 2, provides that an  
          arbitration agreement shall be valid, irrevocable, and  
          enforceable, except on such grounds as exist at law or in equity  
          for the revocation of any contract.  The restrictions on  
          arbitration agreements contained in this bill raise the concern  
          that these restrictions may be preempted by federal law.  In  
          Allied-Bruce Terminix Companies, Inc., et al. v. Dobson (1995)  
          513 U.S. 265, the United States Supreme Court discussed the  
          issue of federal preemption over state regulation of arbitration  
          contracts.  The court stated that Section 2 of the FAA "gives  
          States a method for protecting consumers against unfair pressure  
          to agree to a contract with an unwanted arbitration provision.   
          States may regulate contracts, including arbitration clauses,  
          under general contract law principles and they may invalidate an  
          arbitration clause 'upon such grounds as exist at law or in  
          equity for the revocation of any contract.'  9 U.S.C. [Sec.] 2   
          ? . What States may not do is decide that a contract is fair  
          enough to enforce all its basic terms (price, service, credit),  
                                                                      



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          but not fair enough to enforce its arbitration clause.  The Act  
          makes any such state policy unlawful, for that kind of policy  
          would place arbitration clauses on an unequal 'footing,'  
          directly contrary to the Act's language and Congress' intent."   
          (Id. at pg. 281.)

          This bill would regulate arbitration agreements, as may be  
          contained in the IPA, the same as existing law currently  
          regulates the insurance contract.  Under existing law, the  
          insurance policy must be submitted to the Insurance Commissioner  
          and is subject to approval.  Under this bill, the IPA, which  
          contains material terms relating to the insurance policy, also  
          would have to be submitted to the Insurance Commissioner and  
          would be subject to approval.  California has established a  
          public interest in providing comprehensive regulation of  
          workers' compensation insurance.  This bill would further  
          California's interest in protecting consumers against unfair  
          pressure to agree to a contract with an unwanted arbitration  
          provision.

           5.Application to out-of-state companies 
           
          This bill would apply to all workers' compensation insurance  
          policies issued for the protection of California employees.  As  
          such, this bill would regulate not only California employers and  
          California insurers but also out-of-state employers with  
          California employees and out-of-state insurers.  The Legislature  
          has recognized that only employers who are so engaged in  
          interstate commerce as to not be subject to the legislative  
          power of the state would not be properly regulated under  
          California's Workers' Compensation Act.  (See Lab. Code Sec.  
          3203.)  However, the provisions in this bill would not conflict  
          with this statute since the application of this bill would be  
          limited to disputes arising out of California employee injury  
          claims.  


           Support  :  Altman Plants, Inc.; Ceradyne, Inc.; Pacific Hospital  
          of Long Beach; Roxborough, Pomerance, Nye & Adreani

           Opposition  :  American Insurance Association; California Chamber  
          of Commerce; Civil Justice Association of California

                                        HISTORY
           
           Source  :  An Individual
                                                                      



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           Related Pending Legislation  :  None Known

           Prior Legislation  :  See Background and Comment 3.

           Prior Vote  :

          Assembly Insurance Committee (Ayes 8, Noes 4)
          Assembly Appropriations Committee (Ayes 11, Noes 5)
          Assembly Floor (Ayes 41, Noes 28) 

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