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CA Department of Insurance

Precedential Decisions

Index to Precedential Decisions

The Insurance Commissioner is providing two indexes to precedential decisions. The first index is simply a list of case names and numbers. By selecting the name, you can view the text of the decision. The second index is a topic index, with just the case names displayed. Again, by selecting the name, you can view the text of the decision.

This index is a dynamic document, reflecting the changing case law applicable in Department of Insurance proceedings. Decisions that are not on this list are not precedential and should not be cited or relied upon. As to those decisions that have only certain pages designated, only those pages are precedential. New decisions may be designated and added to the index at any time, while some decisions may be eliminated. The index has categories in which no decisions are currently designated as precedential. The Commissioner may designate precedential decisions in these categories at a later date.

PRECEDENTIAL DECISIONS

I.   CAARP CASES:    (There are currently no precedential decisions in this category.)

II.  CEASE AND DESIST CASES:    (There are currently no precedential decisions in this
       category.)

III.   CIGA CASES (California Insurance Guarantee Association)

 

IV.   EARTHQUAKE CASES:   (There are currently no precedential decisions in this category.)

 

V.   FAIR PLAN CASES:   (There are currently no precedential decisions in this category.)

 

VI.   NONCOMPLIANCE or 11753.1 CASES:     

         1.  American Reliable Insurance Company DISP 06091926

VII.   POLICY APPROVAL CASES:

  1. Unum Life Insurance Company of America; Provident Life and Accident Insurance Company, Hartford Life Insurance Company; and Hartford Life and Accident Insurance Company. 

VIII.     PRIOR APPROVAL CASES

  1. American Healthcare/SCPIE Indemnity Companies; File No. PA02025379Subsections C & D, pps. 8-11
  2. Allstate Insurance Company and Allstate Indemnity Company; File No. PA-2006-00006 

IX.    PRODUCER DISCIPLINE CASES:    

    1.  Marsh USA, Inc.  File No. DISP05047170


X.  ROLLBACK CASES:   (There are currently no precedential decisions in this category.)


XI.   WORKERS' COMPENSATION CASES

A.   Classification:

  1. Advanced Fuel Filtration Systems 03-45, p.12 under "Discussion" through p.18 
  2. Camp Tawonga 07-10 
  3. EMM Machining  00-30
  4. Evans Rents  97-9
  5. Fallbrook Glass  95-1, pp.6-7
  6. Goldberg & Solovy Foods, Inc. 09-01
  7. Healthcare Management Services, LLC, 05-30
  8. Hoyle Products  95-14, p.11 - top of 17
  9. KWA Safety & Hazmat 01-22
  10. LA Fitness Sports Clubs  94-11
  11. Pali Mountain Institute 04-103
  12. Readylink Healthcare, Inc. 08-14
  13. Royal T Management, Inc. 02-25
  14. Sportsmobile West 06-07
  15. Transit Authority  99-23
  16. UPM Global, LLC 08-29

B.   Experience Modification:

  1. Alin Party Supply  93-5, to p.11 top of page
  2. American Chevrolet-Geo  94-3
  3. B.D.D. Pest Control, Inc.  99-29
  4. California & Rancho Cucamonga Restaurant Ventures 00-36 pages 8-11, sub-caption 1
  5. C&W Truck & Equipment  93-9
  6. Cherokee International  SF 6960-R-019
  7. Dav-El Los Angeles, Inc.  95-10, mid-page 11 to mid p.17
  8. DeMiranda Management  00-39
  9. Diamondback Enterprises  SF 6960-R-82
  10. Grenada Residential Care Facility 01-3. pp 16-18
  11. Just Like Home 03-13
  12. Kevin D. Woody  95-11, pp. 16-28  
  13. Preferred Meal Systems  97-1
  14. Staff Resources, Inc. 03-54
  15. Star Roofing Company, Inc.  04-49
  16. VIP Drivers, Inc. 08-02

C.   Procedure:

  1. Aiken Cars/Riverside Mitsubishi 03-80 pp. 17-20
  2. Sierra Children's Home  SF 6960-R-98
  3. Grayson Service  SF 6960-R-83
  4. Peeter's Transportation  92-2
  5. Vista Fence Company  SF 6960-R-021

D.   Other:

  1. Sherries' Schools 95-4       

INDEX OF PRECEDENTIAL DECISIONS AND
PARTS OF DECISIONS BY TOPIC

I.   PRIOR APPROVAL CASES


A.  Standard of Review


     Allstate Insurance Company and Allstate Indemnity Company

     American Healthcare/SCPIE Indemnity Companies

B.  BURDEN OF PROOF

     American Healthcare/SCPIE Indemnity Companies 

II  WORKERS' COMPENSATION CASES

A.  CLASSIFICATION

1.   Agent's Advice
            Fallbrook Glass, Inc.
2.  Building Operating - Commercial

3.   By Analogy
            EMM Machining
            Transit Authority
4.   Division of Payroll
            Hoyle Products, Inc.
5.  Effective Date of Standard Classification Assignments
            Advanced Fuel Filtration Systems
6.  Governing Classification
            Hoyle Products, Inc.
7.  Independent Contractor
            KWA Safety & Hazmat
8.  Jurisdictional
            Sportsmobile West, Inc.
9.  Multiple Enterprises
            Hoyle Products, Inc.
            Pali Mountain Institute
10.  Resident Employees
            Royal T. Management, Inc.
11. Single Enterprise Rule - Standard Exceptions
            Evans Rents
           Healthcare Management Services, LLC
            LA Sports Fitness Club

12.  Special Industry Classification procedures

13. Standard Exceptions
           Pali Mountain Institute  
           Camp Tawonga

B.  CLAIMS HANDLING

         Sherries' Schools

C.  EXPERIENCE MODIFICATION  

1.   Accident
            Cherokee International
2.   Burden of Proof
            DeMiranda Management
3.   Change of Employees
            DeMiranda Management
            Preferred Meal Systems, Inc.
4.   Change of Ownership
            Alin Party Supply Co.
            American Chevrolet-Geo
            Dav-El Los Angeles, Inc.
            Diamondback Enterprises, Inc.
            Grenada Residential Care Facility
            Just Like Home
            Sierra Children's Home
5.   Change in Operations
            Just Like Home
6.   Calculation of Experience Modification
            C&W Truck and Equipment Co.
            Just Like Home            
7.   Claim Value
            B.D.D. Pest Control, Inc.
8.   Combined Entities
            Alin Party Supply Co.
9.   Construction of a word
            B.D.D. Pest Control, Inc.
10  Payroll - Per Diem Payments
            ReadyLink Healthcare, Inc.
11.  Duty of Bureau
            Diamondback Enterprises, Inc.
            Grayson Service
            Vista Fence Co.
12.  Employee Leasing
            Staff Resources, Inc.
13.  Insolvent Insurer
             Star Roofing Company, Inc.            
14.  Payroll
            Preferred Meal Systems, Inc.
15.  "Piercing" of the Corporate Veil
            California & Rancho Cucamonga Restaurant Ventures
16.  Publication of Ex-Mods
            Kevin D. Woody Landscape Maintenance, Inc.
17.  Replacement Policy
           C&W Truck and Equipment Co.
18.  Revision of Ex-Mod
           B.D.D. Pest Control, Inc.
           Grenada Residential Care Facility
           Peeter's Transportation
           Vista Fence
19.  Subterfuge
           Kevin D. Woody Landscape Maintenance, Inc.

D.  Rating Plan

          Gary Milne

E.  Reporting

         Schaefer Ambulance

F.   Procedure

1.   Due Process
         Aiken Cars/Riverside Mitsubishi
2.   Timeliness & Delay
         Grayson Service
         Peeter's Transportation
         Sierra Children's Home
         Vista Fence Co.
3.  Equitable Power to Remedy
          Peeter's Transportation
          Vista Fence Co.

III.  PRODUCER DISCIPLINE CASES

  A.  Insurance Agents and Brokers, Duties of    
     1.   Marsh USA, Inc.

 

IV.  NONCOMPLIANCE 11753.1 CASES

   A.  Producer as Agent or Broker
         1.  American Reliable Insurance Company
   B.  Imputation of Agent Fee to Insurer, to be Deemed Premium
         1.   American Reliable Insurance Company
   C.  Agent Fees Create Violations of Sections
         1861.01 (C) AND 1861.05(A)
         1.   American Reliable Insurance Company
   D.  Insurers May be Compelled to Pay Restitution Pursuant to   
          Sections 1065.1 AND 1065.3
         1.  American Reliable Insurance Company

 




Last Revised - September 18, 2013
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