Opinion Number: 2000-NMCA-043
Filing Date: March 20, 2000
Docket No. 19,644
JEAN A. PETERSON as Personal
Representative of the Estate of
JEFFREY OELCHER,
Plaintiff-Appellant,
v.
WELLS FARGO ARMORED SERVICES CORP.,
Defendant-Appellee.
APPEAL FROM THE DISTRICT COURT OF BERNALILLO COUNTY
W.C. (Woody) Smith, District Judge
Hazen H. Hammel
Cates & Hammel, P.C.
Los Lunas, NM
Mark M. Rhodes
Rhodes & Salmon, P.C.
Albuquerque, NM
for Appellant
J.E. Casados
Gallagher, Casados & Mann, P.C.
Albuquerque, NM
for Appellee
WECHSLER, Judge.
{1}
Jean Peterson (Plaintiff), personal representative of
the estate of Jeffrey Oelcher, appeals from the trial
court's order granting summary judgment in favor of
Defendant Wells Fargo Armored Service Corporation (Wells
Fargo). In essence, the order determines that Wells Fargo
complied with the insurance provisions of the Workers'
Compensation Act and therefore workers' compensation is the
exclusive remedy for the death of Jeffrey Oelcher,
Plaintiff's son. See NMSA 1978, §§ 52-1-6(C) & (D) (1990)
(effective January 1, 1992), 52-1-8 (1989), 52-1-9 (1973);
Harger v. Structural Servs., Inc., 121 N.M. 657, 666, 916
P.2d 1324, 1333 (1996). We conclude that Wells Fargo did not substantially comply with the filing provisions of the
Act and that summary judgment is inappropriate and therefore
reverse and remand.
Facts and Procedural Posture
{2}
The following facts are assumed for purposes of summary
judgment; they may still be subject to some dispute in the
trial court. On August 25, 1994, Wells Fargo employed
Jeffrey Oelcher as a driver-guard. On that day, Oelcher
and a partner had been assigned a Budget Rentals van to use
in their route from Albuquerque to Socorro, Gallup, and
Grants and back to Albuquerque. Two men in a pickup truck
ambushed the van on a back road. One of the men, who was
lying in the bed of the pickup, fired a gun at the van. The
bullet went through the windshield, which was not armored or
in any other way reinforced, and struck Oelcher in the head.
Oelcher died either immediately or a very short time after
being shot.
{3}
Oelcher was survived by his mother, Plaintiff; his
stepfather, Ken Peterson; his fiancé, April Dunton; and his
two minor children born to April Dunton. On August 30,
1994, Ken Peterson called the Workers' Compensation
Administration (the Administration) and asked whether Wells
Fargo or Borg-Warner, its parent company, had workers'
compensation insurance. He was told that the
Administration's records did not show that either company
had workers' compensation insurance. The next day, Sandy
Offerdahl of Travelers Insurance (Travelers), wrote Dunton.
The letter told Dunton that Travelers was the workers'
compensation carrier for Wells Fargo and asked Dunton to
contact Offerdahl. During September 1994, Offerdahl and
Dunton spoke by telephone several times. Offerdahl
indicated that she wanted copies of the birth certificates
of the children so that she could begin processing workers'
compensation benefits. Ultimately, on September 15, 1994,
Dunton told Offerdahl that she wanted to appeal the amount
of the benefits, that she was represented by an attorney,
and that Plaintiff had advised her not to send Offerdahl
copies of the birth certificates. On September 20, 1994,
Offerdahl sent the attorney a letter identifying Travelers
as the workers' compensation carrier and asking for birth
certificates. The attorney never responded.
{4}
In February 1995, Plaintiff, as personal representative
of her son's estate, filed a complaint
and then an amended complaint in district court seeking
damages for wrongful death. As to Wells Fargo, the
complaint alleged that the "Big Red" armored cars used by
Wells Fargo had frequent mechanical difficulties and, as a
result, Wells Fargo had used ordinary rental vans from
Budget on some of its routes, including the route Oelcher
was on at the time of his death.
{5}
On August 1, 1995, the trial court ordered Wells Fargo
to produce evidence, before September 13, 1995, of its
compliance with the insurance provisions of the Act.
Thereafter, Wells Fargo's attorney allowed Plaintiff's
attorneys to inspect the copy of the policy that he had.
Two years later, at the hearing on the motion for summary
judgment, Wells Fargo's attorney informed the trial court
that at the time Plaintiff's attorneys looked at the policy,
the terms and conditions of the policy were not available.
{6}
Also in September 1995, Plaintiff's attorneys contacted
the Administration to determine if a notice of accident
report, referred to as an E-1, had been filed. On September
22, 1995, Alex Maestas, then Records Manager for the
Administration, searched the computer data base and the
archives and told the attorneys that no such report had been
filed. Maestas executed an affidavit on that date to that
effect. Two years later, Maestas did the same search and
found an E-1 for the incident. Maestas could not explain
why he had been unable to find the report two years earlier.
Although the statute requires that a copy of the E-1 be
served on the worker, see NMSA 1978, § 52-1-58(A) (1990), it
is undisputed that no service had been made.
{7}
On September 15, 1995, Plaintiff filed a motion for
leave to amend her complaint to add a claim of negligence
against Wells Fargo. The motion indicated that Wells Fargo
had failed to produce evidence that it had complied with the
insurance provisions of the Act and that it still had not
filed proof of coverage as required by the Act. Plaintiff
attached a second amended complaint to the motion. In
addition to the allegations previously made concerning the
failure to keep the Big Red armored vans in good repair, the
second amended complaint specifically alleged that Wells
Fargo had failed to comply with the provisions of the Act
concerning insurance and therefore Plaintiff was entitled to
sue Wells Fargo for its alleged negligence.
{8}
On November 15, 1995, Wells Fargo filed proof of
insurance coverage for calendar year 1994 with the
Administration. On November 29, 1995, the trial court
granted the motion to amend the complaint. The second
amended complaint was formally filed on December 5, 1995.
{9}
Almost two years later, in September 1997, Wells Fargo
filed a motion for summary judgment. Plaintiff filed a
response. The trial court held argument on the motion on
May 1, 1998. On July 17, 1998, the trial court filed an
order granting summary judgment in favor of Wells Fargo.
This appeal followed.
Applicable Statutory Provisions
{10}
The Workers' Compensation Act (the Act) is, by statute,
the exclusive remedy for on-the-job injuries or deaths.
However, in order to take advantage of the exclusive remedy provisions of the Act, an employer must comply with the
provisions of the Act concerning insurance. See §§ 52-1-6(C) & (D); 52-1-8; 52-1-9. If the employer fails to comply
with those provisions, the worker can sue the employer
either for compensation benefits or for damages in tort
caused by the employer's negligence. See Harger, 121 N.M.
at 666, 916 P.2d at 1333. The worker has the choice of
remedy.
{11}
The provisions of the Act concerning insurance are
relatively straightforward. Employers are given a choice.
They may either qualify as self-insured pursuant to the
provisions of the Act and the regulations of the
Administration, or they may purchase insurance to cover
their potential liability under the Act. See § 52-1-4; 11
NMAC 4.8.8 (1996); In re Mission Ins. Co., 112 N.M. 433,
435, 816 P.2d 502, 504 (1991); Addison v. Tessier, 62 N.M.
120, 125, 305 P.2d 1067, 1069-70 (1957). The standards for
allowing employers to self-insure their liability are
relatively high, requiring, among other things, a tangible
net worth in excess of $2.5 million, at least three years in
business, a risk management program, and a workers'
compensation specific occurrence or aggregate insurance with
retention of $250,000 and statutory upper limits. See 11
NMAC 4.8.8.1.
{12}
If the employer chooses to obtain insurance, the
insurance policy must make the insurer directly and
primarily liable to the injured worker or his dependents.
See § 52-1-4. All states require that the compensation
liability be insured, either through private insurance,
self-insurance, or insurance provided by state funds. See 9
Arthur Larson & Lex K. Larson, Larson's Workers'
Compensation Law § 92.11, at 17-1 to 17-5 (1999). The
rationale is straightforward: to make sure that injured
workers or their dependents will be able to collect the
benefits due to them even if the employer goes out of
business or becomes bankrupt. See id. § 92.12. In
addition, the Act requires the employer to file proof of
insurance coverage with the director of the Administration.
See § 52-1-4(A); 11 NMAC 4.11.8 (1996).
Filing of Proof of Coverage
{13}
Plaintiff contends that summary judgment was improper
because there are disputed issues of fact concerning whether
Wells Fargo substantially complied with the statutory
requirement that it file proof of insurance coverage with
the Administration. See § 52-1-4; 11 NMAC 4.11.8; see also
Roth v. Thompson, 113 N.M. 331, 334-35, 825 P.2d 1241, 1243-44 (1992) (explaining that summary judgment is improper if
there are disputed issues of material fact). In the trial
court and on appeal, Wells Fargo offered three arguments on
this issue. First, it argued that it complied with the
statute by filing proof of coverage with the National
Counsel for Compensation Insurance (NCCI). Second, it argued that by filing proof of coverage in November 1995, it
substantially complied with the statute. Third, it argued
that the date that it complied with the filing requirements
does not matter because Plaintiff was on notice that
benefits were available. For the following reasons, we
conclude that summary judgment was inappropriate. See
Rummel v. Lexington Ins. Co., 1997-NMSC-041, ¶¶ 16-17, 123
N.M. 752, 945 P.2d 970 (recognizing that summary judgment is
inappropriate if the trial court misapplied the law).
{14}
As this Court has observed in a somewhat different
context, "[s]ubstantial compliance means that a court should
determine whether the statute has been followed sufficiently
so as to carry out the intent for which the statute was
adopted and accomplishes the reasonable objectives of the
statute." Vaughn v. United Nuclear Corp., 98 N.M. 481, 485,
650 P.2d 3, 7 (Ct. App. 1982) (analyzing substantial
compliance under the Subsequent Injury Act); see also
Gambrel v. Marriott Hotel, 112 N.M. 668, 672, 818 P.2d 869,
873 (Ct. App. 1991) (measuring substantial compliance by
evaluating the purposes of the Subsequent Injury Act). The
purpose of the mandatory filing requirement is to notify a
worker that the employer has complied with the insurance
provisions of the Act. See Shope v. Don Coe Constr. Co., 92
N.M. 508, 510, 590 P.2d 656, 658 (Ct. App. 1979). With the
filing, the worker is conclusively presumed to have accepted
the Act. See id.; cf. Junge v. John D. Morgan Constr. Co.,
118 N.M. 457, 464, 882 P.2d 48, 55 (Ct. App. 1994) (holding
that sole proprietor's filing on behalf of company did not
establish proprietor's acceptance as an employee). The
filing requirement also serves as a benefit to the worker
because, if followed, the worker will know that the employer
has insurance and the name and address of the responsible
insurer. See Quintana v. Nolan Bros., Inc., 80 N.M. 589,
590, 458 P.2d 841, 842 (Ct. App. 1969); see also Junge,
118 N.M. at 464, 882 P.2d at 55 (stating that filed
certificates were for benefit of workers, not employer).
1. NCCI Filing
{15}
We first examine whether filing proof of coverage with
NCCI establishes substantial compliance. We assume without
deciding that the Administrator considered this method of
filing acceptable in 1994. We note that the proof of
coverage in question shows the named insured as Baker
Industries and makes no mention of either Wells Fargo or
Borg-Warner, the parent company of Wells Fargo. As a
result, it is not surprising that the Administration
informed Ken Peterson that it had no record of insurance for
Wells Fargo or Borg-Warner. We fail to understand how the
NCCI certificate informed the employees of Wells Fargo or
their dependents of the fact that Wells Fargo had obtained
compensation insurance if the Administration could not
ascertain coverage from the same information. Thus, in
these circumstances, the filing with the NCCI would not
suffice to inform Wells Fargo's employees of coverage and was not, therefore, substantial compliance with the filing
requirement.
2. November 15, 1995 Filing with Administration
{16}
We next address the question of whether Wells Fargo
substantially complied with the filing requirement by filing
a certificate of coverage with the Administration on
November 15, 1995. In the trial court, Wells Fargo argued
that Plaintiff did not file the negligence action in this
case until December 5, 1995, and therefore the November 1995
filing constituted substantial compliance. In response,
Plaintiff argued that the lawsuit was filed in February 1995
and her motion to amend the complaint was filed in September
1995, which related back to the initial filing. See Rule 1-015(C) NMRA 2000. We agree with Plaintiff that Wells
Fargo's November 1995 filing was not substantial compliance,
although for somewhat different reasons.
{17}
We note initially that all the cases that have found
substantial compliance with the filing requirement have
involved significantly shorter periods of time than in this
case. Compare Mirabal v. International Minerals & Chem.
Corp., 77 N.M. 576, 578, 425 P.2d 740, 742 (1967) (filing
forty days after accident and eight months before any suit
filed); Shope, 92 N.M. at 509, 590 P.2d at 657 (filing
roughly one month after the accident and roughly six weeks
before common law claim filed); Quintana, 80 N.M. at 589,
458 P.2d at 841 (filing seventy-six days after accident and
some (unspecified) amount of time before suit filed); with
Security Trust v. Smith, 93 N.M. 35, 37-38, 596 P.2d 248,
250-51 (1979) (holding that filing proof of coverage eleven
months after the accident and six weeks after common law
action commenced was not substantial compliance); Montano v.
Williams, 89 N.M. 86, 87-88, 547 P.2d 569, 570-71 (Ct. App.
1976), aff'd, 89 N.M. 252, 550 P.2d 264 (1976) (failing to
file proof of insurance or produce policy during ensuing
common law litigation was not substantial compliance).
Moreover, in none of those cases has the plaintiff sought to
amend the complaint after suit was filed.
{18}
As we have stated, in addition to notice, the purpose
of the filing requirement is to provide information to the
injured worker. In circumstances of death, this purpose
extends to the worker's dependents. In this case, Wells
Fargo did not meet this informational purpose solely by
satisfying the technical filing requirement in November
1995. It produced insurance documents for Plaintiff in
September 1995 only after being ordered by the trial court
to produce evidence of its compliance with the Act's
insurance provisions.
{19}
The documents that Wells Fargos produced included pages
of a Continental Insurance Company (Continental) policy that
included workers' compensation insurance applicable in New
Mexico during 1993-1994. The first page shows the insured as Baker Industries, a subsidiary which was dissolved prior
to Oelcher's death; however, someone had crossed out Baker
Industries and written in by hand "Borg-Warner Security
Corporation." The production also included a revised
schedule A that indicated that the named insured is
completed to read Borg-Warner Security Corporation and Wells
Fargo Armored, among others. This partial production of
only three pages of the Continental policy was inconclusive
as to whether Wells Fargo had workers' compensation
insurance coverage for its employees on August 24, 1994.
The inconclusive nature of the September 1995 production was
borne out by the documents Wells Fargo later filed as a
supplement to its motion for a summary judgment. These
later documents included an endorsement to the Continental
policy which specifically provided that the policy covered
only Baker Industries and specifically excluded all other
Borg-Warner Corporation operations from the policy. The
endorsement indicates that Baker Industries or its insurance
agent may issue certificates of insurance to parties that
have an interest in the Continental policy, but Wells Fargo
did not file any such certificate of insurance.
{20}
Substantial compliance with the mandatory filing
requirement exists when the circumstances accomplish the
same purposes as the filing requirement. See Shope, 92 N.M.
at 510, 590 P.2d at 658. The rationale for this result is
evident: when an employer maintains workers' compensation
insurance and provides information to an injured worker
concerning the insurance that enables the worker to obtain
compensation, the purposes of the Act are fulfilled and the
employer is entitled to the Act's protections from suits in
tort. See generally id. On the other hand, when an
employer does not provide certainty that coverage exists,
the worker or the worker's dependents do not know how to
proceed to obtain compensation for an injury. When this
uncertainty continues for an extended period of time, the
likely result is litigation rather than the efficient
resolution of the claim that the Act contemplates. See
Mirabal, 77 N.M. at 578, 425 P.2d at 742 (stating that one
purpose of the prior workers' compensation act was to avoid
uncertainty in litigation).
{21}
In general, if the employer files the appropriate
document before the worker files a tort suit, the employer
has provided sufficient certainty and has substantially
complied with the filing requirement such that the worker
cannot sue in tort. Compare Mirabal, 77 N.M. at 578, 425
P.2d at 742 (holding that employer substantially complied
by paying benefits and filing the policy eight months before
the worker filed a tort suit); Shope, 92 N.M. at 510-11,
590 P.2d at 658-59 (holding that employer substantially
complied even though it filed the proof of insurance fifteen
days late because the filing was two months before the
common law suit was filed); Quintana, 80 N.M. at 590, 458
P.2d at 842 (holding that employer substantially complied
even though proof of coverage was filed after the accident that caused the employee's death but before employee filed
suit); with Security Trust, 93 N.M. at 37-38, 596 P.2d at
250-51 (holding no compliance where employer did not file
the appropriate document until after the worker filed a tort
suit); Montano, 89 N.M. at 90-91, 547 P.2d at 573-74
(holding no compliance where employer never filed an
appropriate document and never produced a policy of
compensation insurance). However, the substantial
compliance doctrine requires not only that the employer file
proof of insurance coverage before the worker files a suit,
but also that the employer actually had maintained workers'
compensation insurance coverage for its employees as of the
date of the injury in question. See Mirabal, 77 N.M. at
578, 425 P.2d at 742 (observing written evidence of workers'
compensation coverage in record); Shope, 92 N.M. at 510, 590
P.2d at 658 ("We must keep in mind that defendant actually
had compensation insurance within the mandatory 30 day
period, but was late in filing this certificate by 15
days."); Quintana, 80 N.M. at 589, 458 P.2d at 841 (noting
that employer had policy at time of accidental injury).
The doctrine contemplates that the failure of an employer to
file in a timely manner is due to a technical error that is
promptly corrected. See Quintana, 80 N.M. at 590, 458 P.2d
at 842 (noting that employer's "technical delay" did not
permit wrongful death suit); Mirabal, 77 N.M. at 578, 425
P.2d at 742 ("It would seem contrary to legislative intent
that any technical delay which in no way prejudices a
claimant would give rise to a common-law suit.").
{22}
It is not clear whether Wells Fargo's failure to file
proof of insurance was due to technical or substantive
reasons. We do not decide that question on the record
before us. Regardless, Wells Fargo's failure to promptly
correct the problem caused litigation surrounding insurance
coverage, precisely the uncertainty that the filing statute
addresses. Wells Fargo then compounded the problem with its
incomplete and inconclusive September 1995 production which
led to Plaintiff's filing the motion to amend the complaint
to add a negligence claim against Wells Fargo. On November
15, 1995, at a stage of the litigation when Wells Fargo had
previously produced documentation concerning its coverage
and Plaintiff had sought to amend her complaint, the filing
of proof of coverage no longer had any substantive value.
Because the purpose of the Act's filing requirement had
already either been met or frustrated, the November 15, 1995
filing was not substantial compliance with the Act.
3. Actual Notice
{23}
Wells Fargo also argues that Plaintiff had actual
notice that compensation benefits were available due to the
contacts between Offerdahl and Dunton. In addition, Wells
Fargo points to a facsimile communication to Plaintiff's
attorneys from the Administration in August 1995 identifying
the insurance policy in question and providing the name and
address of the insurer. Wells Fargo relies on case law construing actual notice as sufficient to show substantial
compliance with the filing requirement. See Shores v.
Charter Servs., Inc., 106 N.M. 569, 570, 746 P.2d 1101, 1102
(1987); Baldwin v. Worley Mills, Inc., 95 N.M. 398, 399-400,
622 P.2d 706, 707-08 (Ct. App. 1980).
{24}
We recognize that the parties do not dispute that
contacts between Offerdahl and Dunton took place. However,
we are not persuaded by the argument that these contacts
constituted actual notice. We agree with Wells Fargo that
the cases do not require knowledge that benefits are
available; they require that Plaintiff have "actual
knowledge, and thus notice, of the existence of a workmen's
compensation policy of insurance." Baldwin, 95 N.M. at
400, 622 P.2d at 708. However, in September 1995, Plaintiff
had been given conflicting information concerning the
existence of a policy. The Administration had told Ken
Peterson that Wells Fargo did not have compensation
insurance. Later, Offerdahl told Dunton that Travelers was
the compensation carrier. Still later, the Administration
told Plaintiff's attorneys that Continental was the
compensation carrier. When all of these facts are
considered, reasonable minds could differ as to whether
Plaintiff had actual knowledge of the existence of a policy
of compensation insurance. Thus, Wells Fargo was not
entitled to summary judgment on this basis.
{25}
In an argument that would avoid the problems engendered
by the provision of conflicting information, Wells Fargo
additionally contends that if Peterson did not have actual
knowledge of the compensation insurance, she was at least on
notice such that she should inquire further. The record,
however, shows that Plaintiff did inquire further, but that
Wells Fargo resisted her efforts to obtain a copy of the
insurance policy. When Wells Fargo finally provided a copy
for Plaintiff's inspection, it was an incomplete copy. We
therefore find no merit in Wells Fargo's argument.
Conclusion
{26}
We reverse the order granting summary judgment in favor
of Wells Fargo and remand to the district court for further
proceedings consistent with this opinion.
{27}
IT IS SO ORDERED.
_________________________________
JAMES J. WECHSLER, Judge
WE CONCUR:
_________________________________
RUDY S. APODACA, Judge
_________________________________
RICHARD C. BOSSON, Judge