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 Decisions that are not on this list are not precedential and should not be cited or relied upon.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. Non Compliance or 11753.1 Cases:     

1. American Reliable Insurance Company DISP 06091926

VII. Order to Show Cause:

1. Pacificare Life and Health Insurance Company

VIII.  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. 

IX. 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
3. State Farm General Insurance Company; File No. PA-2015-00004

X. Producer Discipline Cases:    

    1.  Marsh USA, Inc.  File No. DISP05047170

XI.  Rollback Cases:  

• (There are currently no precedential decisions in this category.)

XII.   Workers' Compensation Cases

1. Classification:

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

2. 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

3. 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

4. Other:

1. Gary Milne  97-11, pp.8-11
2. Schaefer Ambulance  95-8
3. Sherries' Schools 95-4
4. Shasta Linen Supply, Inc.; File No. AHB-WCA-14-31
5. Connolly Ranch, Inc.; File No. AHB-WCA-17-24

Index of Precedential Decisions  
and Parts of Decisions by Topic

I.  NONCOMPLIANCE 11753.1 CASES

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

II.    ORDER TO SHOW CAUSE CASES

     1.   Pacificare Life and Health Insurance Company

III.   PRIOR APPROVAL CASES

1. A.  Standard of Review

• Allstate Insurance Company and Allstate Indemnity Company
• American Healthcare/SCPIE Indemnity Companies
• State Farm General Insurance Company; File No. PA-2015-00004 

1. B.  Burden of Proof

• American Healthcare/SCPIE Indemnity Companies

IV.  PRODUCER DISCIPLINE CASES

1.   Insurance Agents and Brokers, Duties of

   1. Marsh USA, Inc.

V  WORKERS' COMPENSATION CASES

• 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. Officers/Directors
      Connolly Ranch, Inc.
  11. Resident Employees
      Royal T. Management, Inc.
  12. Single Enterprise Rule - Standard Exceptions
      Evans Rents
      Healthcare Management Services, LLC
      LA Sports Fitness Club
  13. Special Industry Classification procedures
  14. Standard Exceptions
      Pali Mountain Institute
      Camp Tawonga 

• Claims Handling

  1. Sherries' Schools

• 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
  16. California & Rancho Cucamonga Restaurant Ventures
  17. Publication of Ex-Mods
      Kevin D. Woody Landscape Maintenance, Inc.
  18. Replacement Policy
      C&W Truck and Equipment Co.
  19. Revision of Ex-Mod
      B.D.D. Pest Control, Inc.
      Grenada Residential Care Facility
      Peeter's Transportation
      Vista Fence
  20. Subterfuge
      Kevin D. Woody Landscape Maintenance, Inc.

• Rating Plan

  • Gary Milne

• Reporting

  • Schaefer Ambulance

• 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.

• Other

Shasta Linen Supply, Inc.; File No. AHB-WCA-14-31

Last Revised - October 20, 2014