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Peterson v. Wells Fargo Armored Services Corp.3/20/2000
ee 11 NMAC 4.8.8.1.
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
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).
As this Court has observed in a somewhat different context, " 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
We first examine whether filing proof of
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