HCBeck, Ltd. v. RiceHCBeck, Ltd. v. Rice
Lead Opinion
delivered the opinion of the Court,
The purpose of the Texas Workers’ Compensation Act is to provide employees with certainty that their medical bills and lost wages will be covered if they are injured. An employee benefits from workers’ compensation insurance because it saves the time and litigation expense inherent in proving fault in a common law tort claim. But a subscribing employer also receives a benefit because it is then entitled to assert the statutory exclusive remedy defense against the tort claims of its employees for job related injuries. This exclusive remedy defense provided to subscribing employers is also afforded to a general contractor if, pursuant to a written agreement, it “provides” workers’ compensation insurance coverage to the subcontractor and its employees. See
In this case, we consider the extent to which a general contractor must “provide” workers’ compensation insurance under the Act to qualify for statutory employer status and the resulting immunity from the work-related claims of a subcontractor’s employees. See
I
FMR Texas Ltd. (FMR) contracted with HCBeck, Ltd. to construct an office campus on FMR’s property. One of the features of this contract (the Construction Management Agreement, or the Agreement) was a workers’ compensation insurance plan provided by FMR that covered the work site. The Agreement required this insurance plan, part of an owner controlled insurance program (OCIP), together with its corresponding OCIP Handbook, to be incorporated into all construction contracts entered into by HCBeck with any subcontractors. The Agreement described the manner in which FMR would provide insurance on the project:
Prior to commencement of the Work, the Owner [FMR], at its option and cost, may secure and thereafter, except as otherwise provided herein, maintain at all times during the performance of this Agreement [workers’ compensation insurance] ... with the Owner, the Construction Manager [HCBeck], subcontractors, and such other persons or interests as the owner may name as insured parties....
HCBeck and all subcontractors working on the project were required to enroll in the OCIP. As each contractor enrolled in the OCIP, FMR’s insurance representative would designate the contractor “insured” for workers’ compensation and other insur-
Pursuant to the terms of the OCIP, FMR purchased workers’ compensation insurance to cover the construction project and paid the premiums. Meanwhile, HCBeck entered into a subcontract with Haley Greer. The subcontract recognized that the project was covered by FMR’s OCIP and further incorporated the insurance provisions contained in FMR’s original contract with HCBeck. As mandated by the original contract, the subcontract required that Haley Greer apply for and enroll in FMR’s OCIP. Haley Greer then enrolled in the OCIP, and a separate workers’ compensation insurance policy was issued in Haley Greer’s name.
Charles Rice, Haley Greer’s employee, was injured while working on the construction project. Rice made claim upon and received workers’ compensation benefits under the policy issued to Haley Greer pursuant to FMR’s OCIP. He then filed a negligence suit against HCBeck. HCBeck moved for summary judgment claiming that its original contract with FMR specified that FMR’s OCIP “shall” apply to all work at the project performed by HCBeck and subcontractors and, but for HCBeck’s subcontract with Haley Greer, Rice would not be working on a project that contractually provided workers’ compensation insurance covering Haley Greer’s employees. HCBeck therefore maintained that it “provided” workers’ compensation insurance to Haley Greer as permitted by
The trial court granted HCBeck’s motion for summary judgment and denied Rice’s reciprocal cross-motion for partial summary judgment. The court of appeals, however, held that “HCBeck’s contract with Haley Greer — which simply incorporated FMR’s OCIP into the subcontract under the direct order of FMR in its contract with HCBeck — is insufficient to constitute ‘providing’ workers’ compensation insurance to Haley Greer.”
II
We review a trial court’s summary judgment de novo. Valence Operating Co. v. Dorsett,
III
Under the Workers’ Compensation Act, a “general contractor and a subcontractor may enter into a written agreement under which the general contractor provides workers’ compensation insurance coverage to the subcontractor and the employees of the subcontractor.”
The OCIP administered and paid for by FMR provided workers’ compensation insurance coverage to all contractors and their employees working at FMR’s job site. Rice claims HCBeck does not qualify as a statutory employer because, by the terms of the subcontract between HCBeck and Haley Greer, HCBeck was never obligated to provide workers’ compensation insurance coverage to Haley Greer or its employees in the event FMR opted to terminate the OCIP. Both the original FMR/HCBeck contract and the HCBeck/Haley Greer subcontract state that FMR may terminate its OCIP at any time, but in that event, the contractors must obtain “alternate insurance.” As between the general contract and the subcontract, the alternate insurance provisions are slightly different, but they outline the manner in which employees are to be covered if FMR decided to terminate the
ALTERNATE INSURANCE: The Owner [FMR] is not required to furnish the OCIP. If [FMR] elects to terminate the OCIP at any time, [FMR] will give subcontractor written notice. In the event of OCIP termination, Subcontractor and lower-tier subcontractors will be required to provide Alternate Insurance. Alternate Insurance is the coverage required by the [FMR/HCBeck] Contract Documents if the OCIP is not in force or does not apply.
Rice argues that, if the OCIP is terminated, this provision places the obligation of obtaining workers’ compensation insurance for his benefit on his own employer, Haley Greer, and not HCBeck. But although such an interpretation could be gleaned from the paragraph if its third sentence is considered in isolation, the last sentence specifically requires the parties to refer to the FMR/HCBeck contract documents “if the OCIP is not in force or does not apply.” That alternate insurance paragraph states:
If [FMR] elects to exclude this Agreement, or any portion thereof, from the OCIP or for any reason [FMR] is unable or unwilling to furnish [the OCIP] ... the Construction Manager shall secure such insurance at the Owner’s cost....
This paragraph makes it clear that HCBeck is contractually obligated to obtain the insurance to cover the employees on the job site because it specifies that HCBeck, who was identified in the contract as the Construction Manager, “shall” secure the alternate insurance. Moreover, the OCIP Handbook states that “Contractors will be required to provide on-site [insurance” in the event of OCIP termination.
The dissent contends that HCBeck did not “provide” workers’ compensation because “HCBeck did not agree to procure workers’ compensation insurance in force for Haley Greer, nor did it agree to pay or somehow obligate itself to pay the premiums, or otherwise assure the workers’ compensation coverage Haley Greer had in effect when Rice was injured.”
HCBeck’s obligation is further strengthened by its own interest in maintaining its statutory defenses against claims by Haley Greer’s employees. The dissent argues that contracting for coverage does not equate to “providing” because there is no assurance that the general contractor will not abandon its obligation and leave the employee at risk of uncovered injury. But there is no guarantee that any employer will provide workers’ compensation for its employees. The law does not require it, although public policy strongly encourages it. Employers that elect to carry workers’ compensation coverage more than likely do so because the Act includes incentives for employers who provide it for their employees. The most obvious incentive, of course, is that employers are immunized from negligence liability for workplace injuries to their employees. See id. § 408.001(a). But an employer is always free, for whatever reason, to discontinue workers’ compensation insurance. See id. § 406.005 (“An employer shall notify each employee as provided by this section whether or not the employer has workers’ compensation insurance coverage.”) (emphasis added). When that happens, the employer loses its exclusive remedy defense. The same result applies to the general contractor who has, pursuant to a written agreement, purchased a workers’ compensation insurance policy covering its subcontractors and its subcontractors’ employees. When it does so, the general contractor becomes the statutory employer of its subcontractor’s employees, and is thus entitled to the benefits conferred on employers by the Act. See
IV
In a variation of the dissent’s position that HCBeck has not sufficiently involved itself in the actual purchase of Haley Greer’s workers’ compensation insurance to gain any advantage by it, the court of appeals concluded that HCBeck did not “provide” workers’ compensation because, it says, the subcontract called for Haley Greer to obtain its own alternate insurance if FMR terminated the OCIP.
V
The dissent would hold that a general contractor “provides” insurance if the contractor “puts something in the pot,” or “contributes something of value for statutory immunity.”
VI
The point of disagreement lies between two plausible interpretations of the term “provide.” One plausible interpretation is
In construing a statute, whether or not the statute is considered ambiguous on its face, a court may consider among other matters the: (1) object sought to be attained; (2) circumstances under which the statute was enacted; (3) legislative history; (4) common law or former statutory provisions, including laws on the same or similar subjects; (5) consequences of a particular construction; (6) administrative construction of the statute; and (7) title (caption), preamble, and emergency provision.
Tex. Gov’t Code § 311.023; see also id. § 312.005 (“In interpreting a statute, a court shall diligently attempt to ascertain legislative intent and shall consider at all times the old law, the evil, and the remedy.”). Consideration of these factors leads to the conclusion that the “old law, the evil, and the remedy” is best served by adopting the latter, inclusive, interpretation of the statute. See id. § 312.005.
First, the “object sought to be attained” has always been simple: to ensure coverage of subcontractors and their employees. See Act of May 28, 1983, 68th Leg., R.S., ch. 950, 1983 Tex. Gen. Laws 5210, 5210 (captioning the legislation as “relating to workers’ compensation insurance coverage of subcontractors”). In this case, all of the parties agree that Rice was, in fact, insured when he was injured. The dissent agrees that “this matter should be determined by what actually happened, not what might have happened.”
Second, we consider the legislative history and the circumstances under which the statute was enacted. Tex. Gov’t Code § 311.023. For almost one hundred years, the Act has contemplated that subcontractors can be covered by workers’ compensation insurance purchased by others. In 1917, the Act included a provision that was designed to prevent subscribers from escaping liability by hiring subcontractors to perform the same work:
If any subscriber to this Act with the purpose and intention of avoiding any liability imposed by the terms of the Act sublets the whole or any part of the work to be performed or done by said subscriber to any sub-contractor, then in the event any employe[e] of such subcontractor sustains an injury in the course of his employment he shall be deemed to be and taken for all purposes
A subcontractor and prime contractor may make a written contract whereby the prime contractor will provide workers’ compensation benefits to the subcontractor and to employees of the subcontractor .... [T]he contract may provide that the actual premiums (based on payroll) paid or incurred by the prime contractor for workers’ compensation insurance coverage for the sub-contractor and employees of the subcontractor may be deducted from the contract price or any other monies owed to the sub-contractor by the prime contractor. In any such contract, the subcontractor and his employees shall be considered employees of the prime contractor only for purposes of the workers’ compensation laws of this state ... and for no other purpose.
Act of May 28, 1983, 68th Leg., R.S., ch. 950, § 1, sec. 6(c), (d), 1983 Tex. Gen. Laws 5210, 5210-11. It is significant that the Legislature did not specify that only “subscribers” could enter into written agreements to provide workers’ compensation to subcontractors; instead, it added a new term, “prime contractor.”
Further, the second sentence of the written agreement provision allows the prime contractor to deduct the actual premiums from the subcontractor.
Next, to determine intent, we look to “the common law or other or former statutory provisions, including laws on the same or similar subjects.” Tex. Gov’t Code § 311.023. We have previously expressed our understanding of the purpose behind the exclusive remedy defense:
The workers’ compensation act was adopted to provide prompt remuneration to employees who sustain injuries in the course and scope of their employment. ... The act relieves employees of the burden of proving their employer’s negligence, and instead provides timely compensation for injuries sustained on-the-job.... In exchange for this prompt recovery, the act prohibits an employee from seeking common-law remedies from his employer, as well as his employer’s agents, servants, and employees, for personal injuries sustained in the course and scope of his employment.
Wingfoot Enters, v. Alvarado,
[The written agreement] legislation was construed to mean that when a premises owner agree[s] to procure workers’ compensation coverage for its general contractor and the general contractor’s subcontractor, a negligence suit by the subcontractor’s employee against both the general contractor and the subcontractor [is] barred by the exclusive remedy provision....
Wingfoot,
Finally, we consider the consequences of a particular construction. Tex. Gov’t Code § 311.023. Holding that HCBeck “provides” workers’ compensation, even when it has not purchased the insurance directly, would allow multiple tiers of subcontractors to qualify as statutory employers entitled to the exclusive remedy defense. Such a scheme seems consistent with the benefits offered by controlled insurance programs, which are designed to minimize the risk that the subcontractors’ employees will be left uncovered.
VII
We conclude that the Texas workers’ compensation insurance scheme, as enacted by the Legislature, was intended to make the exclusive remedy defense available to a general contractor who, by use of a written agreement with the owner and subcontractors, provides workers’ compensation insurance coverage to its subcontractors and the subcontractors’ employees. The OCIP in this case, established and paid for by FMR pursuant to its contract with HCBeek, qualifies under the Act as “providing” workers’ compensation insurance to subcontractors in a manner that is consistent with
Accordingly, we reverse the court of appeals’s judgment and render judgment in favor of HCBeck.
Notes
. The OCIP Handbook, prepared by an outside risk management firm to provide further clarification regarding FMR's OCIP, differentiates between contractors and subcontractors, stating that, “[i]f the [OCIP] is terminated or does not apply, Contractor [HCBeck] will be required to amend (and cause their Subcontractors [Haley Greer] to amend) their insurance policies to provide additional coverage. ..." This indicates that the higher-tier contractor has the ultimate obligation to ensure that the employees of the lower-tier subcontractors are covered.
. "Prime contractor" became "general contractor” in later revisions of the Act, but the definition remained virtually unchanged. Act of May 28, 1983, 68th Leg., R.S., ch. 950, § 1, sec. 6(c), 1983 Tex. Gen. Laws 5210, 5210-11 amended by Act of Dec. 12, 1989, 71st Leg., 2d C.S., ch. 1, § 3.05(a)(2), 1989 Tex. Gen. Laws 1, 15 (current version at
. The deduction sentence was recodified, finding its final place in
. Both of these cases attempt to distinguish the court of appeals' opinion in Rice v. HCBeck by pointing to the fact that the Haley Greer was not automatically enrolled in the OCIP, and that FMR was not contractually bound to continue the OCIP. See Hunt, - S.W.3d at -,
. The purchasing power of a large construction owner, accompanied by centralized coverage and increased economies of scale are all factors that make it less likely that an owner-subscriber’s workers' compensation coverage would be terminated. See generally Sirany, supra, at 30-33 (discussing various benefits of OCIPs, including reduced costs, certainty of protection, centralized management, and enhanced coverage).
.As a matter of illustration, high courts from other states have highlighted the benefits of the kinds of controlled insurance programs that are prevalent throughout Texas. See generally Indep. Ins. Agents of Okla., Inc. v. Okla. Tpk. Auth.,
. To rule as the dissent suggests would likely do away with OCIPs in Texas, along with the benefits they provide to many large-scale developers. For example, the University of Texas System operates a blanket Rolling Owner Controlled Insurance Program, and since its inception, the ROCIP has enrolled over 4,800 contractors and over $3 billion in construction projects. The System has reported that the impact of its ROCIP program has amounted to $8,800,945. The Univ. of Texas Sys., Office of Risk Mgmt., Risk Management Annual Report 5 (2007), available at h ltp://www. utsystem.edu/orm/reports/annualreport_2007. pdf.
Dissenting Opinion
dissenting.
The workers’ compensation system is bottomed on a voluntary trade. Employers provide workers’ compensation insurance coverage in exchange for statutory immunity from suit by employees injured on the job. Employees accept workers’ compensation insurance coverage in exchange for releasing their common law rights to sue the employer for injuries on the job. In Texas Workers’ Compensation Commission v. Garcia, we described the exchange when considering a challenge to the constitutionality of the Texas Workers’ Compensation Act (TWCA):
[T]he Act — carrying forward the general scheme of the former act — provides benefits to injured workers without the necessity of proving negligence and without regard to the employer’s potential defenses. In exchange, the benefits are more limited than the actual damages recoverable at common law. We believe this quid pro quo, which produces a more limited but more certain recovery, renders the Act an adequate substitutefor purposes of the open courts guarantee.
Today the Court says “[a] general workplace insurance plan that binds a general contractor to provide workers’ compensation insurance for its subcontractors and its subcontractors’ employees achieves the Legislature’s objective to ensure that subcontractors’ employees receive the benefit of workers’ compensation insurance.”
Pursuant to its contract with HCBeck, FMR elected to provide insurance through its OCIP and arranged for an agency to secure individual insurance policies for contractors and subcontractors, including both HCBeck and Haley Greer. The insurance covered only on-site construction activities at FMR’s office campus in West-lake. The contractors and subcontractors were contractually required to maintain and furnish proof of separate insurance for their off-site activities. As to the OCIP insurance, FMR paid the premiums. Each contractor and subcontractor adjusted its individual contract price to reflect the premiums FMR paid for the coverage of the individual contractor or subcontractor. Under HCBeck’s agreement with FMR, if FMR elected not to provide insurance via an OCIP, then “upon thirty (30) days written notice from the Owner,” HCBeck was required to perform the actions FMR actually performed in this case: securing insurers to write coverage for the contractors’ on-site Westlake construction activities, paying for the coverage, and then adjusting contract prices of the contractors, if necessary, to reflect the insurance premiums.
Under HCBeck’s subcontract with Haley Greer, HCBeck did not agree to procure the workers’ compensation insurance in force for Haley Greer, nor did it agree to pay or somehow obligate itself to pay the premiums, or otherwise assure the workers’ compensation coverage Haley Greer had in effect when Rice was injured. Haley Greer’s subcontract incorporated the contract between FMR and HCBeck. In that contract, HCBeck only agreed to secure and pay for insurance if FMR notified HCBeck that FMR was unable or unwilling to furnish the coverage under an OCIP. The latter contingency did not occur before Rice was injured.
Citing
§ 406.123 . Election to Provide Coverage; Administrative Violation (a) A general contractor and a subcontractor may enter into a written agreement under which the general contractor provides workers’ compensation insurance coverage to the subcontractor and the employees of the subcontractor.
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(d) If a general contractor ... elects to provide coverage under Subsection (a) ... the actual premiums, based on payroll, that are paid or incurred by the general contractor or motor carrier for the coverage may be deducted from the contract price or other amount owed to the subcontractor....
(e) An agreement under this section makes the general contractor the employer of the subcontractor and the subcontractor’s employees only for purposes of the workers’ compensation laws of this state.
(f) A general contractor shall file a copy of an agreement entered into under this section with the general contractor’s workers’ compensation insurance carrier not later than the 10th day after the date on which the contract is executed. If the general contractor is a certified self-insurer, the copy must be filed with the [Workers’ Compensation] division.
(g) A general contractor who enters into an agreement with a subcontractor under this section commits an administrative violation if the contractor fails to file a copy of the agreement as required by Subsection (f).
In construing statutes, we ascertain and give effect to the Legislature’s intent as expressed by the statutory language. City
The Legislature did not define “provides” or “provide” as those words are used in
The Court views HCBeck as having provided, that is, supplied or furnished, Haley Greer’s insurance by contractually requiring Haley Greer to participate in FMR’s OCIP. For the same reasons expressed above as to making the insurance “available,” even if HCBeck’s actions fall within an expansive construction of supplying, furnishing, or providing the insurance, its actions do not warrant statutory employer status because HCBeek still did not contribute anything of value — a quid pro quo — to the trade Haley Greer’s employees made for workers’ compensation coverage. Moreover, HCBeck’s actions simply do not equate to supplying or furnishing the insurance. By contractually requiring Haley Greer to enroll in the OCIP, HCBeek supplied or furnished Haley Greer with the opportunity and obligation to apply for insurance; it did not provide the insurance itself. FMR supplied or furnished the insurance when FMR secured the agency to place the insurance and paid the premiums. Absent payment of, or incurring liability for, premiums by FMR, the insurance that covered Rice when he was injured would not have gone into effect and been in place.
The parties, the Court, and I agree this matter should be determined by what actually happened, not what might have happened. As to what actually happened, HCBeek substantively functioned only as a conduit through which FMR’s insurance requirements were communicated to and imposed on Haley Greer. Otherwise, HCBeek played no part in locating the agent who placed the insurance or in securing and making certain the insurance remained in effect. For a general contractor such as HCBeek to “provide” workers’ compensation insurance to a subcontractor under
The Court’s opinion could be interpreted as allowing a general contractor to claim statutory employer status by agreeing in a subcontract to provide workers’ compensation insurance, yet also requiring the subcontractor to provide coverage if the contractor does not. Then, so long as the subcontractor maintains coverage, the general contractor would have contributed nothing to the trade by the subcontractor’s employees of their common law rights, yet may claim statutory immunity because it contractually “provided” the insurance. The Court’s holding might even be interpreted as giving a general contractor statutory employer status if it contractually required a subcontractor to provide workers’ compensation insurance on its own, so long as the subcontractor maintained coverage. Again, the general contractor would have exchanged nothing for the subcontractor’s employees’ release of their common law rights against the general contractor.
I would hold that under
There could be flexibility in how such substantive involvement requirements are met. For example, as to the first requirement referenced above, the statute specifically contemplates a situation in which the subcontractor’s insurance is “provided” if a general contractor adds the subcontractor and its employees as insureds under the general contractor’s workers’ compensation policy. See
The Court says “the reality is that HCBeck was actually paying for the workers’ compensation insurance” because HCBeck contracted to pay the “Subcontract Amount” that did not include premiums FMR paid for Haley Greer’s insurance as opposed to contractually deducting the premiums from Haley Greer’s subcontract. —— S.W.3d at-. It concludes there is no real distinction between the two methods of paying the insurance premiums because it is “simply accounting.” Id. at -. In this case, though, the distinction matters. Insofar as the workers’ compensation insurance that covered Rice, HCBeck was a bystander. It was an interested bystander to be sure; but it was a bystander. FMR bought and paid for Haley Greer’s insurance. It received and checked Haley Greer’s wage reports on which the compensation insurance premiums were calculated. It determined the amount by which Haley Greer’s subcontract was adjusted for the premiums. And the money to pay Haley Greer’s subcontract came from FMR. HCBeck did not actually pay Haley Greer’s premiums, FMR did. HCBeck had no more involvement in “providing” the workers’ compensation insurance covering Rice for his injury on FMR’s Westlake job than it had in “providing” Haley Greer’s workers’ compensation insurance for off-site operations. In both instances HCBeck contractually required Haley Greer to have the insurance in place, but HCBeck neither secured placement of the insurance nor assured its being in force at the time of Rice’s injury.
The question before us is not whether OCIPs are the best or most efficient and economical way to secure insurance — including workers’ compensation insurance — for all workers on job sites. Nor is it how OCIPs interface with workers’ compensation law. Those matters are significant, but they are more in the nature of policy issues better left to the Legislature to balance and address. The question be
I would hold that HCBeck was not Rice’s statutory employer. I would affirm the judgment of the court of appeals.
. The issue of whether HCBeck has immunity on some basis other than as an employer is not before us. See
. Rice disputes this point and asserts that the agreements required Haley Greer to provide its own insurance if FMR did not. Because I would reach the same conclusion regardless of whether HCBeck or Haley Greer was required to provide the insurance if FMR did not, I assume the documents required HCBeck to do so.