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The Collaborative Clearinghouse for Lawsuits and Other Claims Against ACE Group Insurance Companies

PACIFIC EMPLOYERS INSURANCE COMPANY v. RPG ENTERPRISES

ATTENTION: It is possible that this information may no longer be current and therefore may be inaccurate. The index contains both open and closed cases and is not a complete list of cases in which an ACE Insurance Group company is involved. This information is provided to give interested persons an idea of the issues disputed in the indexed cases. For a full understanding of a case, one should read the rest of the court file, including the response. For the most up-to-date and complete information on a case, visit www.pacer.gov or contact the clerk of the relevant court.

Case Number: 
30-2011-00519687- CU-CL-CJC Search Pacer
ACE Group party(s): 
Opposing Party: 
PACIFIC EMPLOYERS INSURANCE COMPANY
Court Type: 
Federal
Date Filed: 
Nov 1 2011

"FIRST CAUSE OF ACTION
(Breach of Contract Against All Defendants)

8. Plaintiff hereby incorporates by reference paragraphs 1 through 6, inclusive, of this Complaint as if set forth in full in this paragraph,

9. On or about December 17,2009, Plaintiff upon the request of Defendants for Workers Compensation and Employers Liability Insurance coverage, provided Defendants with an Insurance Policy No. NWC C45880473 for the period of 12/17/2009 through 12/17/2010, in writing, which was subject to an audit and recomputation of its premium (the "Policy"). Plaintiff is authorized under the Policy to examine and audit all records that relate to the Policy during the policy period. The Policy provides that the final premium will be determined by using the actual premium basis and the proper classifications and rates as determined by an audit. The Policy further obligated Defendants to pay the difference between the estimated and actual premiums after the audit and final premium determined by Plaintiff. In this regard, the Policy, in part, provides: PART FIVE - PREMIUM [If] B. Classifications [If] Item 4 of the information page shows the rate and premium basis for certain business or work classifications. These classifications were assigned based on an estimate of the exposures you would have during the policy period. If your actual exposures are not properly described by those classifications, we will assign proper classifications, rates and premium basis by endorsement to this policy. [If] C. Remuneration [f] Premium for each work classification is determined by multiplying a rate times a premium basis period. Remuneration is the most common premium basis. This premium basis includes payroll and all other remuneration paid or payable during the policy period for the services of: [fj 1. All your officer and employees engaged in work covered by this policy; and flj] 2. All other persons engaged in work that would make us liable under Part One (Workers Compensation Insurance) of this policy period. If you do not have payroll records for these persons, the contract price for their services and materials may be used as the premium basis. This paragraph 2 will not apply if you give us proof that the employers of these persons lawfully secured their workers compensation obligation, [^f] E. Final Premium. The premium shown on the Information Page, schedules and endorsements is an estimate. The final premium will be determined after this policy ends by using the actual, and not the estimated, premium basis and the proper classifications and rates that lawfully apply to the business and work covered by this policy. If the  final premium is more than the premium you paid us, you must pay us the balance. If it is less, we will refund the balance to you. The final premium will not be less than the highest minimum premium for the classifications covered by this policy.... \%\ F. Records. You will keep records of information needed to compute premium. You will provide us with copies of those records when we ask for them. [^] G. Audit, You will let us examine and audit all your records that relate to this policy. These records include ledgers, journals, registers, vouchers, contracts, tax reports, payroll and disbursement records, and programs for storing and retrieving data. We may conduct the audits during regular business hours during the policy period and within three years after the policy period ends. Information developed by audit will be used to determine final premium. Insurance rate service organizations have the same rights we have under this provision.

10. An audit was subsequently performed on the effective policy period for the Policy. The audit found the premium basis estimate provided by the Defendants to be inaccurate and found the actual audited total premium plus tax for the effective policy period for the Policy to be short by $75,798.00.

11. Plaintiff has performed all conditions, covenants and promises required of it on its part in accordance with the terms and conditions of the Policy, except those which are excused by Defendants' breach.

12. Subsequent to the audit, after making payments totaling $40,798.00, Defendants refused to make any further payments toward the policy premium as audited for the Policy. Thus, within the past four years, Defendants have breached the terms of the Policy by failing and refusing to satisfy the amount outstanding on the Policy of $35,000.00, which became fixed or readily ascertainable on October 6, 2011.

13. As a direct and proximate result of Defendants' breach of the Policy, Plaintiff has been damaged in the amount of $3 5,000.00, together with prejudgment interest of $9.59 per day from October 6, 2011 using the legal rate of 10% per annum.

WHEREFORE, Plaintiff prays for judgment against Defendants, and each of them, as follows:
1. For the sum of $35,000.00, together with prejudgment interest of $9.59 per day from October 6, 2011 using the legal rate of 10% per annum;
2. For costs of suit, including attorney's fees, if available; and
3. For such other and further relief as the Court deems just and proper."

The provided text is an excerpt from a document filed in this case. For a full understanding of the case, one should read the complete court file, including the response.

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