Court Opinion

ID: 9795604
Source: CourtListenerOpinion
Date Created: 2023-08-31 03:32:15.386756+00
Date Added: 2024-06-11T08:30:04.959960
License: Public Domain

FABE, Chief Justice,
dissenting.
I disagree with the court's conclusion that the Workers' Compensation Board's post-settlement finding that Crawford and Company frivolously and unfairly controverted Penny Baker-Withrow's claim is a final, appealable order. I depart from the court's reasoning on several grounds. The court has created the right to an appeal that frequently will have no appellee. Furthermore, the Board's finding fails our test for identifying final appealable agency orders because it does not require Crawford to take any action. The finding therefore has no direct effect on the company. And we do not need to be con*987cerned with the preclusive effect of the Board's finding as even Crawford admits it is not binding on the Division of Insurance. Finally, allowing this type of appeal will delay the Division's investigations, to the detriment of the workers' compensation scheme and the public policy behind it. I would affirm the superior court's dismissal of Crawford's appeal and therefore respectfully dissent from the court's opinion and judgment.
"The test for determining whether a judgment is or is not final is essentially a practical one."1 Without even turning to our doctrine on finality, I believe that the court's holding cannot meet this simple standard of pragmatism because in many cases there will be no appellee to defend the appeal the court today allows. A claimant like Baker-With-row has already received the money she needs to make her whole and pay her lawyer. If the employer appeals only the controversion finding, and compensation is not at stake, the employee has no reason to defend the appeal. She will be no better off if the courts affirm the Board than if they reverse it. And she has no way, other than her own out-of-pocket funds, to pay her lawyer to chase the appellant through the appeals process.2 As I explain below, the only direct effect of the Board's ancillary finding of frivolous or unfair controversion is that the Division of Insurance will initiate an investigation into whether the employer or insurer has engaged in unfair claim settlement practices-an investigation that must look beyond the facts of the original claimant's case.3 The Division undertakes this investigation in the public interest, not to advance the claimant's goals.4 The claimant has no direct stake in the investigation's outcome, or even in whether it happens or not. As the court points out, the Board may take part in an appeal to protect its own interests.5 Unfortunately, in this case the Board has determined it has no interest not represented by one of the parties.6 By allowing this appeal, and by leaving a pro se litigant like Baker-Withrow to handle it on her own, the court and the Board are asking workers' compensation claimants to help police claim settlement practices by serving as private attorneys general, without any of the rewards that normally attend fulfilling such a role in a gui tam action or a citizen suit. Although Baker-Withrow has chosen to take on the task, I doubt that many claimants in her position will do the same. We will be left deciding appeals based only upon the arguments of appellants-a notably poor way of getting at the truth of the matter.
The one-sided nature of this type of appeal should at least pique our suspicion that the Board's finding is not the sort of order we ought to consider final and appealable. To determine whether the administrative order is final and appealable, the court uses the two-part test laid out in State, Department of Fish & Game, Sport Fish Division v. Meyer, asking "whether the agency has completed its decisionmaking process, and whether the result of that process is one that will directly affect the parties."7 I agree with the court that the Board has completed its decision-making process in this case, but I would hold that the finding of frivolous and unfair contr-oversion will not directly affect Crawford and Company within the meaning of Meyer.
We have not had occasion to analyze what it means for an agency decision to "directly affect the parties." Cases from other jurisdictions that have considered the question *988have generally granted review only for agency orders that impose definite and concrete obligations on parties or otherwise govern their behavior. In Franklin v. Massachusetts,8 the source of our Meyer test, the United States Supreme Court held that the question of finality hinges on "whether [the agency decision's] impact 'is sufficiently direct and immediate' and has a 'direct effect on ... day-to-day business.'"9 Appealable agency action "imposes an obligation, denies a right, or fixes a legal relationship." 10 The Board's finding of frivolous controversion does none of these. It only triggers the investigation. Crawford is not required by the Board's finding to take any action, nor is the company barred from any action. The Board's finding compels no change in the company's behavior. Its legal status is no different than it was before the finding. The only possible current effect on Crawford is the harm to its reputation. Such damage is not only speculative but is also an "inherent incident{ ] of [an] open and public administrative process" 11 and insufficient to allow an appeal before the investigation has even begun.
The court's holding that the Board's non-dispositive finding directly affects Crawford is driven by an unwarranted concern that an immediate appeal is Crawford's last chance to challenge the Board's finding, because the Division of Insurance will give it "binding effect." 12 An immediate appeal is necessary, the court reasons, because the Board's finding of frivolous and unfair controversion "will go a long way toward establishing an unfair claim settlement practice" of "failing to 'attempt in good faith to make prompt and equitable settlement of elaims in which lHability is reasonably clear," because the two 710 & determinations have "similar" "elements." 13 But there'is no suggestion in the record that any sort of formal preclusion is at work in the Division's proceedings.
The affidavit filed by Robert A. Lohr, Director of the Division of Insurance, does state that the Board's findings are not open to relitigation. But again, the only mandatory effect of those findings is to trigger the investigation. This is an essentially executive action and does not warrant an appeal.14 Director Lohr further states that the Board's finding would be "relevant, probative and persuasive on the question of whether an unfair claim settlement practice ... has occurred." This does not imply the "binding effect" that worries the court. Rather, Lohr's affidavit makes clear that the Division views the Board's finding as good evidence of an unfair claim settlement practice, but that the finding does not conclusively establish any element of that determination.
Crawford itself concedes that the Board's finding does not have a conclusive effect on the Division's decision: "The Division of Insurance can only determine whether Crawford committed an unfair claims settlement practice, not whether Crawford frivolously or unfairly controverted benefits.... [Tihere are no provisions of the Unfair Claims Settlement Practices Act that correlate directly to the Board making a determination of a frivolous or unfair controversion." Thus, the Board's finding is not legally conclusive or irrebuttable. Crawford will be able to rebut the finding's relevance to the question that is before the Division: whether any of the company's violations of AS 21.86.125 have been "committed so frequently as to become a *989trade practice." 15 The company will also be able to appeal any adverse determination that relies on the Board's finding. This appeal, to which the Division will be a party, is sufficient to safeguard Crawford's rights. There is no call for us to provide the company with an extra appeal before the investigation has led to any determination about Crawford's practices, let alone before it has even begun.
Finally, the court has granted insurers two levels of appeal of an ancillary finding of the Board, first to the superior court and then to this court, ensuring that any Division investigation triggered by such a finding will be delayed for years. It is the Division's practice to stay its investigation while an appeal of the triggering finding is pending. This delay will weaken the Division's ability to oversee and regulate the workers' compensation insurance industry. Our respect for the public policy embodied in Alaska's workers' compensation laws should warn us away from impeding the Division's work. Under the scheme the legislature enacted, employees "relinguish[ ] whatever rights they had at common law in exchange for a sure recovery under the compensation statutes." 16 Employers must be held to account for their end of the deal-their liability is limited, but they are required to play by the rules and compensate their workers in good faith.17 The delaying tactics that the court sanctions in this decision will dilute the Division of Insurance's ability to police the bargain.
For all of these reasons, I respectfully dissent.

. Matanuska Maid, Inc. v. State, 620 P.2d 182, 185 (Alaska 1980) (citations and internal quotation marks omitted).

. By the time supplemental briefs were filed in the present case, Baker-Withrow was without counsel and representing herself.

. See O.K. Lumber Co., Inc. v. Providence Washington Ins. Co., 759 P.2d 523, 526-27 (Alaska 1988).

. See AS 21.36.125(b) ("'The provisions of this section do not create or imply a private cause of action for a violation of this section."); O.K. Lumber, 759 P.2d at 527.

. Op. at 986 & n. 10.

. Id.

. Op. at 985 (quoting State, Dep't of Fish & Game, Sport Fish Div. v. Meyer, 906 P.2d 1365, 1370 (Alaska 1995) (quoting Franklin v. Massachusetts, 505 U.S. 788, 797, 112 S.Ct. 2767, 120 L.Ed.2d 636 (1992))).

. 505 U.S. 788, 797, 112 S.Ct. 2767, 120 L.Ed.2d 636 (1992).

. Id. at 796-97, 112 S.Ct. 2767 (quoting Abbott Laboratories v. Gardner, 387 U.S. 136, 152, 87 S.Ct. 1507, 18 L.Ed.2d 681 (1967)) (second alteration in original).

. Geyen v. Marsh, 775 F.2d 1303, 1309 n. 6 (5th Cir.1985) (citation omitted).

. Brian v. State By & Through Oregon Gov't Ethics Comm'n, 126 Or.App. 358, 868 P.2d 1359, 1362-63 (1994).

. Op. at 985.

. Op. at 985 (quoting AS 21.36.125(a)(6)).

. Cf. International Waste Controls, Inc. v. SEC, 362 F.Supp. 117, 119 (S.D.N.Y.1973) (holding that an order initiating an investigation is "not reviewable until a final order is entered as a result of the investigation") (citation omitted).

. O.K. Lumber, 759 P.2d at 527.

. Wright v. Action Vending Co., Inc., 544 P.2d 82, 84-85 (Alaska 1975) (quoting Smither & Co. v. Coles, 242 F.2d 220, 222 (D.C.Cir.1957)).

. Id.; AS 21.36.125(6) (requiring good faith attempt to "settle[] claims in which liability is reasonably clear").