Aetna Casualty & Surety Co. v. Insurance Department

606 A.2d 553, 146 Pa. Commw. 394, 1992 Pa. Commw. LEXIS 216
CourtCommonwealth Court of Pennsylvania
DecidedMarch 16, 1992
Docket324 and 578 C.D. 1991
StatusPublished
Cited by1 cases

This text of 606 A.2d 553 (Aetna Casualty & Surety Co. v. Insurance Department) is published on Counsel Stack Legal Research, covering Commonwealth Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Aetna Casualty & Surety Co. v. Insurance Department, 606 A.2d 553, 146 Pa. Commw. 394, 1992 Pa. Commw. LEXIS 216 (Pa. Ct. App. 1992).

Opinion

LORD, Senior Judge.

This is an appeal by Aetna Casualty and Surety Company (Aetna) from two orders of the Insurance Commissioner. The first order of January 10, 1992 ruled on Aetna’s objections to a draft report of a market conduct examination and issued certain cease and desist orders. The second order of February 25, 1991 imposed penalties on Aetna for certain violations discovered in the course of the investigation.

The market conduct examination and report in this case were made pursuant to the powers granted to the Insurance Commissioner by Sections 213 and 216 of the Insurance Act of 1921, Act of May 17, 1921, P.L. 789, as amended, 40 P.S. § 51 and § 54, respectively. Section 213 provides in part:

[The Insurance Commissioner] shall
without notice at least once annually during the first five years of existence of every domestic insurance company, association and exchange, and thereafter every four years, or oftener if he deems it to be necessary, personally or by his deputy, actuary, or examiners, visit each domestic insurance company, association, and exchange, and thoroughly inspect and examine its affairs to ascertain its financial condition and its ability to fulfill its obligations, whether it has complied with the provisions of law, and any other facts relating to its business methods and management, and the equity of its plans and its dealing with its policyholders and claimants.
[398]*398The Insurance Commissioner shall cause to be prepared a report of the examination of any domestic insurance company, association or exchange immediately upon completion of such examination. He shall submit such report to the domestic insurance company, association or exchange examined which shall have the privilege of objecting to any part of such report within thirty days from the receipt thereof. In the event any objection shall have been made, the Insurance Commissioner shall grant a hearing to the organization examined before making such report available for public inspection. Thereafter, he may, if he deems it for the interest of the public to do so, publish any such report or the results of any such examination as contained therein in one or more newspapers of the Commonwealth.

The market conduct examination was conducted from September 18, 1989 to November 1, 1989 and resulted in numerous findings and eleven specific recommendations. Pursuant to Section 213, Aetna accepted many of the recommendations but objected to some of the findings and recommendations in four general areas.

It is extremely important to an understanding of this case to set forth the procedure adopted thereafter by the Commissioner because, as the Insurance Commissioner points out in her opinion accompanying her adjudication, “the report on Aetna is the first report to proceed through the administrative hearing process pursuant to 31 Pa.Code Chapter 58.” In accordance with accepted procedure, the Insurance Commissioner appointed a hearing officer, and a hearing was held. At the beginning of the hearing, the presiding officer outlined the issues to be considered and did not mention penalties. Throughout this entire hearing, there was only a single mention by the presiding officer of the possibility of penalties. That one instance took place in response to an evidentiary objection. (Notes of Testimony, 4/27/90, p. 317.)

After the hearing, the Insurance Commissioner made findings, based on the transcript of that hearing, on the [399]*399disputed items. On January 10, 1991, she issued an opinion and an order which upheld the market conduct report and made it available for public inspection. She also ordered Aetna to cease and desist from engaging in the following practices.

(a) Applying driving experience guidelines of Auto Rite I and II to drivers aged 16 to 25 years.
(b) Using the High loss Potential Vehicles list to nonrenew policies.
(c) Using accidents occurring under other, separate policies to nonrenew a current policy.
(d) Passively nonrenewing policies written through an agent that terminates its agency contract.

The Insurance Commissioner concluded her opinion as follows:

The parties in this proceeding were advised by the Presiding Officer that penalties would not be imposed at the conclusion and that a second, penalty proceeding would be scheduled. Accordingly, rather than impose penalties at this stage, the Commissioner will give the Department the opportunity to submit a memorandum outlining the penalty it recommends. Aetna shall be given the opportunity to respond. A final order imposing penalties will be issued after consideration of the recommendations.

(Order and Adjudication, 1/10/91, p. 39.)

Briefs were filed by both parties and on February 25, 1991 the Commissioner handed down an order imposing penalties of $96,000 on Aetna for the violations contained in the market conduct report. On January 10, 1991, the Commissioner issued an order and adjudication. Both of those orders have been appealed.

In this opinion, we shall address each of the matters decided in the January 10, 1991 adjudication and then address the penalties assessed in the February 25, 1991 order.

Our scope of review of an Insurance Commission order is limited to a determination of whether constitutional [400]*400rights have been violated, an error of law was committed or findings of fact were not supported by substantial evidence. Travelers Indemnity Company of America v. Insurance Department 63 Pa. Commonwealth Ct. 542, 440 A.2d 645 (1981).

Inexperience vs. Age

Aetna’s first argument needs no extended discussion. Aetna argues that the requirement of nine years “experience” (or five years “experience” if an insured has been an occasional driver on an Aetna policy for one year) to qualify for Auto-Rite I coverage and rates or five years experience to qualify for Auto-Rite II rates is a valid criterion of risk and not age discrimination prohibited by Act 78.

Aetna argues that, since the statute forbids “age” discrimination but does not forbid using experience as a factor, the Commissioner’s order was an error of law. We disagree. It takes little figuring to conclude that the sixteen year old driver must wait at least until he is twenty-one to obtain the advantage of the rates of Auto-Rite II and if he is not an occasional driver under an Aetna policy he must wait until he is twenty-five before he can attain Auto-Rite I status.

On its face, this criterion discriminates against youthful drivers and was therefore properly prohibited by the order as unlawful under section 3(a)(1) of the act. See Travelers Indemnity v. Insurance Department 63 Pa. Commonwealth 542, 440 A.2d 645 (1981), where the court said “inexperience was in this case a subterfuge____” Id., 63 Pa.Commonwealth Ct. at 545, n. 1, 440 A.2d at 646, n. 1.

Aetna makes two other arguments on this issue. It maintains that the Commission has allowed experience to be a factor under the Assigned Risk Plan and that, in a letter to Aetna, a department deputy in another instance allowed [401]*401it.1 These arguments are rejected as irrelevant to the issue before us now.

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Related

Aetna Casualty & Surety Co. v. Commonwealth
638 A.2d 194 (Supreme Court of Pennsylvania, 1994)

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606 A.2d 553, 146 Pa. Commw. 394, 1992 Pa. Commw. LEXIS 216, Counsel Stack Legal Research, https://law.counselstack.com/opinion/aetna-casualty-surety-co-v-insurance-department-pacommwct-1992.