American Bankers Life Assurance Co. of Florida v. Division of Consumer Counsel

263 S.E.2d 867, 220 Va. 773, 1980 Va. LEXIS 168
CourtSupreme Court of Virginia
DecidedFebruary 29, 1980
DocketRecords Nos. 791180, 791189, 791193, 791198 and 791200 to 791204
StatusPublished
Cited by6 cases

This text of 263 S.E.2d 867 (American Bankers Life Assurance Co. of Florida v. Division of Consumer Counsel) is published on Counsel Stack Legal Research, covering Supreme Court of Virginia primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
American Bankers Life Assurance Co. of Florida v. Division of Consumer Counsel, 263 S.E.2d 867, 220 Va. 773, 1980 Va. LEXIS 168 (Va. 1980).

Opinion

I’ANSON, C J.,

delivered the opinion of the Court.

In this appeal brought pursuant to Code § 12.1-39, we consider various challenges to the substance of the State Corporation Commission’s “Rules Governing Credit Life Insurance” (hereafter referred to as the Rule) and the procedure used by the Commission in promulgating the Rule. The primary issues for resolution are whether provisions of the Rule exceed the Commission’s statutory authority provided in Code §§ 38.1-482.1 through -482.16, and whether the Commission denied procedural due process in promulgating a rule different from, its initial proposal without additional notice and opportunity to comment.

Credit life insurance is “insurance on the life of a debtor pursuant to or in connection with a specific loan or other credit transaction.” Code § 38.1-482.2(a). Although insurers occasionally sell such insurance directly to debtors, it is generally sold by the creditor (frequently a lending institution) under a group policy. Thus, although the insurer provides the coverage, the creditor generally performs the various administrative services related to the insurance. Specifically, *778 the creditor generally collects the premium or finances it with the loan and remits a portion of the premium to the insurer while retaining the balance to cover its costs and commission. The portion remitted to the insurer is used to pay losses, to cover costs, and to provide a return on the investment. If the debtor dies while the debt is outstanding, the insurance proceeds are paid to the creditor to discharge the debt.

I.

In the past three decades, during which consumer sales and use of credit have grown rapidly, state authorities have increasingly recognized the need for regulation of credit life insurance. Note, 1973 Wis. L. Rev. 943, 945. In 1960, the Virginia General Assembly adopted Article 5.1 of Chapter 9 of Title 38.1 (Code §§ 38.1-482.1 through -482.16), which regulates credit life insurance and credit accident and sickness insurance. In 1972, Article 5.1 was amended to require the Commission’s disapproval of any form for credit life insurance if the Commission “finds that the premium, rates or charges are not reasonable in relation to the benefits provided.” Code § 38.1-482.7(b). The General Assembly, however, did not adopt a proposed amendment that would have required the Commission to issue “regulations setting forth the prima facie rates which may be charged for credit life and accident and sickness insurance.”

The Rule promulgated by the Commission establishes an interim rate and provides for subsequent experienced-based rates for each insurer. The experienced-based rate allows an insurer to charge rates that produce or can reasonably be expected to produce a loss ratio (the ratio of payments for mortality losses to premiums earned) of 50%. The interim rate, providing for a yearly premium of 60 cents for every $100 of indebtedness insured, was also based upon a loss ratio of 50% and was calculated on the basis of a study of mortality losses incurred by Virginia credit life insurers. Section 11 of the Rule provides, however, that “if the insurer can demonstrate to the Commission that such rates are inadequate to produce a fair return to the creditor and insurer,” the insurer may receive a rate higher than the interim or experience-based rate.

The appellants contend that the Commission’s Rule constitutes a veiled attempt to set rates, a power that the appellants claim is not granted to the Commission by either Code § 38.1-482.7 1 or Code *779 § 38.1-482.13(a). 2 In particular, the appellants rely upon the Commission’s order dated July 31, 1974 (Case No. 15019), in which the Commission expressly disavowed any rate-setting powers, and upon the General Assembly’s refusal to adopt the proposed amendment requiring the Commission to promulgate regulations setting forth prima facie rates. In addition, the appellants claim that Section 11 of the Rule is contrary to Code § 38.1-482.7 in that if the insurers’ proposed rate exceeds the interim or experienced-based rate, the insurers bear the burden of proving the reasonableness of a rate request.

We do not agree with the appellants’ contention that the General Assembly’s refusal to adopt the proposed amendment is a clear indication of the legislature’s desire to prohibit the Commission from issuing a prima facie rate. It is noteworthy that the section that would *780 have been amended, Code § 38.1-482.13, allows the Commission to “issue such rules and regulations consistent with the provisions of this article as it deems appropriate for the supervision of the regulatory provision of this article.” The proposed amendment would have added a sentence requiring the Commission to set a prima facie rate. While it is possible that the General Assembly’s rejection of the amendment reflected a desire to prohibit such a prima facie rate making, it is equally likely that the legislature merely wished to avoid requiring the Commission to undertake such a task or concluded that the power conferred by the amendment was unnecessary in light of the broad rule-making power already conferred in Code § 38.1-482.13(a). In the absence of a clearer indication of legislative intent, we cannot accord significant weight to the General Assembly’s refusal to amend Code § 38.1-482.13.

Moreover, because we conclude the Rule does not constitute rate setting, we find that the Rule is consistent with the Commission’s prior ruling in Case No. 15019. The cases cited by the appellants for the proposition that other states’ regulatory entities have not been given the authority to regulate rates, see, e.g., State ex rel. Commissioner of Insurance v. Integon Life Insurance Co., 28 N.C. App. 7, 220 S.E.2d 409 (1975), and Calhoun Life Insurance Co. v. Gambrell, 245 S.C. 406, 140 S.E.2d 774 (1965), are not persuasive here because the statutes discussed in those cases do not parallel Article 5.1, which specifically requires the Commission to disapprove forms setting forth unreasonable rates. Far more helpful is Old Republic Life Insurance Co. v. Wikler, 9 N.Y.2d 524, 175 N.E.2d 147, 215 N.Y.S.2d 481 (1961), a case cited by the appellees, because the New York statute discussed in Wikler resembles Virginia’s in several important respects. Under the New York statute, the Superintendent of Insurance was required to disapprove premium rates if they were “unreasonable in relation to the benefits provided.” Id. at 528, 175 N.E.2d at 148, 215 N.Y.S.2d at 483. The Superintendent was also allowed to issue written regulations in furtherance of his supervisory duties. Pursuant to his regulatory authority, the New York Superintendent issued a regulation setting forth a prima facie rate that he would consider adequate and “not unreasonable” as a standard for insurers. Id.

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Bluebook (online)
263 S.E.2d 867, 220 Va. 773, 1980 Va. LEXIS 168, Counsel Stack Legal Research, https://law.counselstack.com/opinion/american-bankers-life-assurance-co-of-florida-v-division-of-consumer-va-1980.