Attorney General v. Commissioner of Insurance

353 N.E.2d 745, 370 Mass. 791, 1976 Mass. LEXIS 1038
CourtMassachusetts Supreme Judicial Court
DecidedAugust 16, 1976
StatusPublished
Cited by24 cases

This text of 353 N.E.2d 745 (Attorney General v. Commissioner of Insurance) is published on Counsel Stack Legal Research, covering Massachusetts Supreme Judicial Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Attorney General v. Commissioner of Insurance, 353 N.E.2d 745, 370 Mass. 791, 1976 Mass. LEXIS 1038 (Mass. 1976).

Opinion

Kaplan, J.

These cases question the legality of indus-trywide automobile insurance rates for the policy year 1976 set by the Commissioner of Insurance (Commissioner) under G. L. c. 175, § 113B. 2 The Commissioner commenced hearings on the bodily-injury insurance coverages on September 2, 1975, and issued ids decision establishing those rates on November 17, 1975. The Massachusetts Automobile Rating and Accident Prevention Bureau (Bureau), an unincorporated association of insurance companies writing motor vehicle insurance in the Commonwealth, together with various of the insurance companies, filed a petition for review of that decision in the Supreme Judicial Court for Suffolk County within the twenty-day period prescribed by G. L. c. 175, § 113B. The Attorney General also sought review. In the meantime, the Commissioner, who had recessed the hearings on other coverages to await action by the Legislature on changes in laws governing automobile insurance, on November 19, 1975, *795 resumed hearings on the property-damage rates. His decision issued on December 30, 1975, and again the Bureau, various companies, and the Attorney General sought review. In addition, the Bureau and the companies filed a complaint seeking a declaration as to the effect on the setting of the 1976 rates of St. 1975, c. 707, § 1A, which repealed a certain “second look” provision of G. L. c. 175, § 113B, inserted by St. 1971, c. 977, § 1A, described below. 3 The matters were reserved and reported by the single justice for decision by the full court upon the pleadings and the record of the hearings. 4

The rates set represent a forecast based on analysis of past experience. The several components of a rate are isolated and the contribution of each to the total premium is analyzed separately. Crudely divided, the total premium breaks up into components as follows: an allowance for losses (the portion of the premium uséd mostly for the payment of claims), an allowance for expenses, an allow- *796 anee for profit, and, at least with regard to certain of the 1976 rates, a possible allowance for the inadequacy of those rates for the previous year.

I. Allowance for Losses

A. The Formation of the Rate Level Pure Premium. Whereas the Commissioner innovated in his methods for establishing the allowances for expenses and profits, he used the conventional method for determining the loss allowance. The rate setter uses as his basis for prediction the most recent year for which reasonably complete claims data are available; in setting the 1976 rates, he used the claims experience for the 1974 policy year. The rate setter takes the total claims arising from 1974 policies plus certain expenses allocated to those claims (1974 “losses” in insurance terminology) and divides by the total insurance exposure, i.e., the number of car years for which policies were written. Thereby he derives the “1974 Raw Pure Premium.” This figure is the observed 1974 loss cost per vehicle. From it, the rate setter builds a parallel predicted figure for 1976 just adequate to cover the expected 1976 loss — the “1976 Rate Level Pure Premium.” He does this by making several adjustments in the 1974 Raw Pure Premium to take account of the fact that the data arising out of 1974 policies are not final, and the further fact that the 1976 experience will differ in predictable ways from that observed for the 1974 policy year. Each of the adjustments is expressed as a multiplicative factor.

(1) The development factor. The 1974 data are not final at the time of the rate setting process. Some claims have not yet been filed, and the loss adjuster’s estimate of the size of claims filed but not paid may prove to.be erroneous. The adjustment of the 1974 Raw Pure Premium to reflect expected final loss experience is made by means of a “development factor” which is estimated from the observed change during the course of a year of the losses attributed to other policy years. See Massachusetts Bonding & Ins. Co. v. Commissioner of Ins., 329 Mass. 265, 274 (1952).

*797 (2) Trend and projection factors. The losses on the 1976 policies will be paid, on average, later than those on the 1974 policies, and it can be expected that cost levels for the losses in the two years will differ, necessitating an adjustment for the change in those levels. The 1974 losses reflect experience for policies centered on July 1,1974, and the period for which rates are set centers on July 1,1976. The “trend” factor adjusts for observed changes in price levels from July, 1974, to a later point for which data are available, and the “projection” factor adjusts for any expected continued change in prices to July, 1976. 5

(3) Frequency adjustment. If the probability that an insured vehicle will be involved in a claim is expected to be different in 1976 than in 1974, a further adjustment is needed to reflect the difference.

Before getting into our analysis of the factors just mentioned, we note that the data for 1974 which form the basis for the estimation of the 1976 Rate Level Pure Premium were collected and summarized by the Bureau, and are not directly challenged here. The Bureau’s contention is that the Commissioner committed certain errors in fixing the adjustment factors in the light of these data and others. As the type of insurance coverage has a bearing on the estimation of the adjustment factors, we have to consider separately the bodily-injury and property-damage coverages.

B. The Bodily-Injury Coverages. (1) The development factor. The Bureau recommended a development factor of 1.085, based on an examination of the change in the course of one year (1974) of the losses attributed to a series of recent policy years. However, the actuary for the Division of Insurance (Division) observed that the development factor for changes in the losses in the previous year (1973) was much less. He considered the factor to *798 be a “predictor” which should not vary radically from one rate revision to the next; and he attributed the difference in the factors for the two years to “some form of variation in the data rather than to [the] intrinsic property of the losses themselves.” Accordingly, he recommended, as the factor for 1976, a “more stable” predictor, the average for the two years, 1.038. This recommendation the Commissioner adopted.

The Bureau argues, first, that the industry is entitled to consistency of approach, and hence the traditional procedure, using a factor derived from a single year’s observations, must be followed. See Boston Gas Co. v. Department of Pub. Util., 367 Mass. 92, 104 (1975) (condemning “decision according to the whim or caprice of the Department”). But the Commissioner gave a convincing reason for his departure from the tradition in citing the need for a less volatile predictor. Cf. id. at 104.

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Bluebook (online)
353 N.E.2d 745, 370 Mass. 791, 1976 Mass. LEXIS 1038, Counsel Stack Legal Research, https://law.counselstack.com/opinion/attorney-general-v-commissioner-of-insurance-mass-1976.