Central Reserve Life Corporation and Subsidiaries v. Commissioner

113 T.C. No. 19
CourtUnited States Tax Court
DecidedOctober 12, 1999
Docket21390-96
StatusUnknown

This text of 113 T.C. No. 19 (Central Reserve Life Corporation and Subsidiaries v. Commissioner) is published on Counsel Stack Legal Research, covering United States Tax Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Central Reserve Life Corporation and Subsidiaries v. Commissioner, 113 T.C. No. 19 (tax 1999).

Opinion

113 T.C. No. 19

UNITED STATES TAX COURT

CENTRAL RESERVE LIFE CORPORATION AND SUBSIDIARIES, Petitioner v. COMMISSIONER OF INTERNAL REVENUE, Respondent

Docket No. 21390-96. Filed October 12, 1999.

P's subsidiary, L, writes cancelable accident and health (CA&H) insurance. R argues that L is not a “life insurance company" under sec. 816(a), I.R.C., because L's accrued unpaid losses on CA&H insurance are “unpaid losses" for purposes of ascertaining its “total reserves" under sec. 816(c), I.R.C. P argues that L is a life insurance company under sec. 816(a), I.R.C., because the term “unpaid losses", as used in sec. 816(c), I.R.C., does not include accrued unpaid losses on CA&H insurance. Held: L is a life insurance company under sec. 816(a), I.R.C.; its accrued unpaid losses on CA&H insurance are not “unpaid losses” for purposes of sec. 816(c), I.R.C. - 2 -

Michael R. Schlessinger and Michael A. Clark, for

petitioner.

Katherine Lee Wambsgans, for respondent.

OPINION

LARO, Judge: This case is before the Court fully

stipulated. See Rule 122. Central Reserve Life Corporation and

Subsidiaries petitioned the Court to redetermine respondent's

determination of deficiencies of $1,936,766 and $225,070 in its

consolidated Federal income tax for 1991 and 1992, respectively.

Following the parties' concessions, we must decide whether the

phrase “unpaid losses * * * not included in life insurance

reserves” as used to define the term “total reserves” in section

816(c)(2) includes accrued unpaid losses on cancelable accident

and health (CA&H) insurance policies.1 We hold it does not.

Unless otherwise stated, section references are to the Internal

Revenue Code in effect for the subject years. Rule references

1 An “unpaid loss” generally is an insurer's estimate of its liability for claims arising out of injuries which have already occurred. Unpaid losses may be accrued or unaccrued. Assume, for example, that a policyholder fractures his pelvis in an automobile accident and is transported to the emergency room by ambulance. The expenses incurred in the emergency room are accrued because reimbursement may be claimed at any time. Future rehabilitation expenses are unaccrued; although these expenses may be estimated before they are incurred, the insurer need not pay for them until they are incurred. See Harco Holdings, Inc. v. United States, 977 F.2d 1027, 1029 (7th Cir. 1992). - 3 -

are to the Tax Court Rules of Practice and Procedure. We use the

term “petitioner” to refer solely to Central Reserve Life

Corporation.

Background

All facts have been stipulated. The stipulation of facts

and the exhibits submitted therewith are incorporated herein by

this reference. Petitioner's principal place of business was in

Strongsville, Ohio, when its petition was filed.

Petitioner is the parent corporation of an affiliated group

of corporations that files consolidated Federal income tax

returns. Central Reserve Life Insurance Company (Central Life)

is petitioner's wholly owned subsidiary. Central Life writes

life insurance and accident and health (A&H) insurance.

Insurance regulators require that insurance companies

maintain defined levels of assets to guarantee that they can pay

their claims when the claims become due. These asset reserves

generally must equal the amount of funds which, when increased at

a stated rate of interest, will allow the company to pay its

claims at their actuarially estimated due dates.

Insurance companies must report their anticipated

obligations for claims on a standard annual statement promulgated

by the National Association of Insurance Commissioners (NAIC) and

adopted by all 50 States. The annual statement characterizes an

insurer's life and A&H obligations as either “reserves” or - 4 -

“liabilities”, and it uses the word “accrual” to distinguish

current obligations from future obligations.2 A reserve is an

unaccrued claim for which the insurer will become liable in the

future; e.g., the future rehabilitation expenses described supra

note 1. A liability is an accrued claim for which the insurer is

liable now; e.g., the emergency room expenses described supra

note 1. Exhibit 8 of the annual statement lists an insurer's

“Aggregate Reserve for Life Policies and Contracts”. Exhibit 9

lists an insurer's “Aggregate Reserve for Accident and Health

Policies”. Exhibit 11 lists an insurer's “Policy and Contract

Claims”; data on these claims is listed separately as to yearend

liabilities for life insurance and A&H insurance.

Central Life filed its 1990 through 1992 annual statements

with the Ohio Department of Insurance. As relevant herein,

Central Life reported its claim obligations on life insurance

policies and annuities on exhibits 8 and 11, and it reported its

claim obligations on A&H insurance policies on exhibits 9 and 11.

Central Life reported its unaccrued claim obligations for life

insurance and A&H insurance as reserves on exhibits 8 and 9,

respectively, and it reported all of its accrued claim

obligations as liabilities on exhibit 11. During 1990 and 1991,

2 The use of the word “accrual” in the insurance industry does not conform to the definition of that word under Generally Accepted Accounting Principles. - 5 -

Central Life wrote primarily guaranteed renewable A&H insurance.

In the latter year, Central Life qualified as a life insurance

company under the ratio (reserve ratio) set forth in section

816(a). In 1991, Central Life properly included unpaid losses

with respect to its guaranteed renewable A&H insurance in the

reserve ratio's numerator and denominator.

Beginning in late 1991, Central Life added a rider to its

existing guaranteed renewable A&H insurance policies, which

allowed it to terminate any of these policies upon 90 days’

notice. By virtue of this rider, Central Life's A&H insurance

policies issued after late 1991 were no longer guaranteed

renewable policies; they were nonguaranteed renewable or CA&H

insurance policies. Because Central Life stopped issuing

guaranteed renewable A&H insurance policies in late 1991,

unearned premiums and unpaid losses with respect to those

policies were no longer properly includable in the reserve

ratio's numerator in 1992 and years thereafter. Central Life's

A&H insurance business in 1992 consisted almost exclusively of

CA&H insurance; it also wrote a small amount of guaranteed

renewable group A&H insurance.

The parties agree that unpaid losses with respect to Central

Life's CA&H insurance policies are not includable in the reserve

ratio's numerator. The parties dispute whether those amounts

must be included in the reserve ratio’s denominator. Respondent - 6 -

determined and argues that the denominator includes these

amounts. Petitioner argues that the denominator does not include

these amounts. If petitioner is correct, Central Life qualifies

as a life insurance company under section 816(a). If respondent

is correct, Central Life fails to qualify as a life insurance

company for Federal income tax purposes, and petitioner's taxable

income would include Central Life's policyholder surplus of

$2,869,768. Central Life also would not be entitled to the small

life insurance company deduction in the amounts that it reported

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