Donabedian v. Mercury Insurance

11 Cal. Rptr. 3d 45, 116 Cal. App. 4th 968
CourtCalifornia Court of Appeal
DecidedMarch 30, 2004
DocketB159982
StatusPublished
Cited by39 cases

This text of 11 Cal. Rptr. 3d 45 (Donabedian v. Mercury Insurance) is published on Counsel Stack Legal Research, covering California Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Donabedian v. Mercury Insurance, 11 Cal. Rptr. 3d 45, 116 Cal. App. 4th 968 (Cal. Ct. App. 2004).

Opinion

Opinion

MALLANO, J.

Proposition 103, approved by the voters on November 8, 1988, requires automobile insurance companies to determine rates, premiums, and insurability based on certain rating factors.

Plaintiff, whose automobile was insured with Mercury Insurance Company (Mercury), filed this action under California’s unfair competition law (UCL) (Bus. & Prof. Code, §§ 17200-17210), alleging that Mercury had used applicants’ absence of prior insurance, in and of itself, in determining premiums, a discount for good driving, and insurability, all in violation of Proposition 103.

Mercury demurred to the complaint on the ground that the Insurance Commissioner had exclusive jurisdiction over plaintiff’s claim. The trial court sustained the demurrer without leave to amend and dismissed the case.

The question on appeal is whether Proposition 103 permits a person to maintain a civil action under the UCL where the complaint alleges that an insurer has used an applicant’s absence of prior insurance, in and of itself, in determining premiums, a discount for good driving, or insurability. We answer that question in the affirmative because the plain language of Proposition 103 and its legislative history compel that conclusion.

*973 I

BACKGROUND

Section 1861.02 of the' Insurance Code, enacted by Proposition 103, provides that “[r]ates and premiums for an automobile insurance policy . . . shall be determined by application of the following factors in decreasing order of importance: [ft] (1) The insured’s driving safety record, [ft] (2) The number of miles he or she drives annually, [ft] (3) The number of years of driving experience the insured has had. [ft] (4) Those other factors that the [Insurance] [Commissioner may adopt by regulation and that have a substantial relationship to the risk of loss.” (Ins. Code, § 1861.02, subd. (a)(l)-(4); all further statutory references are to the Insurance Code unless otherwise indicated.)

At the crux of this case is the provision of Proposition 103 that provides, “The absence of prior automobile insurance coverage, in and of itself, shall not be a criterion for determining eligibility for a Good Driver Discount policy, or generally for automobile rates, premiums, or insurability.” (§ 1861.02, former subd. (c).) 1 An insured is entitled to a “Good Driver Discount” of at least 20 percent if, subject to specified exceptions, he or she has been licensed to drive for the previous three years and, during that period, has not had more than one at-fault accident. (§§ 1861.02, subd. (b), 1861.025.)

In 1996, the Insurance Commissioner adopted regulations listing “persistency” as one of several optional rating factors. (See Dept. of Ins., Initial Statement of Reasons, RH-402 (Dec. 21, 2001) p. 1; Cal. Code Regs., tit. 10, § 2632.5, subd. (d)(ll), Register 96, No. 27 (July 5, 1996) pp. 728.11-728.12.) The regulations did not define that term (ibid.), resulting in a lack of uniform application by insurers.

As the Insurance Commissioner eventually recognized, “insurers have implemented differing interpretations of the meaning of persistency as an *974 optional rating factor. Some insurers have interpreted persistency to mean the length of time a consumer has continuously maintained automobile insurance exclusively with the present insurer. Other insurers have defined persistency more broadly to include coverage by different insurers, so long as there is not a lapse in coverage. The Commissioner has noted that some of these insurers required consumers to provide evidence of prior insurance to show that the consumer was ‘persistently’ covered by one insurer or another over time.” (Dept. of Ins., Notice of Proposed Action and Notice of Public Hearing, (Dec. 21, 2001), proposed amendment to Cal. Code Regs., tit. 10, § 2632.5, subd. (d)(ll) <http://www20.insurance.ca.gov/epubacc/reg/3401.htm> [as of Mar. 11, 2004].)

On April 20, 2001, plaintiff, an insured with Mercury, filed this action, alleging that, at some point after Proposition 103 became effective on November 8, 1989, Mercury violated the UCL by using the absence of prior insurance, in and of itself, as a criterion in determining eligibility for the Good Driver Discount, generally for automobile premiums and insurability, and in applying a persistency discount.

Mercury filed a demurrer, arguing that plaintiff’s claim involved ratemaking and was thus within the exclusive jurisdiction of the Insurance Commissioner. The trial court sustained the demurrer with leave to amend and then stayed proceedings so that plaintiff could present the dispute to the commissioner.

By letter dated September 17, 2001, counsel for plaintiff wrote to the Insurance Commissioner, describing Mercury’s alleged wrongful conduct, submitting a copy of the complaint filed in this suit, and asking the commissioner to conduct a public hearing and take action on the matter.

The commissioner responded by order dated January 29, 2002, stating: “[Plaintiff] in the present matter ha[s] alleged that [Mercury] ‘engaged in a uniform and system-wide course of conduct which deprived those policyholders without prior history of automobile insurance of the benefits of Proposition 103 as well as the Good Driver Discount by offsetting all, if not a substantial portion, of the discount with a discount [Mercury has] classified as a persistency discount which is implemented in such a way as to deny those without prior insurance of the benefits thereunder.’ . . .

“When the Department of Insurance (hereafter ‘Department’) adopted ‘persistency’ as an optional rating factor, . . . that term was not expressly defined. The Department is aware that some insurance companies have interpreted ‘persistency’ broadly; to authorize a credit to persons who have switched insurance carriers, but have been continuously insured. Such a *975 definition necessarily requires [an insurance] company to consider a consumer’s prior insurance, or lack thereof. In the Commissioner’s opinion, this type of stretched interpretation of ‘persistency’ would violate Insurance Code section 1861.02, subdivision (c). Presently, the Department is in the process of promulgating a definition of persistency that will address this issue industry-wide, and emphatically preclude such an interpretation by all insurers. A Notice of Proposed Regulatory Action was published in the California Notice Register on January 4, 2002. A public hearing regarding this definition is set for February 28, 2002. . . . The Department anticipates, therefore, that the new regulation will be in effect some time later this year.

“ ‘The doctrine of primary jurisdiction . . . provides the appropriate administrative agency with an opportunity to act if it so chooses.’. . . Without addressing the merits of [plaintiff’s] allegations in this case, the Department finds that it would be an inefficient allocation of Department resources to adjudicate every [insurance] company’s class plan piecemeal in order to solve this problem. The ambiguity and potential for abuse of the current optional rating factor ‘persistency’ cr[y] out for resolution via rulemaking. Therefore, because the Department anticipates that the proposed definition .

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Cite This Page — Counsel Stack

Bluebook (online)
11 Cal. Rptr. 3d 45, 116 Cal. App. 4th 968, Counsel Stack Legal Research, https://law.counselstack.com/opinion/donabedian-v-mercury-insurance-calctapp-2004.