Erie Insurance Exchange Ex Rel. Sullivan v. Pennsylvania Insurance Department

133 A.3d 102, 2016 Pa. Commw. LEXIS 65, 2016 WL 324682
CourtCommonwealth Court of Pennsylvania
DecidedJanuary 27, 2016
Docket872 C.D. 2015
StatusPublished
Cited by6 cases

This text of 133 A.3d 102 (Erie Insurance Exchange Ex Rel. Sullivan v. Pennsylvania 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
Erie Insurance Exchange Ex Rel. Sullivan v. Pennsylvania Insurance Department, 133 A.3d 102, 2016 Pa. Commw. LEXIS 65, 2016 WL 324682 (Pa. Ct. App. 2016).

Opinions

OPINION BY

Judge BROBSON.

Petitioners Joseph S. Sullivan, Anita Sullivan, Jenna L. DeBord, and Patricia R. Beltz, purportedly acting on behalf of Erie Insurance Exchange (Exchange), an unincorporated association, petition for appellate review of an April 29, 2015 Declaratory Opinion and Order by then-Aet-ing Insurance Commissioner (Commissioner) Teresa D. Miller.3 That decision places the Commissioner’s regulatory imprimatur on “transactions between ... Exchange and Erie Indemnity Company (Indemnity)4 in which Indémnity retained or received revenue from installment and other service charges from Exchange subscribers.” Specifically, the Commissioner concluded that these transactions did not violate Article XIV, of the Insurance Company Law. of 1921, commonly referred to as the Insurance Holding Companies Act (IHCA).5 For the reasons set forth below, we vacate the Commissioner’s decision and remand this matter for further proceedings.

I. BACKGROUND

Petitioners initiated their lawsuit against Indemnity in the Court- of Common Pleas of Fayette County (trial court) in 2012. • At present, Petitioners are proceeding under their Second Alhended' Complaint. (Reproduced Record (R.R.) ■ 6a-18a.)6 ■ Petitioners allege that they are -members of Exchange. Exchange is a reciprocal insurance exchange . organized under the laws of the Commonwealth .of Pennsylvania.7 Exchange is part of a group of affili[104]*104ated companies, known as the Erie Group, and thus is part of ah insurance holding company system. See Section 1401 of the IHCA, 40 P.S. § 991.1401 (defining “insurance holding company system”). A reciprocal insurance exchange is a vehicle through which individuals or entities, called .“subscribers,” can exchange contracts to indemnify each .other for losses. Section 1001 of Article X, 40 P.S. § 961. Simply stated, it is a type of insurance company.

Under Article X, the subscribers of a reciprocal insurance exchange may appoint an attorney-in-fact to issue the contracts of insurance to the subscribers — ie., to conduct the business of the exchange. Sec-, tion 1003 of Article X, 40 P.S. § 963. Since Exchange’s inception in 1926, Indemnity has served as the designated attorney-in-fact for Exchange. As the attorney-in-fact, Indemnity is required to make periodic filings with the Pennsylvania Insurance Department (Department) and to procure annually from the Commissioner a certificate of authority to act as attorney-in-fact. Sections 1004-1007 of Article X, 40 P.S. §§ 964-967. '

As the attorney-in-fact for Exchange and part of the Erie Group insurance holding company system, Indemnity’s authority to act on behalf of Exchange and its subscribers is prescribed by both governing Pennsylvania insurance laws and its agreement with Exchange’s subscribers— the Subscriber’s Agreement. (R.R. 81a). In their Second Amended Complaint, Petitioners seek to recover sums allegedly due to Exchange that Petitioners claim have been wrongfully appropriated by Indemnity as attorney-in-fact. (Compl. ¶ 9.) Petitioners allege that under the Subscriber’s Agreement, Indemnity agreed to perform certain sendees for Exchange, including managing Exchange’s business affairs; issuing, cancelling, or nonrenewing policies; and collecting premiums, which includes the processing of invoices for the collection of premiums. (Compl. ¶¶ 23-24.) In return for these services, Petitioners allege that under the Subscriber’s Agreement, Indemnity is to be paid a “maximum fee ... [of] 26% of all written and assumed premiums received by Exchange.” (Compl. ¶ 20.)8

Petitioners allege that prior to September 1, 1997, certain subscribers of Exchange who paid their insurance premium in installments paid a fixed fee, which Petitioners refer to as a “Service Charge,” to Exchange as consideration for the installment plan. (Compl. ¶ 26.) Beginning on September 1, 1997, Petitioners allege that Indemnity began to keep the Service Charges for itself, rather than pass the monies on to Exchange. Petitioners allege that Indemnity kept these funds “in addition to” the compensation provided in the Compensation Provision of the Subscriber’s Agreement. Petitioners further allege that beginning in 2008, Indemnity began to [105]*105assess Exchange subscribers late payment and policy reinstatement fees, which Petitioners refer to . as “Added Service Charges,” but did not pass those collected funds on to Exchange. Petitioners complain that Indemnity took these actions without amending the Subscriber’s Agreement. (Compl. ¶¶ 27-28.)

Petitioners’ six-count pleading essentially advances three legal theories. First, Petitioners contend that in retaining the Service Charges and the Added Service Charges, Exchange has breached the Subscriber’s Agreement, and its duty of good faith and fair dealing related thereto, by taking additional compensation compensation beyond the up to 25% of premiums paid by Exchange subscribers) for services that Exchange was required to perform as attorney-in-fact for the compensation set forth in the Compensation Provision of the Subscriber’s Agreement. (Compl. ¶¶ 34, 35, 53, 54, 76, 77.) Second, Petitioners allege that by retaining the Service Charges and Added Service Charges, Indemnity took economic advantage of its attorney-in-fact status and entered into an “Intercompany Transaction” with Exchange for its own profit, in breach of its role as- a fiduciary of Exchange. (Compl. ¶¶ 38-41, 57-60,. 80-83.) Third, but somewhat related to both their as-sumpsit and breach of fiduciary duty claims, Petitioners complain that Indemnity has been unjustly enriched by its conduct. Petitioners seek equitable relief in the form of an accounting of all “Intercom-pany Transactions”- between Indemnity and Exchange from January 1996 to the present; an injunction barring Indemnity from receiving compensation for its attorney-in-fact services other than that permitted in the Compensation Provision of the Subscriber’s Agreement; an order of restitution and creation of a constructive trust; and “such other relief as may be appropriate.” (Compl. ¶¶ 46-50, 65-69,88-92.)

According to the trial court’s December 19, 2013 Opinion and Order, (R.R. 19a-25a), Indemnity lodged eight preliminary objections to the Second Amended Complaint. The trial court overruled the first, sustained the second, and deferred ruling on the remaining preliminary objections.9 In its second preliminary objection, Indemnity, invoking the doctrine of primary jurisdiction, requested that "the trial court stay further proceedings and refer issues raised in the Second Amended Complaint that fall within the Department’s area of expertise to the Department for consideration. Through its December 19, 2013 Order, (R.R. 25a), and a subsequent amending order, (R.R. 26a-27a), the trial court did just that.10

Upon referral, the parties sought a status conference with the Department.11. A [106]*106binder, of “Relevant Pleadings, Motions, and Briefing” from the trial court was filed with the Department. On March 17, 2014, then-insurance Commissioner Michael F. Consedine appointed James A. Johnson to serve as Presiding Officer. The Presiding Officer conducted a conference, after which he issued an. April 21, 2014 Order, directing, inter alia,

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Rite Aid v. Brines Refrigeration Heating
Superior Court of Pennsylvania, 2022
New Garden Twp. v. Artesian Resources Corp., Inc.
Commonwealth Court of Pennsylvania, 2019
Erie Ins. Exchange ex rel. Sullivan v. Pennsylvania Ins. Dept.
145 A.3d 722 (Supreme Court of Pennsylvania, 2016)
Varney v. Richards
Maine Superior, 2016

Cite This Page — Counsel Stack

Bluebook (online)
133 A.3d 102, 2016 Pa. Commw. LEXIS 65, 2016 WL 324682, Counsel Stack Legal Research, https://law.counselstack.com/opinion/erie-insurance-exchange-ex-rel-sullivan-v-pennsylvania-insurance-pacommwct-2016.