Everett Cash Mutual Insurance Co. v. Insurance Department

940 A.2d 1259, 2008 Pa. Commw. LEXIS 31
CourtCommonwealth Court of Pennsylvania
DecidedJanuary 23, 2008
StatusPublished

This text of 940 A.2d 1259 (Everett Cash Mutual Insurance Co. v. 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
Everett Cash Mutual Insurance Co. v. Insurance Department, 940 A.2d 1259, 2008 Pa. Commw. LEXIS 31 (Pa. Ct. App. 2008).

Opinion

OPINION BY

President Judge LEADBETTER.

Everett Cash Mutual Insurance Company petitions for review of the decision of the Insurance Commissioner (by her designee), concluding that Insurance Company failed to comply with Section 3 of Act 143 (Act),1 40 P.S. § 243 (hereafter re[1261]*1261ferred to as Section 243), after it terminated its agency contract with C. Kenneth Grant Inc. Resolution of this appeal requires the court to construe Section 243(a), a matter of first impression.

It is undisputed that C. Kenneth Grant Inc. (Agency) has been an authorized agency of Everett Cash Mutual Insurance Company (Insurance Company), a property and casualty insurer, since 1994. In 2004, Insurance Company placed Agency on rehabilitation. When Agency failed to meet its goals, Insurance Company terminated the contract by letter dated October 3, 2005; the termination was effective January 1, 2006. Shortly thereafter, Insurance Company began sending nonrenewal notices to Agency’s policyholders, which stated, among other things, that the subject policy would not be renewed on the anniversary date, that Agency no longer represented Insurance Company, and that if other arrangements had not been made, the policyholder could contact Insurance Company to renew coverage through its in-house agency.

Pursuant to Agency’s request, the Insurance Department (Department) reviewed the termination and determined that the termination complied with the Act, which governs termination of agency contracts. For reasons not clear from the record, the matter was then referred to the Department’s Administrative Hearings Office for further review.2 As a result, the Department directed Insurance Company to reinstate any insurance policy on which a notice of cancellation or refusal to renew had been issued; Insurance Company reinstated the policies as directed. The matter then proceeded upon the parties’ joint stipulation of facts, briefs and oral argument. The parties’ stipulation limited the issue to construction of Section 243(a).

Section 243(a) provides, in pertinent part:

Where an insurer notifies an agent that its contract shall be terminated, the insurer shall offer to continue such agent’s policies and any amendments thereto, through such agent for a period of 12 months from the effective date of termination, subject to the insurer’s current underwriting standards.[Emphasis added]

In construing Section 243(a), the Commissioner took administrative notice that, in the insurance industry, “to continue” is synonymous with “to renew”. The Commissioner then reasoned:

Section 243(a) thus directs a company to offer renewal for all its policies for 12 months from a contract termination effective date. The offer must be made through the agency whose contract has been terminated. Nowhere does this section require an entire book of business to be closed within those 12 months. This section simply places a limit on how long policies need to be renewed by a company through the agency whose contract has ended.
Presumably the legislature knew the difference between the offering to continue a policy and issuing nonrenewal notices. Presumably too it knew that insurance policies are renewed in one year increments and that insurers may not interfere with an insurance policy during that one year policy period except under certain underwriting situations. Nevertheless, it directed a company to “offer to continue such agent’s polices.” The effect of this interpreta[1262]*1262tion is that the last policy for which a company must offer renewal is the one with an effective date 12 months from the contract termination date.

Commissioner’s decision at 7-8 (footnote omitted). Based upon this reasoning, the Commissioner concluded that Insurance Company was required to renew policies during the twelve-month period following the contract termination and, therefore, its failure to renew policies following Agency’s termination violated Section 243(a). The Commissioner then held that the effective date of the termination was January 30, 2007, the date of her decision, and required Insurance Company to “offer to renew for one year, each and every remaining active policy through [Agency]” until January 30, 2008. Id. at 11. The present appeal followed.

On appeal, Insurance Company contends that the Commissioner erred in construing Section 243(a). According to Insurance Company, Section 243(a) permits “an insurer [ ] to cancel- or non-renew a terminated agent’s policyholders from the effective date of termination through twelve months from the effective date of termination .... The cancellation or non-renewal of a terminated agent’s policies is therefore staggered on a monthly rolling basis throughout the twelve months following the effective date of termination until all the terminated agent’s policies are canceled or non-renewed.”3 Petitioner’s appellate brief at 12-13 (emphasis in original). Pursuant to Insurance Company’s construction, if a policy is subject to renewal on the date of termination, it may properly send out a notice of cancellation or non-renewal sixty days prior thereto, even though the agency contract had not yet terminated.4

Insurance Company also contends that it has complied with the statutory directive that it shall continue policies after termination of the agency contract because it did not cancel policies midterm on the termination date but continued them thereafter, and it offered to continue policies through its in-house agency. Finally, Insurance Company contends that the Commissioner erred in setting a new termination date of January 1, 2007, because the parties stipulated, and the Department found, that the contract terminated on January 1, 2006. Insurance Company demands disgorgement of all commissions Agency received after January 1, 2007.

In response, the Department contends, inter alia, that the Commissioner’s construction of Section 243(a) comports with [1263]*1263the plain language of the provision and effectuates the purposes of the statute.

Prior to addressing the arguments on appeal, we note that the Act, which governs the termination of agency contracts that have been in effect for at least four years, provides certain procedural protections to covered agencies. As this court noted in Robert E. Faust Agency, Inc. v. Pennsylvania Insurance Department, 734 A.2d 932, 933 n. 2 (Pa.Cmwlth.1999):

[The Act] requires [90]-days prior notice of the termination by the insurer; requires that terminations due to adverse experience be based on at least two successive years of adverse experience pri- or to the notice of termination; restricts termination based upon adverse experience, mix of business and lack of premium volume by imposing on the insurer an obligation to make a reasonable attempt to rehabilitate the agent prior to termination. [The Act] further provides for the continuation of business and payment of commissions following the contract termination.

Turning to the merits of the parties’ arguments, we initially note that there is neither judicial nor administrative authority interpreting Section 243(a).5

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940 A.2d 1259, 2008 Pa. Commw. LEXIS 31, Counsel Stack Legal Research, https://law.counselstack.com/opinion/everett-cash-mutual-insurance-co-v-insurance-department-pacommwct-2008.