G.G. Skotnicki v. Insurance Department

146 A.3d 271, 2016 Pa. Commw. LEXIS 356, 2016 WL 4376608
CourtCommonwealth Court of Pennsylvania
DecidedAugust 17, 2016
Docket156 C.D. 2015
StatusPublished
Cited by12 cases

This text of 146 A.3d 271 (G.G. Skotnicki 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
G.G. Skotnicki v. Insurance Department, 146 A.3d 271, 2016 Pa. Commw. LEXIS 356, 2016 WL 4376608 (Pa. Ct. App. 2016).

Opinion

OPINION BY

JUDGE ANNE E. COVEY

Gregory G. Skotnicki (Skotnicki), pro se, petitions for review of the Pennsylvania Insurance Department (Department) Commissioner’s (Commissioner) January 15, 2015 adjudication and order affirming Phoenix Insurance Company’s (PIC) 3 cancellation of Homeowner’s Insurance Policy No. 9926866966331 (New Policy) and concluding that there was no Unfair Insurance Practices Act (Act 205) violation. 4 Essentially, there are three issues for this Court’s review: (1) whether substantial evidence supported the Commissioner’s conclusion that PIC did not violate Act 205; (2) whether the Commissioner erred by permitting non-attorney Thomas McGilpin (McGilpin) to represent PIC; and, (3) whether the Commissioner erred by taking administrative notice post-hearing that the *275 Department pre-approved PIC’s cancellation notice form.

Skotnicki owns real property located at 400 Brentwater Road, Camp Hill, Pennsylvania (Property), which PIC insured under Homeowner’s Insurance Policy No. 9754066736331 (Original Policy) since 2003. In December 2009, Skotnicki acquired a 3/¿-year-old English springer spaniel. On July 3, 2013, the dog bit a neighbor, requiring the neighbor to seek medical treatment. Based upon PIC Claims Adjuster Cynthia Weiser’s (Weiser) July 25, 2013 interview of Skotnicki’s wife Susan Skot-nicki, Weiser determined that the dog acted “out of the blue” and, thus, PIC accepted liability for the neighbor’s claim and paid $42,000.00 in damages. Reproduced Record (R.R.) at 61a; see also Skotnicki Amended Br. Ex. F.

On April 22, 2014, PIC sent Skotnicki a notice that the Original Policy would not be renewed effective May 29, 2014 because “THERE IS A SUBSTANTIAL CHANGE OR INCREASE IN HAZARD IN THE RISK ASSUMED BY THE COMPANY SUBSEQUENT TO THE DATE THE POLICY WAS FIRST ISSUED, AS DESCRIBED BELOW: THERE IS AN ANIMAL OR PET THAT HAS BITTEN OR INJURED.” Skotnicki Amended Br. Ex. B. 5 On April 30, 2014, Skotnicki requested that the Department’s Bureau of Consumer Services (BCS) review PIC’s non-renewal because the dog bite was provoked. On May 28, 2014, BCS issued an Investigative Report Order to PIC which stated:

It is our finding that [PIC] by its action, is in violation of Act 205. [Skotnicki] provides a narrative explaining how this dog bite occurred. [PIC] did not comment on the circumstances surrounding this bite in the response dated May 12, 2014.[ 6 ] Our Department requested [PIC’s] narrative and details of the claim on May 21, 2014 and to date we have no record of a response.
Based on [Skotnicki’s] narrative[,] this appears to have been a provoked dog bite incidente.] As [PIC] has not justifiably proven any increase in hazard, [PIC] is directed to continue the [Original P]olicy with no lapse in coverage.
Please confirm the continuation of coverage to [Skotnicki] no later than ten (10) days from the date you receive this Investigative Report/Order.

R.R. at 20a (emphasis in original). Rather than continuing the Original • Policy, PIC issued a New Policy because

due to system limitations, once a policy at [PIC] has been terminated for more than five days ... past the expiration date of a policyL] there’s no physical way to reinstate it. So instead we reissue a new policy, but in all respects, the new policy is not treated as new business[;] it’s treated as a continuation.

R.R. at 71a-72a. PIC deems new policies issued in these circumstances effective without lapse. See R.R. at 72a.

On June 18, 2014, PIC sent Skot-nicki notice of the New Policy’s cancellation effective July 25, 2014 based again upon “a SUBSTANTIAL CHANGE OR INCREASE IN HAZARD IN THE RISK ASSUMED . . . [due to a] pet on the residence premises that has exhibited dangerous propensities by biting a person without provocation.” R.R. at 6a, 13a. Skotnicki requested BCS’ review of the cancellation notice. In its July 14, 2014 Investigative Report, BCS stated: “Our investigation has determined that [PIC] met *276 the requirements of Act 205 and the [Department] therefore finds that your [New P]olicy may be terminated.” R.R. at 22a. On July 23, 2014, Skotnicki appealed from the BCS’ Investigative Report, and a hearing was held on September 30, 2014 before an Administrative Law Judge (ALJ). The Commissioner issued his January 15, 2015 adjudication and order affirming the New Policy’s cancellation because PIC did not violate Act 205. Skotnicki appealed to this Court. 7

Substantial Evidence

Skotnicki argues that substantial evidence did not support the Commissioner’s conclusion that PIC properly cancelled the New Policy due to a substantial change in PIC’s assumed risk resulting from an unprovoked dog bite. Act 205 prohibits persons in the insurance business from engaging in unfair or deceptive insurance practices. Nationwide Mut. Fire Ins. Co. v. Ins. Dep’t, 4 A.3d 231 (Pa.Cmwlth.2010). Section 5(a)(9) of Act 205 defines “unfair or deceptive acts or practices” to include, in relevant part:

Cancelling any policy of insurance covering owner-occupied private residential properties ... that has been in force for sixty days or more or refusing to renew any such policy unless ... there has been a substantial change or increase in hazard in the risk assumed by the company subsequent to the date the policy was issued[.]

40 P.S. § 1171.5(a)(9) (emphasis added). “The term ‘substantial change or " increase in hazard’ in Section 5(a)(9) of [Act 205] ... has been defined as a risk that an insurance company could not have reasonably been presumed to have contracted for when the policy was written.” Aegis Sec. Ins. Co. v. Pa. Ins. Dep’t, 798 A.2d 330, 332 (Pa.Cmwlth.2002)., “The standard to apply in determining whether an incident involving a particular dog represents a substantial increase in hazard is whether or not that dog was provoked. If a dog is provoked, no increase in hazard exists.” Id. at 334. Section 5(a)(9) of Act 205’s cancellation notice requirements are to be strictly construed in Skotnieki’s favor and against PIC. See Statesman Ins. Co. v. Ins. Dep’t, 107 Pa.Cmwlth. 419, 528 A.2d 1042 (1987).

Skotnicki requested the Commissioner’s review of PIC’s non-renewal notice. BCS’ review included “the consumeras unchallenged] .., narrative explaining how this dog bite occurred.” R.R. at 20a. The narrative consisted of Weiser’s notes of Susan Skotnicki’s July 25, 2013 interview, which reflect that the dog had never before shown aggression or bitten anyone, except on July 3, 2013. The interview notes provided, in pertinent part:

[Susan Skotnicki] was crossing the street, just about up at the curb and onto her property when the [neighbor] who had just moved into the neighborhood was taking a walk[,] so they struck up conversation, She stated he walked over to where they were ... when out of the blue he bit the [neighbor] in the back of the calf.

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Bluebook (online)
146 A.3d 271, 2016 Pa. Commw. LEXIS 356, 2016 WL 4376608, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gg-skotnicki-v-insurance-department-pacommwct-2016.