Goldberg v. Insurance Department

540 A.2d 365, 207 Conn. 77, 1988 Conn. LEXIS 60
CourtSupreme Court of Connecticut
DecidedApril 12, 1988
Docket13153
StatusPublished
Cited by13 cases

This text of 540 A.2d 365 (Goldberg v. Insurance Department) is published on Counsel Stack Legal Research, covering Supreme Court of Connecticut primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Goldberg v. Insurance Department, 540 A.2d 365, 207 Conn. 77, 1988 Conn. LEXIS 60 (Colo. 1988).

Opinion

Callahan, J.

The defendants, the insurance department of the state of Connecticut (department) and Peter W. Gillies, the insurance commissioner (commissioner), having been granted certification by this court, filed the instant appeal from a decision of the Appellate Court. See Goldberg v. Insurance Department, 9 Conn. App. 622, 520 A.2d 1038 (1987). The Appellate Court, by a divided vote, upheld the judgment of the trial court, Bieluch, J., that sustained the administrative appeal of the plaintiffs, Mark W. Goldberg and Options Services, Inc., from a decision of the commissioner suspending for a period of three months all insurance licenses previously issued to the plaintiffs and levying a $4100 fine against Goldberg for violations of the state insurance laws. The trial court and the Appellate Court found that the insurance department was without authority to take any administrative action on its charges against the plaintiffs because the department had failed to comply with the mandates of General Statutes § 4-167 (a) (2).1 Section 4-167 (a) (2) requires the department to “adopt as a regulation rules of practice setting forth the nature and requirements of all formal and informal procedures available provided such rules shall be in conformance with the provisions of this chapter.”

[79]*79The underlying facts are not in dispute. In response to a formal complaint, the department began an investigation of a medical benefits insurance plan that was allegedly being operated by the plaintiffs in contravention of the insurance laws. Subsequently, it brought an injunction action to enjoin the plaintiffs from operating the plan. This action was later withdrawn because the Provident Mutual Life Insurance Company had agreed to take over the plan and pay all outstanding claims. In July, 1982, however, the department served notices upon the plaintiffs regarding its intent to hold hearings to determine whether administrative sanctions should be levied. The plaintiffs moved to enjoin the department from conducting the hearings on the ground that, inter alia, § 38-4-82 of the Regulations of Connecticut State Agencies, which was adopted by the department, was legally insufficient and not in compliance with § 4-167 (a) (2). The trial court, Spada, J., denied the injunctive relief sought.

Pursuant to a second amended notice, the administrative hearings were held before a hearing officer over the course of three days: October 19,1982, October 21, 1982, and November 12, 1982.3 The hearing officer’s “Memorandum of Findings and Recommendations” [80]*80contained extensive findings of fact and conclusions of law, and recommended the revocation of all insurance licenses issued to the plaintiffs and the imposition of $3100 in fines against Goldberg. Thereafter, the commissioner adopted the factual findings and conclusions of law of the hearing officer but entered a final order suspending the plaintiffs’ insurance licenses for only three months and imposing a fine of $4100 on Goldberg.

The plaintiffs took a timely appeal to the Superior Court from the final order of the commissioner. In their appeal they argued that the defendants acted illegally, arbitrarily, in abuse of their discretion, and in violation of the Uniform Administrative Procedure Act (UAPA) and the United States and Connecticut constitutions in that: “(a) the Insurance Department failed to adopt as a regulation written rules of procedure governing its hearing; (b) the Insurance Department failed to adopt substantive regulations with regard to the standards for the suspension of Plaintiffs’ licenses and the imposition of fines; (c) there was insufficient evidence on which [the commissioner] could suspend Goldberg’s licenses or impose a fine on Goldberg; [and] (d) there was insufficient evidence on which [the commissioner] could suspend [Option] Services’ license.” The trial court sustained the plaintiffs’ appeal on the first ground only and held that the department had failed to adopt sufficient procedural regulations as required by § 4-167 (a) (2), thus rendering the department’s actions void.

Thereafter, the defendants appealed to the Appellate Court which upheld the judgment of the trial court. Goldberg v. Insurance Department, supra, 628. The defendants then petitioned this court for certification which was granted limited to the following issues: “(1) Whether the Insurance Department’s adoption by reference of the sections of the Uniform Administrative Procedure Act (UAPA) governing the conduct of hear[81]*81ings satisfies the UAPA requirement that an agency adopt ‘rules of practice setting forth the nature and requirements of all formal and informal procedures available?’ (2) Whether an administrative proceeding held in accordance with the UAPA can be invalidated because an agency did not sufficiently comply with a statutory requirement to adopt regulatory rules of practice without a showing of prejudice?”

In 1971, the legislature passed the UAPA, which became effective on January 1,1972. See Public Acts 1971, No. 854. The act was subsequently codified in General Statutes §§ 4-166 through 4-189. “ ‘[T]he UAPA was intended to be a uniform guide to all agency action, as the term “agency” is defined in § 4-166 (1). . . . [T]he act was designed for two purposes. First, it provides for uniform standards by which all non-exempted agency action is to be judged; second, it provides a vehicle for judicial review as an alternative for preexisting statutes or in situations in which no appellate review was previously provided.’ McDermott v. Commissioner of Children & Youth Services, 168 Conn. 435, 440-41, 363 A.2d 103 (1975).” Hartford v. Powers, 183 Conn. 76, 80, 438 A.2d 824 (1981); see also Salmon Brook Convalescent Home v. Commissioner on Hospital & Health Care, 177 Conn. 356, 417 A.2d 358 (1979).

In attempted compliance with § 4-167 (a) (2) the department published a series of eight regulations that went into effect on October 11,1972. See Regs., Conn. State Agencies §§ 38-4-1 through 38-4-8. The only one challenged by the plaintiffs is § 38-4-8 which then provided: “All hearings conducted in the insurance department are conducted in accordance with the requirements of and procedures suggested in Public Act 854 of the 1971 Session of General Assembly, Sections 12 through 17 inclusive, as the same may be amended from time to time. Conferences, interviews, and formal hearings conducted or held as a part of the administrative pro[82]*82cess of the insurance department are conducted on an informal basis, in accordance with standards designed to meet the purposes to be accomplished by the proceeding:”

The plaintiffs’ primary challenge is addressed to the sufficiency of the content of § 38-4-8, and not to the process by which the regulation was promulgated.4

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Bluebook (online)
540 A.2d 365, 207 Conn. 77, 1988 Conn. LEXIS 60, Counsel Stack Legal Research, https://law.counselstack.com/opinion/goldberg-v-insurance-department-conn-1988.