Humana, Inc. v. Commissioner

1985 T.C. Memo. 426, 50 T.C.M. 784, 1985 Tax Ct. Memo LEXIS 207
CourtUnited States Tax Court
DecidedAugust 14, 1985
DocketDocket Nos. 15292-80, 17130-82.
StatusUnpublished

This text of 1985 T.C. Memo. 426 (Humana, Inc. v. Commissioner) is published on Counsel Stack Legal Research, covering United States Tax Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Humana, Inc. v. Commissioner, 1985 T.C. Memo. 426, 50 T.C.M. 784, 1985 Tax Ct. Memo LEXIS 207 (tax 1985).

Opinion

HUMANA INC. AND SUBSIDIARIES, Petitioners v. COMMISSIONER OF INTERNAL REVENUE, Respondent
Humana, Inc. v. Commissioner
Docket Nos. 15292-80, 17130-82.1
United States Tax Court
T.C. Memo 1985-426; 1985 Tax Ct. Memo LEXIS 207; 50 T.C.M. (CCH) 784; T.C.M. (RIA) 85426;
August 14, 1985.
James E. Milliman,Charles J. Lavelle,Arthur Hipwell, for the petitioners.
Joel V. Williamson,Scott R. Cox, for the respondent.

KORNER

MEMORANDUM FINDINGS OF FACT AND OPINION

KORNER, Judge: Respondent determined deficiencies against petitioners, Humana Inc. and subsidiaries, as follows:

Docket No.Tax year endedDeficiency
15292-808/31/76$4,615,905
8/31/779,409,814
17130-828/31/787,723,542
8/31/7920,460,078

After concessions, the sole issue for decision is whether petitioners are entitled to deduct, as an ordinary and necessary business expense, amounts paid to Humana Inc.'s captive insurance company and deducted as premiums for general liability and medical malpractice insurance.

*208 FINDINGS OF FACT

Some of the facts have been stipulated and are so found. The stipulations of facts and exhibits attached thereto are incorporated herein by this reference.

Humana Inc. is a Delaware corporation organized and incorporated on July 27, 1964. At all times here pertinent, Humana Inc.'s stock was publicly traded on the New York Stock Exchange, and the company's principal place of business was in Louisville, Kentucky.

Humana Inc. was the common parent of an affiliated group that filed Federal income tax returns on a consolidated basis for the taxable years ending August 31, 1976 through August 31, 1979, inclusive, with the Internal Revenue Service Center at Memphis, Tennessee (hereinafter referred to, collectively, as "petitioners").

American Medicorp, Inc. (hereinafter "AMI") was incorporated on January 11, 1968, and was primarily in the business of operating general, acute care community hospitals offering a wide range of medical, surgical and related services. On February 2, 1978, Humana Inc. acquired 53.4 percent of the common stock of AMI in exchange for $85,500,000 and 2,849,567 shares of its preferred stock. On September 27, 1978, Humana Subsidiary, Inc. *209 , a wholly-owned subsidiary of Humana Inc., which was formed for such purpose, was merged with and into AMI. As a result of the merger, Humana Inc. became the owner of all of the outstanding common stock of AMI. AMI's final short period taxable year ended on September 27, 1978. It was merged into Humana Inc. on December 21, 1978, and AMI became part of Humana Inc.'s consolidated group during its taxable year ended August 31, 1979.

As of February of 1978, AMI had two general liability insurance policies. The primary policy was provided by American Home Assurance Co. (hereinafter "American Home"), and an excess layer of insurance was provided by an industry pooling arrangement known as Hospital Underwriting Group (hereinafter "HUG").

As of November of 1976, Humana Inc. operated 62 hospitals in 16 states and one foreign country containing 8,586 beds. As of 1979, principally as a result of its acquisition of AMI, Humana Inc. operated 92 hospitals in 23 states and one foreign country containing 16,529 beds. Humana Inc., together with all of its subsidiaries and affiliates currently operate, inter alia, 87 hospitals owned by 36 corporations.

From 1972 until August 31, 1976, Continental*210 Insurance Company (hereinafter "Continental") provided Humana Inc. with general liability insurance, including malpractice liability and workers' compensation insurance. From as early as 1973, however, there were signs that the availability of such coverage to hospitals was diminishing, and by the mid-1970's, this problem had become severe for reasons explained by respondent's expert witness, Richard Stewart, as follows:

The main difference between liability insurance, particularly the more exotic kinds, like products liability, or medical malpractice, is this very long interval between setting your premium rate and collecting your money, and ultimatly [sic] knowing what your costs are, ultimately settling the claims.

In the meantime, through accural [sic] accounting, what you think your ultimate losses are going to be is carried as a loss reserve. Again, small errors in the loss reserve have terrible effects on capital and on earnings.

And all over the insurance business, through a combination of changing rules, general economic inflation, and misjudgments, companies were taking these terrible hits to their earnings as they tried to correct their loss reserved and liability*211 insurance in several lines, one of which was medical malpractice. A number of companies -- I would say a vast majority of companies -- concluded that they simply did not have any confidence in their numbers; that the swings were too wide.

By letter dated May 7, 1976, Continental advised Humana Inc. that it would be unable to renew its insurance coverage when it expired on August 31, 1976.

Through the services of its insurance broker, Marsh & McLennan, Inc. (hereinafter "MMI"), Humana Inc. attempted to obtain general and professional liability insurance from third-party insurers, but was unsuccessful. By letter dated June 1, 1976, directed to Humana Inc.'s then vice president for insurance, John V.

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Bluebook (online)
1985 T.C. Memo. 426, 50 T.C.M. 784, 1985 Tax Ct. Memo LEXIS 207, Counsel Stack Legal Research, https://law.counselstack.com/opinion/humana-inc-v-commissioner-tax-1985.