INA Life Insurance v. Commonwealth

376 A.2d 670, 31 Pa. Commw. 416, 1977 Pa. Commw. LEXIS 997
CourtCommonwealth Court of Pennsylvania
DecidedAugust 11, 1977
DocketAppeal, No. 204 C.D. 1977
StatusPublished
Cited by10 cases

This text of 376 A.2d 670 (INA Life Insurance v. Commonwealth) 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
INA Life Insurance v. Commonwealth, 376 A.2d 670, 31 Pa. Commw. 416, 1977 Pa. Commw. LEXIS 997 (Pa. Ct. App. 1977).

Opinion

Opinion by

President Judge Bowman,

INA Life Insurance Company (INA) submitted for approval to the Insurance Department (Department) three policy forms offering double indemnity accidental death benefits that it planned to offer as riders to its standard life insurance policies.1 Included [418]*418in the proposed riders was the following limitation or condition:

INDEMNITY. If the Insured sustains an accidental bodily injury while insured under this policy which results, directly and independently of all other causes and within 365 days of the accident causing such injury, in the Insured’s death, the Company agrees to pay . . . upon receipt at its Administrative Office of satisfactory proof of death, the amount of Accident Indemnity. (Emphasis added.)2

A Department rate and policy examiner rejected these riders on the ground, inter alia, that said 365 day limitation conflicted with a statement of policy issued by the Insurance Commissioner (Commissioner) in conjunction with proposed regulations appearing at 4 Pa. B. 1924 (September 7, 1974). Said statement of policy provided, in pertinent part:

The Pennsylvania Supreme Court, in Burne v. Franklin Life Insurance Company, 451 Pa. 218, 301 A.2d 799 (1973), held that a policy provision that accidental death benefits would be payable only if death occurred within 90 days from the date of the accident was contrary to public policy and unenforceable. The Court further held that such provision was not applicable where there was no dispute as to the cause of death. The Court’s opinion also contained dicta against any time period limitation restricting recovery of accidental death benefits where death is caused by accident.
[419]*419In response to the request of the Insurance Commissioner, the Attorney General issued an opinion on April 26, 1974, Pa. B. 962, May 11, 1974, [Atty. Gen. Op. No. 22] that the Insurance Commissioner may disapprove any policies ‘which purport to cut off accidental death benefits hy any arbitrary time limit’.

INA and the Department subsequently entered into a stipulation of facts and, INA having waived the hearing it had previously requested, the matter was submitted on briefs to a hearing officer. On December 30,1976,.the Commissioner entered an order and adjudication affirming the disapproval of the proposed riders upon the authority of Burne and Atty. Gen. Op. No. 22.

Thereafter, INA, hy a petition for review, invoked our original jurisdiction in the nature of a complaint in equity under Section 401, Appellate Court Jurisdiction Act of 1970 (ACJA), Act of July 31, 1970, P.L. 673, as amended, 17 P.S. §211.401, and sought judicial review of the adjudication of the Commissioner pursuant to Section 403, ACJA, 17 P.S. §211.403. Preliminary objections in the nature of a demurrer and questioning this Court’s jurisdiction in equity were then filed, which, in our view, must he considered as directed solely to the ACJA Section 401 assertion of INA’s petition for review. Centennial Bank v. Whitesell, 30 Pa. Commonwealth Ct. 445 n. 1, 375 A.2d 1333 n. 1 (1977).

A court of equity will not invoke its jurisdiction where there exists an adequate remedy at law which has not been exhausted. Friestad v. Travelers Indemnity Co., 452 Pa. 417, 306 A.2d 295 (1973); Pennsylvania Life Instirance Co. v. Pennsylvania National Life Insurance Co., 417 Pa. 168, 208 A.2d 780 (1965). The Administrative Agency Law, supra note 1, affords [420]*420such a remedy, and the facts of this case are not such as to justify a departure from this sound limitation on equity’s jurisdiction. We, therefore, sustain the preliminary objection to that portion of the petition for review in the nature of a complaint in equity invoking our original jurisdiction and, to that extent, the petition for review is dismissed.

We turn next to that portion of the petition for review framed as a Section 403 ACJA appeal from an adjudication3 of the Commissioner.

INA argues first that it was denied due process of law because the proposed regulations accompanying the above quoted statement of policy were never, in fact, adopted, and because the Commissioner relied in his adjudication upon authority other than that relied upon by the Department’s rate and policy examiner. This argument is patently without merit. Section 354 of the Act, 40 P.S. §477b, requires approval by the Commissioner of proposed policies, riders, etc., and it is from an adjudication of the Commissioner that an appeal lies. There is no authority for the proposition that the Commissioner is bound in his adjudications by the decisions and reasoning of a subordinate. In the context of an appeal from an adjudication of the Commissioner the decision and reasoning of a rate examiner are of no moment.4

INA next argues that the provisions of 45 Pa. C.S. §1101 et seq. (Commonwealth Documents Law) were violated because the Commissioner relied in his determination upon proposed regulations never formally [421]*421processed and adopted. This too is without merit as the proposed regulations in question played no role in the Commissioner’s determination. Rather, the Commissioner relied specifically upon Burne and Atty. Gen. Op. No. 22. The statement of policy, which INA also claims to have been erroneously relied upon, did no more than take cognizance of and interpret these decisions by which the Commissioner was bound, see Townsend Trust, 349 Pa. 162, 36 A.2d 438 (1944), and such a statement is specifically authorized by 45 Pa. C.S. §1101(13). Being merely interpretive, and not an exercise in delegated lawmaking power, the statement of policy was, in any event, exempt from the procedural provisions of 45 Pa. C.S. §1101 et seq. Pennsylvania Human Relations Commission v. Norristown Area School District, 20 Pa. Commonwealth Ct. 555, 342 A.2d 464 (1975).

The ultimate issue in these proceedings is whether the pronouncement of Burne represents an absolute ban upon provisions in accidental death insurance policies which require, as a prerequisite to payment of benefits, that the insured die within a given period of time following the accident, or whether it is to be narrowly construed as limited to its facts. In Burne, the insured was struck by an automobile and suffered fatal injuries. By heroic medical efforts, he was nevertheless kept alive for four and one-half years. The insured’s accidental death policies contained a time limitation identical in all significant respects to the proposed riders in question here, except the time limitation in Burne required death within 90 days in Lieu of 365 days.

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Bluebook (online)
376 A.2d 670, 31 Pa. Commw. 416, 1977 Pa. Commw. LEXIS 997, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ina-life-insurance-v-commonwealth-pacommwct-1977.