Kramer v. Department of Insurance

654 A.2d 203, 1995 Pa. Commw. LEXIS 47
CourtCommonwealth Court of Pennsylvania
DecidedJanuary 23, 1995
StatusPublished
Cited by11 cases

This text of 654 A.2d 203 (Kramer v. Department of Insurance) 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
Kramer v. Department of Insurance, 654 A.2d 203, 1995 Pa. Commw. LEXIS 47 (Pa. Ct. App. 1995).

Opinion

DOYLE, Judge.

Before the Court is the appeal of J. Scott Kramer (Petitioner) from an order of Cynthia M. MalesM, Insurance Commissioner, which affirmed a determination by the Insurance Department that The Travelers Insurance Company could properly decline to renew Petitioner’s automobile insurance policy.

On June 19, 1992, Travelers mailed a notice to Petitioner which informed him that the company would not renew his automobile insurance policy, because he had had two accidents within thirty-six months of August 26, 1992, the anniversary date of his policy. Petitioner appealed to the Department which determined that two accidents had indeed occurred, one on June 1, 1990, and another on December 7, 1991. Accordingly, the Department determined that Travelers could lawfully terminate his coverage pursuant to the provisions of Act 78.1

Petitioner appealed this determination to the Commissioner. A presiding officer was appointed and a hearing was held on September 28, 1992. After the record was closed, the matter was referred to the Commissioner for adjudication. The Commissioner found that an accident occurred on December 7, 1991, when Jennifer Grant, who had permission to use Petitioner’s car, rear-ended another vehicle resulting in $6,684.25 in claims which Travelers paid. The other incident involved damage to the sunroof and ladder of Petitioner’s van. The Commissioner found that:

On June 1,1990, Melissa Jarrett, a permissive user of the insured’s vehicle, collided with a fixed object on a rural, straight road. (N.T., 5). According to Mr. Gill-man, [Travelers representative] the vehicle was a van and the fixed object was an underpass. (N.T., 27). The company paid a $218.68 collision claim. (N.T., 5). Mr. Gillman submitted Travelers records which corroborated this testimony regarding the two accidents and resulting claim payments. (Travelers Exhibits 1, 2.)

(Commissioner’s op. at 5-6.) Petitioner objected to this description of the accident, alleging that Travelers had no basis for concluding that the damage occurred from a collision with an underpass. He testified that his van was lawfully parked at a train station, where it had been parked by Ms. Jarrett, his former nanny. Although he had no knowledge of how the accident happened,2 Petitioner argued that the damage could have occurred when the van was parked, or was involved in a “hit and run” accident, or was caused by flying gravel, missiles, or falling objects. If the accident involved any of these scenarios, it would be excluded as a chargeable collision by Section 3 of Act 78, 40 P.S. § 1008.3, and Travelers could not have refused to renew Petitioner’s policy.

After reviewing all the evidence, the Commissioner concluded that Travelers had sustained its burden of proof that two chargeable accidents had occurred within thirty-six months, and, therefore, the nonre-newal of Petitioner’s policy did not violate Act 78. This appeal followed.3

Petitioner argues that the Commissioner (1) improperly allocated the burden of proof, (2) improperly admitted certain business documents of Travelers because they were hearsay, and (3) erred by appointing a [205]*205presiding officer who adjudicated his claim although he was not present at the hearing.

Section 3(b) of Act 78 provides that

[n]o insurer shall cancel or refuse to renew a policy of automobile insurance on the basis of one accident within the thirty-six month period prior to the upcoming anniversary date of the policy.

40 P.S. § 1008.8(b). Section 3(a) enumerates several reasons which also prevent the insurer from cancelling or refusing to renew, including:

(13) Any accident which occurred under the following circumstances:
(i) auto lawfully parked (if the parked vehicle rolls from the parked position then any such accident is charged to the person who parked the auto);
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(v) auto operated by the applicant or any resident operator is struck by a “hit- and-run” vehicle, if the accident is reported to the proper authority within twenty-four hours by the applicant or resident operator;
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(vii) accident involving physical damage, limited to and caused by flying gravel, missiles, or falling objects....

40 P.S. § 1008.3(a)(13)(i),(v),(vii). The initial burden of proof lies with the insurer to show that there was more than one accident. Egnal v. Insurance Department, 132 Pa.Commonwealth Ct. 413, 573 A.2d 236, petition for allowance of appeal denied, 524 Pa. 632, 574 A.2d 73 (1989). The burden then shifts to the insured to show that there are circumstances warranting exclusion. Id.

Petitioner contends that the Commissioner erred by charging him with the burden of proving that the June 1, 1990 accident falls into one of the categories listed in Section 3(a)(13) of Act 78, rather than requiring Travelers to prove that the accident did not fall into one of the exclusions. The Commissioner argues that Petitioner waived this issue by failing to raise it below. We agree with the Commissioner.

Our review of the record fails to reveal any instance where Petitioner questioned the burden of proof in this matter. In fact, Petitioner acknowledged that it was incumbent upon him to prove that the accident was excludable. In his brief to the Commissioner, he states:

The burden of proof lies with the insurer to show that there was more than one accident. The burden then shifts to the insured through circumstances warranting exclusion, [sic] Egnal v. Tom. [sic] Ins. Dept., [132 Pa.Cmwlth. 413] 573 A.2d 236 (Pa.Comwlth, 1989). (Emphasis added.)

He argued only that he had sustained his burden, not that the burden was not his:

In addition, Mr. Kramer has carried his burden in showing that the accident of 6/1/90 fits into Exception 13(i) or (vii) given Mr. Kramer’s testimony about the observation of the property damage and the placement of the vehicle in the parking space at the train station at the time it was recovered. (Emphasis added.)

Issues not raised before a governmental agency are waived and may not be raised for the first time on appeal. Pa.R.A.P. 1551; Prudential Property and Casualty Insurance Co. v. Department of Insurance, 141 Pa.Commonwealth Ct. 156, 595 A.2d 649 (1991).

Petitioner next argues that the Commissioner erred relying on records submitted after the hearing because they were hearsay. The documents in question were various records from Travelers’ claim file which the presiding officer permitted Travelers to submit after the hearing, but before the record was closed. Petitioner submitted a letter in response to these documents, but never objected to them on the grounds of hearsay, nor did he request an opportunity to cross examine Mr. Gilknan, Travelers’ representative. Accordingly, this issue also has been waived.

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654 A.2d 203, 1995 Pa. Commw. LEXIS 47, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kramer-v-department-of-insurance-pacommwct-1995.