Lewis v. State Farm Mutual Automobile Insurance

685 A.2d 467, 112 Md. App. 311, 1996 Md. App. LEXIS 158
CourtCourt of Special Appeals of Maryland
DecidedNovember 27, 1996
DocketNo. 972
StatusPublished

This text of 685 A.2d 467 (Lewis v. State Farm Mutual Automobile Insurance) is published on Counsel Stack Legal Research, covering Court of Special Appeals of Maryland primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Lewis v. State Farm Mutual Automobile Insurance, 685 A.2d 467, 112 Md. App. 311, 1996 Md. App. LEXIS 158 (Md. Ct. App. 1996).

Opinion

FISCHER, Judge.

Fraeda Lewis (Mrs. Lewis) appeals from an order of the Circuit Court for Baltimore City that affirmed an administrative law judge’s (ALJ) finding that State Farm Mutual Automobile Insurance Company’s (State Farm) decision to add a premium surcharge to Mrs. Lewis’s automobile insurance policy was justified and proper.1 Following the Maryland Insurance Administration’s (MIA) finding that State Farm’s surcharge decision was proper, Mrs. Lewis requested a hear[314]*314ing before the State Insurance Commissioner of Maryland (the Commissioner), which assigned the hearing to an ALJ of the Office of Administrative Hearings.2 The ALJ found that State Farm’s actions were justified and accordingly dismissed Mrs. Lewis’s protest. Lewis then appealed to the circuit court, which affirmed the ALJ’s decision. Mrs. Lewis raises the following issue for our review, which we have reworded and condensed as follows:

I. Did the circuit court err by affirming the decision of the Administrative Law Judge?

FACTS

On November 13, 1993, Mr. Lewis was driving Mrs. Lewis’s 1988 Mercedes automobile. Mrs. Lewis and Fred and Joan Cohen were passengers in the.car. While in Baltimore City, Mr. Lewis lost control of the car and skidded into a guard rail. At the time of the accident, the road was still wet from a rainstorm that had occurred earlier in the day. No one in the car sustained injuries, but the accident caused substantial damage to the car itself.

Following the accident, Mrs. Lewis filed a claim with State Farm, her insurance company, under her collision coverage. State Farm investigated the claim, determined that Mrs. Lewis’s policy covered the accident, and paid $1,577.66 for repairs to the car.3

Subsequent to its payment to Mrs. Lewis, State Farm decided to impose a surcharge on Mrs. Lewis’s policy based on its belief that Mr. Lewis was more than fifty percent at fault in causing the accident.4 State Farm then notified Mrs. Lewis [315]*315of its plans to add the surcharge. Mrs. Lewis requested that the MIA investigate State Farm’s decision. The MIA did so and eventually confirmed that decision as proper and justified.

After the MIA’s decision, Mrs. Lewis requested a hearing with the Commissioner. On November 3, 1994, a hearing was held before an ALJ, which found that:

The Licensee’s [State Farm’s] proposed surcharge is in accordance with MD. ANN, CODE art. 48A, § 240AA. It gave adequate notice to the Complainant [Mrs. Lewis] of its intention to surcharge her policy according to the terms of its established rating plan on file with the Maryland Insurance Administration. Furthermore, it used adequate and reasonable means to investigate the accident, determine liability under collision coverage and pay the resulting claim. Where there is a single-car accident, the provision that the driver must be 50% at fault does not apply. The Administrative Law Judge finds that the Licensee’s actions to surcharge Fraeda J. Lewis’s policy is lawful.

Mrs. Lewis appealed this decision to the circuit court, which affirmed the ALJ. Following the circuit court’s order, Mrs. Lewis filed a timely appeal with this Court.

STANDARD OF REVIEW

In this case, the circuit court’s revisory power over the ALJ’s findings of fact and mixed questions of fact and law was limited to whether substantial evidence existed in the record to support the ALJ’s decision. Lumbermen’s Mut. Casualty v. Insurance Comm’r, 302 Md. 248, 266, 487 A.2d 271 (1985). The Court of Appeals has described the substantial evidence standard as whether “a reasoning mind reasonably could have [316]*316reached the factual conclusion the agency reached.” Id.; see also Insurance Comm’r v. Nat’l Bureau, 248 Md. 292, 309-310, 236 A.2d 282 (1967) (stating that the judicial review under the substantial evidence standard is neither a judicial fact-finding mission nor a substitution of a judicial judgment for an agency judgment).

Reviewing courts do not apply the substantial evidence test to every aspect of an agency decision. For example, a reviewing court does not afford any deference to an agency’s conclusion on a question of law. Liberty Nursing Ctr. v. Department of Health & Mental Hygiene, 330 Md. 433, 443, 624 A.2d 941 (1993). Thus, the scope of judicial review for findings of fact or mixed questions of fact and law is narrow, United Parcel Service, Inc. v. People’s Counsel, 336 Md. 569, 576, 650 A.2d 226 (1994), but there is no such limitation on the review of questions of law.

DISCUSSION

Mrs. Lewis argues that the circuit court erred by affirming the decision of the ALJ. Specifically, Mrs. Lewis insists that State Farm did not present sufficient evidence to demonstrate that Mr. Lewis was at least 50 percent at fault. State Farm counters that there was substantial evidence to support the ALJ’s decision.

Md.Code (1957, 1994 RepLVol., 1995 Supp.), Art. 48A, § 240AA establishes the procedures used in a proceeding for the cancellation, non-renewal, increase in premiums, or reduction of coverage under a motor vehicle liability insurance policy.5 Section 240AA (f) reads, in part, that “at the hearing the insurer has the burden of proving its proposed action to be justified, and, in doing so, may rely only upon the reasons set forth in its notice to the insured.” Md.Code, Art. 48A, § 240AA(f) (emphasis added). This case, therefore, hinges on whether State Farm’s premium surcharge was “justified;” a [317]*317term that this Court and the Court of Appeals have not defined in the context of a premium surcharge, but have defined with respect to a cancellation and non-renewal.6

Because there is no language in section 240AA that says otherwise, the term “justified” has the same meaning in all hearings and proceedings covered by section 240AA. See Comptroller v. Jameson, 332 Md. 723, 732, 633 A.2d 93 (1993) (stating that the foremost goal of statutory construction is to discern the legislature’s intent and the primary source of this intent is the words of the statute itself); Atkinson v. State, 331 Md. 199, 215, 627 A.2d 1019 (1993) (stating that the words of the statute are accorded their ordinary meaning unless otherwise specified). Thus, we are bound by prior interpretations of the term “justified.”

The Court of Appeals has held that under section 240AA(f) “the insurer must establish that its assigned reason [for cancelling a policy, increasing a premium, or reducing coverage] is an actual one, that is, genuine; and that the facts on which it is based are true.” Insurance Comm’r v. Nevas, 81 Md.App.

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627 A.2d 1019 (Court of Appeals of Maryland, 1993)
Lumbermen's Mutual Casualty Co. v. Insurance Commissioner
487 A.2d 271 (Court of Appeals of Maryland, 1985)
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United Parcel Service, Inc. v. People's Counsel
650 A.2d 226 (Court of Appeals of Maryland, 1994)
Insurance Commissioner v. Nevas
568 A.2d 1144 (Court of Special Appeals of Maryland, 1990)

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Bluebook (online)
685 A.2d 467, 112 Md. App. 311, 1996 Md. App. LEXIS 158, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lewis-v-state-farm-mutual-automobile-insurance-mdctspecapp-1996.