Massachusetts Automobile Rating & Accident Prevention Bureau v. Commissioner of Insurance

516 N.E.2d 1132, 401 Mass. 282, 1987 Mass. LEXIS 1529
CourtMassachusetts Supreme Judicial Court
DecidedDecember 15, 1987
StatusPublished
Cited by16 cases

This text of 516 N.E.2d 1132 (Massachusetts Automobile Rating & Accident Prevention Bureau v. Commissioner of Insurance) is published on Counsel Stack Legal Research, covering Massachusetts Supreme Judicial Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Massachusetts Automobile Rating & Accident Prevention Bureau v. Commissioner of Insurance, 516 N.E.2d 1132, 401 Mass. 282, 1987 Mass. LEXIS 1529 (Mass. 1987).

Opinion

Lynch, J.

This is a reservation and report of three cases filed and consolidated in the Supreme Judicial Court for the county of Suffolk, each challenging the decision of the Commissioner of Insurance fixing automobile insurance rates for the calendar year 1987. One of the cases has since been dismissed upon stipulation of all parties. The second, brought by a State legislator, alleges that the rates as set are excessive. No brief having been filed in that action, it is hereby dismissed. Mass. R. A. P. 19 (c), 365 Mass. 867 (1974). Thus, we are left with only the third case, brought by the Massachusetts Automobile Rating and Accident Prevention Bureau and ten [284]*284of its member insurance companies. For simplicity’s sake, we shall refer to the plaintiffs as either the bureau or the industry.

We summarize the facts. The Commissioner of Insurance (commissioner) may fix and establish annual insurance rates if he finds, upon investigation and hearing, that (1) competition in the industry will not ensure that rates will not be excessive or, (2) competition will be “so conducted as to be destructive of competition or detrimental to the solvency of insurers . . . .” G. L. c. 175E, § 5 (1986 ed.). The rates set by the commissioner are comprised of three basic components: (1) the loss allowance (expenses from payment of claims); (2) the expense allowance (nonclaim expenses); and (3) the underwriting profit allowance (an estimate of profit solely from the business of selling insurance). Massachusetts Auto. Rating & Accident Prevention Bureaus v. Commissioner of Ins., 389 Mass. 824,826 (1983).

This year’s hearing lasted eighty-six days. The parties included the bureau, the State Rating Bureau of the Division of Insurance (SRB), and the Attorney General. The commissioner attributed the extraordinary length of this year’s hearing to the gross disparity between the parties’ rate recommendations. According to the commissioner, “[n]early 40 points, amounting to $550 million, separate[d] the industry on one side and the Attorney General and the State Rating Bureau on the other.” The industry says it asked for a rate increase of 37.2%, but only got an increase of about 9%. It claims that the rates set are inadequate1 and argues in support of this claim as set out below.

1. Underwriting Experience.

a. Exclusion of evidence. The bureau sought to introduce evidence of past underwriting results to show that the commissioner’s current provision for underwriting loss was likely to be inadequate. “Underwriting results” are the measure of the industry’s profit or loss solely from underwriting insurance and from no other activity. The bureau’s evidence included [285]*285three documents: (1) A chart comparing the commissioner’s target underwriting profit provision with the actual underwriting profit earned by the State’s insurance industry for the years 1975-1986, inclusive. (2) A document relied on by the SRB’s witness, Paul Chemick. This document was an excerpt from an industry source book identified by the parties as Best’s Aggregates and Averages, showing country-wide underwriting results. (3) A chart compiling the most recent country-wide underwriting results, abstracted from Best’s Aggregates and Averages.

The bureau claims that experts from both sides and the commissioner all have relied on similar data in the past.2 Nonetheless, the items above were all excluded from evidence without explanation by the commissioner. On this appeal, the bureau contends that the exclusion of the evidence this year — at least without an explanation — was error requiring remand. We agree.

With respect to administrative agencies’ evidentiary rulings, “ ‘unless the admission [or exclusion] of the evidence resulted in a denial ... of substantial justice,’ the appellants have no valid complaint.” Sudbury v. Department of Pub. Utils., 351 [286]*286Mass. 214, 220 (1966), quoting Mayor of Everett v. Superior Court, 324 Mass. 144,148(1949). See Framingham v. Department of Pub. Utils., 355 Mass. 138, 144 (1969); A.J. Celia, Administrative Law § 280 (1986), and cases cited. Cf. K.C. Davis, Administrative Law § 16.11 (2d ed. 1980 & 1982 Supp.). In another context, we have said that an agency “has a wide discretion in ruling on evidence.” Sudbury v. Department of Pub. Utils., supra at 219. Cf. Maddocks v. Contributory Retirement Appeal Bd., 369 Mass. 488, 498 (1976), and cases cited. Therefore, we review the commissioner’s evidentiary rulings for errors of law resulting in a denial of substantial justice.

The goal in setting rates is to reproduce the effects of competitive markets and the rates as ultimately set must leave the industry with at least the opportunity to achieve the average returns earned in competitive markets. See Massachusetts Auto. Rating & Accident Prevention Bureau v. Commissioner of Ins., 381 Mass. 592, 605 (1980); Fitchburg Gas & Elec. Light Co. v. Department of Pub. Utils., 371 Mass. 881, 884 (1977); Attorney Gen. v. Commissioner of Ins., 370 Mass. 791, 813 (1976); Aetna Casualty & Sur. Co. v. Commissioner of Ins., 358 Mass. 272, 281 (1970). The commissioner contends here that exclusion of the evidence was nonetheless proper because past underwriting results are irrelevant to a determination whether the present rates are reasonable. Further, the commissioner argues that even if the bureau’s evidence did have some probative value, the evidence was properly excluded because any probative value was outweighed by concerns of undue delay and expense.

There is no question that, taken by themselves, underwriting results do not reflect over-all industry profitability. As we have recognized on prior occasions, in the insurance business “money is made on investments, not on underwriting.” Massachusetts Auto. Rating & Accident Prevention Bureau v. Commissioner of Ins., 389 Mass. at 829, quoting Massachusetts Auto. Rating & Accident Prevention Bureau v. Commissioner of Ins., 381 Mass, at 604-605. But this does not necessarily mean that underwriting results are irrelevant to profitability or to the reasonableness of the rates.

[287]*287Evidence is relevant if it has any tendency to make the existence of a material fact more probable or less probable than it would be without the evidence. McCormick, Evidence § 185 (3d ed. 1984). Under this definition, the bureau’s evidence is relevant. Dr. William Fairley, recognized as an expert in the field by this court, Massachusetts Auto. Rating & Accident Prevention Bureau v. Commissioner of Ins., 389 Mass, at 831, has written that a direct way to test the reasonableness of “target” underwriting provisions is to compare them with long-term historical data on underwriting profit margins in competitive markets nationwide. W. Fairley, Investment Income and Profit Margins in Property-Liability Insurance, 10 Bell J. of Econ. 192, 205-206 (1979).

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Bluebook (online)
516 N.E.2d 1132, 401 Mass. 282, 1987 Mass. LEXIS 1529, Counsel Stack Legal Research, https://law.counselstack.com/opinion/massachusetts-automobile-rating-accident-prevention-bureau-v-mass-1987.