Miller v. Insurance Commissioner

521 A.2d 761, 70 Md. App. 355, 1987 Md. App. LEXIS 270
CourtCourt of Special Appeals of Maryland
DecidedMarch 4, 1987
Docket635, September Term, 1986
StatusPublished
Cited by9 cases

This text of 521 A.2d 761 (Miller v. Insurance Commissioner) 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
Miller v. Insurance Commissioner, 521 A.2d 761, 70 Md. App. 355, 1987 Md. App. LEXIS 270 (Md. Ct. App. 1987).

Opinion

POLLITT, Judge.

This is an appeal from a judgment of the Circuit Court for Baltimore City (Bothe, J.) affirming the order of the State Insurance Commissioner of Maryland.

On October 15, 1985, General Accident Insurance Company of America (General Accident) notified Gerald A. Miller, M.D., that his professional liability insurance policy with *357 General Accident would be cancelled as of December 4, 1985. 1 On November 27,1985, Dr. Miller requested that the Insurance Commissioner investigate that cancellation, pursuant to § 234A. 2 After investigation the Commissioner determined, without a hearing, that the cancellation was not in violation of any provisions of the Maryland Insurance Code. Pursuant to § 40(1), Dr. Miller appealed that decision to the Circuit Court for Baltimore City and, at the same time, moved for a stay of the Commissioner’s decision, pursuant to § 40(2). On April 8, 1986, Judge Bothe denied the stay and affirmed the Commissioner. From that judgment, Dr. Miller appeals to this Court.

The appellant, Dr. Miller, and the appellees, General Accident and the Commissioner, each state the questions presented in varying form, reflecting their respective positions, but we perceive them to be substantially as follows:

I. Whether the Commissioner correctly determined that General Accident was justified in cancelling Dr. Miller’s policy on the grounds of fraud and misrepresentation in the application for the policy without further evidence of standards reasonably related to General Accident’s economic and business purposes?
II. Whether General Accident was estopped from cancel-ling Dr. Miller’s policy by its knowledge of the misrepresentations prior to the latest renewal of the policy?

Facts

In August of 1982, Dr. Miller obtained professional liability insurance with General Accident. He previously had *358 been insured by the Medical Mutual Liability Insurance Society of Maryland but had terminated that insurance after a dispute with Medical Mutual over a malpractice claim which resulted in a verdict against him for $500,000, including $200,000 in punitive damages. 3 That case precipitated an investigation of Dr. Miller before the Commission on Medical Discipline of Maryland. That investigation began in January of 1988 and continued through January of 1985, when the Commission entered an order noting severe deficiencies in Dr. Miller’s practice and suspending his license to practice medicine unless he complied with numerous conditions imposed by that order.

In August of 1983 Dr. Miller filed a renewal application with General Accident. Question 22 on that application was “Have you ... ever been the subject of investigative or disciplinary proceedings or reprimand by a governmental or administrative agency, hospital or professional association?” Dr. Miller answered, “No.” The renewal application contained a warranty stating:

It is warranted ... that the information contained herein is true and that it shall be the basis of the policy of insurance and deemed incorporated therein, should the Company evidence its acceptance of this application by issuance of a policy.
A standard condition of the policy was:
1. Application. By acceptance of this policy, the Named Insured agrees that the statements in the application are his or her representations, that this policy is issued in reliance upon the truth of such representations and that this policy embodies all agreements existing between the Named Insured and the Company, or any of its agents, relating to this insurance.

On June 23, 1984, Dr. Miller again applied for renewal of the policy for the period of August 7, 1984, through August *359 7, 1985. Question 13 of that application was identical to question 22 of the previous application, and, again Dr. Miller answered, “No.” That application also contained the following:

REPRESENTATION: It is represented that the information contained herein is true and that it shall be the basis of the policy of insurance and deemed incorporated therein, should the Company evidence its acceptance of this application by issuance of a policy.

A signed but undated renewal application was filed by Dr. Miller shortly before August 7, 1985. On this application, for the first time, Dr. Miller answered “yes” to the question as to whether he had been the subject of investigative or disciplinary proceedings, and attached to the application a copy of the findings and order of the Commission on Medical Discipline, dated January 29, 1985. This revelation was not made in time for General Accident to give the 45 days notice of nonrenewal required by § 240A.

After review of this information, Shand, Morahan & Company, Inc. (Shand), underwriting managers for General Accident, sent Dr. Miller the aforementioned notice of cancellation. A letter accompanying that notice stated, in part:

It has recently come to our attention that you have been the subject of an investigation by the Commission on Medical Discipline, which on January 29, 1985 issued an Order imposing certain conditions on your practice of medicine. Our information indicates that this investigation was undertaken as a result of a complaint filed in connection with your performance of a lens implant on November 17, 1978. Your various applications for renewal of your coverage prior to 1985 do not disclose this investigation. For that reason and because you do not meet our underwriting standards, we enclose herewith a Notice of Cancellation of any policy coverage which may exist by operation of law.

Some six weeks after receipt of the notice of cancellation, Dr. Miller wrote the Insurance Commissioner, requesting an *360 investigation to determine if the action by General Accident was justified. In that letter to the Commissioner, Dr. Miller wrote, in part:

I had terminated my insurance with Medical Mutual on 8/83 due to my distress with the situation that had unfolded in the past. I joined General Accident unaware at that time of any disciplinary action. On the renewal application of 8/84, I did not alert them to the investigation as I did not believe that it would end the way it did and also because I was fearful that it would influence their consideration of me as an insured. 4

Pursuant to § 234A(a), the Commissioner undertook an investigation and directed General Accident to continue the policy in effect pending the issuance of his findings. On January 23, 1986, the Commissioner found, in part:

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Bluebook (online)
521 A.2d 761, 70 Md. App. 355, 1987 Md. App. LEXIS 270, Counsel Stack Legal Research, https://law.counselstack.com/opinion/miller-v-insurance-commissioner-mdctspecapp-1987.