National States Ins. Co. v. Commissioner

81 T.C. No. 25, 81 T.C. 325, 1983 U.S. Tax Ct. LEXIS 38
CourtUnited States Tax Court
DecidedSeptember 19, 1983
DocketDocket No. 17289-79
StatusPublished
Cited by14 cases

This text of 81 T.C. No. 25 (National States Ins. Co. v. Commissioner) is published on Counsel Stack Legal Research, covering United States Tax Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
National States Ins. Co. v. Commissioner, 81 T.C. No. 25, 81 T.C. 325, 1983 U.S. Tax Ct. LEXIS 38 (tax 1983).

Opinions

Wilbur, Judge:

Respondent determined deficiencies and an addition to petitioner’s Federal income taxes as follows:

Addition to tax Year Deficiency under sec. 6653(a)
1973 .$56,556.24
1974 . 169,687.01 $8,484.35
1975 . 157,315.55
1976 . 177,534.31

After concessions, the sole question presented for decision is whether petitioner qualified as a life insurance company during the years in issue under the provisions of section 801(a).1 Specifically, we must decide whether petitioner’s individual accident and health policies were "guaranteed renewable” within the meaning of section 1.801-3(d), Income Tax Regs.

FINDINGS OF FACT

Some of the facts have been stipulated, and those facts are so found. The stipulation and the exhibits attached thereto are incorporated by this reference.

Petitioner is a Missouri corporation engaged in the business of issuing policies of insurance, with its principal office in University City, Mo. It filed its Federal income tax returns for each of the calendar years 1973 through 1976 with the Internal Revenue Service Center at Kansas City, Mo., on Forms 1120L, together with the annual convention statement for each year.

Petitioner was incorporated in 1964 as a life insurance company under the law of the State of Missouri. Petitioner underwrites insurance in numerous States. During the taxable years in controversy, it primarily wrote guaranteed renewable health and accident insurance policies (hereafter GRHA policies) and a small amount of life insurance and group accident and health insurance. Petitioner did not issue policies of insurance other than life, accident, and health insurance.

Under the terms of the individual accident and health policies written by petitioner (with minor exceptions not here material), petitioner may neither cancel nor refuse to renew coverage for life or to age 65, at a level premium. Petitioner may, however, adjust premiums by class based on experience, but at rates based upon the age and insurable condition of the insured'at the original date of issue. No changes in premium rates may be based on the insured’s increased age (from the time the policy was first issued), changes in health or occupation, or claims made under the policy.

Guaranteed renewable individual accident and health policies are a recognized product type within the health insurance industry. For purposes of classification by the insurance industry, the contractual provisions described in the preceding paragraph distinguish a guaranteed renewable individual accident and health policy from, other forms of health and accident, insurance. All of petitioner’s individual GRHA policies satisfy the industry definition and understanding of the guaranteed renewable product type.

All of petitioner’s GRHA policies are level premium policies, as distinguished from step-rate or 1-year term policies. A level premium policy is one under which the premium is based on original issue age, and does not increase based on attained age (although the insurer may adjust premiums by class under the guaranteed renewable provision). A step-rate policy is one under which the premiums provided for in the contract increase at specified periods based on attained age.

Guaranteed renewable level premium policies, which came into use in the early 1950’s, provide the insured with the benefit of a premium rate unaffected by changes in age and condition of health, but also enable the insurer, through its ability to change premium rates by class, to cope with inflation and changes in health care standards affecting claim costs. These policies, like policies of life insurance, present long-term hazards extending beyond the current premium payment period. The requirement of a reserve, in addition to the unearned premium reserve, recognizes that long-term or continuing risk.

At all times here relevant, petitioner was subject to regulation, supervision, and examination under the insurance laws of the State of Missouri by the Missouri Insurance Division, which was charged by State statute with the execution of laws in relation to insurance companies doing business in Missouri.

The Missouri minimum valuation standard classifies accident and health policies as type A, type B, type C, or type D, depending on the nature of the policy provisions. Type B policies are described therein as follows:

B. Policies which are guaranteed renewable for life or to a specified age * * * but under which the company reserves the right to change the scale of premiums.

With immaterial exceptions, áll petitioner’s individual GRHA policies satisfied the above-quoted definition of a type B policy.

As a minimum reserve standard for type B policies, the Missouri minimum valuation standard authorized use of one of the following three generally recognized reserve methods:

(1) Mean reserves diminished by appropriate credit for valuation net deferred premiums;

(2) Mid-terminal reserves plus gross pro rata unearned premium reserves;

(3) Mid-terminal reserves plus net pro rata unearned premium reserves.

In 1973 through 1976, petitioner estimated its active life reserve on its individual accident and health policies using method (2) referred to above.

Active life reserves are reserves for future claims or liabilities not yet incurred; "claim reserves” are for claims and liabilities already incurred, but not yet paid. Active life reserves include (a) the "unearned premium reserve,” which is a reserve for claims or liabilities which will be incurred during the remainder of the term or period for which the premium has been paid, and (b) the "additional reserve,” generally designated as the "mid-terminal” reserve in technical insurance terminology, which is a reserve for claims or liabilities that will be incurred after the end of the current premium period. This additional or mid-terminal reserve is normally concerned only with policies which place on the insurer a risk extending beyond the current premium payment period for which future premiums at some point will be inadequate.

Premiums are treated as earned by the passage of time. A pro rata unearned premium reserve, whether gross or net, diminishes as time passes, and is necessarily reduced to zero at the end of the current policy term or premium payment period. The mid-terminal or additional reserve represents an amount held back or reserved from premiums which would otherwise be treated as earned, and remains at the end of the current premium or policy term when the unearned premium reserve is at zero.

The gross premium is the total premium actually paid by the insured. It consists of (a) the net premium or net valuation premium, which, with assumed earnings, is the amount deemed necessary to meet claims and obligations arising under the policy, and (b) the "loading” factor, which is required to pay commissions, taxes, and expenses, and (in the case of stock insurers) to provide a profit margin.

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Cite This Page — Counsel Stack

Bluebook (online)
81 T.C. No. 25, 81 T.C. 325, 1983 U.S. Tax Ct. LEXIS 38, Counsel Stack Legal Research, https://law.counselstack.com/opinion/national-states-ins-co-v-commissioner-tax-1983.