New York State Society of Obstetricians & Gynecologists, Inc. v. Corcoran

138 Misc. 2d 591, 525 N.Y.S.2d 457, 1987 N.Y. Misc. LEXIS 2807
CourtNew York Supreme Court
DecidedOctober 1, 1987
StatusPublished

This text of 138 Misc. 2d 591 (New York State Society of Obstetricians & Gynecologists, Inc. v. Corcoran) is published on Counsel Stack Legal Research, covering New York Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
New York State Society of Obstetricians & Gynecologists, Inc. v. Corcoran, 138 Misc. 2d 591, 525 N.Y.S.2d 457, 1987 N.Y. Misc. LEXIS 2807 (N.Y. Super. Ct. 1987).

Opinion

OPINION OF THE COURT

Karla Moskowitz, J.

Petitioner New York State Society of Obstetricians and Gynecologists, Inc., a not-for-profit corporation, and Jerome J. Schwartz, M.D., as the president of the society, commenced this CPLR article 78 proceeding challenging regulation 124 (11 NYCRR part 152) promulgated by the Superintendent of Insurance as unconstitutional, and arbitrary and capricious. Respondent James P. Corcoran, the Superintendent of Insurance, cross-moves to dismiss the petitions (CPLR 7804 [f]) on the grounds that the proceeding is premature, and that the petition fails to state a cause of action.

In July 1985, the Legislature required the Superintendent to promulgate a regulation establishing a physicians professional liability insurance merit rating plan as part of the Medical Malpractice Reform Act (L 1985, ch 294, § 16), which reflects an individual physician’s or surgeon’s experience with respect to incidents or occurrences of alleged medical malpractice, and which would be reasonable, not unfairly discriminatory, inequitable or violative of public policy (Insurance Law § 2343 [d]). The Legislature directed that the regulation include:

"(1) reasonable standards to be applied in arriving at premium rates, surcharges and discounts based on an evaluation of the hazards of the insured, geographical area, specialities of practice, past and prospective loss and expense experience for medical malpractice insurance written and to be written in this state, trends in the frequency and severity of losses, and the limited nature, if any, of the practice of the insured;
"(2) rules for recognizing experience of individual risks;
"(3) any other factors deemed relevant in a system of merit rating for the purpose of establishing equitable merit rates.” (Insurance Law § 2343 [d].)

The Superintendent was also directed to consider whether [593]*593"premium rates unfairly burden physicians who are initiating their practice, those who are transitioning to retirement or those who practice part-time or hold academic positions” (Insurance Law § 2343 [d]).

On December 30, 1985, the Superintendent promulgated a proposed regulation establishing a merit rating plan which was challenged by petitioners. The application to annul the regulation was denied by court order without prejudice to renewal upon promulgation of a final regulation.

The final regulation, regulation No. 124 (11 NYCRR 152), establishing a merit rating plan was promulgated by the Superintendent, pursuant to his authority under section 2343 of the Insurance Law, on June 12, 1986. It is this regulation that petitioners challenge here.

On a motion to dismiss for failure to state a cause of action (CPLR 3211 [a] [7]; 7804 [f]), the court looks to the substance of the pleading to determine whether the pleader has a cause of action, not whether it has properly stated one (Rovello v Orofino Realty Co., 40 NY2d 633).

Petitioners’ pleadings are inartfully drafted. Nevertheless, as best as this court can determine petitioners’ theories of recovery appear to seek to declare regulation No. 124 unconstitutional on its face on the grounds that it is confiscatory, violates due process and constitutes a denial of equal protection of the laws. In addition, petitioners claim that the regulation is arbitrary and capricious and fails to conform to section 2343 of the Insurance Law on the ground that it unfairly discriminates. Because the present article 78 proceeding is an inappropriate vehicle in which to advance these claims, the proceeding is converted to an action for a declaratory judgment (see, CPLR 103 [c]; Matter of Gold v Lomenzo, 29 NY2d 468, 476, n 4; Matter of Montgomery Ward & Co. v New York State Dept. of Motor Vehicles, 90 AD2d 643, 644), and the petition deemed the complaint. Petitioners shall hereinafter be referred to as plaintiffs.

With respect to the branch of the cross motion to dismiss the complaint on the ground that the action is premature, the Superintendent argues that regulation No. 124 is not yet fully operational, and in any event, it provides for periodic adjustment of the method for calculating surcharges as more experience data becomes available (11 NYCRR 152.3 [c]). Regulation No. 124, however, has been in effect for over one year, during which time insurers were required to adopt, and then submit [594]*594to the Superintendent for approval, a merit rating plan in accordance with its provisions (11 NYCRR 152.5); or alternatively, under unique circumstances to adopt and submit a plan at variance with its provisions (11 NYCRR 152.4). Insureds presumably have been charged with premium surcharges based upon the approved plans, or face the prospect of that happening soon (cf., American Ins. Assn. v Chu, 64 NY2d 379, 385 [claim dismissed because the issue to be determined was contingent upon a future event, beyond the control of the parties, which might never occur]). Moreover, plaintiffs’ attacks on the regulation are directed at its face, not as applied to individual physicians. That the regulation permits periodic adjustment of those factors specified for assigning points to generate surcharges (11 NYCRR 152.3 [c]), does not render premature or moot challenges to the methodology in its present formulation.

With respect to that branch of the cross motion to dismiss the complaint for failure to state a cause of action, the Superintendent argues that the promulgation of regulation No. 124 is neither arbitrary, capricious, irrational, nor confiscatory.

Plaintiffs claim the regulation permits a confiscatory taking of property by establishing a period of review of chargeable losses which exceeds the limits of reasonable retroactivity. In addition, plaintiffs claim that the regulation arbitrarily and capriciously discriminates among doctors in terms of dollar amounts charged per premium surcharge because it fails to distinguish between the risks faced by physicians practicing different medical specialties.

The Superintendent of Insurance is vested with broad power to interpret, clarify, and implement legislative policy (see, Insurance Law § 301; Matter of New York Pub. Interest Research Group v New York State Dept. of Ins., 66 NY2d 444; Ostrer v Schenck, 41 NY2d 782). Implementation of legislative policy, via regulation, however, must be consistent with statutory and constitutional requirements. As a general rule, legislative and regulatory adjustments of the burdens and benefits of economic life are afforded great latitude, and will not be overturned as violative of due process and equal protection rights so long as the means utilized are rationally related to the legitimate State objective (see, e.g., Usery v Turner Elkhorn Min. Co., 428 US 1; Montgomery v Daniels, 38 NY2d 41).

The legislative purpose allegedly sought to be addressed by regulation No. 124 is set out in the regulation’s preamble:

[595]*595"(a) Section 2343 (d) of the Insurance Law requires that the Insurance Department promulgate a regulation establishing a Physicians and Surgeons Professional Liability Merit Rating Plan to take effect on January 1, 1986. A merit rating plan is a system of rules for imposing rate surcharges or credits, within the existing class and territory matrix, based upon an individual’s past history of claims or disciplinary actions.

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Related

Usery v. Turner Elkhorn Mining Co.
428 U.S. 1 (Supreme Court, 1976)
Gold v. Lomenzo
280 N.E.2d 640 (New York Court of Appeals, 1972)
Montgomery v. Daniels
340 N.E.2d 444 (New York Court of Appeals, 1975)
Rovello v. Orofino Realty Co.
357 N.E.2d 970 (New York Court of Appeals, 1976)
American Insurance Ass'n v. Chu
476 N.E.2d 637 (New York Court of Appeals, 1985)
Montgomery Ward & Co. v. New York State Department of Motor Vehicles
90 A.D.2d 643 (Appellate Division of the Supreme Court of New York, 1982)

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Bluebook (online)
138 Misc. 2d 591, 525 N.Y.S.2d 457, 1987 N.Y. Misc. LEXIS 2807, Counsel Stack Legal Research, https://law.counselstack.com/opinion/new-york-state-society-of-obstetricians-gynecologists-inc-v-corcoran-nysupct-1987.