North Carolina Reinsurance Facility v. Long

390 S.E.2d 176, 98 N.C. App. 41, 1990 N.C. App. LEXIS 303
CourtCourt of Appeals of North Carolina
DecidedApril 3, 1990
Docket8910SC509
StatusPublished
Cited by7 cases

This text of 390 S.E.2d 176 (North Carolina Reinsurance Facility v. Long) is published on Counsel Stack Legal Research, covering Court of Appeals of North Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
North Carolina Reinsurance Facility v. Long, 390 S.E.2d 176, 98 N.C. App. 41, 1990 N.C. App. LEXIS 303 (N.C. Ct. App. 1990).

Opinion

JOHNSON, Judge.

Appellee North Carolina Reinsurance Facility (“Facility”) is a nonprofit unincorporated entity created by the 1973 General Assembly and organized pursuant to Article 25A of Chapter 58 of the North Carolina General Statutes (“Facility Act”). The Facility was created to insure the availability of automobile insurance to all North Carolina drivers. Appellant, Universal Insurance Company (“Universal”), a licensed automobile liability insurer, is a member of the Facility.

*43 Universal and all other members of the Facility are required to issue liability policies to “eligible risk” applicants, but may cede the policies to the Facility. By ceding the policies, each insurance company receives reimbursement for its underwriting expenses by retaining a certain percentage of the premiums collected. The Facility determines the ceding expense allowance for each company for each fiscal year by analyzing the data each company submits. Such data is designed to illustrate the company’s expenses attributable to the ceded policies for the preceding calendar year. The ceding expense allowance, calculated by the Facility for each company, is intended to reimburse each company for its expenses up to a maximum cap which is equal to the average ceding expense allowance for all member companies. Each company’s ceding expense allowance is developed based upon an annual “call for expense experience” which is annually submitted by all companies to the North Carolina Rate Bureau.

In April 1987, Universal notified the Facility that it wanted to change, retroactively, the data it had submitted for the years 1984 and 1985. Universal alleged that all data was based upon allocations of combined automobile liability and physical damage expenses. If further advised the Facility that as a result of its new allocation method Facility owed Universal an additional ceding expense allowance of $229,282.00 for 1 October 1985 through 30 September 1986.

Shortly thereafter, members of the Facility met with representatives of Universal and Universal was advised that the Facility staff did not have the authority to grant Universal’s request. It was also advised that the request would have to be presented to the Facility’s Board of Governors (“Board”) for consideration. The Board is comprised of executives from five insurance companies who are members of the Facility and four insurance agents appointed by the Commissioner of Insurance.

On 24 June 1987, the Board met and Universal’s request was heard. At the conclusion of Universal’s presentation and after discussion and deliberation, the Board unanimously voted: “(i) to deny the request for retroactive change in the allocation method and retroactive increase in the ceding expense allowance for the period October 1, 1986 through September 30, 1987; and (ii) to defer action on the request with respect to the period October 1, 1985 through September 30, 1986.”

*44 On 26 August 1987, the Board met once again to consider Universal’s request for the period 1 October 1985 through 30 September 1986. The request was subsequently denied. Universal appealed this decision to the Commissioner of Insurance (“Commissioner”) by letters dated 22 September 1987 and 23 September 1987. The Commissioner thereafter appointed a hearing officer to review the action of the Board.

An order issued 6 January 1988 by the Commissioner through his designated hearing officer resulted in the disapproval of the action taken by the Board. Through petitions dated 8 February 1988 and 10 February 1988, both the Facility and Universal sought judicial review of the Commissioner’s order. Such review was requested of the Superior Court of Wake County.

Oral arguments on the matter were heard in superior court on 7 November 1988. On 5 December 1988, the Honorable B. Craig Ellis ruled in favor of the Facility and vacated the order of the Commissioner. Universal appealed in apt time.

By its first Assignment of Error, Universal contends that the trial court erred in vacating the order of the hearing officer. Universal argues that the order was entered pursuant to statutory authority and was supported by material and substantial evidence. We disagree.

G.S. sec. 150B-43, a part of the Administrative Procedure Act (“APA”), provides in part that

[a]ny person who is aggrieved by the final decision in a contested case, and who has exhausted all administrative remedies made available to him by statute or agency rule, is entitled to judicial review of the decision under this Article, unless adequate procedure for judicial review is provided by another statute, in which case the review shall be under such other statute.

The Department of Insurance is an “agency” subject to the provisions of APA, G.S. sec. 150B-2(1), and therefore the threshold question is whether “another statute” provides “adequate procedure for judicial review.” Our Supreme Court has held that adequate procedure for judicial review exists “only if the scope of review is equal to that under present Article 4 of G.S. Chapter 150A.” Effective 1 January 1986, G.S. Chapter 150A was recodified as G.S. Chapter 150B. Comr. of Insurance v. Rate Bureau, 300 N.C. *45 381, 395, 269 S.E.2d 547, 559, pet. reh’g denied, 301 N.C. 107, 273 S.E.2d 300 (1980).

Another statute, namely the Facility Act, provides guidance for judicial review of decisions made by the Insurance Commissioner. G.S. sec. 58-37-65(f) of the Facility Act provides that “[a]ll rulings or orders of the Commissioner . . . shall be subject to judicial review as approved by G.S. sec. 58-2-75.” G.S. sec. 58-2-75(a) provides that “[a]ny order or decision made, issued or executed by the Commissioner [of Insurance] . . . shall be subject to review in the Superior Court of Wake County on petition by any person aggrieved.” Such appeals shall be based upon the transcript of the record for a review of the findings of fact and errors of law only. Cases involving judicial review before a court other than the Wake County Superior Court, by statutory interpretation and implication extends the application of G.S. sec. 58-2-75 to higher appeals, particularly, appeals to this Court. See State Farm Mutual Automobile Ins. Co. v. Com’r of Insurance, 288 N.C. 381, 218 S.E.2d 364 (1975).

G.S. sec. 58-2-75(c) is somewhat limited in that it merely provides that “[t]he trial judge shall have jurisdiction to affirm or to set aside the order or decision of the Commissioner and to restrain the enforcement thereof.” We find this provision to be virtually identical to the broader review set forth in G.S! sec. 150B-51(b). The standard of review set forth in G.S. sec. 150B-51 has come to be known as the “whole record” test and provides that

the [trial] court reviewing a final decision may affirm the decision of the agency or remand the case for further proceedings. It may also reverse or modify the agency’s decision if the substantial rights of the petitioners may have been prejudiced because the agency findings, inferences, conclusions, or decisions are:

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Bluebook (online)
390 S.E.2d 176, 98 N.C. App. 41, 1990 N.C. App. LEXIS 303, Counsel Stack Legal Research, https://law.counselstack.com/opinion/north-carolina-reinsurance-facility-v-long-ncctapp-1990.