Paul W. Lightner v. Michael D. Riley, W.Va. Insurance Commissioner

760 S.E.2d 142, 233 W. Va. 573, 2014 WL 2565192, 2014 W. Va. LEXIS 629
CourtWest Virginia Supreme Court
DecidedJune 4, 2014
Docket12-0566
StatusPublished
Cited by5 cases

This text of 760 S.E.2d 142 (Paul W. Lightner v. Michael D. Riley, W.Va. Insurance Commissioner) is published on Counsel Stack Legal Research, covering West Virginia Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Paul W. Lightner v. Michael D. Riley, W.Va. Insurance Commissioner, 760 S.E.2d 142, 233 W. Va. 573, 2014 WL 2565192, 2014 W. Va. LEXIS 629 (W. Va. 2014).

Opinion

PER CURIAM:

This case is before the Court upon the appeal of Paul W. Lightner, Petitioner, from a March 26, 2012, order of the Circuit Court of Kanawha County affirming the decision of the West Virginia Insurance Commissioner (“Insurance Commissioner”), which found that the rates charged by Respondents, CitiFinancial and Triton Insurance Company, were reasonable. Herein, Lightner alleges that the circuit court erred in upholding the order of the Insurance Commissioner because it refused Lightner a hearing in violation of both State ex rel. CitiFinancial v. Madden, 223 W.Va. 229, 672 S.E.2d 365 (2008), and express statutory language requiring such a hearing, and because the Commissioner denied Lightner other due process rights as well. Additionally, Lightner asserts that the circuit court’s order shows a clear error of law, is clearly wrong, and was arbitrary and capricious because it presumed, unrebuttably, that the approved insurance rates were reasonable. Conversely, Respondent Insurance Commissioner 1 contends that the circuit court did not err in upholding its order denying a hearing because an administrative hearing would serve no useful purpose and Lightner did not have an automatic right to a hearing. Respondents CitiFinaneial and Triton assert that the circuit court properly concluded that the Insurance Commission’s handling of the rate issues raised in Lightner’s complaint met statutory, regulatory and constitutional standards. As set forth more fully below, we affirm the circuit court’s order.

I.

FACTUAL AND PROCEDURAL BACKGROUND

This is the second time this case has been before this Court. This matter originated in the Circuit Court of Marshall County, West Virginia in 2002 when CitiFinaneial instituted a civil action against Mr. Lightner following his default on a $6,500 loan. Lightner filed an amended counterclaim in January 2004 alleging that CitiFinaneial violated the finance charge provisions of the West Virginia Consumer Credit Protection Act, W. Va.Code § 46A-3-109 and § 46A-5-101 by charging unreasonable and excessive amounts for credit insurance for two other loans Lightner obtained from CitiFinaneial in 2001. In October 2006, Lightner sought to expand his claim for unreasonable and excessive credit insurance charges into a class action to include additional individuals who obtained loans from CitiFinaneial over a fourteen-year period.

The nature of the underlying dispute and the procedural history of this matter while it was pending in the Circuit Court of Marshall County are set forth in detail in State ex rel. CitiFinancial v. Madden, 223 W.Va. 229, 672 S.E.2d 365 (2008), wherein CitiFinaneial filed a writ of prohibition to prevent the circuit court from enforcing its denial of CitiFinancial’s motion for partial summary judgment. CitiFinaneial sought a dismissal of the claims pending against it, or alternatively, sought a stay of the underlying matter until the Insurance Commissioner made a determination regarding whether any of the credit insurance charges assessed by CitiFinaneial against Lightner were either excessive or unreasonable. This Court *576 granted CitiFinancial’s writ of prohibition and found in syllabus point 2 that,

[i]n providing for a cause of action that permits the recovery of excess charges included in a consumer credit transaction pursuant to the provisions of West Virginia Code § 46A-3-109 (1998) (Repl.Vol.2006) and § 46A-5-101 (1996) (Repl.Vol.2006), the Legislature did not authorize the circuit courts to invade the jurisdiction of the Insurance Commissioner and conduct a reexamination of insurance rates previously approved by the Commissioner.

Id., syl. pt. 2, 672 S.E.2d 365. In syllabus point 3, we held that,

[a]ny challenge to an approved insurance rate by an aggrieved person or organization should be raised pursuant to the provisions of West Virginia Code § 33 — 20—5(d) (1967) (Repl.Vol.2006) in a proceeding before the Insurance Commissioner.

Id., syl. pt. 3, 672 S.E.2d 365. Finally, in syllabus point 4, this Court stated that “[t]he presumption of statutory compliance for approved insurance rates set forth in West Virginia Code § 33-6-30(c) (2002) (Repl.Vol. 2006) may only be rebutted in a proceeding before the Insurance Commissioner.” Id., syl. pt. 4. 2

Subsequently, on or about September 29, 2009, Lightner filed a consumer complaint before the Insurance Commissioner against CitiFinancial and Triton. 3 The Complaint was filed on behalf of himself and other policyholders and challenged the rates for certain insurance products known as credit property insurance 4 and credit involuntary unemployment insurance. 5 The Complaint alleged that historically low loss ratios incurred by Triton as opposed to projections and filings were indicative of excessive rates and therefore in violation of the Insurance Code. 6 The Complaint also asserted that Triton was not forthcoming with relevant information provided in filings made to the Commissioner which should, in turn, cause the filings to be rejected. Lightner requested a hearing pursuant to W.Va.Code § 33-2-13 (1957), W.Va.Code § 33-20-5(d) (1967), and W.Va.C.S.R. § 114-13-1, et seq. (2003). Lightner also sought an order from the Commissioner withdrawing approval for the rate filings of Triton over a period of fourteen years.

By letter dated November 13, 2009, the Commissioner advised that he wanted to investigate the issues raised in the Complaint for a ninety day period after which the Commissioner would make the following decisions: (1) whether to appoint a hearing examiner to hear issues in the matter; (2) whether to intervene in the matter; and/or (3) whether to take a final position on poten *577 tially denying a hearing in the matter on the substantive issues.

The Commissioner then undertook an investigation and analysis of not only Lightner’s allegations, but all of Triton’s rate filings in West Virginia, pursuant to W.Va. Code § 33-2-3a (2007) and W.Va.Code § 33-2-9 (2006). During the Commissioner’s investigation, a data call was requested from Triton which resulted in the production of thousands of documents. During the course of the investigation, the Commissioner and representatives of Triton had discussions concerning the information supplied and the impact of the information on the Commissioner’s investigation. Lightner was likewise afforded the opportunity to provide additional information and argument in support of his position.

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760 S.E.2d 142, 233 W. Va. 573, 2014 WL 2565192, 2014 W. Va. LEXIS 629, Counsel Stack Legal Research, https://law.counselstack.com/opinion/paul-w-lightner-v-michael-d-riley-wva-insurance-commissioner-wva-2014.