Prudential Insurance Co. of America v. Insurance Commissioner

293 A.2d 529, 1972 Me. LEXIS 315
CourtSupreme Judicial Court of Maine
DecidedJuly 13, 1972
StatusPublished
Cited by10 cases

This text of 293 A.2d 529 (Prudential Insurance Co. of America v. Insurance Commissioner) is published on Counsel Stack Legal Research, covering Supreme Judicial Court of Maine primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Prudential Insurance Co. of America v. Insurance Commissioner, 293 A.2d 529, 1972 Me. LEXIS 315 (Me. 1972).

Opinion

WEATHERBEE, Justice.

In 1969 the Legislature enacted P.L.1969, Chap. 374 which has become 24 — A M.R.S. A. § 4751 and was added as one additional section to our statutes concerning insurance. The new section 4751, which became effective October 1, 1969, reads:

“Strikes of insurance agents
§ 4751. Life, noncancellable health, hospital expense and hospital and surgi *531 cal expense insurance contracts; default in payment of premium during strike of insurance agents

1. Default. No contract of life, non-cancellable health, hospital expense or hospital and surgical expense, insurance which goes into effect in this State on or after the 30th day after January 2, 1970 shall lapse during any 30-day period immediately following the inception of a strike by reason of any default in the payment of any premium during a strike of insurance agents employed by an insurer authorized to transact business in this State, if

A. The collection of the contract premium was, at commencement of the strike, a duty, charge or obligation of any of such agents, according to the records, books, instructions, practice or organization of the insurer, and
B. Such agents are represented for purposes of collective bargaining by a labor organization which has been so recognized or certified or has been a party to any collective bargaining agreement with the insurer.

2. Definitions. For the purpose of this section:

A. Lapse. ‘Lapse’ shall mean lapse, be terminated or in any way modified or qualified as to the obligations of the insurer and the right of the insured.
B. Premium. ‘Premium’ shall mean premium, interest, assessment or any other payment or charge for or in connection with the insurance which would be due to the insurer under the insurance contract during the strike of agents, except for the operation of this section.
C. Strike. ‘Strike’ shall mean strike or other concerted stoppage of work by employees, including a stoppage by reason of the expiration of a collective bargaining agreement, so long as any of the foregoing is authorized by the labor organization according to the labor organization’s own interpretation and application of its applicable internal rules and procedures.
3. Claims. If a claim under any insurance contract covered by this section arises during a 30-day period immediately following the inception of a strike, the insurer may deduct from any amounts payable on account of the claim any premiums which are thus in default.
4. Notice. Within 10 days from the inception of a strike, notice of same containing instructions to make payment of premiums by mail shall be mailed to each affected insured by the insurer.”

The Plaintiff is engaged in the business of life insurance and health and accident insurance in Maine, as well as in every other state. It submitted to the Defendant, who is the Insurance Commissioner of the State of Maine, for his review and approval 1 an Endorsement Form for attachment to its policies issued for delivery in the State of Maine on or after February 1, 1970. The Defendant Commissioner disapproved of the proposed Endorsement Form on the ground that it did not comply with section 4751.

Following a hearing which the Plaintiff had requested, 2 the Defendant issued an order affirming his prior refusal. 3 The effect of the order was to prohibit the Plaintiff from using the proposed Form.

The Plaintiff then filed a complaint in the Superior Court of Kennebec County seeking a review of the Defendant’s order, a determination that section 4751 is unconstitutional and a ruling that the Plaintiff’s proposed Form complies with Maine law.

By stipulation of the parties the action was then reported to this Court on the *532 complaint, answer and exhibits. An Agreed Statement of Facts accompanied the Report. Because of the industry-wide interest in the issue, we received briefs from the John Hancock Mutual Life Insurance Company, the Boston Mutual Life Insurance Company, the Life Insurance Association of America and the Insurance Workers International Union, AFL-CIO.

While the proposed Form did not comply with section 4751, 4 the Plaintiff takes the position that section 4751 is unconstitutional and invalid because 1) it is not a proper exercise of the police power and it impinges upon free collective bargaining relationships in an area preempted by the National Labor Relations Act in violation of the Supremacy Clause of the Constitution of the United States and 2) it interferes with Plaintiff’s freedom to engage in a lawful business on sound actuarial principles and is so vague and indefinite that it deprives the Plaintiff of liberty and property without due process of law.

In order to fully appreciate the operation of the new section upon the Plaintiff’s conduct of its business we must review some of the agreed essential principles underlying the insurance business and the agreed facts as to the Plaintiff’s operating situation and practices as of the time of oral argument.

The principle of insurance is the spreading of the consequences of a loss over the entire group whose premium payments, with returns from investments, create a common fund from which losses are paid. The lifeblood of the insurance industry is, of course, the timely payment of premiums.

The amount of the premium charged to each insured is calculated with reference to his life expectancy and class, the benefits promised and the risks covered by his particular policy, the assumed rate of return on the insurer’s investments of premium funds and the assumed amount of applicable expenses, all calculated in the light of statistical data reflecting actual past experience and with regard to predictable future experience.

It is an agreed principle of pooling insurance risks that the premium must be paid by the insured in advance of the period for which insurance is provided because of the tendency of some persons who have incurred no loss to deny later that coverage was intended. Advance payment of premiums protects the common fund to make it available for payment of current expenses and benefits without a need to liquidate long-term investments at loss.

Plaintiff must conduct its business in accordance with such principles and the losses which might result from the operation of section 4751 are not calculable with accuracy.

It is agreed that the Plaintiff is engaged and intends to continue to be engaged in issuing individual life, noncancellable health, hospital expense and hospital and surgical expense policies. It is the practice of the Plaintiff that the premiums on a substantial part of these policies are collected by its debit agents at the residences or places of employment of the insureds.

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Cite This Page — Counsel Stack

Bluebook (online)
293 A.2d 529, 1972 Me. LEXIS 315, Counsel Stack Legal Research, https://law.counselstack.com/opinion/prudential-insurance-co-of-america-v-insurance-commissioner-me-1972.