Prudential Property & Casualty Insurance v. Department of Insurance

595 A.2d 649, 141 Pa. Commw. 156, 1991 Pa. Commw. LEXIS 713
CourtCommonwealth Court of Pennsylvania
DecidedJuly 10, 1991
Docket2368 C.D. 1990
StatusPublished
Cited by17 cases

This text of 595 A.2d 649 (Prudential Property & Casualty Insurance v. Department of Insurance) is published on Counsel Stack Legal Research, covering Commonwealth Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Prudential Property & Casualty Insurance v. Department of Insurance, 595 A.2d 649, 141 Pa. Commw. 156, 1991 Pa. Commw. LEXIS 713 (Pa. Ct. App. 1991).

Opinion

SMITH, Judge.

Prudential Property and Casualty Insurance Company (PRUPAC) and Prudential General Insurance Company (PRUGEN) (collectively, Prudential) petitions for review of an order of the Insurance Commissioner (Commissioner) denying Prudential’s request for extraordinary circumstances relief from the private passenger automobile insurance rate reductions mandated by the Act of February 7, 1990, P.L. 11 (Act 6), which amended certain provisions of Titles 18, 42, and 75 of the Pennsylvania Consolidated Statutes. Prudential filed its request for relief pursuant to 75 Pa.C.S. § 1799.7(b)(3), which provides that an insurer aggrieved by the rate rollbacks mandated by Act 6 may seek relief from the Commissioner who is empowered to grant relief if he or she deems the same necessary in extraordinary circumstances. The Commissioner’s order is vacated, and this matter is remanded for further proceedings consistent with this opinion.

I

Act 6 was enacted by the General Assembly in an effort to contain and reduce the rapidly escalating costs of auto *161 mobile insurance coverage in the Commonwealth and especially in the City of Philadelphia. See Keystone Insurance Co. v. Foster, 732 F.Supp. 36 (E.D.Pa.1990). While the provisions of Act 6 are extensive, the principle cost reduction features are set forth in its amendments to the Motor Vehicle Financial Responsibility Law, 75 Pa.C.S. §§ 1701-1799.7, and in particular Section 1799.7 which requires a rate reduction for an insured choosing a “full tort option” (as described in 75 Pa.C.S. § 1705) of 10% from the applicable premium, and a rate reduction for an insured choosing a “limited tort option” (as described in 75 Pa.C.S. § 1705) of 22% from the applicable premium. The limited tort option is known also as the “verbal threshold.” Section 1799.7 requires that all insurers file new private passenger motor vehicle rates reflecting the aforesaid rate reductions by May 1, 1990, which new rates shall become effective on July 1, 1990. Other significant provisions of Act 6 include a ceiling on medical costs, peer review of medical charges, increased protections against insurance fraud, and a lowered minimum first-party coverage from $10,000 to $5,000.

Prudential submitted timely filings to the Pennsylvania Insurance Department (Department) as required by Section 1799.7, reducing its rates by 10.8% for full tort electors and by 22.8% for limited tort electors, the additional reductions owing to Prudential’s use of next dollar rounding. Thereafter, on June 28, 1990, Prudential submitted to the Department a filing for extraordinary circumstances relief pursuant to Section 1799.7(b)(3), which states:

An insurer aggrieved by the rate reductions mandated by this subsection [which concern the aforesaid 10% and 22% rollbacks] may seek relief from the commissioner, which relief may be granted when the commissioner deems necessary in extraordinary circumstances.

Prudential’s filing for relief was based, at least in part, upon information issued by the Department that insurers making less than a 12% after-tax rate of return on statutory surplus would be eligible for relief under Section 1799.-7(b)(3); and Prudential calculated that because of the man *162 datory rate reductions, its rate of return on surplus would fall below this threshold. O’Brien Direct, pp. 20-21. 1 Prudential requested an 8.6% rate increase. The Department denied Prudential’s relief request on July 27, 1990, finding that Prudential would achieve a rate of return on surplus in excess of 12% for the seventeen-month period between February 1, 1990 and June 30, 1991 based upon data supplied to the Department by Prudential. 2 Prudential sought review of the Department’s determination, and a referee’s hearing was held on September 12 and 13, 1990.

At the hearing, the prefiled direct testimony of the parties’ witnesses was submitted into evidence and the witnesses were subjected to cross-examination. Prudential presented the testimony of Robert M. O’Brien, its Director of Pricing; John P. Finn, a Prudential marketing manager and former claims manager; and Jerry W. Rapp, F.A.C.S., who is employed by an actuarial consulting firm. The *163 Department presented the testimony of James R. Neidermyer, an actuary employed by an insurance consulting firm. Finding from the evidence presented that PRUPAC would earn an after-tax rate of return of 14.25% on surplus and that PRUGEN would earn an after-tax rate of return of 17.31% on surplus, the Commissioner affirmed the .Department’s denial of Prudential’s request for extraordinary circumstances relief.

In its appeal to this Court, Prudential raises the following issues for this Court’s consideration:

1. Whether the methodology developed and used by the Commissioner to determine filings for extraordinary circumstances relief constitutes an unpublished regulation' because it establishes an inflexible mathematical standard which applies across-the-board to all insurers and which cannot be modified at hearing.
2. Whether the use of the period February [1990] — June [1991] constitutes retroactive ratemaking in violation of the Rate Act and [this] Court’s recent State Farm decision.
3. Whether the Commissioner erred as a matter of law in failing to accept necessary corrections to the Department’s denial of Prudential’s extraordinary circumstances request.
4. Whether the Commissioner’s wholesale adoption of the Department’s Act 6 cost saving analysis is contrary to law, not supported by substantial evidence and not credible.
5. Whether the Commissioner’s application of a ‘non-confiscatory’ standard for rate regulation, which is lower than a ‘fair and reasonable’ or ‘adequate’ standard, is constitutional.
6. Whether the procedures utilized by the Department at the hearing denied Prudential an opportunity for a fair hearing.

This Court’s scope of review of these issues is well circumscribed. This Court may not reverse or modify an agency *164 adjudication unless the adjudication violates constitutional rights, is not in accordance with agency procedure or with applicable law, or unless any finding of fact necessary to support the adjudication is not based upon substantial evidence. 2 Pa.C.S. § 704. An agency’s adjudication is not in accordance with law if it represents a manifest and flagrant abuse of discretion or a purely arbitrary execution of the agency’s duties or functions. Slawek v. State Board of Medical Education & Licensure, 526 Pa. 316, 586 A.2d 362 (1991). With these principles in mind, this Court shall review Prudential’s contentions.

II

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Bluebook (online)
595 A.2d 649, 141 Pa. Commw. 156, 1991 Pa. Commw. LEXIS 713, Counsel Stack Legal Research, https://law.counselstack.com/opinion/prudential-property-casualty-insurance-v-department-of-insurance-pacommwct-1991.