Sandy River Nursing Care Center v. National Council on Compensation Insurance

798 F. Supp. 810, 1992 U.S. Dist. LEXIS 11125
CourtDistrict Court, D. Maine
DecidedJune 18, 1992
DocketCiv. 91-0210-B
StatusPublished
Cited by2 cases

This text of 798 F. Supp. 810 (Sandy River Nursing Care Center v. National Council on Compensation Insurance) is published on Counsel Stack Legal Research, covering District Court, D. Maine primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Sandy River Nursing Care Center v. National Council on Compensation Insurance, 798 F. Supp. 810, 1992 U.S. Dist. LEXIS 11125 (D. Me. 1992).

Opinion

ORDER AND MEMORANDUM OF OPINION

BRODY, District Judge.

This antitrust action is before the Court on Defendants’ motion for summary judgment. The Plaintiffs allege that they were injured by workers’ compensation rate increases approved by the Maine Superintendent of Insurance after the Maine legislature enacted a law in 1987 permitting insurers to apply for rate hikes exceeding ceilings allowed under prior law. The Plaintiffs complain that the 1987 legislation was enacted because insurers successfully conspired to pressure the Maine legislature by threatening to withdraw from the workers’ compensation insurance market. The Plaintiffs seek to recover damages for the increased premiums they have paid since the 1987 legislation was passed and higher workers’ compensation insurance rates were approved. Plaintiffs acknowledge that the premiums charged by the insurers were lawful, at least insofar as they were authorized by the legislature and approved by the Superintendent of Insurance. Because federal antitrust laws generally neither prohibit private actors from collectively seeking favorable rate legislation from States nor provide relief to persons proximately injured by legislation passed by States, Defendants’ motion is GRANTED.

1. BACKGROUND

A. The Complaint

Thirteen Maine businesses filed this class action 1 on September 12, 1991, against the National Council on Compensation Insurance (“NCCI”), an insurance rating organization, and fourteen named insurance companies together with their subsidiaries and affiliates. 2 The Plaintiffs’ four count complaint alleges that “the defendants entered into a conspiracy to fix the price of workers’ compensation insurance sold in Maine *812 [Count I]; and to effectuate that conspiracy by acting and agreeing to boycott, coerce and intimidate Maine employers [Count II] and Maine insurers [Count III]” in violation of federal antitrust law. Plaintiffs’ Memorandum in Opposition to Defendants’ Joint Motion for Summary Judgment at 2. Count IV of the complaint, which the Plaintiffs discussed in neither of their memoranda nor at oral argument, charges that Defendants’ conduct violated Maine antitrust law as well.

Plaintiffs indicate that the true object of the suit is “Defendants’ private, unsupervised conspiracy to extract higher prices from Maine employers by utilizing their [i.e., Defendants’] collective economic power to ... coerce and intimidate ... the State of Maine.” Id. at 2-3. According to the Plaintiffs, “Defendants entered into the conspiracy ... with the objective of coercing the enactment of favorable legislation to permit these Defendants to charge the higher prices they had agreed upon.” Id. at 3.

B. Maine’s Workers’ Compensation Market

Workers’ compensation insurance has long been — and remains — an extremely sensitive political issue in Maine. Regulation is strict. All employers who do not self-insure are required to purchase workers’ compensation insurance. Insurers are “required by Maine law to charge only those rates for workers’ compensation insurance which have been filed with, and approved by, the Maine Superintendent of Insurance in conformance with Maine Law.” Cmplt. 1132.

Neither the insurers nor the insureds are happy with the regulatory regime. Businesses believe that rates are too high. Insurers believe that rates are too low. Consequently, workers’ compensation is a perennial political battleground.

According to the Plaintiffs, NCCI and the insurance industry’s dissatisfaction with the rates insurers were permitted to charge dates at least back to 1981. Plaintiffs' Memo at 5 (citing National Council on Compensation Ins. v. Superintendent of Ins., 481 A.2d 775 (Me.1984) (affirming Superintendent’s disapproval of a requested rate increase of 27.5%; NCCI had claimed that statistical evidence showed that a 110% increase was warranted)). NCCI and its members have consistently lobbied for legislation permitting them to charge higher rates and lowering statutory benefits. Between 1981 and 1985, their efforts were unsuccessful.

C. The 1985 Legislation

In 1985, the Maine legislature enacted the “Workers’ Compensation Competitive Rating Act,” 1985 Me.Laws Ch. 372 (“1985 Act”), rolling back workers’ compensation insurance rates 8% and freezing rates at that level until 1987. Under the 1985 Act, insurers were prohibited from requesting rate increases exceeding 10% in 1987, 1988, or 1989. 24-A M.R.S.A. § 2355 (1985). In addition, the 1985 Act declared that it was intended, inter alia:

1 ... To prohibit price fixing agreements and other anti-competitive behavior by insurers.
3 ... To promote price competition among insurers....

24-A M.R.S.A. § 2332 (1985).

The rate reduction and caps on future increases greatly displeased the insurance industry. The insurers attacked the 1985 Act in court, but their litigation efforts were no more successful than their lobby efforts. Although the Maine Superior Court determined that the rate ceilings were so low they were confiscatory, the court held that the ceilings were not unconstitutional because insurers were free to withdraw from the market for workers’ compensation insurance in Maine. National Council on Compensation Ins. v. Superintendent of Ins., CV-85-459 et seq. (Sup.Ct. May 14, 1987) (Alexander, J.), appeal dismissed, 538 A.2d 759 (Me.1988) (appeal dismissed as moot because legislation passed in November 1987 repealed 1985 Act).

According to the Plaintiffs, “beginning in the late summer of 1987 and continuing through October, 1987 ‘virtually all insur *813 ers in the Maine Workers’ Compensation Market’ ” prepared to withdraw from Maine. Plaintiffs’ Memo at 9 (quoting affidavit of Sidney St.F Thaxter, Exhibit A). Significantly injured, insurers responsible for writing over 90% of workers’ compensation in Maine filed plans for withdrawal from the state that were approved by the Superintendent of Insurance.

D. The 1987 Legislation

In the fall of 1987, facing a “potential crisis,” 1987 Me.Laws 2585, Governor John McKernan convened a special session of the legislature devoted exclusively to reviewing and reforming Maine’s workers’ compensation system. With the State’s attention focused on this issue, the legislature approved an Act to Improve the Maine Workers” Compensation System, 1987 Me. Laws Ch. 559 (“1987 Act”). The insurers recovered ground they had lost in 1985. The 1987 Act removed the limitations on rate increases contained in the 1985 Act. The 1987 Act also permitted NCCI to act as an agent for its members by submitting joint rate proposals on behalf of insurers, deemphasizing the role price competition played under the 1985 Act.

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Cite This Page — Counsel Stack

Bluebook (online)
798 F. Supp. 810, 1992 U.S. Dist. LEXIS 11125, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sandy-river-nursing-care-center-v-national-council-on-compensation-med-1992.