Sandy River Nursing Care v. Aetna Casualty

985 F.2d 1138, 1993 U.S. App. LEXIS 3077, 1993 WL 43743
CourtCourt of Appeals for the First Circuit
DecidedFebruary 25, 1993
Docket92-1856
StatusPublished
Cited by20 cases

This text of 985 F.2d 1138 (Sandy River Nursing Care v. Aetna Casualty) is published on Counsel Stack Legal Research, covering Court of Appeals for the First Circuit 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 v. Aetna Casualty, 985 F.2d 1138, 1993 U.S. App. LEXIS 3077, 1993 WL 43743 (1st Cir. 1993).

Opinion

COFFIN, Senior Circuit Judge.

Plaintiffs are a group of Maine employers who claim that the defendant insurance companies illegally conspired to fix prices and conduct a boycott in a successful effort to coerce the state legislature into permitting higher rates for workers’ compensation insurance. 1 The district court granted summary judgment for defendants based on the doctrines established in Parker v. Brown, 317 U.S. 341, 63 S.Ct. 307, 87 L.Ed. 315 (1943), and Eastern R.R. Presidents Conference v. Noerr Motor Freight, 365 U.S. 127, 81 S.Ct. 523, 5 L.Ed.2d 464 (1961). 2 798 F.Supp. 810. The court concluded that plaintiffs’ claimed damage — the additional cost of their insurance — was attributable to the legislation rather than to the alleged conspiracy, and that, consequently, federal antitrust laws provide no relief.

On appeal, plaintiffs contend that the court erred both in construing their claims and in immunizing defendants’ actions. After carefully reviewing the record and pertinent caselaw, we conclude that the district court properly granted summary judgment for defendants. Although we depart somewhat from the court’s analysis— finding that the alleged conspiracy constituted a per se violation of the Sherman Act, 15 U.S.C. § 1 — we affirm the court’s holding that the Parker doctrine bars plaintiffs’ requested relief. 3

I. 4

Workers’ compensation insurance has long been an extremely sensitive issue in Maine. Regulation is strict. All employers who do not self-insure are required to purchase such insurance. Insurers are “required by Maine Law to charge only those *1140 rates for workers’ compensation insurance which have been filed with, and approved by, the Maine Superintendent of Insurance in conformance with Maine Law.” Complt. ¶ 32. The businesses and the insurers both have been dissatisfied with the system.

At least since 1981, NCCI and its members have taken affirmative steps to challenge the allowable rates as unfairly low. They have sought review of the Superintendent’s r#te decisions in court, see, e.g., 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), and consistently have lobbied for legislation that would reduce statutory benefits and permit insurers to charge higher rates. Neither their litigation nor lobbying proved successful during the period relevant to this litigation.

Indeed, to the contrary, the Maine legislature in 1985 enacted the “Workers’ Compensation Competitive Rating Act,” which directed that workers’ compensation insurance rates be rolled back at least 8% and frozen at that level until 1987. Me.Rev. Stat.Ann. tit. 24-A, §§ 2331-2357 (1985) (repealed). Under the Act, insurers were prohibited from requesting rate increases exceeding 10% in 1987, 1988 and 1989. Id. at § 2355. In addition, the 1985 Act declared that it was intended, inter alia:

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

Id. at § 2332.

The insurers challenged the 1985 act in court. Although the Maine Superior Court determined that the rate ceilings were so low that 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 (Sup.Ct. May 14, 1987) (Alexander, J.), appeal dismissed, 538 A.2d 759 (Me.1988) (dismissed as moot because 1987 legislation repealed 1985 Act).

In this lawsuit, plaintiffs assert that defendants, unable to achieve their goals legally, resorted to improper means. Plaintiffs contend that defendants allegedly conspired to fix prices at a higher-than-lawful rate and to conduct a boycott of the Maine workers’ compensation market to induce legislation authorizing rate increases. As early as 1986, plaintiffs claim, defendants jointly began refusing to insure employers voluntarily, requiring them to obtain workers’ compensation coverage through the “residual” or “involuntary” system. Every insurer authorized to write workers’ compensation policies in Maine is required by state law to participate in the “involuntary market” and, thus, to share the underwriting responsibility for employers otherwise unable to obtain coverage. 5 The conspirators allegedly increased the pressure on the Maine legislature to act when, between late summer and October 1987, virtually all workers’ compensation insurers in Maine prepared to withdraw from the state.

To avert the crisis that would occur if all workers’ compensation insurers left, Governor John McKernan convened a special session of the legislature devoted exclusively to reviewing and reforming Maine’s workers’ compensation system. In short order, the legislature approved the “Workers’ Compensation Rating Act” (deleting the word “competitive” that had been in the title of the 1985 Act), Me.Rev.St.Ann. tit. 24-A, §§ 2361-2374 (West 1990 and 1992 Supp.). The 1987 Act removed the limitations on rate increases contained in the 1985 Act. It authorized NCCI to act as agent for its member insurance companies by submitting joint rate proposals on their behalf to the Superintendent of Insurance, who is the ultimate decisionmaker on the rates insurers may charge. Insurers are *1141 permitted, however, to deviate below the rate approved by the Superintendent.

In 1988, 1989 and 1990, the insurers collectively applied for rates beyond the limits allowed in the 1985 Act. Each year, the Superintendent rejected the requested rate increases, but authorized lower increases that still exceeded the 10% caps set by the 1985 legislation. Plaintiffs contend that, as part of the insurers’ continuing price-fixing conspiracy, defendants unlawfully agreed to charge only the maximum rates allowed by the Superintendent.

Through this lawsuit, plaintiffs seek recovery of damages in the amount of the increased premiums they have paid since the 1987 Act was passed and defendants began charging higher rates. The district court concluded that this relief was barred because the alleged harm was directly traceable to the 1987 legislation and the approval of rate increases by the Maine Superintendent of Insurance.

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Bluebook (online)
985 F.2d 1138, 1993 U.S. App. LEXIS 3077, 1993 WL 43743, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sandy-river-nursing-care-v-aetna-casualty-ca1-1993.