Sheet Metal Contractors of Iowa v. Commissioner of Insurance of the State

427 N.W.2d 859, 1988 Iowa Sup. LEXIS 187, 1988 WL 74427
CourtSupreme Court of Iowa
DecidedJuly 20, 1988
Docket87-101
StatusPublished
Cited by10 cases

This text of 427 N.W.2d 859 (Sheet Metal Contractors of Iowa v. Commissioner of Insurance of the State) is published on Counsel Stack Legal Research, covering Supreme Court of Iowa primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Sheet Metal Contractors of Iowa v. Commissioner of Insurance of the State, 427 N.W.2d 859, 1988 Iowa Sup. LEXIS 187, 1988 WL 74427 (iowa 1988).

Opinion

CARTER, Justice.

This appeal involves the April 1, 1986, order of the Iowa Commissioner of Insurance, approving a proposed increase in workers’ compensation insurance premiums. After the district court affirmed the commissioner’s order, the issue was reviewed by the court of appeals. That court found that the commissioner’s failure to approve the proposed premium increase within the fifteen-day time period specified in Iowa Code section 515A.6(7)(e) (1985) rendered his subsequent action invalid. It therefore reversed the judgment of the district court.

We granted further review of the decision of the court of appeals. Review of the entire record and the arguments presented convinces us that the commissioner’s determination should be upheld notwithstanding his failure to strictly adhere to the statutory procedural scheme. We therefore vacate the judgment of the court of appeals and affirm the judgment of the district court.

The National Council on Compensation Insurance (NCCI) collects statistical data on behalf of approximately 200 member and subscriber insurance carriers writing workers’ compensation insurance, analyzes that data on a continuing basis, and acts as agent for its members and subscribers in presenting'requests for premium changes to the proper state regulatory authorities. It carries out these activities in Iowa and thirty-one other states. On November 18, 1985, NCCI submitted a proposed workers’ compensation insurance premium rate filing to the Iowa Commissioner of Insurance (the agency). That filing proposed a 25.2% increase in premium levels effective February 1, 1986.

On December 4, 1985, the agency published the proposed rate filing in the Iowa Administrative Bulletin as required by Iowa Code section 515A.6(7)(a) (1985). On December 31, 1985, and January 2, 1986, respectively, petitioners, Sheet Metal Contractors of Iowa and National Federation of Independent Business (the objectors), filed a demand for hearing on the rate filing as provided by Iowa Code section *861 515A.6(7). As a result, the agency entered an order on January 10, 1986, setting a public hearing for January 22, 1986, and postponing the effective date of the rate filing pending the hearing and resulting decision. On January 17, 1986, the order setting hearing was expanded so as to provide, in part, as follows:

The hearing in this matter is informal in nature and is not a contested case within the meaning of Iowa Code ch. 17A. The hearing will be conducted without cross-examination or extensive use of witnesses....
After presentation of statements and evidence on January 22, 1986, the record in this matter will be left open for a reasonable period of time....
The order in this matter will either approve or disapprove, without modification, NCCI’s rate filing.

On January 22, 1986, a public hearing was held on the rate filing. In addition to presenting statistical evidence on premium-loss ratios deemed to support its request for a premium increase, 1 NCCI presented testimony at the hearing from William Van Ark, an actuary working for that organization in the central region of the United States, and Philip Borba, an economist who specializes in workers’ compensation issues. The general conclusions espoused by these witnesses were that, based on the most current data available, projected loss experience and projected costs of processing claims for the period which the rate filing covered justified the proposed premium increases. These witnesses noted that, although the proposed premium increases were large when compared with 1984 levels, the proposals would place the standard premiums only 7.9% above 1979 premium levels. Premium reductions, since 1979, had, they suggested, produced some losses. They stated, however, that their calculations were entirely prospective, utilizing past losses as a guide for predicting future losses.

Sharelle Moranville and Gregory Kohn testified for the objectors at the hearing. Although purporting to testify as experts in the workers’ compensation field, their precise qualifications are not set forth in the hearing transcript. Ms. Moranville opined that the NCCI projected data was flawed due to the fact that figures reported tó NCCI by its members and subscribers were accepted at face value without being audited at the source. She also indicated that NCCI misclassified losses among the various subgroups of premium payors. Mr. Kohn testified that the projections improperly failed to consider subrogation recoveries, investment income, and coordination offsets of benefits. He also indicated his belief that unfavorable premium-loss ratios were in part due to abnormal variations in the industrial economy.

At the conclusion of the hearing, the commissioner questioned Mr. Van Ark as follows:

Q. Companies really aren't required to report to you the basis for their claims increases or any data related to those claims increases that might tell you why they are occurring, is that correct? A. Really not. We do have a study in a few states called the Detail Claims Study that attempts to answer such questions in terms other than claim frequency. Why is claims size changing? That study has not been implemented in Iowa, and I don’t think there would be much light there for us.
Q. Where in the filing do you reflect that large claims increase that’s being experienced? A. It would be an Exhibit 1-A and 1-B in the total claims that are being reported to us. In Exhibit 1-A, lines 6 and 12 are the amounts of medical and indeminity benefit costs that have been reported to us; and even with the adjustments downward for the anticipated favorable development of the reserve levels, we still wind up with a cost ratio *862 substantially above what we would like to see.
Q. Okay. I see those summarized, but do you have documentation supporting that in the appendices? A. We have documentation supporting all the adjustments factors. The actual numbers themselves, that’s all that we have put in the filing.
Q. For lines 6 and 12 there would be the data supporting the claims increase that’s being experienced? A. Other than on that line, that would be it.
Q. So basically — I don’t want to misspeak here, but the filing is based — this substantial increase, would it be fair to say is based upon a significant increase in claims, but you have not given me data to show or support these figures in Exhibit 1-A and 1-B? A. Well, we certainly could give you data to support those figures. The data as we collect it, as I discussed earlier, calls for financial data which are sent to us by our several hundred members in Iowa. We go through the validation process, as I mentioned earlier, to remove as many errors as possible from the data and give data of high quality, and we compile it in the computer. The results then show up in the filing as the numbers that are in Exhibit 1. We certainly could give you more detail than you see there at your pleasure, depending on what you would like to see.

The statutory hearing procedures on approval of proposed workers’ compensation insurance premium adjustments provide:

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427 N.W.2d 859, 1988 Iowa Sup. LEXIS 187, 1988 WL 74427, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sheet-metal-contractors-of-iowa-v-commissioner-of-insurance-of-the-state-iowa-1988.