Southwest Professional Indemnity Corporation, Perry H. Peterson and Edward G. Fisch v. Texas Department of Insurance

914 S.W.2d 256, 1996 Tex. App. LEXIS 144, 1996 WL 13977
CourtCourt of Appeals of Texas
DecidedJanuary 17, 1996
Docket03-95-00295-CV
StatusPublished
Cited by6 cases

This text of 914 S.W.2d 256 (Southwest Professional Indemnity Corporation, Perry H. Peterson and Edward G. Fisch v. Texas Department of Insurance) is published on Counsel Stack Legal Research, covering Court of Appeals of Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Southwest Professional Indemnity Corporation, Perry H. Peterson and Edward G. Fisch v. Texas Department of Insurance, 914 S.W.2d 256, 1996 Tex. App. LEXIS 144, 1996 WL 13977 (Tex. Ct. App. 1996).

Opinion

BE A ANN SMITH, Justice.

The Board of Insurance 1 affirmed an emergency order directing Southwest Professional Indemnity Corporation to cease and desist from engaging with other named parties in the unauthorized business of insurance, unfair methods of competition, and in deceptive acts or practices in the business of insurance. The insurance company and two of its shareholders (“SPIC”) sought judicial review of the Board’s order, which the trial court affirmed in all respects.

SPIC, organized in the Grand Cayman Islands, insists that it is not subject to regulation by the Board because it conducted all of its insurance business entirely outside the state. In fifteen points of error it argues that there is not substantial evidence to support the Board’s finding that SPIC engaged in the business of insurance in Texas or that it does not qualify for any exemption from regulation; consequently, the Board’s order exceeds its statutory authority, is overly broad or vague, arbitrary and capricious, and impermissibly interferes with SPIC’s constitutional rights to enter contracts and do business. SPIC also claims that the order was issued in violation of numerous constitutional protections. Because we find substantial evidence to support the Board’s finding that SPIC engaged in the business of insurance in Texas and did not qualify for any statutory exemptions, and because the issuance of the order was constitutionally sound, we will overrule all of SPIC’s points of error and affirm the trial court’s judgment.

BACKGROUND

In 1980 twenty-eight podiatrists, all residents of Texas licensed to practice in this state, formed their own company to provide medical malpractice liability insurance. These doctors formed SPIC in the hopes of better controlling the price of their premiums and their settlements. SPIC was organized as a Grand Caymans corporation, with three resident shareholders holding common stock valued at $1 per share. Each Texas podiatrist owns at least ten shares of preferred stock valued at $3000 per share and as a shareholder is entitled but not required to purchase insurance. Only preferred shareholders who purchase insurance are entitled to vote at the annual meeting in the Cayman Islands.

The president and secretary of SPIC are residents of the Cayman Islands and employees of a trust company that charges SPIC for its management services. SPIC shares the office and telephone of its trust company; it has no other employees or agents and pays no commissions.

*260 SPIC does not solicit business in the traditional manner; potential insureds learn of its product from shareholders at seminars and meetings, many of which occur in Texas. New podiatrists are invited to become shareholders and thus to become eligible to purchase insurance.

Policy premiums are set at the annual meeting held in the Cayman Islands. Originally SPIC’s secretary sent a premium notice from the Cayman Islands to the Texas address of the doctor who would in turn mail payment back to the Cayman Islands address. After 1987, SPIC began to send invoices to the Texas address listing the three ranges of coverage and their corresponding premium prices. The Texas doctor elected the desired level of coverage and returned the invoice with a check in the appropriate amount; the SPIC secretary would then forward a Declaration Page from the policy to the Texas address of the insured. SPIC hired a Texas attorney to adjust and resolve or defend claims made by Texas patients against the Texas doctors.

SPIC does not hold a certificate of authority to engage in the business of insurance in Texas and has not filed with the Department of Insurance a notice of any claimed exemption to regulation. SPIC has not paid premium taxes to the Department on most of the premiums received from its podiatrists.

In 1991 the Commissioner of Insurance became aware of facts that led him to believe that SPIC was engaged in the unauthorized practice of insurance. The Commissioner issued an ex parte cease and desist order against SPIC and four other parties, as authorized by the Insurance Code (the 1991 order, Commissioner’s Order No. 91-1344, dated September 11, 1991). See Tex.Ins. Code Ann. art. 1.10A, § 2 (West Supp.1996). At the hearing granted by article 1.10A, section 3, SPIC contested the cease and desist order, insisting that the Commissioner relied on misinformation that erroneously connected SPIC with International Bahamian Insurance Company, which had failed to pay claims to Texas patients. SPIC also argued that it conducted its insurance business entirely outside the state and thus was not subject to regulation. After the hearing, relying on stipulations entered by the parties, the Commissioner affirmed the cease and desist order, entering findings of fact and conclusions of law (the 1992 order, Commissioner’s Order No. 92-0602, dated June 22, 1992). SPIC appealed the Commissioner’s order to the Board. Tex.Ins.Code Ann. art. 1.04(d) (West 1981). For the first time Drs. Peterson and Fiseh sought to be granted party status as shareholders; their request was denied at a prehearing conference. After a September 1992 hearing, the Board modified the cease and desist order to make it clear that the company could continue to pay claims, and otherwise affirmed the Commissioner’s two previous orders (the 1993 order of the Board No. 60153, dated January 27,1993).

SUBSTANTIAL EVIDENCE

Standard of Review

SPIC brings eight points of error maintaining that the Board’s order is arbitrary and capricious and its underlying findings are not supported by substantial evidence. See Administrative Procedure Act (APA), Tex.Gov’t Code Ann. § 2001.174(2)(E), (F) (West 1996). Agency decisions that are not supported by substantial evidence are deemed arbitrary and capricious. Public Util. Comm’n v. Gulf States Utils. Co., 809 S.W.2d 201, 211 (Tex.1991).

In conducting a substantial-evidence review, we must first determine whether the evidence as a whole is such that reasonable minds could have reached the conclusion the agency must have reached in order to take the disputed action. Texas State Bd. of Dental Examiners v. Sizemore, 759 S.W.2d 114, 116 (Tex.1988), cert. denied, 490 U.S. 1080, 109 S.Ct. 2100, 104 L.Ed.2d 662 (1989); Texas Health Facilities Comm’n v. Charter Medical-Dallas, Inc., 665 S.W.2d 446, 453 (Tex.1984). We may not substitute our judgment for that of the agency and may consider only the record on which the agency based its decision. Sizemore, 759 S.W.2d at 116.

The agency’s findings, inferences and conclusions are presumed to be sup *261 ported by substantial evidence, and the appealing party bears the burden of showing a lack of substantial evidence. Charter Medical, 665 S.W.2d at 453. Appellant cannot meet this burden merely by showing that the evidence preponderates against the agency decision.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Cite This Page — Counsel Stack

Bluebook (online)
914 S.W.2d 256, 1996 Tex. App. LEXIS 144, 1996 WL 13977, Counsel Stack Legal Research, https://law.counselstack.com/opinion/southwest-professional-indemnity-corporation-perry-h-peterson-and-edward-texapp-1996.