State ex rel. Commissioner of Insurance v. North Carolina Fire Insurance Rating Bureau

234 S.E.2d 720, 292 N.C. 471, 1977 N.C. LEXIS 1133
Supreme Court of North Carolina·Decided May 10, 1977·No. No. 13·Published·Cited by 25 cases

Opinion

LAKE, Justice.

In fairness to the Court of Appeals and to the Commissioner of Insurance, it should be observed that at the times of their respective decisions in this matter neither had the benefit of recent decisions of this Court which are largely determinative of matters here involved. Commissioner of Insurance v. Rating Bureau, 292 N.C. 70, 231 S.E. 2d 882 (1977) ; State ex rel. Commissioner of Insurance v. Automobile Rate Administrative Office, 292 N.C. 1, 231 S.E. 2d 867 (1977) ; and Commissioner of Insurance v. Rating Bureau, 291 N.C. 55, 229 S.E. 2d 268 (1976).

The Bureau was created by G;S. 58-125 and was organized pursuant to G.S. 58-127 by the insurance companies writing fire insurance in North Carolina. The Bureau is not a State agency. It is composed of and controlled by these companies. It acts for them in the establishment of premium rates. It files proposed rates with the Commissioner for his approval. G.S. [480]*48058-131.1. “For rate making1 purposes, the Bureau is to be regarded as if it were the only insurance company operating in North Carolina and as if it had an earned premium experience, an incurred loss experience and an operating experience equivalent to the composite of those of the companies actually in operation.” In re Filing by Fire Insurance Rating Bureau, 275 N.C. 15, 32, 165 S.E. 2d 207 (1968).

The Commissioner has no inherent power to fix premium rates. His authority is confined to that conferred upon him by the General Assembly in Chapter 58 of the General Statutes. Commissioner of Insurance v. Automobile Rate Office, 287 N.C. 192, 214 S.E. 2d 98 (1973) ; In re Filing by Fire Insurance Rating Bureau, supra.

G.S. 58-131.1 provides:

“No rating method, schedule, classification, underwriting rule, bylaw, or regulation shall become effective or be applied by the Rating Bureau until it shall have been first submitted to and approved by the Commissioner. * * * Every rating method, schedule, classification, underwriting rule, bylaw or regulation submitted to the Commissioner for approval shall be deemed approved, if not disapproved by him in writing within 60 days after submission.” (Emphasis added.)

In Commissioner of Insurance v. Rating Bureau, 292 N.C. 70, 231 S.E. 2d 882 (1977), we said:

“Operation of the ‘deemer’ provision can be averted only by the approval or disapproval of the Commissioner within 60 days. * * *
“In establishing the rate-making procedures, the Legislature provided three methods by which the Commissioner may dispose of proposed rate changes, to wit: (1) He may approve the proposed rate adjustment; (2) he may disapprove it; or (3) he may do neither for 60 days and the proposal is thereupon deemed approved. G.S. 58-131.1. To avoid the automatic operation of the deemer provision, the Commissioner must approve or disapprove the proposal in writing within 60 days after submission. Approval or disapproval necessarily contemplates action by the Commissioner, and a public hearing is required prior to such action upon a proposed material rate change. G.S. 58-27.2 (a). * * *
[481]*481“[W]e find no merit in the contention of the Commissioner that his action in setting a hearing date tolled the running of the 60-day period.”

Thus, the Court of Appeals erred in its conclusion that the “deemer provision” of G.S. 58-131.1 did not cause the premium rate changes proposed in the filing to take effect on 8 December 1975.

In the case last cited, we also said:

“Since the ‘deemer’ provision operates in conjunction with the hearing provisions, it cannot stand alone as a final resolution of the proposal. Final resolution comes only after a valid approval or disapproval by the Commissioner. We hold, therefore, that where, as here, the deemer provision is triggered by failure of the Commissioner to validly approve or disapprove a proposed rate adjustment, it operates only as a temporary approval pending valid action by the Commissioner as contemplated by G.S. 58-27.1 (c) and G.S. 58-27.2 (a) . Thus, in the present case, the Bureau is lawfully entitled to place the proposed rates into effect, prospectively, under the deemer provision until such time as a valid final order is entered by the Commissioner— either in this proceeding or in a subsequent filing.” (Emphasis added.)

Chapter 58 of the General Statutes contains no provision comparable to G.S. 62-134 (b) whereby the Utilities Commission is authorized to set for hearing a proposed rate increase by a public utility and to suspend such proposed rates pending such hearing, nor does it contain a provision comparable to G.S. 62-135 whereby a public utility, notwithstanding such suspension, may put its proposed rate increase into effect by filing a bond to assure refund of the collected increase to the extent that it may ultimately be disallowed. The insurance rate-making procedure is, however, somewhat analagous to the provision in G.S. 62-134 (b) which limits the authority of the Utilities Commission to suspend a proposed increase in rates, pending hearing, to a period of 270 days and which provides that if the hearing has not been concluded and an order made within such period, “the proposed change of rate shall go into effect at the end of such period” and further provides that “after hearing, whether completed before or after the rate goes into effect, the Commission may make such order with respect [482]*482thereto as would be proper in a proceeding instituted after it had become effective.”

In the silence of Chapter 58 of the General Statutes upon this aspect of insurance premium rate regulation, we conclude: (1) Notwithstanding the Commissioner’s having set the filing for hearing, the action of the Bureau in putting the proposed premium rates into effect on 8 October 1975, more than 60 days after the submission of the filing, was lawful. (2) Such proposed rates thereupon became as effective as if they had been formally approved by the Commissioner and their ■ subsequent collection, pending further action by the Commissioner, was lawful. (3) The premium rates, so made effective by the operation of the “deemer provision,” continue in effect until disapproved, in whole or in part, by an order of the Commissioner issued pursuant to the authority granted him by Chapter 58 of the General Statutes, or until otherwise changed pursuant to such chapter. (4) Premiums lawfully collected, pursuant to such filing, are not subject to refund, even though the filing be subsequently disapproved by the Commissioner. (5) The taking effect of the filing, pursuant to the “deemer provision,” does not abort the hearing previously ordered by the Commissioner. (6) At such hearing, the Commissioner may proceed as if the “deémer provision” had not put the filing into effect and, upon the conclusion of the hearing, he may issue such order as would have been within his authority had the filing not taken effect pursuant to the “deemer provision.” (7) Such order of the Commissioner, otherwise valid, may approve or may disapprove the filing in whole or in part. (8) Such disapproval takes effect from the date of the order but is not retroactive and so does not render unlawful the collection of premiums made prior thereto so as to require, or authorize the requirement of, a refund thereof.

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State ex rel. Commissioner of Insurance v. North Carolina Fire Insurance Rating Bureau, 234 S.E.2d 720, 292 N.C. 471, 1977 N.C. LEXIS 1133 (N.C. 1977).

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