State Ex Rel. Commissioner of Insurance v. North Carolina Rate Bureau

269 S.E.2d 602, 300 N.C. 485, 1980 N.C. LEXIS 1124
Supreme Court of North Carolina·Decided July 15, 1980·No. 74·Published·Cited by 6 cases

Opinion

*487 CARLTON, Justice.

I.

On 12 October 1978 the North Carolina Rate Bureau, on its own behalf and on behalf of its member companies writing workers’ compensation insurance in North Carolina, filed with the North Carolina Commissioner of Insurance a proposed revised premium rate schedule for workers’ compensation insurance. The filing also involved a proposed change in rating and miscellaneous values. The filing stated that statistical information substantiated the need for an average increase of 19.8°/o in the overall level of workers’ compensation insurance rates and rating values presently enforced.

The Commissioner filed notice of public hearing on 14 November 1978 contending that the filing failed to comply with statutory and other requirements and was otherwise incomplete in a number of respects. After the hearing, the Commissioner made extensive findings of fact and conclusions of law and disapproved the filing in its entirety. From the Commissioner’s disapproval order, the Rate Bureau appealed to the North Carolina Court of Appeals. That court, Judge Clark writing, vacated the Commissioner’s order. Judge Arnold dissented on the limited ground that, in his view, there was substantial evidence to support the Commissioner’s conclusion that unaudited data was not reliable. Chief Judge Morris, not a member of the panel in this case, concurred for the purpose of clarifying the holding of the Court of Appeals in that court’s opinion in State ex rel. Commissioner of Insurance v. North Carolina Rate Bureau, 41 N.C. App. 310, 255 S.E. 2d 557, affirmed in part and reversed in part by our Case No. 85 filed today, pertaining to investment income on invested capital as a factor to be considered in ratemaking. Judge Erwin, who had dissented in an earlier opinion reversing the Commissioner’s conclusion that unaudited data was not reliable, 44 N.C. App. 75, 259 S.E. 2d 926 (1979), filed a concurring opinion in the instant case stating that he found a “marked distinction compelling the vacating of the order in the instant case which did not appear of record” in the earlier case. 44 N.C. App. at 209, 261 S.E. 2d at 682.

While Judge Arnold’s dissent was limited only to one question, in light of widespread public interest and the importance of *488 the issues here raised to the people of North Carolina, we exercise our supervisory and discretionary power and review all assignments of error and arguments presented to the Court of Appeals. As in the other three insurance ratemaking decisions we file today, in light of the magnitude of error in the Commissioner’s order, we agree with the conclusion of the Court of Appeals that the order must be voided. We also order the filing approved and order the escrowed premium funds representing this proposed increase remitted to the member insurers pursuant to G.S. 58424.22(b).

Other facts important to an understanding of our decision are noted below.

II.

The Court of Appeals held that the Commissioner erred as a matter of law in concluding that unaudited data submitted in a filing of this nature is not reliable. We affirm. This portion of our decision is controlled by Section II. of our decision in Case No. 85 filed today.

III.

The Commissioner found and concluded that underwriting profit should be reduced by an amount for theoretical investment income on unearned premium reserves and loss reserves. We disagree. This portion of our holding is controlled by Section V. A. of our opinion in Case No. 85 filed today.

IV.

The Court of Appeals held that the Commissioner erred in concluding that investment income on invested capital should be considered in a ratemaking hearing of this nature. We affirm. This portion of our decision is controlled by Section IV. of our opinion in Case No. 85 filed today.

V.

The Commissioner’s conclusion of law No. 19 provided:

That the determination of underwriting profit margins should be calculated in accord with contemporary concepts of risk and return as understood in financial theory, specifically the capital asset pricing model as testified to by expert *489 witness Dr. William Bishop Fairley and detailed in the attached appendix the use of which theory and methodology in insurance rate-making has been upheld by the Supreme Judicial Court of Massachusetts.

We reverse. This portion of our decision is controlled by Section V.in our opinion in Case No. 85 filed today.

VI.

Appellees here argued before the Court of Appeals that the Commissioner erred in admitting into evidence the testimony of Dr. William Fairley at a prior unrelated hearing concerning automobile insurance rates. We have discussed this argument in Section VII. of our opinion in State ex rel. Commissioner of Insurance v. North Carolina Rate Bureau, Case No. 54, filed today and reaffirm that portion of our holding.

VII.

Appellees raise again on this appeal the question whether the burden of proof in a ratemaking hearing has been shifted to the Commissioner by virtue of changes made by the 1977 Legislature. We reaffirm our holding in Section VI. of our opinion in Case No. 85 filed today. The burden of proof, as that term is ordinarily understood in civil litigation, rests with the Rate Bureau in a ratemaking hearing of this nature.

VIII.

We next turn to the sole question presented on this appeal not presented in one of our three other insurance ratemaking decisions handed down today. In his findings of fact, the Commissioner stated:

10. That the expense allowance in the rate-making formula is based solely on the expense experience of stock companies.
11. That stock companies have greater expenses than other companies.
12. That using the expense experience of stock companies purportedly allows a margin for other companies to pay dividends.
13. That there has been no study conducted to determine the extent of a correlation, if any, between stock company ex *490 penses and non-stock company dividends or whether the non-stock companies paid dividends during the period upon which the filing is based.
14. That the proposed rates are excessive due to basing the expense allowance in the rate-making formula solely on the expense experience of stock companies.

Based on the foregoing findings of fact, the Commissioner concluded as a matter of law, “That the proposed rates are excessive due to basing the expense allowance in the rate-making formula solely on the expense experience of stock companies when stock companies have greater expenses than other companies.”

The Commissioner correctly argues that the record establishes that expenses for the operation of stock companies exceed that of mutual companies.

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State Ex Rel. Commissioner of Insurance v. North Carolina Rate Bureau, 269 S.E.2d 602, 300 N.C. 485, 1980 N.C. LEXIS 1124 (N.C. 1980).

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