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

255 S.E.2d 557, 41 N.C. App. 310, 1979 N.C. App. LEXIS 2644
CourtCourt of Appeals of North Carolina
DecidedJune 5, 1979
Docket7810INS625
StatusPublished
Cited by4 cases

This text of 255 S.E.2d 557 (State Ex Rel. Commissioner of Insurance v. North Carolina Rate Bureau) is published on Counsel Stack Legal Research, covering Court of Appeals of North Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
State Ex Rel. Commissioner of Insurance v. North Carolina Rate Bureau, 255 S.E.2d 557, 41 N.C. App. 310, 1979 N.C. App. LEXIS 2644 (N.C. Ct. App. 1979).

Opinions

ARNOLD, Judge.

We note with disapproval that counsel for the Bureau has failed to comply with the requirements of App. R. 10(b)(1): “Each exception shall be set out immediately following the record of judicial action to which it is addressed.” App. R. 10(a) makes clear that exceptions not so set out in the record cannot be made the bases of assignments of error. The necessity for this rule is most obvious in cases such as the one before us, which involves a 442-page record. It is an unnecessary waste of judicial time, and a source of possibly ineffective review, to require this Court to guess at the parts of the record to which the appellant objects.

Nevertheless, in view of the impact of the insurance rate-making process upon the citizens of the State, we have in our discretion considered this appeal on its merits.

Commissioner complied with requirements of G.S. 58-124.21(a)

The Bureau argues that the Commissioner failed to comply with the statutory requirement that in his order disapproving a filing he indicate “wherein and to what extent such filing is deemed to be improper.” G.S. 58-124.21(a). We disagree. The Commissioner in his order set out 99 findings of fact and 32 conclusions of law, detailing the improprieties he found in the filing, and we find that these are sufficient compliance with the statute. Nor do we find merit in the Bureau’s argument that the enactment of G.S. [313]*31358-124.21 has transferred the burden of proof to the Commissioner. There is no burden upon the Commissioner to disprove the filing. The burden upon him is that of being certain that material and substantial evidence exists in the record to support his findings.

G.S. 58424.21(a) provides in part that when a filing is made “the Commissioner may give written notice to the Bureau specifying in what respect and to what extent he contends, such filing fails to comply” with the law. As correctly contended by the Bureau, the purpose of this provision is to provide the Bureau a reasonable opportunity to prepare and offer evidence, and to prevent surprise at the hearing.

In his notice of hearing the Commissioner set forth several items, but he did not disclose that he intended to challenge the data as unreliable because it was unaudited. For this reason, the Bureau argues, the Commissioner failed to comply with the statute, and his findings and conclusions concerning the unreliability of data should be set aside.

The filing does not indicate whether the data had been audited. Assuming the Commissioner knew that the data would be unaudited, fairness in the rate-making process would require him to disclose his objections and intention to challenge the data. This Court, however, cannot assume that which is not supported by the record. Nowhere in the filing does it appear that the data was unaudited. The Commissioner complied with the requirements of G.S. 58424.21(a).

Material and substantial evidence supports the Commissioner’s holding that data is unreliable.

The Commissioner found as fact that none of the underlying loss or expense experience upon which the filing was based had been audited; that in past unaudited filings, errors had later been found; that the accuracy of projections, here, rate level changes, depends upon the accuracy of the underlying data; and that unaudited data are not reliable as a basis for making projections. The Bureau argues that the Commissioner erred in holding the data unreliable.

The standard for review of the Commissioner’s decisions is set out in G.S. 58-9.6(b). If the “substantial rights” of the ap[314]*314pellants have been prejudiced, this Court may reverse or modify the Commissioner’s “findings, inferences, conclusions or decisions” where they are “[unsupported by material and substantial evidence in view of the entire record as submitted.” G.S. 58-9.6(b)(5). “Substantial evidence has been described as such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” State ex rel. Comr. of Insurance v. Automobile Rate Office, 287 N.C. 192, 205, 214 S.E. 2d 98, 106 (1975).

The record contains the testimony of Byron Tatum, Director of Technical Operations for the North Carolina Department of Insurance. Tatum is a certified public accountant, responsible for the audits, examinations and admissions of insurance companies in North Carolina; he qualified at the hearing as an expert in accounting and financial reporting. Tatum testified in pertinent part:

“[A]n audit is an examination not only of the document but the source data from which the document was prepared. . . . The idea is if you do enough of these things . . . you can then say . . . this report is properly prepared and properly . . . shows what it is supposed to show.
Q. In your opinion are unaudited reports accurate and reliable?
A. No, ma’am. Unaudited reports cannot be relied upon.
Q. All right, in your opinion, then, would an unaudited statement or report be an appropriate basis on which to base future projections?
A. No, ma’am.
Q. Why?
A. Well, it gets back to the same old basis of, has it been examined. In . . . my experience with Price-Waterhouse making projections, we were never allowed to make projections on unaudited financial statements. . . . The purpose of an audit is to add the credibility to the figures that they lack when they are prepared by management or company accountants.

[315]*315Also appearing in the record is the testimony of George Gallant, an employee of Insurance Services Office (ISO), which collects insurance statistics from member companies and summarizes the information for the Bureau.

Q. . . . [D]oes ISO send auditors into any of these companies that report data to it to check their figures?
A. We do not have ... an auditing team ... to go out to a company, no, we do not. I think we are relying on your Insurance Department examiners ....
Q. All right, you said . . . when this data comes in that it is edited?
A. Yes.
Q. Would you please explain to me the difference between editing and auditing data?
A. I would be hard put to describe it. . . . [Editing ... is reviewing the data for reasonableness, say, accuracy of codes.

Mr. Robert Brooks, an employee of the National Association of Independent Insurers (NÁII), which also collects and summarizes insurance statistics, testified:

... As each individual report is received it is logged in and entered into the computer. The . . . part that we would consider edit is that which is checked by the computer, which is to prepare totals and make sure the records are readable, verify the territory . . . and . . . numerical codes. From that is . . ..prepared audit lists that individual auditors go over looking for reasonableness between classes, distribution of data and the average rates. . . .
NAII has approximately thirty people in the audit division. They are not mostly CPA’s. They are basically people that we háve trained ... to review this information so that you can determine whether the material is logical and reasonable.

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Related

In Re Redmond Ex Rel. Nichols
369 N.C. 490 (Supreme Court of North Carolina, 2017)
State Ex Rel. Commissioner of Insurance v. North Carolina Rate Bureau
269 S.E.2d 602 (Supreme Court of North Carolina, 1980)
State ex rel. Commissioner of Insurance v. North Carolina Rate Bureau
261 S.E.2d 671 (Court of Appeals of North Carolina, 1979)

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255 S.E.2d 557, 41 N.C. App. 310, 1979 N.C. App. LEXIS 2644, Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-ex-rel-commissioner-of-insurance-v-north-carolina-rate-bureau-ncctapp-1979.