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

478 S.E.2d 794, 124 N.C. App. 674
CourtCourt of Appeals of North Carolina
DecidedDecember 17, 1996
DocketCOA95-641
StatusPublished
Cited by10 cases

This text of 478 S.E.2d 794 (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, 478 S.E.2d 794, 124 N.C. App. 674 (N.C. Ct. App. 1996).

Opinions

McGEE, Judge.

On 1 February 1994, the North Carolina Rate Bureau (Bureau) filed a general request for increased rates for private passenger automobiles and motorcycles. The rate increase requested an increase of 10.8% for automobile rates and 22.4% for motorcycle rates. The Commissioner held a comprehensive hearing during the summer of 1994. The filing request was more than 1,500 pages in length; there were an additional 800 pages of responses by the Bureau to the Commissioner’s requests for data to explain the filing; the hearing transcript is more than 3,500 pages in length and the evidence included more than 120 exhibits. The Commissioner’s lengthy order of more than 500 pages, including calculations and exhibits, disapproved the Bureau’s filing and ordered rate changes reducing rates for automobiles by 13.8% and increasing rates for motorcycles by 10.2%. The Bureau appealed from this order and brought forward 13 [678]*678assignments of error based on more than 40 pages of exceptions to various findings of fact, conclusions of law and exhibits.

I. STANDARDS OF REVIEW

A. Appellate Court Review

In reviewing orders of the Insurance Commissioner, the test is whether the Commissioner’s conclusions of law are supported by material and substantial evidence in light of the whole record. State ex rel. Comr. of Insurance v. N.C. Rate Bureau, 75 N.C. App. 201, 208, 331 S.E.2d 124, 131, disc. review denied, 314 N.C. 547, 335 S.E.2d 319 (1985). “The whole record test requires the reviewing court to consider the record evidence supporting the Commissioner’s order, to also consider the record evidence contradicting the Commissioner’s findings, and to determine if the Commissioner’s decision had a rational basis in the material and substantial evidence offered.” Id. Substantial evidence is “such relevant evidence as a reasonable mind might accept as adequate to support a conclusion.” Comr. of Insurance v. Automobile Rate Office, 287 N.C. 192, 205, 214 S.E.2d 98, 106 (1975). It is “more than a scintilla or a permissible inference.” Id. (quoting Utilities Commission v. Trucking Company, 223 N.C. 687, 690, 28 S.E.2d 201, 203 (1943)).

While this Court employs the “whole record” test in reviewing the Commissioner’s orders, “it is not our function to substitute our judgment for that of the Commissioner when the evidence is conflicting.” State ex rel. Comr. of Insurance v. N.C. Rate Bureau, 96 N.C. App. 220, 221, 385 S.E.2d 510, 511 (1989). The weight and sufficiency of the evidence as well as the credibility of the witnesses are determined by the Commissioner. Id.

B. Review by the Insurance Commissioner

An order or decision of the Insurance Commissioner regarding premium rates is presumed to be correct if it is supported by substantial evidence. N.C. Gen. Stat. § 58-2-80. “Upon any appeal, the rates fixed or any rule, regulation, finding, determination, or order made by the Commissioner under the provisions of Articles 1 through 64 of this Chapter shall be prima facie correct.” N.C. Gen. Stat. § 58-2-90(e).

The Commissioner’s order regarding a rate filing must comply with the standards set forth in N.C. Gen. Stat. § 58-36-10:

(1) Rates shall not be excessive, inadequate or unfairly discriminatory.
[679]*679(2) Due consideration shall be given to actual loss and expense experience within this State for the most recent three-year period for which such information is available; to prospective loss and expense experience within this State; to the hazards of conflagration and catastrophe; to a reasonable margin for underwriting profit and to contingencies; to dividends, savings, or unabsorbed premium deposits allowed or returned by insurers to their policyholders, members, or subscribers; to investment income earned or realized by insurers from their unearned premium, loss, and loss expense reserve funds generated from business within this State; to past and prospective expenses specially applicable to this State; and to all other relevant factors within this State: Provided, however, that countrywide expense and loss experience and other countrywide data may be considered only where credible North Carolina experience or data is not available.

N.C. Gen. Stat. § 58-36-70(d) regarding rate filings and hearings for motor vehicle insurance states, in part:

If the Commissioner after the hearing finds that the filing does not comply with the provisions of this Article, he may issue an order disapproving the filing, determining in what respect the filing is improper, and specifying the appropriate rate level or levels that may be used by the members of the Bureau instead of the rate level or levels proposed by the Bureau filing, unless there has not been data admitted into evidence in the hearing that is sufficiently credible for arriving at the appropriate rate level or levels.

“In reaching his ultimate determination, the Commissioner must make findings which clearly and specifically indicate the facts on which he bases his order, the resolution of conflicting evidence, and the consideration he has given to the material and substantial evidence that has been offered.” State ex rel. Comr. of Insurance v. N.C. Rate Bureau, 95 N.C. App. 157, 159, 381 S.E.2d 801, 803 (1989). This requires the Commissioner to be mathematically specific as to his findings of fact. Comr. of Insurance v. Rate Bureau, 300 N.C. 381, 456, 269 S.E.2d 547, 592, reh’g denied, 301 N.C. 107, 273 S.E.2d 300 (1980).

II. DIVIDENDS AND DEVIATIONS

The Bureau contends the Commissioner exceeded his statutory authority and entered an order which is unsupported by material and [680]*680substantial evidence when he ignored the requirements set forth in G.S. 58-36-10 by failing to give “due consideration” to dividends and deviations in ruling on this rate request. Particularly, the Bureau argues the Commissioner determined the aggregate losses, expenses and an appropriate profit; he then calculated and used underwriting profit provisions without any adjustment in the ratemaking formula for dividends and deviations. In so doing, the Bureau contends the Commissioner “camouflage [d] his continuing refusal to adhere to the requirement of the law that the rates reflect the effects of dividends and deviations” by devoting almost half of his order to an examination of the issue of dividends and deviations, but ultimately concluding that our current system of ratemaking already includes, within the average rate, a provision for dividends and deviations.

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Bluebook (online)
478 S.E.2d 794, 124 N.C. App. 674, Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-ex-rel-commissioner-of-insurance-v-north-carolina-rate-bureau-ncctapp-1996.