Stone & Edwards Insurance Agency, Inc. v. Department of Insurance

636 A.2d 293, 686 A.2d 293, 161 Pa. Commw. 177
CourtCommonwealth Court of Pennsylvania
DecidedJanuary 3, 1994
Docket216, 317 M.D. 1992
StatusPublished

This text of 636 A.2d 293 (Stone & Edwards Insurance Agency, Inc. v. Department of Insurance) is published on Counsel Stack Legal Research, covering Commonwealth Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Stone & Edwards Insurance Agency, Inc. v. Department of Insurance, 636 A.2d 293, 686 A.2d 293, 161 Pa. Commw. 177 (Pa. Ct. App. 1994).

Opinions

PELLEGRINI, Judge.

Before this court are cross-motions for summary judgment questioning whether the Unfair Insurance Practices Act (UIPA)1 is unconstitutional because it permits commingling of prosecutorial and adjudicative functions in the office of Insurance Commissioner (Commissioner), and whether the Insurance Department’s (Department) placing of administrative “holds” on an agent’s applications is improper.

I.

Stone & Edwards Insurance Agency, Inc. (Stone & Edwards) is a licensed corporation authorized to sell insurance2 within the Commonwealth. Both Emerson Lightner and Gary Lightner (collectively, with Stone & Edwards, Petitioners) are licensed agents affiliated with Stone & Edwards.3

In February, 1988, the Department began investigating allegations of insurance law violations made against the Petitioners. As a result of the investigation, the Department determined $107,000 in premiums collected by Stone & Edwards to be unlawful, and in the summer of 1990, demanded [182]*182that restitution be made. Stone & Edwards denied any impropriety and refused.

The Department, through the Deputy Insurance Commissioner for Consumer Service Enforcement and Program Services (Deputy Commissioner-Enforcement), commenced an enforcement action, P-91-10-35 (enforcement proceeding), seeking to have the existing licenses of Gary and Emerson Lightner revoked. The Lightners answered and requested a hearing. The Office of Hearing Appeals then appointed a hearing officer to take testimony and make a recommendation to the Commissioner pursuant to 31 Pa.Code § 56.1 and 1 Pa.Code §§ 35.123, 35.187.

While their investigation into Petitioners’ business practices was ongoing but before the enforcement proceeding was instituted by the Department, two insurance companies, Colony Life Insurance Company (Colony) and Aetna Life Insurance & Annuity Company (Aetna) applied to have Emerson Lightner licensed as their agent.4 The Department advised both Aetna and Colony that no new licenses would be issued for Emerson Lightner until the investigation of Stone & Edwards was resolved. No notice, however, of the “holds” on license applications was given to Emerson Lightner.

The day after the Department commenced the enforcement proceeding, it lifted the “hold” and denied the Colony and Aetna applications to have Emerson Lightner appointed their agent. The reason for this denial was that the Department considered Emerson Lightner to be “unworthy” for additional licenses based upon the underlying facts of the enforcement proceeding. Emerson Lightner appealed the denial (P92-0306 (license appeal)). Because the issues in the two proceedings were similar, the Insurance Commissioner appointed the same hearing officer to hear the license appeal and the proceedings were consolidated for hearing. On October 16, [183]*1831992, the Department placed “holds” on any new license applications by either Gary or Emerson Lightner and Stone & Edwards pending disposition of the enforcement proceeding.5

Before any hearings were held on the enforcement proceeding and license appeal, Petitioners filed two petitions for review. The first was a complaint for declaratory judgment and request for injunctive relief (No. 216 M.D.1992) seeking to have Section 506 of the Administrative Code of 19296 and Section 102(a) of the Administrative Agency Law7 declared unconstitutional because facially, those provisions permit an impermissible commingling of prosecutorial and adjudicative functions within the Insurance Department.8 The second petition (No. 317 M.D.1992) sought to have Sections 7, 8 and 9 of UIPA declared unconstitutional also for impermissible commingling, as well as seeking a mandamus to have the Department issue the “held” licenses.9

[184]*184Following the Department’s answers and the close of the pleadings, both parties filed motions for summary judgment,10 agreeing that the disposition of this matter turns strictly on questions of law.11 The cross-motion presents two general issues: 1) whether a statute which on its face vests both prosecutorial and adjudicative functions is unconstitutional because it purportedly permits impermissible commingling; and 2) whether the Department’s holding of Petitioners’ license applications pending the outcome of the enforcement action against Petitioners is unlawful.

II.

Article I, Sections 1, 9 and 11 of the Pennsylvania Constitution12 give to the people of Pennsylvania the right to due process guaranteeing those appearing in any judicial or [185]*185administrative tribunal the right to a fair and impartial hearing. While the rights protected under those Articles and the rights guaranteed under the Fourteenth Amendment are substantially coextensive, the Pennsylvania due process rights are more expansive in that, unlike under the Fourteenth Amendment, a violation of due process occurs, even if no prejudice is shown, when the same entity or individual participates in both the prosecutorial and adjudicatory aspects of a proceeding. Compare Lyness v. State Board of Medical Examiners, 529 Pa. 535, 605 A.2d 1204 (1992) with Withrow v. Larkin, 421 U.S. 35, 95 S.Ct. 1456, 43 L.Ed.2d 712 (1975). Petitioners contend that their right to a fair hearing under the Pennsylvania Constitution is being denied because of the appearance of impermissible commingling by the purported vesting by UIPA of prosecutorial and adjudicatory functions to investigate unlawful insurance practices in the Insurance Commissioner.

Impermissible commingling exists within an administrative agency when the prosecutorial and administrative functions are not adequately separated. Lyness, supra; Dussia v. Barger, 466 Pa. 152, 351 A.2d 667 (1975). Due process rights not only can be violated when there is actual commingling, but even when an appearance that commingling of functions may have taken place within the agency exists. As our Supreme Court stated in Lyness:

Whether or not actual bias existed as a result of the board acting as both prosecutor and judge is inconsequential; the potential bias and the appearance of non-objectivity is sufficient to create a fatal defect under the Pennsylvania Constitution.

Id. 529 Pa. at 548, 605 A.2d at 1210 (citations omitted). See also Copeland v. Township of Newtown, 147 Pa.Commonwealth Ct. 463, 608 A.2d 601 (1992). However, a single administrative agency may exercise both prosecutorial and adjudicative functions if “walls of division” are constructed within an agency that clearly separates those two functions. [186]*186Lyness, 529 Pa. at 546, 605 A.2d at 1209.13

The “walls of division” necessary to prevent commingling appears to have been breached by Sections 7,14 815

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

Related

Withrow v. Larkin
421 U.S. 35 (Supreme Court, 1975)
Dussia v. Barger
351 A.2d 667 (Supreme Court of Pennsylvania, 1975)
Equitable Gas Co. v. City of Pittsburgh
488 A.2d 270 (Supreme Court of Pennsylvania, 1985)
Georgia-Pacific Corp. v. City of Reading Commission on Human Relations
585 A.2d 1166 (Commonwealth Court of Pennsylvania, 1991)
Roth v. Borough of Verona
519 A.2d 537 (Commonwealth Court of Pennsylvania, 1986)
Bunch v. BD. OF AUCTIONEER EXAMINERS
620 A.2d 578 (Commonwealth Court of Pennsylvania, 1993)
Copeland v. Township of Newtown
608 A.2d 601 (Commonwealth Court of Pennsylvania, 1992)
Replogle v. COM., PA. LIQUOR CONT. BD.
523 A.2d 327 (Supreme Court of Pennsylvania, 1987)
McNeal v. City of Easton
598 A.2d 638 (Commonwealth Court of Pennsylvania, 1991)
Fumo v. Commonwealth, Insurance Department
427 A.2d 1259 (Commonwealth Court of Pennsylvania, 1981)
Cooper v. State Board of Medicine
623 A.2d 433 (Commonwealth Court of Pennsylvania, 1993)
Marinari v. DEPT. OF ENV. RESOURCES
566 A.2d 385 (Commonwealth Court of Pennsylvania, 1989)
Pennsylvania Dental Ass'n v. Commonwealth Insurance Department
516 A.2d 647 (Supreme Court of Pennsylvania, 1986)
Lyness v. Com., State Bd. of Medicine
605 A.2d 1204 (Supreme Court of Pennsylvania, 1992)
Sweeney v. Tucker
375 A.2d 698 (Supreme Court of Pennsylvania, 1977)
Pittenger v. Department of State, Bureau of Professional & Occupational Affairs
596 A.2d 1227 (Commonwealth Court of Pennsylvania, 1991)
Commonwealth v. Thompson
281 A.2d 856 (Supreme Court of Pennsylvania, 1971)

Cite This Page — Counsel Stack

Bluebook (online)
636 A.2d 293, 686 A.2d 293, 161 Pa. Commw. 177, Counsel Stack Legal Research, https://law.counselstack.com/opinion/stone-edwards-insurance-agency-inc-v-department-of-insurance-pacommwct-1994.