McCarthy Finance, Inc. v. Premera
182 Wash. 2d 936
| Wash. | 2015Background
- Washington health insurance premiums are approved by the OIC under RCW 48.44; courts apply the filed rate doctrine to bar reevaluation of agency-approved rates.
- The doctrine allows consideration of claims incidental to rates but bars damages requiring the court to reassess the reasonableness of approved rates.
- Policyholders allege CPA violations by Premera and WAHIT based on deceptive practices related to premiums and surplus, seeking damages tied to the rate reasonableness.
- Plaintiffs request two specific damages: a refund of excess premium payments and a refund of excessive surplus to subscribers.
- Trial court dismissed all claims under filed rate, primary jurisdiction, and exhaustion doctrines; Court of Appeals partially reversed.
- The Court held that awarding the two specified damages would require reevaluating agency-approved rates, thus the claims are barred by the filed rate doctrine.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether CPA claims are barred by the filed rate doctrine. | Policyholders argue CPA claims are not barred if damages relate to deceptive practices. | Premera/WAHIT contend damages would require reevaluating OIC-approved rates, which is barred. | Yes; damages would require reevaluating rates, so barred. |
| Whether the CPA claims can proceed under theories not requiring rate reevaluation. | Policyholders claim some damages are recoverable independent of rate reasonableness. | Court would still be evaluating rate reasonableness via the claimed damages. | Not applicable as framed; the two specific damages requested are barred. |
Key Cases Cited
- Tenore v. AT&T Wireless Servs., 136 Wn.2d 322 (1998) (filed-rate doctrine; limits on challenging agency-approved rates)
- Panag v. Farmers Ins. Co. of Wash., 166 Wn.2d 27 (2009) (liberal CPA construction; harms and remedies considerations)
- Indoor Billboard/Wash., Inc. v. Integra Telecom of Wash., Inc., 162 Wn.2d 59 (2007) (CPA interpretation; limits on exemptions from CPA)
- Vogt v. Seattle-First Nat'l Bank, 117 Wn.2d 541 (1991) (CPA applicability; statutory design in governance)
- In re Real Estate Brokerage Antitrust Litig., 95 Wn.2d 297 (1980) (CPA exceptions; alternatives to direct rate challenges)
- Wegoland, Ltd. v. NYNEX Corp., 806 F. Supp. 1112 (S.D.N.Y. 1992) (origin of filed rate doctrine; purpose and scope)