Robbins v. Insurance Department
11 A.3d 1048
Pa. Commw. Ct.2010Background
- Robbins petitions for review of an Insurance Commissioner decision affirming the Department that USAA's refusal to write an automobile policy for Robbins did not violate Act 68.
- USAA is a membership insurer that writes policies through the Pennsylvania Assigned Risk Plan; non-members are not eligible on the voluntary market.
- In 1991 the Assigned Risk Plan assigned Ms. Mendels to USAA; in 1994 she added Robbins as a named insured after marriage; Robbins paid premiums for over ten years under that arrangement.
- In 2008 Robbins and Mendels separated; USAA removed Robbins from Mendels' policy, because USAA does not insure a non-resident spouse; no new policy was issued to Robbins.
- The Department and Commissioner concluded there was no cancellation or termination of a policy; instead USAA declined to issue a new policy to Robbins, appropriately treated as a refusal to write.
- Robbins argued about the admissibility of evidence by a non-PA-licensed representative, and various interpretations of Act 68; the court found waiver of evidentiary objections and upheld the agency determinations.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Waiver of objection to evidence | Robbins argues Joy's evidence was improperly admitted because he wasn't licensed PA counsel. | Commissioner properly found waiver due to no timely objection at hearing. | Waiver upheld; no reversible error on this point. |
| Act 68 applicability to a refusal to write | USAA’s action was a refusal to write in a context of long-standing coverage via an assigned-risk policy. | This is a refusal to write, not a cancellation/termination; Act 68 provisions on cancellation/termination do not apply. | Act 68 does not apply to this refusal to write; decision upheld. |
| Eligibility under Act 68 | Petitioner should be eligible due to marriage, long-term coverage, and status as named insured. | Petitioner was not eligible for USAA membership; Act 68 allows refusals for non-prohibited reasons. | USAA's refusal based on membership eligibility was permissible under Act 68. |
Key Cases Cited
- Beitler v. Department of Transportation, 811 A.2d 30 (Pa. Cmwlth. 2002) (regulates insurer conduct in cancellation/termination contexts under Act 68)
- Seidman v. Insurance Commissioner of Commonwealth, 532 A.2d 917 (Pa. Cmwlth. 1987) (fact-finder credibility; substantial evidence standard)
- Novak v. Pennsylvania Insurance Department, 106 Pa. Cmwlth. 232 (1987) (agency review framework; substantial evidence standard)
- Goods v. Pennsylvania Board of Probation and Parole, 912 A.2d 226 (Pa. 2006) (administrative tribunal error correction remains the norm)
- McKay v. Workmen's Compensation Appeal Board (Osmolinski), 688 A.2d 259 (Pa. Cmwlth. 1997) (issues not raised are waived)