ST. PAUL FIRE & MARINE INSURANCE COMPANY v. INSURANCE COMMISSIONER OF THE STATE OF MARYLAND ET AL.
No. 10 (Adv.), September Term, 1975.
Court of Appeals of Maryland
Decided June 2, 1975.
275 Md. 130
Thomas Waxter, Jr., and Norman P. Ramsey, with whom were Alan N. Gamse and Semmes, Bowen & Semmes on the brief, for appellant.
Francis B. Burch, Attorney General, and William J. Giacofci, Assistant Attorney General, with whom was Gerald Langbaum, Assistant Attorney General, on the brief, for Insurance Commissioner of the State of Maryland and John F. King, Frederick G. Savage and Anderson, Coe & King on the brief, for Hilbert M. Levine.
LEVINE, J., delivered the opinion of the Court. ELDRIDGE, J., dissents and filed a dissenting opinion at page 144 infra.
This appeal by St. Paul Fire & Marine Insurance Company (the company) is from an order of the Baltimore City Court (Liss, J.) affirming an order of the Insurance Commissioner of the State of Maryland (the commissioner), one of two appellees in this Court.
The order requires the company to “accept for renewal at currently applicable rates” the physicians’ and surgeons’
Following the oral argument on March 21, 1975, we issued a per curiam order in which, after concluding that the statutory basis for the orders passed by the commissioner and the court below —
The company, a “multi-line” insurance carrier operating throughout the United States and in other countries, is authorized to do business in Maryland by virtue of a certificate of authority issued by the commissioner. In the late 1930‘s or early 1940‘s, it became one of the first insurers to market what is commonly referred to as medical malpractice insurance. In 1960, it commenced a special relationship with the Maryland Medical and Chirurgical Faculty (Med-Chi), whereby it became the sponsored insurer of its members for medical malpractice insurance. At that time, as is the case today, the company was one of approximately twelve writing such insurance in Maryland.
The sponsorship arrangement imports neither group
With the advent of specialization and greater complexity in the practice of medicine have come increasing demands upon the insurance companies handling medical malpractice insurance. Claims adjusters and defense attorneys in this field must now possess a specialized expertise. Not surprisingly, therefore, these circumstances, together with other developments in medical malpractice litigation, have increased the underwriting risk of this form of coverage, and have reduced the national market to some 12 insurance companies.
As this case demonstrates, however, nothing reflects the impact of these trends more impressively than the dramatic rise which has occurred in the cost of such insurance in the last few years. In September 1973, the company filed a request for a rate increase of 59.7 percent which was denied on the following November 13. As the result of a conference between the commissioner and company representatives, an amended request for an increase of 45.9 percent was filed, which was granted effective January 4, 1974.
Reacting sharply to the action of the commissioner in paring its request, the company wrote to the executive director of Med-Chi that it could not continue to write medical malpractice coverage on what it characterized as “a net loss basis.” After summarizing the efforts it had made to obtain rate relief, it predicted that the loss experience would continue “to deteriorate.” Hence, an early request for
Subsequently, a request was made for an increase of 48 percent which was denied in May 1974. In rejecting this request, the commissioner assigned several reasons, the essence of which was that he disagreed with the actuarial procedures employed by the company in assembling its request. Further administrative and judicial review of the commissioner‘s action was not sought.
Upon the rejection of the rate increase, the company wrote to both the commissioner and Med-Chi on June 17, 1974, and announced that a new sponsored insurer should be sought, since it would “cease writing physicians and surgeons professional liability in Maryland by January 1, 1975.” It promised “to provide [its] normal market until such time as a new sponsored carrier [was] designated by Med-Chi, or January 1, 1975, whichever occur[red] first.”
On November 14, 1974, the company directed a “notice of non-renewal” to Dr. Levine in which he was advised that his two policies (“primary” and “excess” coverage), which were scheduled to expire on January 1 and 2, 1975, respectively, would not be renewed. In an accompanying explanation, the company summarized its unsuccessful efforts to obtain what it regarded as the necessary rate relief. The thrust of its position was that in its 13-year relationship with Med-Chi, it had incurred an alleged “deficit on this line of business in Maryland of nearly $10,000,000.” Hence, it was compelled “to withdraw from Maryland for this line of business.” At the same time, the company initiated a similar procedure of issuing notices to all of the physicians it insured in Maryland 45 days in advance of their respective expiration dates.
Upon a complaint being lodged with the commissioner by Dr. Levine, a hearing was scheduled which was held on December 20 and 23, 1974. The commissioner ruled that
“The statute in question specifically limits the action of an insurer (or agent or broker) in making what is termed ‘underwriting decisions’ (refusal to write a risk or class of risk in the first instance, the cancellation of a risk or class of risk in midterm or the failure to renew a risk or class of risk at the end of a policy period), in three distinct areas. These include:
“1. Underwriting decisions based ‘in whole or in part upon race, color, creed or sex of an applicant or policyholder.’
“2. Underwriting decisions based on ‘any arbitrary, capricious, or unfairly discriminatory reason.’
“3. Underwriting decisions not based on ‘standards which are reasonably related to the insurer‘s economic and business purposes.‘”
He then found that the company had violated standards “2” and “3” in reference to both Dr. Levine, an individual risk, and the medical community as a whole, a class of risk. On appeal to the Baltimore City Court, as we noted earlier, the order of the commissioner was modified and, as modified, affirmed.
In this Court, the company advances these contentions:
1)
3) That
Since we agree that the statute is inapplicable to this case, it is unnecessary for us to decide the remaining two points.
By chapter 789 of the Laws of 1971,
We considered
“It is clear to us that the principal thrust of this legislation was directed toward any action of an insurer in failing to underwrite or renew a particular risk or class of risk for any reason based in whole or in part upon race, color, creed or sex of an applicant or policyholder for any arbitrary, capricious or unfairly discriminatory reason like those specifically mentioned, including, but not
restricted to, religion, national origin, place of residency or other similar irrelevant considerations. In short, the General Assembly intended to broaden the scope of ‘arbitrary, capricious, or unfairly discriminatory reason,’ but within the frame of reference of the specifically mentioned ‘reasons.‘” 268 Md. at 442 (emphasis in original).
Our decision in Allstate led directly to the enactment of chapter 752 of the Laws of 1974, which produced
“... that all underwriting decisions of insurers and insurance agents and brokers, with regard to both eligibility and acceptability of applicants for insurance and insureds, [should] be made solely on the basis of a reasonable application to relevant facts of underwriting principles, standards and rules that can be demonstrated objectively to measure the probability of a direct and substantial adverse effect upon losses or expenses of the insurer....”
The General Assembly also determined that the general welfare of the people “is insufficiently assured and inadequately promoted merely upon a showing by insurers that their underwriting decisions” are not based on the historic prejudices such as “race, color, religion or creed, sex, national origin or place of residence and the like.” Thus, it added the last two sentences to subsection (a) of
“(a) No insurer, agent or broker shall cancel or refuse to underwrite or renew a particular insurance risk or class of risk for any reason based in whole or in part upon race, color, creed or sex of an applicant or policyholder or for any arbitrary, capricious, or unfairly discriminatory reason. . . .
No insurer, agent or broker may cancel or refuse to underwrite or renew a particular insurance risk or class of risk except by the application of standards which are reasonably related to the insurer‘s economic and business purposes. At any hearing to determine whether there has been a violation of this section, the burden of persuasion shall be upon the insurer to demonstrate that the cancellation, or refusal to underwrite or renew is justified under the standards so demonstrated.” (emphasis added).
The company contends that it decided to withdraw entirely from the medical malpractice insurance market in Maryland because of “deteriorating” conditions in that line, the unsympathetic regulatory climate, and the fact that it had lost over $10,000,000 in that market and was continuing to lose money. To demonstrate the accuracy of this appraisal, it points to the fact that no other insurance carrier has offered to furnish any of the coverage being relinquished by the company.
In pressing its argument that
The commissioner, on the other hand, concerned with what he regards as a form of blackmail in the pursuit of
Essentially, then, the applicability vel non of
In deciding the meaning of the word “risk,” as used in
“In the absence of statute, it is purely voluntary on the part of the company as to whom it will insure, and it is under no duty to write insurance for any
particular applicant. The insurer is at liberty to choose its own risks and may accept or reject applicants as it sees fit.” (emphasis added). Gov‘t Employees Ins. v. Ins. Comm‘r, 273 Md. 467, 478, 330 A. 2d 653 (1975); Insurance Comm‘r v. Allstate Ins., 268 Md. 428, 441, 302 A. 2d 200 (1973); Edelstein v. Nationwide Mut. Ins., 252 Md. 455, 462, 250 A. 2d 241 (1969).
This statement suggests that the word “risk,” which is used synonymously with the words “whom” and “applicant,” refers in this context to the person being insured. Similar use of the word was made in Insurance Comm‘r v. Allstate Ins., supra, quoting from Edelstein v. Nationwide Mut. Ins., supra, 252 Md. at 461:
“It is well established in Maryland and generally that an insurance company has the unqualified right to select the risks it considers profitable to insure and the company is under no obligation to accept an insurance application submitted by its agent or broker. . . .” 268 Md. at 440 (emphasis added).
The language of the first sentence of
Clearly, then, the evil aimed at by the statute is discrimination against individuals or classes of individuals. When the Legislature added a new standard to
The commissioner claims, however, that even if a
Logically, then, the commissioner‘s interpretation would mean that all insurers could be required to underwrite any given line of insurance, since the statute makes no distinction between underwriting “in the first instance,” and the non-renewal of existing policies. That no such result was intended is evident from the plain language of
Furthermore, if the words “particular insurance risk,” referring to each individual person no matter how many there are in the aggregate, could be applied in this manner to every case, as urged by the commissioner, then the phrase “or class of risk” would be completely superfluous. Absent a clear indication to the contrary, a statute, if reasonably possible, is to be read so that no word, clause, sentence or phrase shall be rendered surplusage, superfluous, meaningless or nugatory. A.H. Smith Sand & Gravel v. Dep‘t, 270 Md. 652, 659, 313 A. 2d 820 (1974); Baltimore City v. United Stores, 250 Md. 361, 368-69, 243 A. 2d 521 (1968); Thomas v. Police Commissioner, 211 Md. 357, 361, 127 A. 2d 625 (1956).
In light of the evident purposes of
Lastly, the commissioner contends that an insurer can make such basic decisions to underwrite or not underwrite an entire line of insurance without being subjected to the scrutiny mandated by
Were the statute to be read so as to require the company to justify its non-renewal of medical malpractice insurance, so long as it continued to underwrite all other “liability other than automobile” insurance, then the other companies writing the latter insurance in Maryland — approximately 300 in number — would also be compelled to justify their refusal to underwrite medical malpractice coverage. This result would follow, we think, from the meaning of the statutory language, “cancel or refuse to underwrite or renew,” to which we referred earlier. In effect, the argument of the commissioner, if adopted, would ascribe to
As we noted earlier, chapter 752 was a direct response to our decision in Allstate. There, we had held that despite the 1971 amendment,
In sum, as its placement under the subtitle “Unfair Trade Practices” also tends to suggest,
Judgment reversed; remanded to the Baltimore City Court with directions to vacate the order of the Insurance Commissioner of Maryland dated January 21, 1975; appellee, Insurance Commissioner, to pay costs.
Eldridge, J., dissenting:
The majority concludes that
This Court has once before taken a very narrow view of the scope of coverage of
“No insurer, agent or broker shall cancel or refuse to underwrite or renew a particular insurance risk or class of risk for any reason based in whole or in part upon race, color, creed or sex of an applicant or policy-holder or for any arbitrary, capricious, or unfairly discriminatory reason. . . . No insurer, agent or broker may cancel or refuse to underwrite or renew a particular insurance risk or
class of risk except by the application of standards which are reasonably related to the insurer‘s economic and business purposes. At any hearing to determine whether there has been a violation of this section, the burden of persuasion shall be upon the insurer to demonstrate that the cancellation, or refusal to underwrite or renew is justified under the standards so demonstrated.”
The intent of the Legislature, that ”all underwriting decisions” be based on underwriting criteria having a reasonable relation to the insurer‘s economic and business purposes, is in conflict with the Court‘s limitation in this case of the applicability of
The majority‘s holding is based on an arbitrary denomination of medical malpractice coverage as being a “line of insurance” rather than a “class of risk.”2 In making this important choice of terms, the majority rejects the Insurance Commissioner‘s determination that medical malpractice is a “class of risk” within the line of insurance of “liability other than automobile.” This is indeed a “technical” definition, as the majority labels it, which the Commissioner in the exercise of his expert judgment has made. When reviewing questions arising in a complex area such as the regulation of insurance, we should give significant weight to determinations made by expert administrative bodies. A. Davis, Administrative Law § 30.09, at 243 (1958). The majority offers no basis in law or fact for preferring their presumably nontechnical formula to the Commissioner‘s “technical” definition of a “line of insurance.”
However, in this case St. Paul did not exhaust the administrative remedies available to it with regard to the rate increase it sought. St. Paul was granted a 45.9% rate increase, effective January 4, 1974. It informed the Maryland Medical and Chirurgical Faculty that if it could not obtain another rate increase, it would cease writing medical malpractice insurance. Shortly thereafter it sought another increase of 48%. The Commissioner tentatively rejected this request. St. Paul did not seek further adminstrative consideration of this requested rate increase.
This action by St. Paul was “arbitrary” within the meaning of that term as used in
However, the company‘s precipitous action, in failing to explore fully the possibilities available to it with regard to an increase in rates, deprived the Commissioner and the public of the ability to determine whether the company‘s claim that it could not obtain rate relief was correct. Thus, the Commissioner could determine that St. Paul‘s action was arbitrary, and he was not, at that point, obligated to accept St. Paul‘s business judgment with regard to its inability to continue writing medical malpractice coverage.
I would affirm the order of the Baltimore City Court that St. Paul Fire and Marine Insurance Company renew Dr. Levine‘s policies and “continue to accept the business of physicians’ and surgeons’ liability insurance in the State of Maryland.”
Notes
This provision, which allows rates to be based on certain characteristics of the insureds covered by a particular type of insurance, indicates that the Legislature did not intend the term “class of risk” in“Risks may be grouped by classifications for the establishment of rates and minimum premiums. Classification rates may be modified to produce rates for individual risks in accordance with rating plans which establish standards for measuring variations in hazards or expense provisions, or both. The standards may measure any difference among risks that can be demonstrated objectively to have a probable effect upon losses or expenses. . . .”
“Any insurer or rating organization aggrieved by any order or decision of the Commissioner under this subtitle made without a hearing, may within thirty (30) days after notice of the order to the insurer or organization, make written request to the Commissioner for a hearing thereon. The Commissioner shall hear such party or parties within twenty (20) days, after receipt of such request and shall give not less than ten (10) days’ written notice of the time and place of the hearing. The hearing shall be concluded within fifteen (15) days from the commencement thereof; provided, however, that the Commissioner, upon application with notice to the interested parties and for good cause shown, may grant addi-tional time, not exceeding fifteen (15) days. Within twenty (20) days after the conclusion of such hearing the Commissioner shall affirm, reverse or modify his previous action, specifying his reason therefor, and shall give a copy of such order or deci-sion to all interested parties. In the event of the Commissioner‘s failure to hold or complete the hearing or to render his order or decision within the period specified herein, the filing or applica-tion in issue shall be deemed to meet the requirements of this subtitle and shall be deemed approved.
“The order shall contain specific findings of fact by the Commissioner in relation to the matter before him, such findings to be supported by a preponderance of the evidence on consideration of the record as a whole. Any party may file with the Commissioner proposed findings of fact, to be accepted or rejected by the Commissioner.
“Pending such hearing and decision thereon the Commissioner may suspend or postpone the effective date of his previous action.
“Nothing contained in this subtitle shall require the observance at any hearing of formal rules of pleading or evidence.”
