STATE of Missouri ex rel. C. Lawrence LEGGETT, Superintendent of the Division of Insurance, Department of Business and Administration, of the State of Missouri, Relator, v. The Honorable Richard C. JENSEN, Judge of the Circuit Court of Jackson County, Missouri, Respondent.
No. 46983.
Supreme Court of Missouri, En Banc.
Nov. 10, 1958.
Rehearing Denied Dec. 8, 1958.
318 S.W.2d 353
Walter A. Raymond, Kansas City, and William H. Becker, Columbia, for respondent, John T. Barker, Floyd E. Jacobs, Kansas City, of counsel.
HYDE, Judge.
This is an original proceeding in prohibition to prevent respondent from exercising jurisdiction in the case of John T. Barker and Floyd E. Jacobs vs. C. Lawrence Leggett, Superintendent of the State Division of Insurance, in the Circuit Court of Jackson County, except to enter a final judgment dismissing same for want of jurisdiction. Barker and Jacobs are hereinafter referred to as plaintiffs.
The case against the Superintendent was commenced in Jackson County, the county of plaintiffs’ residence (
An account of the employment and services of plaintiffs will be found in Jacobs v. Leggett, Mo.Sup., 295 S.W.2d 825, 828, showing they were lawfully employed and had performed their services but could not be paid out of the funds recovered for insurance rate overcharges in the litigation (the method of payment provided in their contract) because these funds belonged to policy holders and the provisions of the insurance code provided other and exclusive methods of payment. After the decision in that case and in Barker v. Leggett, Mo.Sup., 295 S.W.2d 836, plaintiffs filed a claim for their fees with the Superintendent making among others the following requests:
“(a) Accept jurisdiction of and recognize these claims and this and preceding applications as merged herein.
“(b) Proceed under the Insurance Code and Chapter 536, R.S.Mo., 1949, on notice to hear and determine this application and preceding applications praying allowance of the claims set forth herein, and to hear evidence thereon.
“(c) Allow and approve these claims as expenses of the Insurance Department in a full and adequate reasonable amount as may be justified by the evidence which will be presented by the applicants.
“(d) Determine whether these claims and each of them (1) should be allowed as expenses of ‘proceedings’ against insurance companies involved in the restitution proceedings, and assessed against them ratably; or (2) are usual expenses of the Division (formerly Department) of Insurance payable out of amounts appropriated by law from the Insurance Division fund on warrants issued on such fund on vouchers approved by the Superintendent and Comptroller.”
Relator‘s petition for prohibition states that he concluded “that he was not required by law to grant a hearing upon claimants’ application and that he was without authority to allow them a fee“; and that “he therefore denied the claim.” Plaintiffs’ return states that “without any notice, without opportunity to be heard and without any statement of the reasons therefor, the Superintendent notified the claimants by letter that their application for hearing had been denied and their claims had been denied peremptorily“.
The Insurance Code provides two methods of payment of expenses which are invoked by plaintiffs. Section
The Administrative Procedure Act of 1945 covered two matters: (1) Promulgation of rules by agencies and determination of their validity (
This is made clearer by the fact that, at the next session of the Legislature after the adoption of the original act, another act was introduced (prepared by the Administrative Law Committee of the Missouri Bar), however not enacted until 1953 (Laws 1953, p. 678), which is now
“This is a companion bill to the proposed ‘Administrative Procedure Act of Missouri.’ It is supplementary to L.Mo.1945, p. 1504, and to Section 22, Article V of the Constitution. The Constitution and the 1945 act deal with judicial review of administrative decisions where evidence is taken before an agency so that there is a record to review of the same kind that exists when an appellate court reviews the judgment of a lower court.
“There are numerous cases, however, where agencies may act without having a hearing or making a record of evidence heard. In those cases the remedies of certiorari, mandamus, etc., are frequently inadequate, because of the inability of the court to consider the facts bearing on the merits of the agency‘s decision, because no record of evidence has been made for the court to review.
“This bill is designed to correct this situation. It provides for the making in court, in a certiorari proceeding, for example, of the same kind of record that would be made before the agency in a case reviewable under Section 22 of Article V of
the Constitution. In other words it gives the court power to hear evidence on the merits of the plaintiff‘s case before the agency, so that it can determine in the light of the facts as they appear to the court whether the agency‘s decision is proper.‘”
The comment of the Committee in regard to Section 2, contained in the same report, reads as follows:
“This act applies only where ‘there is no other provision by statute, municipal charter or ordinance for judicial or administrative review.’ This refers to particular review provisions so provided. Inasmuch as Section 10 of L.1945, p. 1504, applies ‘unless some other provision for judicial review is provided by statute,’ it is important that contested cases reviewable under Section 10 be expressly excluded from the operation of this act, so that there will be no possibility of conflict.”
Sec.
“2. Nothing in this section * * * shall apply to contested cases reviewable pursuant to sections 536.100 to 536.140.
“3. Nothing in this section shall be construed to impair any power to take summary action lawfully vested in any such administrative officer or body, or to limit the jurisdiction of any court or the scope of any remedy available in the absence of this section.”
Both the Administrative Procedure Act of 1945 and
We said in Wood v. Wagner Electric Corporation, 355 Mo. 670, 197 S.W.2d 647, 649, concerning this constitutional provision: “The provision in Section 22 that administrative decisions ‘shall be subject to direct review by the courts as provided by law’ refers to the method of review to be provided (certiorari, appeal, etc.) and not to the scope of the review ‘in cases in which a hearing is required by law.’
The trouble with plaintiffs’ contention (as to their right to invoke the review procedure of
Plaintiffs rely on State ex rel. Police Retirement System of City of St. Louis v. Murphy, 359 Mo. 854, 224 S.W.2d 68, 71, for their contention that a hearing is required on their claim by the Superintendent. That decision held that Sec. 9469, R.S.1939, “imposes the duty on the board to hold hearings and to receive evidence and proof,” on claims for accidental death benefits from the St. Louis Police Retirement System. That ruling was based on the language of the statute under which the board of trustees had the duty to decide “upon the receipt of evidence and proof” whether the death of a policeman, under the System, “was the result of an accident in the performance of duty and not caused by negligence” on his part. On a claim made by the widow of a policeman as his beneficiary a hearing was had, in which witnesses appeared and the testimony was transcribed, and we held the beneficiary‘s right of review was under the Administrative Procedure Act. We think that decision was correct and that it was a reasonable construction of the provisions of the statute involved to hold that it did require that board to determine such a claim after hearing. No similar language in the Insurance Code is pointed out by plaintiffs as applicable to their claim and we find none.
Plaintiffs also rely on what was said in the Barker case (295 S.W.2d loc. cit. 840) denying their right to maintain a suit against the Superintendent in quantum meruit, in which we pointed out we had uniformly held that the Insurance Code indicated “an intention to regulate the business from beginning to end“; and that “the superintendent of insurance is the administrative officer in charge of that interest, and courts are without authority to interfere with his administration of the Code.” We then said: “We believe it is the intent of the insurance code to vest the superintendent with primary jurisdiction to approve the usual expenses and to assess the expenses of proceedings against companies. We believe this right of primary decision by the superintendent is exclusive, subject only to review by the courts in the manner provided in the insurance code or as otherwise provided by Chapter 536, RSMo 1949, V.A.M.S., and more particularly
Our preliminary rule in prohibition is made absolute.
STORCKMAN, J., dissents in separate opinion filed.
HOLLINGSWORTH, C. J., dissents and concurs in dissenting opinion of STORCKMAN, J.
WESTHUES, LEEDY and DALTON, JJ., concur.
EAGER, J., not voting.
STORCKMAN, Judge (dissenting).
I readily agree that our decision in Barker v. Leggett, Mo. Sup., 295 S.W.2d 836, 840 [4], does not determine if this is a “contested case.” The particular section of Chapter 536, applicable in this situation, was not involved and the reference to
The question involved is a difficult one, but I am persuaded, in these circumstances, that the case should be reviewed as a “contested” one and desire to state briefly the basis of my dissent.
After the decision in Barker v. Leggett, supra, the plaintiffs filed with the superintendent a lengthy written application stating the basis of their claim and its history. The prayer of their petition, in substance, was that the superintendent accept jurisdiction and hear evidence and determine the claim for fees and determine whether the claim “(1) should be allowed as expenses of ‘proceedings’ against insurance companies involved in the restitution proceedings, and assessed against them ratably; or (2) are usual expenses of the Division (formerly Department) of Insurance payable out of amounts appropriated by law from the Insurance Division fund on warrants issued on such fund on vouchers approved by the Superintendent and Comptroller.” There was also a general prayer for relief.
Thereafter the superintendent requested the official opinion of the Attorney General “as to my jurisdiction in this matter to try and determine the application now pending before me” and on April 17, 1957, the superintendent was advised by the Attorney General as follows:
“Therefore, we conclude that, under the provisions of Section
374.220 , RSMo 1949, you do have jurisdiction to consider and determine the application now before you. As we have pointed out above, there is no statutory requirement that a hearing for such purpose be held. We think it obvious that the Superintendent is not required to hold a hearing on every claim or question that may be presented to him for determination. However, the circumstances of the present application may be such that denial of a hearing would be considered by a reviewing court to be an arbitrary and unreasonable act. Determination of the procedure is, we feel, primarily a matter within your discretion.”
On July 26, 1957, the superintendent wrote a letter to the insurance companies involved in the “proceedings” advising them of the pendency of the claim and among other things stating: “It is my thought that you and the other companies who might be liable for any amount allowed these Attorneys, if an amount is allowed them and if said allowance is determined by me to be properly assessible against the insurance companies, might want to give the matter of this present claim consideration before it is acted upon either by trying to effect a compromise with the claimants or otherwise, and it is
The superintendent, the Relator herein, alleges in his petition for prohibition filed in this court that he received a reply from the insurance companies “stating that in their opinion, and for reasons also here immaterial, Relator was without authority to make an allowance to claimants.”
On February 7, 1958, the superintendent wrote the plaintiffs a letter in which he acknowledged their letter of January 29, 1958, requesting a hearing, and in which he further stated:
“After a careful review of all the matters which have been submitted to me in connection with the above mentioned claims, I have concluded that I am not required by law to grant a hearing upon the applications before making a decision upon them.
“Even though I am not required by law to grant applicants a hearing upon their claims before deciding them, I assume that I could grant such a hearing if I thought the same would enable me better to rule upon the claims. However, it is my view that even though I should hold a hearing on these claims and should conclude after such hearing that applicants had been lawfully employed as claimed in the applications, and had rendered valuable services pursuant to said employment, the value of the services of claimants could not be allowed as expenses of the insurance department which could be paid out of current appropriations, as provided by Section
374.160 , RSMo 1949, nor could the value of said services be assessed against insurance companies as expenses of proceedings against such insurance companies, as contemplated by Sections374.160 and374.220 RSMo 1949.“In view of the above, I am respectfully denying your application for a hearing upon these claims, and must deny the claims.”
Thereafter the plaintiffs filed in the Circuit Court of Jackson County their petition for review of the action of the superintendent which gives rise to the present petition for prohibition.
Section
In addition to other matters specifically mentioned, it is the duty of the superintendent of the Insurance Division “generally to do and perform with justice and impartiality all such duties as are or may be imposed upon him by the laws regulating the business of insurance in this state.” §
All expenses of the Division except, inter alia, expenses of “proceedings against any company * * * which expenses are to be paid by the company, or as provided by the law” shall be paid monthly out of the general funds of the Insurance Division. §
The manner in which expenses of proceedings against insurance companies (
“1. The superintendent may bring suit to recover any fees or other sums which he is authorized by law to demand or collect.
“2. Any company or person liable for any fees or assessments who shall neglect or refuse to pay the same within ten days after written demand by the superintendent, shall be liable to pay double the amount of such fees or assessments; and any judgment recovered in such case shall be for double such amount and costs.” §
374.240 .
The state cannot “be responsible in any manner” for any expenses of the Division or “any charges connected therewith.” This is expressly guarded against in §
This court has stated with meticulous care at every opportunity presented that the Insurance Code indicates an intention “to regulate the business from beginning to end,” and that: “The superintendent of insurance is the administrative officer in charge of that interest, and courts are without authority to interfere with his administration of the Code.” See State ex rel. Missouri State Life Ins. Co. v. Hall, 330 Mo. 1107, 52 S.W.2d 174, 177, and the approval of the statement in Barker v. Leggett, Mo.Sup., 295 S.W.2d 836, 840.
As we have held the courts cannot invade the province of the superintendent of the Insurance Division, so we should hold that the superintendent cannot abdicate his functions in favor of the courts. There should be no doubt about the superintendent‘s authority or jurisdiction in this matter. This is made clear by the Code and by our holding in the case of Barker v. Leggett, Mo.Sup., 295 S.W.2d 840, in which we stated: “We believe it is the intent of the insurance code to vest the superintendent with primary jurisdiction to approve the usual expenses and to assess the expenses of proceedings against companies. We believe this right of primary decision by the superintendent is exclusive, subject only to review by the courts * * *”
It seems to me in these circumstances the superintendent is acting in a quasi-judicial capacity in deciding whether or not to approve the claims for assessment against the insurance companies. State ex rel. Police Retirement System of City of St. Louis v. Murphy, 359 Mo. 854, 224 S.W.2d 68, 70 [2], 72 [5]. There can hardly be any questions that private rights are affected.
If we are correct in saying that the primary decision is exclusively for the superintendent, as we did in Barker v. Leggett, supra, then it would seem he should conduct a hearing. The inquiry “which hears before it condemns” (State ex rel. Hurwitz v. North, 304 Mo. 607, 264 S.W. 678, 681), should be conducted by the superintendent under the circumstances of this case. I believe this is the legislative intent and accords with our settled construction of the Insurance Code.
The proceedings in this case were initiated by the filing of a written application seeking to invoke the relief provided by the statutes and a hearing was requested. In a case where the basic facts occurred before the term of the present superintendent, it seems especially necessary that the plaintiffs be granted an opportunity to be heard, not only to permit them to support their claim with proof, but also to afford plaintiffs an opportunity to rebut evidence or information tending to defeat the claim for compensation.
Believing that the Insurance Code and our decisions construing it contemplate and require a hearing before the superintendent in this situation, I would quash our preliminary rule as having been improvidently granted.
On Motion for Rehearing or for Modification.
PER CURIAM.
Respondent has filed a motion for rehearing or for modification of the opinion herein. However, it is not contended that the opinion is wrong in holding that review must be under
The first is to modify the statement that after our decisions in the Barker and Jacobs cases (295 S.W.2d 825 and 295 S.W.2d 836) “plaintiffs filed a claim for their fees with the superintendent, etc.” It is urged that this should be modified to state that in 1936 and repeatedly and continuously thereafter plaintiffs made claims for their fees and to show in detail what requests they made for action by the superintendent. While these facts may be material on review of the superintendent‘s denial of plaintiffs’ claims, and may be shown by evidence in such a proceeding, they are wholly immaterial to the issue of respondent‘s jurisdiction in this case and this request for modification is denied.
The second request for modification concerns the statements that “undoubtedly, it is intended that the Superintendent shall have discretion as to the use of these authorized methods, which plaintiffs apparently recognized by asking him to do one or the other“; and that “plaintiffs recognize the authority and discretion of the Superintendent to assess the companies under either
The third and last request for modification is to eliminate the statement that “plaintiffs’ claims, at least at this stage, are claims against the state.” They say: “Plaintiffs’ claims are against either the insurance companies proceeded against and found guilty of violating the 10% rate reduction order of Superintendent Hyde; or all of the insurance companies, depending on whether such expense is found to be expenses of proceedings against companies or expenses of the Division of Insurance. It is a derivative claim in which the Superintendent acts quasi judicially as the determining and assessing officer, subject to judicial review under
What we meant was (as we think the context shows) that plaintiffs’ claims are against the state, in the sense that they are at least claims against a state agency authorized by the state to employ them, even though the legislature has provided a method by which the money to pay them (and other claims for operation of the division of insurance) can be collected from sources other than general taxation. If either of the methods, which plaintiffs say might be proper, should be adopted, it seems that the insurance code has provided for state action (through the superintendent,
Respondent‘s motion is overruled and our opinion modified on the court‘s own motion to the extent herein indicated.
