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In re Filing by Automobile Rate Office

Supreme Court of North Carolina
Apr 1, 1971
278 N.C. 302 (N.C. 1971)

Opinion

No. 39

Filed 5 April 1971

1. Insurance 1; Constitutional Law 7 — power of Commissioner to fix rates The only power the Commissioner of Insurance has to fix rates is such power as the General Assembly has delegated to and vested in him.

2. Administrative Law 4; Insurance 1, 79.1 — determination of automobile insurance rates — applicable rules of evidence The statute providing that the rules of evidence as applied in the superior and district courts shall be followed in all administrative proceedings before State agencies, held not applicable to a public hearing before the Commissioner of Insurance on proposals for a general revision of insurance rates submitted by a statutory rate-making bureau. G.S. 143-317; 143-318.

3. Insurance 1 — rate-fixing power of the Commissioner The power of the Commissioner of Insurance to fix rates effective from a specified future date is a legislative power. G.S. 58-248.

4. Insurance 79.1 — automobile insurance rate hearing — competency of evidence for rate hearing In fixing a 2.8% rate increase on passenger automobile liability insurance effective 28 January 1970, the Commissioner of Insurance could properly consider testimony and documentary evidence that had been compiled by the Automobile Rate Administrative Office from various sources, including (1) data furnished by the Statistical Agents of the Rate Office reflecting the composite experience of all licensed insurance companies and showing that losses for 1966 and 1967 had exceeded the proportion of the premiums allocated for the payment of losses under the then existing rates, and (2) data obtained from various state, federal and private agencies showing the increase in motor vehicle accidents, hospital charges, physicians' fees, automobile repair parts, and weekly gross earnings of production workers; the fact that much of this evidence would have been inadmissible in a trial in the superior or district courts does not affect the Commissioner's consideration of it in the rate hearing. G.S. 58-27.1; G.S. 58-248; G.S. 58-248.1.

5. Insurance 79.1 — automobile insurance rates — showing of "expense loading" component Data submitted to the Rate Office by automobile liability insurers must reflect the insurers' underwriting profit and loss experience in North Carolina

6. Insurance 79.1 — automobile insurance rate increase An order of the Insurance Commissioner approving a 2.8% rate increase on passenger automobile liability insurance is supported by sufficient evidence and is affirmed by the Supreme Court, although the data submitted by the Rate Office failed to show the insurers' underwriting profit and loss experience in this State.

APPEAL by the Attorney General from the judgment entered by Bailey, J., on April 24, 1970, in WAKE Superior Court, certified in accordance with G.S. 7A-31(a) for initial appellate review by the Supreme Court, docketed and argued as No. 9 at Fall Term 1970.

Attorney General Morgan, Deputy Attorney General Benoy and Assistant Attorney General Rosser and Hudson, appellant intervenor.

Allen, Steed Pullen, by Arch T. Allen, for North Carolina Automobile Rate Administrative Office.

William T. Joyner for North Carolina Fire Insurance Rating Bureau, amicus curiae.


Justice LAKE dissenting.


On July 1, 1969, the North Carolina Automobile Rate Administrative Office (Rate Office) made a filing with the Commissioner of Insurance (Commissioner), pursuant to G.S. 58-248, which proposed a schedule of increased rates on private passenger automobile liability insurance in the amount of 1.5% for bodily injury insurance and 11.7% for property damage insurance, making an overall (composite) increase of 5.3%.

After due advertisement, the Commissioner, on September 16, 1969, conducted a public hearing, which was continued to and resumed on September 18, 1969. It was then continued to and resumed on October 6, 7, 9, 14 and 15, and November 12, 1969. It was concluded on November 18, 1969.

Prior to the hearing, to wit, on September 15, 1969, the Attorney General, as authorized by Chapter 535, Session Laws of 1969, intervened in behalf of "the insurance consuming public," and denied that "a rate increase for private passenger liability insurance is necessary or justified at this time."

At the hearing, the evidence presented by the Rate Office consisted of numerous exhibits and the testimony of its General Manager, Paul Mize, and of John C. Jeffries and J. Robert Hunter. The Commissioner called as witnesses George Edward King, Chief Fiscal Examiner, and Robert Holcombe, Assistant Fire and Casualty Actuary, both of the staff of the North Carolina Department of Insurance. The Attorney General offered no evidence. Statements presented by individual members of the public are not material to the present appeal.

In his order of December 18, 1969, which comprises eleven pages of the record, the Commissioner, after preliminary recitals, made certain "Findings of Fact," stated "Conclusions," and approved an increase in the rate level of 2.8% effective on and after January 28, 1970. He denied the requested overall rate level increase of 5.3%. The Attorney General excepted to the Commissioner's order and, in his petition for review, set forth ten assignments of error and prayed that "the Court set aside the Decision and Order of the Insurance Commissioner approving a 2.8% rate increase and cause this matter to be remanded to the Insurance Commissioner with instructions that the 1969 Filing of the Rate Administrative Office be denied in its entirety for want of competent evidence." (Our italics.)

The Rate Office excepted to those portions of the Commissioner's order which denied the overall increase of 5.3% requested in its filing of July 1, 1969.

The judgment entered by Judge Bailey overruled the exceptions and assignments of error set forth in the petitions for review filed by the Attorney General and the Rate Office, respectively, and affirmed in its entirety the Commissioner's order of December 18, 1969.

The Attorney General excepted to the judgment entered by Judge Bailey and gave notice of appeal. The Rate Office did not appeal.

In the Superior Court and in the Supreme Court the North Carolina Fire Insurance Rating Bureau sought and received permission to appear and file a brief and to argue as amicus curiae.


STATUTORY FRAMEWORK

General Statutes of North Carolina, Chapter 58, known as "the Insurance Law," G.S. 58-1, is composed of seven sub-chapters and is set forth on pages 346-592, both inclusive, of Vol. 2B, Replacement 1965.

In Subchapter I, the Insurance Department is established "as a separate and distinct department," G.S. 58-4, and the "Commissioner of Insurance" is designated the chief officer thereof, G.S. 58-5. Subchapter I contains provisions which set forth powers and duties of the Commissioner. G.S. 58-9(1) confers upon the Commissioner "power and authority to make rules and regulations, not inconsistent with law, to enforce, carry out and make effective the provisions of this chapter . . . ." G.S. 58-9.2 relates to examinations, investigations and hearings conducted by the Commissioner. G.S. 58-9.3, which relates to court review of the Commissioner's orders and decisions, contains the following provision: "The order or decision of the Commissioner if supported by substantial evidence shall be presumed to be correct and proper."

It is provided that the Commissioner "shall appoint" a chief deputy commissioner, a chief actuary and "such other deputies, actuaries, examiners, clerks and other employees as may be found necessary for the proper execution of the work of the Insurance Department, at such compensation as shall be fixed and provided by the Budget Bureau." G.S. 58-7.1; G.S. 58-7.2; G.S. 58-7.3. On or before March 1st of each year, every insurance company is required to file in the office of the Commissioner a statement, sworn to by its chief managing agent or officer, showing its "business standing and financial condition" on the preceding 31st day of December. G.S. 58-21.

G.S. 58, Subchapter 5, Article 25, consisting of G.S. 58-246 through G.S. 58-248.8, relates specifically to automobile liability insurance. These provisions are codifications of Chapter 394 of the Public Laws of 1939 and amendments thereto.

The 1939 Act created and established the Rate Office. G.S. 58-246; G.S. 58-248. The Commissioner has authority to grant permission to write liability insurance for bodily injury and for property damage on private passenger automobiles only to those insurance companies or organizations which subscribe to and become members of the Rate Office. G.S. 58-247(a). Each member is entitled to one representative and to one vote in the administration of its affairs. The members elect the Governing Committee. G.S. 58-247(b). The expenses are prorated among the members in proportion to their respective gross premium receipts. G.S. 58-247(c).

G.S. 58-247(d) provides that the Commissioner, or such deputy as he may appoint, shall be ex officio chairman of the Rate Office; that he shall preside over all of its meetings, including those of its Governing Committee; and that he shall determine any controversy that may arise by reason of a tie vote between the members of the governing committee." G.S 58-248.6 authorizes any member to appeal to the Commissioner from any decision of the Rate Office.

One of the stated objects and functions of the Rate Office is" (t)o maintain rules and regulations and fix rates for automobile bodily injury and property damage insurance and equitably adjust the same as far as practicable in accordance with the hazard of the different classes of risks as established by said bureau."

G.S. 58-248 authorizes the Commissioner "to compel the production of all books, data, papers and records and any other data necessary to compile statistics for the purpose of determining the pure cost and expense loading of automobile bodily injury and property damage insurance in North Carolina and this information shall be available and for the use of the North Carolina Automobile Rate Administrative Office for the capitulation (sic) and promulgation of rates on automobile bodily injury and property damage insurance." G.S. 58-248 also provides that the rate "compiled and promulgated by such bureau shall be submitted to the Commissioner of Insurance for approval and no such rates shall be put into effect in this State until approved by the Commissioner of Insurance and not subsequently disapproved."

The statutory provisions referred to above are codifications of the provisions of the 1939 Act. They authorized the Rate Office to "fix rates for automobile bodily injury and property damage insurance." However, approval of the Commissioner was required before the rates could be put into effect.

In United States v. South-Eastern Underwriters Association, 322 U.S. 533, 64 S.Ct. 1162, 88 L.Ed. 1440 (1944), the Supreme Court of the United States considered an appeal by the United States from a decision of the United States District Court for the Northern District of Georgia dismissing an indictment which charged the appellees, an association of nearly two hundred private stock fire insurance companies, and twenty-seven individuals, with violations of the Sherman Anti-Trust Act ( 15 U.S.C.A. 1 and 2). The indictment charged two conspiracies, namely, (1) a conspiracy "to restrain interstate trade and commerce by fixing and maintaining arbitrary and noncompetitive premium rates on fire and specified `allied lines' of insurance in Alabama, Florida, Georgia, North Carolina, South Carolina, and Virginia"; and (2) a conspiracy "to monopolize trade and commerce in the same lines of insurance in and among the same states." The Supreme Court reversed, basing its decision upon the holding that insurance transactions which stretch across State lines constitute interstate commerce so as to make them subject to regulation by Congress under the Commerce Clause. (Note: Apparently, less than five of the two hundred and forty-eight companies represented in the July 1, 1969 Filing are North Carolina corporations.)

Soon after the decision in United States v. South-Eastern Underwriters Association, supra, the Congress of the United States enacted legislation (Act of March 9, 1945, 59 Stat. 33, codified as 15 U.S.C.A. 1011-1015), which provided, inter alia, that after January 1, 1948 (by amendment, June 30, 1948), the Sherman Act, the Clayton Act, and the Federal Trade Commission Act, "shall be applicable to the business of insurance to the extent that such business is not regulated by State law." (Our italics.)

Seemingly in response to the decision in United States v. South-Eastern Underwriters Association, supra, and in anticipation of the enactment of federal legislation such as that embodied in the Act of March 9, 1945, known as the McCarran-Ferguson Act, the General Assembly enacted Chapter 381 of the Session Laws of 1945, codified as G.S. 58-248.1, which provides, inter alia: "Whenever the Commissioner, upon his own motion or upon petition of any aggrieved party, shall determine, after notice and a hearing, that the rates charged or filed on any class of risks are excessive, inadequate, unreasonable, unfairly discriminatory, or otherwise not in the public interest, or that a classification or classification assignment is unwarranted, unreasonable, improper or unfairly discriminatory he shall issue an order to the bureau directing that such rates, classifications or classification assignments be altered or revised in the manner and to the extent stated in such order to produce rates, classifications or classification assignments which are reasonable, adequate, not unfairly discriminatory, and in the public interest." Another new section added by the 1945 Act, to wit, G.S. 58-248.5, provided that a review of any order made by the Commissioner in accordance with the provisions of G.S. 58, Article 25, which is comprised of G.S. 58-246 through G.S. 58-248.8, was by appeal to the Superior Court of Wake County in accordance with G.S. 58-9.3.

In Allstate Insurance Company v. Lanier, a declaratory judgment involving our statutes, G.S. 58-246 through G.S. 58-248.8 (1968), was entered in the United States District Court for the Eastern District of North Carolina, 242 F. Supp. 73 (1965), and affirmed by the Court of Appeals, 361 F.2d 870 (4th Cir. 1966). The plaintiffs, "five large insurance companies doing 29% of the total business in North Carolina," filed the suit to obtain a judgment declaring the North Carolina statutory provisions invalid "insofar as it restricts competition by prohibiting the offering of lower premium rates." 361 F.2d at 871. A summary judgment dissolving the complaint was affirmed on the ground that, since the Rate Office "was established and administered under the active supervision of the State, it was not subject to attack under the federal antitrust laws, which condemn only private noncompetitive activities," and that the North Carolina statutory provisions had not been preempted either by the Sherman Act or by the McCarran-Ferguson Act. The opinion of Circuit Judge Sobeloff concludes with this observation: "Whether the statutory plan embodies the wisest and most effective type of regulation is, of course, not a judicial question."

Prior to the enactment of Chapter 943 of the Session Laws of 1965, no statute provided for periodic filings by the Rate Office with the Commissioner of the data referred to in G.S. 58-248, to wit, "data necessary to compile statistics for the purpose of determining the pure cost and expense loading of automobile bodily injury and property damage insurance in North Carolina." This Act of 1965 incorporated in G.S. 58-248 the following: "On or before July 1 of each calendar year the . . . Rate . . . Office shall submit to the Commissioner the data hereinabove referred to for bodily injury and property damage insurance on private passenger vehicles and a rate review based on such data. Such proposals shall be approved or disapproved by the Commissioner . . . ."

Except as indicated below, the foregoing constitutes the statutory framework for the consideration by the Commissioner of the Rate Office's filing of July 1, 1969.

STATISTICAL DATA

Regulation 21, made and promulgated by the Commissioner, provides, inter alia:

"Bureaus and companies to which the provisions of Article 25, entitled Regulation of Automobile Liability Insurance Rates, (apply) are requested to file all rate manuals, classification plans, rating plans, rating schedules, rating rules and statistical plans proposed to be used in North Carolina, relating to: Automobile Liability Coverages.

"Statistical agents for the various regulated lines are hereby appointed as follows:

1. Mutual Insurance Rating Bureau

2. Insurance Rating Board

3. National Association of Independent Insurers

4. National Independent Statistical Service

"These bureaus will annually collect and compile all experience data, prepare the necessary experience exhibits for rate making purposes and make such filings as may be required."

The Mutual Insurance Rating Bureau (MIRB) and the Insurance Rating Board (IRB) are licensed rate-making bureaus in many States. They are approved Statistical Agents in all States. The National Association of Independent Insurers (NAII) and the National Independent Statistical Service (NISS) are approved Statistical Agents for their member companies but are not licensed rate-making bureaus.

The testimony of Paul Mize, General Manager of the Rate Office, was to the effect that each of the licensed companies (then 251) is required to submit at regular intervals a statistical report, accompanied by a transmittal letter and affidavit from an official of the company, to one of the four designated statistical agents in accordance with a statistical plan or code approved by the Commissioner. According to Mize, these reports set forth in required detail the company's exposures, including the number of cars insured and the coverages, the amount of the premiums, and the amounts of paid and outstanding claims. The data is checked by experienced employees of the Statistical Agent to correct errors and to insure conformity to the approved statistical plan or code. "The data is then tabulated on highspeed electronic computers and the tabulations are then filed with the Commissioner of Insurance and made available to the North Carolina Automobile Rate Administrative Office." The filing of July 1, 1969, submitted by the Rate Office to the Commissioner, was prepared under the supervision of Mize by direction of the Governing Committee of the Rate Office.

Every licensed company, irrespective of its size or the extent of its business in North Carolina, has equal representation and vote in the Rate Office. The data furnished the Rate Office by the Statistical Agents does not disclose the experience of any one company. It reflects the aggregate or composite experience of all licensed companies as if this were the experience of a single company. The statistical data submitted to it by the Statistical Agents is used by the Rate Office in preparing its July 1 Filing.

THE JULY 1, 1969 FILING

The private passenger automobile liability insurance rates in effect since April 9, 1969, are those approved by the Commissioner by order of March 20, 1969, as a result of the July 1, 1968 Filing submitted by the Rate Office. This 1968 Filing was based (mainly) on experience during 1965 and 1966.

On May 20, 1969, the Governing Committee of the Rate Office, after reviewing the statistical data compiled and furnished to it by the Statistical Agents adopted a schedule providing for an increase of 1.5% in the rates applicable to bodily injury insurance and an increase of 11.7% in the rates applicable to property damage insurance, or an overall (composite) increase of 5.3%. The July 1, 1969 Filing set forth the proposed increases, the experience and reasons asserted in justification thereof, and sought the approval of the proposed increases by the Commissioner. This 1969 Filing was based (mainly) on experience during 1966 and 1967.

Mize testified that the figures showing the effect of the proposed increases were based on the old manual rates or policy limits of 5/10/5 despite the fact a policy written or renewed after January 1, 1968, was required to have minimum limits of 10/20/5 to serve as proof of financial responsibility (G.S. 20-309) under G.S. 20-279.21. He explained that "the Rate Office had no actual experience on the 10/20/5 limits through the year 1967."

The rate-making process on which the 1969 Filing was based is substantially the same as that used as a basis for the filing in 1968 and prior years.

The 1969 Filing asserts as justification for the proposed increases that, during the years 1966 and 1967, weighted equally, the companies incurred losses ($151,733,706.00) in excess of premiums provided for losses ($141,146,346.00) in the amount of $10,587,360.00. In explanation, it was asserted: (1) That the increase in motor vehicle accidents was greater than the increase in automobile registrations; and (2) that the increase in accident frequency was compounded by the increases in claim settlements, attributable to increases in medical and hospital costs, wage losses, automobile labor repair charges, and the prices of automobile parts necessary to make repairs.

If the Commissioner determines, after a hearing, that the rates proposed by the Rate Office "are excessive, inadequate, unreasonable, unfairly discriminatory, or otherwise not in the public interest," it becomes his duty to issue an order to the Rate Office directing that the proposed rates "be altered or revised in the manner and to the extent stated in such order to produce rates, classifications or classification assignments which are reasonable, adequate, not unfairly discriminatory, and in the public interest." (Our italics. ) G.S. 58-248.1.

In his order of December 18, 1969, the Commissioner altered or revised the proposals of the Rate Office in two particulars, viz.: First, he adopted a different method for calculating the "factor to adjust losses" in determining the expense to be allocated for the payment of pending claims; and second, he found that the Rate Office "did not take into direct consideration the effect of investment income from unearned premium reserves." See G.S. 58-246(5). On these grounds, the Commissioner did not approve the overall increase of 5.3% requested in the 1969 Filing but did approve an increase of 2.8% to become effective on and after January 28, 1970.

THE EVIDENCE

The Rate Office relied on the data furnished to it by the Statistical Agents to support its assertion that the losses during 1966 and 1967 had exceeded the proportion of the premiums allocated for the payment of losses under the then existing rates. It relied upon data it had obtained from the North Carolina Motor Vehicle Department to show the increase in motor vehicle accidents was greater than the increase in automobile registrations. It relied upon data obtained from the Consumer Price Index, Medical Care Sector, United States Department of Labor, to show the increase countrywide in hospital charges and physicians' fees. It relied upon data obtained from the Bureau of Labor Statistics, U.S. Department of Labor, to show the increases in the United States and in North Carolina in the weekly gross earnings of production workers engaged in manufacturing. It relied upon data obtained from National Market Reports, Inc., to show the increases in the prices of automobile repair parts. It offered the testimony of John C. Jeffries, who is engaged in the independent automobile damage appraisal business, to show the increase in automobile labor repair charges.

THE RATE-MAKING PROCEDURE

Since the Act of 1965, G.S. 58-248 has required the Rate Office to submit to the Commissioner the data "hereinabove referred to" for bodily injury and property damage insurance on private passenger vehicles and a rate review based on such data. The data "hereinabove referred to" consists "of all books, data, papers and records and any other data necessary to compile statistics for the purpose of determining the pure cost and expense loading of automobile bodily injury and property damage insurance in North Carolina . . . ." (Our italics.)

"For rate-making purposes, the components of a casualty insurance premium are the `pure premium' and `expense loading.' The `pure premium' is the amount allocated for the settlement of casualty losses, including loss adjustment expenses. `Expense loading' is the amount allocated for operating expenses and for underwriting profit and contingencies." Virginia State AFL-CIO v. Commonwealth, 209 Va. 776, 167 S.E.2d 322 (1969).

The increases proposed by the Rate Office in its 1969 Filing are based on an allocation of 68.6% of the premium dollar to "Losses and Loss Adjustment Expenses" and the remaining 31.4% to "Expense Loading." The 31.4% is composed of the following items: Production cost, 16.8%, which is a composite of 10% for assigned risks and 20% for voluntary risks; general administration, 5.5%; taxes, licenses and fees, exclusive of federal income taxes, 3.1%; inspection and bureau fees, 1%; and underwriting profit and contingencies, 5%.

A contingency contemplated in the allowance of 5% for "underwriting profit and contingencies" is federal income tax, approximately 50% of a company's net profit, if any.

The 68.6% allocated to "Losses and Loss Adjustment Expenses" is based on 1966 and 1967 experience as reported by the Statistical Agents upon their analysis of the reports submitted to them by all licensed companies. It is noteworthy that this proportion was greater than that on which prior filings have been based, thus leaving a smaller total percentage for allocation to "Expense Loading."

It does not appear that the licensed companies, in their reports to the Statistical Agents or otherwise, supplied data as to their actual experience in North Carolina in 1966 and 1967 with reference to the items constituting "Expense Loading." The Rate Office offered evidence that each of these allocations was reasonable and in line with allowances recognized as reasonable throughout the country. This evidence consisted of the opinion evidence of Mize, Holcombe and Hunter, and of statistics as to similar allowances approved elsewhere in the country.

The record contains no statistical or other evidence as to the profits and losses in North Carolina in 1966 and 1967 of any or all of the companies licensed to write automobile liability insurance in this State.

The evidence includes the tabulation by the Insurance Rating Board as of September 3, 1969, of the automobile liability insurance rates in effect in the twenty-five eastern States according to the latest information then obtainable. In this tabulation, North Carolina is twenty-third, the only lower rates being those of Delaware and of Georgia. Too, this tabulation indicates that the North Carolina rates are approximately 30% lower than the average of the rates in the twenty-five eastern States. The evidence does not disclose when, from whom or the circumstances under which the Insurance Rating Board obtained the information from which its tabulation was prepared.

ABSENCE OF LEGISLATIVE STANDARDS

If the Commissioner, after a hearing, determines that "the rates charged or filed . . . are excessive, inadequate, unreasonable, unfairly discriminatory, or otherwise not in the public interest," G.S. 58-248.1 provides that "he shall issue an order . . . directing that such rates . . . be altered or revised in the manner and to the extent stated in such order to produce rates . . . which are reasonable, adequate, not unfairly discriminatory, and in the public interest." (Our italics.) However, no legislative provision purports to define what constitutes a "reasonable rate" or provides a formula or standards for the guidance of the Commissioner in the determination thereof.

We pass, without discussion, questions relating to the power of the General Assembly to fix the rates for automobile liability insurance. It is noteworthy that a casualty insurance company, unlike a public utility, has no monopolistic or exclusive rights. All of the 251 competing companies are required to issue policies at the rate fixed by a State agency as a condition of doing business in North Carolina. Suffice to say, the only power the Commissioner has to fix rates is such power as the General Assembly has delegated to and vested in him.

"It is settled and fundamental in our law that the Legislature may not abdicate its power to make laws nor delegate its supreme legislative power to any other coordinate branch or to any agency which it may create. Coastal Highway v. Turnpike Authority, 237 N.C. 52, 74 S.E.2d 310. It is equally well settled that, as to some specific subject matter, it may delegate a limited portion of its legislative power to an administrative agency of it prescribes the standards under which the agency is to exercise the delegated powers." Turnpike Authority v. Pine Island, 265 N.C. 109, 114, 143 S.E.2d 319, 323, and cases there cited.

For present purposes, it is sufficient to say that no question is presented in the Attorney General's petition for review of the Commissioner's order of December 18, 1969, as to the power of the General Assembly or of the Commissioner to fix rates. The arguments brought forward assume the existence of such power.

In the absence of a legislative formula or standards, the Commissioner has had no alternative but to look to the ratemaking procedures recognized in the industry and in other States. The words, "pure cost" and "expense loading" as used, without explanation, in G.S. 58-248, facilitated this course. Thus, the Rate Office and the Commissioner adopted the industry view that the reasonableness of a profit to be allowed to a company writing automobile liability insurance was determinable on the basis of a percentage of the gross premium rather than on the basis of a rate of return on invested capital. Underlying this view is the fact that the required capital assets of a casualty insurance company are primarily reserves to guarantee its ability to discharge its liability rather than for use as working capital in the prosecution of its business. Such a company has no significant inventory of assets which are used and useful in the prosecution of its business. The primary function of such a company is to render a service. It is noted that the 5% of premium allowed for underwriting profit and contingencies in computing the rates proposed by the 1969 Filing is the same as that used in preceding filings and is the same as that generally approved in the industry.

SCOPE OF REVIEW

The case is before us upon the ten assignments of error set forth in the Attorney General's petition for review by the Superior Court of the Commissioner's order of December 18, 1969. These assignments challenge all findings of fact in the Commissioner's order on the ground they were based wholly or principally on incompetent testimony and unauthenticated and otherwise incompetent documentary evidence. At the hearing(s), the Attorney General objected to practically all of the evidence offered by the Rate Office and excepted to the overruling of his objections. He contended the provisions of Chapter 930 of the Session Laws of 1967, codified as G.S. 143-317 and G.S. 143-318, were applicable in determining the competency of evidence at the hearing(s) before the Commissioner, and that the bulk of the evidence offered by the Rate Office was incompetent under "(t)he rules of evidence as applied in the superior and district court divisions of the General Court of Justice."

The Attorney General's petition for review of the Commissioner's order of December 18, 1969, brought the matter to the Superior Court for hearing on the assignments of error set forth in that petition. We are concerned only with that portion of Judge Bailey's judgment which overrules these assignments of error and affirms the Commissioner's order.

THE 1967 ACT

The 1967 Act, as codified, is quoted below:

" 143-317. Definitions. — As used in this article,

(1) `Administrative agency' means any State authority board, bureau, commission, committee, department, or officer authorized by law to make administrative decisions, except those agencies in the legislative and judicial departments of government, the North Carolina Utilities Commission, the North Carolina Industrial Commission, the Employment Security Commission of North Carolina, and the institutions and agencies that operate pursuant to chapters 115, 115A, and 116 of the General Statutes.

(2) `Party' means each person or agency named or admitted as a party, or properly seeking and entitled as of right to be admitted as a party.

(3) `Proceeding' shall mean any proceeding, by whatever name called, before an administrative agency of the State, wherein the legal rights, duties, or privileges of specific parties are required by law or by constitutional right to be determined after an opportunity for agency hearing. (Our italics.)

"143-318. Rules of evidence official notice. — In all proceedings:

(1) Incompetent, irrelevant, immaterial, unduly repetitious, and hearsay evidence shall be excluded. The rules of evidence as applied on the superior and district court divisions of the General Court of Justice shall be followed. (Our italics.)

(2) Documentary evidence may be received in the form of copies or excerpts, if the original is not readily available. Upon request, parties shall be given an opportunity to compare the copy with the original.

(3) Notice may be taken of judicially cognizable facts. In addition, notice may be taken of generally recognized technical or scientific facts within the agency's specialized knowledge. Parties shall be notified either before or during the hearing, or by reference in preliminary reports or otherwise, of the material noticed, including any staff memoranda or data, and they shall be afforded an opportunity to contest the material so noticed. The agency's experience, technical competence, and specialized knowledge may be utilized in the evaluation of the evidence."

These facts are noted: In In re Filing by Fire Ins. Rating Bureau, 275 N.C. 15, 165 S.E.2d 207, no question was raised as to the applicability of the 1967 Act to the evidence then offered by the North Carolina Fire Insurance Rating Bureau in support of its proposal for increased rates on fire insurance policies. Nor does it appear that any question was raised as to the applicability of the 1967 Act to the evidence offered by the Rate Office in support of its proposals filed July 1, 1967, and July 1, 1968, on private passenger automobile liability insurance policies. In these proceedings, the Attorney General appeared as counsel for the Commissioner. In the present proceeding, the Attorney General, as authorized by Chapter 535 of the Session Laws of 1969, intervened and appeared "in a representative capacity for and on behalf of the using and consuming public of this State." Understandably, when so intervening and appearing, the Attorney General deemed it his duty to assert the applicability of the 1967 Act to rate-making proceedings before the Commissioner and obtain an authoritative ruling thereon.

G.S. 58-27.1 provides that "(t)here shall be in the Insurance Department an insurance advisory board which shall consist of seven members." It designates the Commissioner "a member of the board and its chairman and executive head." It provides for the appointment by the Governor of the remaining six members. It provides that the Insurance Advisory Board "shall . . . promulgate rules and regulations to provide for the holding of public hearings before the Commissioner . . . on such proposals, to revise an existing rating schedule the effect of which is to increase or decrease the charge for insurance or to set up a new rating schedule, as are subject to the approval of the Commissioner and as, in the judgment of the board, are of such nature and importance as to justify and require a public hearing.

Pursuant to G.S. 58-27.1, the Insurance Advisory Board adopted rules and regulations for such public hearings by the Commissioner, which rules and regulations were filed with the Secretary of State on March 1, 1950. Section 6 thereof is quoted below.

"6. Public hearings shall be conducted in an orderly but informal manner. The hearing office shall admit all evidence of any type having reasonable probative value, and shall include in the evidence any relevant or material evidence which may be made available to him by any records of the Insurance Department or disclosed by any investigation or study of the problem by personnel of the Department. Irrelevant, immaterial or unduly repetitious evidence shall be excluded. Any evidence of the type upon which responsible persons are accustomed to rely in the conduct of insurance affairs shall be deemed to have reasonable probative value. A hearing may be continued when such continuation is, in the Commissioner's judgment, warranted." (Our italics.)

It is noted that both G.S. 58-27.1 and the rules and regulations adopted by the Insurance Advisory Board relate specifically and solely to public hearings before the Commissioner on proposals to revise insurance rates.

We are of opinion, and so hold, that the 1967 Act, now codified as G.S. 143-317 and G.S. 143-318, is not applicable to a public hearing before the Commissioner on proposals for a general revision of insurance rates submitted by a statutory rate-making bureau such as the Rate Office. The rates approved or fixed by the Commissioner apply equally to all companies licensed to issue and to all persons who obtain liability insurance on private passenger automobiles. The statutes, G.S. 143-317 and G.S. 143-318, are applicable only to a "proceeding" before an administrative agency "wherein the legal rights, duties, or privileges of specific parties are required by law or by constitutional right to be determined after an opportunity for an agency hearing." (Our italics.) G.S. 143-317(3). The quoted portion of G.S. 143-317(3) shows that G.S. 143-318 was intended to apply only to hearings which might result in a loss by a specific party of some legal right, duty or privilege, such as hearings relating to the revocation of the license of a specified insurance agent (G.S. 58-42, G.S. 58-248.3) or of a specified insurance company (G.S. 58-44.4, G.S. 58-248.3) or to the imposition of a fine or penalty (G.S. 58-262) upon an insurance agent or insurance company for violation of the "Insurance Law." Such hearings involve the essential elements of a court trial. In such cases, the Attorney General, as legal adviser to the Commissioner, can provide counsel as to whether proffered evidence complies with "(t)he rules of evidence as applied in the superior and district court divisions of the General Court of Justice."

G.S. 143-317 and G.S. 143-318 apply only to judicial or quasi-judicial proceedings. The power to fix rates effective from a specified future date, which G.S. 58-248 purports to delegate to the Commissioner, is a legislative power. This is no less true because its exercise is preceded by investigations and hearings. In Prentis v. Atlantic Coast Line Co., 211 U.S. 210, 53 L.Ed. 150, 29 S.Ct. 67 (1908), which involved proceedings before a Virginia Commission to establish railway passenger rates for the future, Mr. Justice Holmes said: "But we think it equally plain that the proceedings drawn in question here are legislative in their nature, and none the less so that they have taken place with a body which, at another moment, or in its principal or dominant aspect, is a court . . . . A judicial inquiry investigates, declares, and enforces liabilities as they stand on present or past facts and under laws supposed already to exist. That is its purpose and end. Legislation, on the other hand, looks to the future and changes existing conditions by making a new rule, to be applied thereafter to all or some part of those subject to its power. The establishment of a rate is the making of a rule for the future, and therefore is an act legislative, not judicial, in kind . . . ." As stated in In re Filing by Fire Ins. Rating Bureau, supra at 32, 165 S.E.2d at 219: "In fixing by law the premium rate, it is the legislative power of the State which is being exercised."

There were no specific parties to the public hearing before the Commissioner. In submitting the 1969 Filing, the Rate Office, a statutory bureau, was engaged in the performance of the duty imposed upon it by G.S. 58-248. The proposals embodied in the 1969 Filing were in accordance with the determinations and directions of the Governing Committee. Although each of the two hundred and fifty-one licensed companies had an equal vote in the selection of the Governing Committee, nothing in the record indicates the proposal embodied in the 1969 Filing represent the views or have the approval of any specific insurance company. It would seem that the plaintiffs in Allstate Insurance Company v. Lanier, supra, were seeking an opportunity to fix their own rates and be free from the necessity of conforming to the rate proposals and presentation thereof as made by the Rate Office.

SUFFICIENCY OF THE EVIDENCE

We agree with the Attorney General that much of the testimony and documentary evidence produced at the hearing(s) did not meet the tests required for the admissibility of evidence over objection thereto in a trial in a Superior or District Court. However, we think the evidence produced was "of the type upon which responsible persons are accustomed to rely in the conduct of insurance affairs" and was for consideration by the Commissioner in connection with his approval or fixing of rates to be effective from some future date. Too, in making what must be considered in large measure a policy or judgment decision, the Commissioner had the benefit of his own continuous study and knowledge of changing conditions, including the enactment of Chapter 215, Session Laws of 1969, which rewrote G.S. 28-174 relating to the damages recoverable in wrongful death actions. Without elaboration, it is noted that, as shown by his rulings in connection with the 1967 and 1968 Filings by the Rate Office, the Commissioner has held a tight rein with reference to any proposed increase of rates.

The opinion testimony of Mize, Hunter and Holcombe supports the Commissioner's decision and order of December 18, 1969. Each of these men has had extensive experience and is well informed with reference to liability insurance rates on private passenger automobiles in North Carolina and throughout the country, including the percentages allocated to "pure cost" and to each of the various items included in "expense loading."

Mize has been connected with the Rate Office since 1950 and has been General Manager thereof since February, 1968. He has testified "a good many times in prior automobile liability insurance rate cases before the Commissioner of Insurance." His work has kept him in close touch with automobile statistical data, compilations and automobile liability insurance rates.

Hunter's experience includes employment by the Insurance Rating Board and by the Mutual Insurance Rating Bureau. These bureaus are licensed as Statistical Agents in all States and as Rating Organizations in most States, though not in North Carolina, for automobile liability insurance. In his present position as Assistant Actuary of MIRB, Hunter supervises the preparation of rate revisions in all States where MIRB is licensed as a Rating Organization.

Holcombe, for the past thirteen years, has been employed by the North Carolina Department of Insurance as Assistant Fire and Casualty Actuary. His work involves a critical review of filed material. This includes an analysis of the accounting and statistical methods, practices and procedures used by insurance companies as they relate to automobile liability insurance rates in North Carolina. It was stipulated that he was an expert "in rate analysis."

DATA REQUIRED BY G.S. 58-248

The record contains no exhibit or testimony that shows precisely what data each company is required to submit to the Statistical Agent to which it reports. The data required and supplied seems sufficient as to the "pure cost" component of the rate. It falls short of that required to reflect the experience on North Carolina as to the "expense loading" component of the rate. Mr. Mize testified: "Countrywide experience is the only experience available. Related to automobile liability insurance specifically, no expense statistics, data, or experience is available for operations solely in the State of North Carolina." As stated above, the data required and supplied does not reflect a reporting company's underwriting profit and loss experience in North Carolina. We are mindful that items such as production costs, administration costs, etc., may consist in part of expenditures elsewhere than in North Carolina, e.g., home office expenses. Even so, G.S. 58-248 contemplates that each company furnish data based on North Carolina experience with reference to the items composing "expense loading" as well as those composing "pure cost." Whether this requirement is reasonable or will prove of substantial value is for legislative determination. The Rate Office and the Commissioner should take notice that under present statutory provisions, each company should be required to provide all of the data required by G.S. 58-248.

CONCLUSION

As indicated, the data supplied by the companies to the Statistical Agents falls short of that required by G.S. 58-248. Even so, we think the uncontradicted evidence sufficient to support the Commissioner's allowance of the overall increase of 2.8% (instead of the 5.3% increase proposed by the Rate Office) notwithstanding the failure to comply with all requirements of G.S. 58-248.

It is noted that the Rate Office has made its July 1, 1970 Filing and soon will be required to make its July 1, 1971 Filing.

We are of opinion that Judge Bailey's judgment, which affirms the Commissioner's order of December 18, 1969, should be, and it is hereby, affirmed.

Affirmed.


Summaries of

In re Filing by Automobile Rate Office

Supreme Court of North Carolina
Apr 1, 1971
278 N.C. 302 (N.C. 1971)
Case details for

In re Filing by Automobile Rate Office

Case Details

Full title:IN THE MATTER OF A FILING BY THE NORTH CAROLINA AUTOMOBILE RATE…

Court:Supreme Court of North Carolina

Date published: Apr 1, 1971

Citations

278 N.C. 302 (N.C. 1971)
180 S.E.2d 155

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