Hamm v. Central States Health and Life Co., of Omaha, No. 22710
| Court | United States State Supreme Court of South Carolina |
| Writing for the Court | HARWELL; NESS, C.J., GREGORY and FINNEY, JJ., and BRUCE LITTLEJOHN |
| Citation | 357 S.E.2d 5,292 S.C. 408 |
| Parties | Steven W. HAMM, Consumer Advocate for the State of South Carolina, Appellant, v. CENTRAL STATES HEALTH AND LIFE COMPANY OF OMAHA, John G. Richards, V, Chief Insurance Commissioner, and South Carolina Department of Insurance, Respondents. . Heard |
| Docket Number | No. 22710 |
| Decision Date | 23 March 1987 |
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Carolina, Appellant,
v.
CENTRAL STATES HEALTH AND LIFE COMPANY OF OMAHA, John G.
Richards, V, Chief Insurance Commissioner, and
South Carolina Department of Insurance,
Respondents.
Decided April 27, 1987.
[292 S.C. 409] Steven W. Hamm, Raymon E. Lark, Jr., and Nancy J. Vaughn, S.C. Dept. of Consumer Affairs, Columbia, for appellant.
James C. Gray, Jr., of Nelson, Mullins, Riley & Scarborough, Columbia, for respondent Cent. States Health and Life Co.
Susanne K. Murphy, of S.C. Dept. of Ins., Columbia, for respondents John G. Richards, V, and the South Carolina Dept. of Ins.
HARWELL, Justice:
This is an insurance rate case. The Hearing Officer and Chief Insurance Commissioner allowed the 9% rate increase requested by Central States Health and Life Company of Omaha (Central States). The circuit court affirmed. We affirm in part; reverse in part; and remand.
Central States requested a 9% rate increase for its Major Medical Policy Form 280. The Hearing Officer of the South Carolina Department of Insurance recommended approval of the entire rate increase. The Chief Insurance Commissioner adopted the Hearing Officer's report in its entirety. The Consumer Advocate appealed, contending that the portion of the rate increase attributed to "medical intensity" was not based on substantial evidence. The circuit court found that the order was based on substantial evidence and affirmed the commissioner. We disagree.
The portion of the increase in dispute is based on the development of more effective medical technologies which engender more expensive methods to combat the same medical problems. This "medical intensity" factor is distinguishable from mere inflation which simply renders the same treatment more expensive when combating the same problem years later. In order to justify the portion of its 1985 [292 S.C. 410] rate increase request attributable to "medical intensity," Central States introduced the results of a study which was conducted from 1969-1978 and published in 1981. The witness for the Consumer Advocate testified that the development
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of medical technology had leveled off and this "medical intensity" was no longer a valid factor in determining a rate increase. No substantial evidence was presented by Central States as to the current impact of "medical intensity." 1The...
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BP Staff, Inc. v. Capital City Ins. Co., 2008-UP-060
...(2006). The Department's decision can be set aside if it is unsupported by substantial evidence. Hamm v. Central States Health & Life Co., 292 S.C. 408, 410, 357 S.E.2d 5, 6 (1987); Lark v. Bi-Lo, Inc., 276 S.C. 130, 136, 276 S.E.2d 304, 307 (1981). "Substantial evidence" is not a mere scin......
-
BP Staff, Inc. v. Capital City Insurance Company, Opinion No. 2008-UP-060 (S.C. App. 1/16/2008), Opinion No. 2008-UP-060.
...(2006). The Department's decision can be set aside if it is unsupported by substantial evidence. Hamm v. Central States Health & Life Co., 292 S.C. 408, 410, 357 S.E.2d 5, 6 (1987); Lark v. Bi-Lo, Inc., 276 S.C. 130, 136, 276 S.E.2d 304, 307 (1981). "Substantial evidence" is not a mere scin......
-
BP Staff, Inc. v. Capital City Ins. Co., 2008-UP-060
...(2006). The Department's decision can be set aside if it is unsupported by substantial evidence. Hamm v. Central States Health & Life Co., 292 S.C. 408, 410, 357 S.E.2d 5, 6 (1987); Lark v. Bi-Lo, Inc., 276 S.C. 130, 136, 276 S.E.2d 304, 307 (1981). Substantial evidence” is not a mere scint......
-
Hamm v. Central States Health and Life Co. of Omaha, No. 23095
...for a determination by the Commissioner of "the appropriate rate to be charged by Central States consistent with [the] opinion." Hamm, 292 S.C. 408 at 411, 357 S.E.2d 5 at 6 (1987) (emphasis added). Our consideration upon rehearing was that requiring the Commissioner to make refunds might h......
-
BP Staff, Inc. v. Capital City Ins. Co., 2008-UP-060
...(2006). The Department's decision can be set aside if it is unsupported by substantial evidence. Hamm v. Central States Health & Life Co., 292 S.C. 408, 410, 357 S.E.2d 5, 6 (1987); Lark v. Bi-Lo, Inc., 276 S.C. 130, 136, 276 S.E.2d 304, 307 (1981). "Substantial evidence" is not a mere scin......
-
BP Staff, Inc. v. Capital City Insurance Company, Opinion No. 2008-UP-060 (S.C. App. 1/16/2008), Opinion No. 2008-UP-060.
...(2006). The Department's decision can be set aside if it is unsupported by substantial evidence. Hamm v. Central States Health & Life Co., 292 S.C. 408, 410, 357 S.E.2d 5, 6 (1987); Lark v. Bi-Lo, Inc., 276 S.C. 130, 136, 276 S.E.2d 304, 307 (1981). "Substantial evidence" is not a mere scin......
-
BP Staff, Inc. v. Capital City Ins. Co., 2008-UP-060
...(2006). The Department's decision can be set aside if it is unsupported by substantial evidence. Hamm v. Central States Health & Life Co., 292 S.C. 408, 410, 357 S.E.2d 5, 6 (1987); Lark v. Bi-Lo, Inc., 276 S.C. 130, 136, 276 S.E.2d 304, 307 (1981). Substantial evidence” is not a mere scint......
-
Hamm v. Central States Health and Life Co. of Omaha, No. 23095
...for a determination by the Commissioner of "the appropriate rate to be charged by Central States consistent with [the] opinion." Hamm, 292 S.C. 408 at 411, 357 S.E.2d 5 at 6 (1987) (emphasis added). Our consideration upon rehearing was that requiring the Commissioner to make refunds might h......