State ex rel. Consumers League of Ohio v. Ratchford

Decision Date30 December 1982
Citation457 N.E.2d 878,8 Ohio App.3d 420,8 OBR 544
Parties, 8 O.B.R. 544 The STATE, ex rel. CONSUMERS LEAGUE OF OHIO et al., v. RATCHFORD, Supt., et al.
CourtOhio Court of Appeals

Syllabus by the Court

1. R.C. 3918.07(B) imposes a mandatory legal duty upon the Superintendent of Insurance to disapprove a policy of credit life insurance within thirty days of its filing, if its premium rates violate the standards of either subdivisions (C)(1) or (C)(7) of Ohio Adm.Code 3901-1-14.

2. Where a policy's premium rates are deemed prima facie reasonable under subdivision (C)(1) of Ohio Adm.Code 3901-1-14 at the time of filing, if experience later proves a violation of subdivision (C)(7) of the regulation, then the regulation imposes a mandatory legal duty upon the superintendent to exercise the discretion granted him by that subdivision of the regulation, and by R.C. 3918.07(D), to proceed against the company.

3. Standing requires demonstration of concrete injury in fact, rather than an abstract or suspected injury. Demonstration of injury in fact is limited to those situations where an individual can show he has suffered or will suffer a specific injury even if slight, from the challenged action or inaction, and that this injury is likely to be redressed if the court invalidates the action or inaction.

Carolyn L. Carter, Cleveland, Marcia Brehmer, Columbus, and David Cleveland, Cleveland, for relators.

William J. Brown, Atty. Gen., Roger P. Sugarman, Thomas W. Hess and Timothy R. Parry, Asst. Attys. Gen., for respondents.

NORRIS, Judge.

According to stipulated facts, relator, Consumers League of Ohio, is a voluntary membership association, many of whose members have in the past and will likely in the future purchase credit life insurance. Relator, Donald Zahnke, has purchased credit life insurance in the past and expects to do so in the future. Relators demanded in writing of respondents that they require insurers to reduce credit life insurance premiums rates or show cause why their rates should not be reduced. If premium rates for credit life insurance had been reduced to effect a fifty percent loss ratio for 1977 through 1979, Ohio consumers could have purchased the same amount of credit life insurance at a savings of $71,438,000, or an average of $23,812,667 per year.

Relators seek a writ of mandamus ordering respondents to require those credit life insurance companies which have paid less than fifty percent of premiums in benefits, to make appropriate rate reductions or show cause why their premium rates should not be reduced. Respondents filed a motion to dismiss the complaint on the ground that relators have failed to state a claim upon which relief may be granted.

Respondents also filed a motion seeking leave to file supplemental exhibits consisting of an affidavit and letter from an actuary. The motion is overruled. The affidavit and letter do not meet standards for admissible evidence and do not conform to Section 7 of our Local R. 11. Even were the exhibits admitted into evidence, their contents would not be critical to our decision.

In order to grant a writ of mandamus, we must find that relators have a clear legal right to the relief prayed for, that respondents are under a clear legal duty to perform the requested act, and that relators have no plain and adequate remedy at law. State, ex rel. Montrie Nursing Home v. Aggrey (1980), 63 Ohio St.2d 121, at 126, 407 N.E.2d 485 . The most perplexing issue to be addressed in this case is whether respondents are under a clear legal duty to perform the requested official act. Central to our consideration of that issue are provisions of R.C. 3918.07 and Ohio Adm.Code 3901-1-14:

R.C. 3918.07:

"(A) All policies * * * of insurance * * * shall be filed with the superintendent of insurance.

"(B) The superintendant shall within thirty days after the filing of any such policies * * * disapprove any such form if the table of premium rates charged or to be charged appears by reasonable assumptions to be excessive in relation to benefits * * * or are contrary to any provision of the insurance laws of Ohio or of any rule or regulation promulgated thereunder.

" * * *

"(D) The superintendent may, at any time after a hearing held not less than twenty days after written notice to the insurer withdraw his approval of any such form on any ground set forth in division (B) of this section. The written notice of such hearing shall state the reasons for the proposed withdrawal."

Ohio Adm.Code 3901-1-14:

"3901-1-14 Credit life and credit accident and health insurance

"(A) Applicability "This regulation is issued pursuant to Chapter 3918 of the Ohio Revised Code regulating credit life insurance and credit accident and health insurance and is applicable to all policies * * * of insurance * * *providing credit life insurance and credit accident and health insurance * * *.

"(B) Filing and Approval, Disclosure

"(1) * * * [I]n order to discharge his duties and exercise his powers under Sections 3918.07 * * * the Director of Insurance adopts this regulation.

"(2) No * * * policy of credit life insurance or credit accident and health insurance shall be issued * * * unless such forms and the premium rates * * * therefor have been filed with the Director and approved by him prior to such issuance or use and have not been subsequently disapproved in accordance with paragraph (B) of Section 3918.07.

" * * *

"(C) Premium Rate and Coverage Standards

"(1) As a guide to insurers in preparing filings for credit life insurance and credit accident and health insurance on the term plan, certain premium rate standards are set forth below. Where rate filings are made in accordance with such premium rate standards, they shall prima facie be deemed not to be excessive in relation to the benefits provided.

"(2) Standards for Premium Rates for Credit Life Insurance

"(a) Monthly Premium Rate

"It is presumed that the premium rate for credit life insurance, for which premiums are paid monthly on outstanding balances, is not excessive in relation to the benefits provided if the monthly premium rate for such coverage does not exceed $1.00 per $1,000 of outstanding balance of insured indebtedness.

"(b) Prima Facie Single Premium Rate for Decreasing Term Credit Life Insurance

"It is presumed that the single premium rate for decreasing term credit life insurance for which premiums are paid in one sum for the entire duration of indebtedness, is not excessive in relation to the benefits provided if the single premium rate for such insurance does not exceed a rate of $.65 per $100 * * *.

" * * *

"(7) Required Downward Rate Deviations

"Any insurer which produces, for a case or class of business, a credible loss ratio of less than 50% shall be required to make appropriate rate reductions or show cause why its premium rates for such case or class of business should not be reduced. * * *

"(8) Credit Accident and Health

"Premium rate deviations for credit accident and health insurance shall be subject to the standards set forth above for credit life insurance, taking into account differing rates for various loan durations for each plan of benefits. * * * "

It is well-settled that an agency is required to follow its own regulations. See Kroger Grocery & Baking Co. v. Glander (1948), 149 Ohio St. 120, at 126, 77 N.E.2d 921 ; Lawrence v. Leach (1964), 120 Ohio App. 411, at 414, 202 N.E.2d 703; State, ex rel. Cincinnati, v. Ohio Civil Rights Comm. (1981), 2 Ohio App.3d 287, 441 N.E.2d 829.

Among the facts stipulated by the parties are those which clearly establish that insurers, in writing credit life insurance, are producing a loss ratio of less than fifty percent. Respondents argue that the loss ratio exceeds fifty percent when premium rates for both credit life insurance and credit accident and health insurance are aggregated together as a single "class of business" and that, therefore, the superintendent is under no duty to act under Ohio Adm.Code 3901-1-14(C)(7). This argument is demonstratively captious when the language of the regulation and of stipulated evidence is...

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