(This syllabus is not part of the opinion of the Court. It has been prepared by the Office of the Clerk for
the convenience of the reader. It has been neither reviewed nor approved by the Supreme Court. Please
note that, in the interests of brevity, portions of any opinion may not have been summarized).
I/M/O THE COMMISSIONER OF INSURANCE'S ISSUANCE OF ORDERS A92-189 AND A92-212, AND
ADOPTION OF N.J.A.C. 11:3-20.5 AND ADOPTION OF N.J.A.C. 11:3-20 - APPENDIX (A-96-93)
(NOTE: The Court wrote no full opinion in this case. Rather, the Court's affirmance of the
judgment of the Appellate Division is based substantially on the reasons expressed in the written
opinion of Judge King below.)
Argued February 28, 1994 -- Decided June 14, 1994
PER CURIAM
This appeal addresses whether the Commissioner of Insurance (Commissioner) exceeded his
authority in promulgating regulation N.J.A.C. 11:3-20.5(e) (section 20.5(e), under the Excess Profits Law,
N.J.S.A. 17:29A-5.6 to 5.16 (EPL), that was intended to implement the mandate of the Fair Automobile
Insurance Reform Act of 1990 (the FAIR Act). Provisions of the FAIR Act prevent automobile insurers
from passing through to insureds the surtax and assessment costs imposed on insurers to bailout the multi-billion dollar deficit of the New Jersey Automobile Full Insurance Underwriting Association (JUA). Insurers
are precluded from including the surtax and assessment costs in the rate base unless absolutely necessary to
achieve a fair and reasonable rate of return.
The specific question posed in this case is whether the Commissioner exceeded his authority in
promulgating section 20.5(e) which prohibits automobile insurers from deducting the surtax and assessment
costs as an expense in their excess profit report unless the Commissioner permitted the insurer to include the
surtax and assessment costs in its rate filing. Selective Insurance Company, Hanover Insurance Company,
and State Farm Insurance Company (collectively referred to as insurers) claim that the regulation violates
both the express language of, and the intent of, the EPL and is unconstitutional as confiscatory on its face.
The Commissioner claims that the appeal is nonjusticiable and should be dismissed because none of the
insurers have shown excess profits or have been harmed by the new regulation.
On the justiciability question, the Appellate Division held that the insurers have the right to
challenge the regulation on its face, even though they have not realized any "excess profit." The court noted
that appeals may be taken as of right to review final decisions or actions of any state administrative agency
or officer and to review the validity of any rule promulgated by such agency or officer.
The Appellate Division also concluded that section 20.5(e) is not facially confiscatory and upheld the
validity of the regulation. The Appellate Division considered reasonable rates and the EPL, noting that the
Commissioner must approve rates that are reasonable and adequate and not unfairly discriminatory, taking
into account a reasonable profit for the insurer. The court found that the mandate of the FAIR Act was
clear. As such, an insurer cannot treat the surtax and assessment costs as expenses in the context of
standard ratemaking unless it can demonstrate that they are otherwise unable to earn a constitutionally
adequate rate of return. The court noted that none of the insurers have met that burden. The court found
that, in view of the explicit commands of the Legislature in preventing direct pass-throughs, it would strain
logic to conclude that the Legislature intended to permit indirect pass-through of surtax and assessment costs
to policyholders by way of the EPL.
The Appellate Division further concluded that the Commissioner has ample authority pursuant to the FAIR Act and the intent of the EPL to promulgate section 20.5. The Commissioner has broad authority under the EPL to promulgate regulations governing excess profits that are necessary to implement the
provisions of the FAIR Act. While the EPL provides that "general expenses" are to be included in excess
profit reports, the court found that this does not mean that the Commissioner lacks the authority to exclude
certain expenses that would otherwise defeat the specific legislative directive and intent of the FAIR Act.
The Appellate Division noted that the EPL, like the statutory ratemaking scheme, was designed to
protect members of the public from improper insurance rates. The court found that, consistent with the
FAIR Act's directive, the Commissioner amended the ratemaking regulations to confirm that the FAIR Act
surtax and assessment costs could not be automatically incorporated into the expense base for determining
rates. Because of the related function of the excess profit reports, the Commissioner correlatively recognized
the need to harmonize the excess profit calculation with the treatment of expenses and the ratemaking
regulations. The court concluded that any contrary construction of the term "expenses" in the EPL would
defeat the anti-pass-through provisions of the FAIR Act intended to protect policyholders from paying the
insurers' FAIR Act obligations. Thus, the Commissioner's authority "to take such action as is necessary" to
achieve the legislative objective of the FAIR Act, combined with his authority to enact necessary excess profit
regulations, made his action in promulgating N.J.A.C. 11:3-20.5 reasonable. The Appellate Division did note
that an amendment and clarification of the language in the EPL would have been cleaner; however, that fact
does not detract from the Commissioner's power to use his judgment and expertise through rulemaking to
implement the legislative will.
Lastly, the Appellate Division found that the regulation was not confiscatory on its face; it noted that
State Farm effectively disposed of arguments that the FAIR Act or regulations promulgated pursuant to that
Act are facially confiscatory.
HELD: Judgment of the Appellate Division is AFFIRMED substantially for the reasons expressed in
Judge King's written opinion below. By promulgating N.J.A.C. 11:3-20.5(e), the Commissioner of
Insurance did not exceed his authority in prohibiting automobile insurers from deducting the
surtax and assessment costs as an expense in their excess profit report unless permitted by the
Commissioner to include such costs in its rate filing to insure a reasonable rate of return.
JUSTICE GARIBALDI, dissenting, in which JUSTICE O'HERN joins, is of the view that the
Court upholds N.J.A.C. 11:3-20.5(e), a regulation that requires insurers in calculating their excess profits to
exclude from "other expenses" the assessment and surtax costs paid by insurers pursuant to the FAIR Act.
However, the FAIR Act surtax and assessment costs are "taxes," "fees," or "general expenses" and, hence,
should be deducted in the excess-profits calculation. As such, the regulation's exclusion of the FAIR Act's
surtax and assessment costs contravene both the plain language and the intent of the Excess Profit Law.
JUSTICES CLIFFORD, HANDLER, POLLOCK and STEIN join in this opinion. JUSTICE
GARIBALDI filed a separate dissenting opinion in which JUSTICE O'HERN joins. CHIEF JUSTICE
WILENTZ did not participate.
SUPREME COURT OF NEW JERSEY
A-
96 September Term 1993
IMO THE COMMISSIONER OF
INSURANCE'S ISSUANCE OF
ORDERS A-92-189 AND A-92-212,
AND ADOPTION OF AMENDMENT TO
N.J.A.C. 11:3-20.5 AND
ADOPTION OF N.J.A.C. 11:3-20 -
APPENDIX
Argued February 28, 1994 -- Decided June 14, 1994
On certification to the Superior Court,
Appellate Division, whose opinion is reported
at ___ N.J. Super. ___ (1993).
Thomas P. Weidner argued the cause for
appellants State Farm Mutual Automobile
Insurance Company, Selective Insurance
Company, and Hanover Insurance Company
(Jamieson, Moore, Peskin & Spicer, attorneys;
Mr. Weidner and Lee R. Jamieson, of counsel
and on the briefs).
Joseph L. Yannotti, Assistant Attorney
General, argued the cause for respondent,
Commissioner of Insurance (Alexander P.
Waugh, Acting Attorney General of New Jersey,
attorney; Mary C. Jacobson, Assistant
Attorney General, of counsel; Marilyn S.
Silvia, Deputy Attorney General, on the
brief).
PER CURIAM
The judgment is affirmed, substantially for the reasons
expressed in the opinion of the Appellate Division, reported at
___ N.J. Super. ___ (1993).
Justices Clifford, Handler, Pollock, and Stein join in
this opinion. Justice Garibaldi has filed a separate dissenting
opinion, in which Justice O'Hern joins. Chief Justice Wilentz
did not participate.
SUPREME COURT OF NEW JERSEY
A-
96 September Term 1993
I/M/O The Commissioner of
Insurance's Issuance of Orders
A-92-189 and A-92-212, and Adoption
of Amendment to N.J.A.C. 11:3-20.5
and Adoption of N.J.A.C. 11:3-20 -
Appendix
_____________________________________
GARIBALDI, J., dissenting.
In l988 the Legislature enacted the present Excess Profits
Law (EPL). L. l988, c. ll8. The statute's purpose, according to
then-Governor Kean, was to "assure that a complete and accurate
assessment of profits and losses is presented by insurers."
Governor's Conditional Veto Message to Senate Bill No. 3090, at 2
(Nov. 9, l987) (emphasis added) (hereinafter Conditional Veto
Message). The Court today violates the EPL by upholding N.J.A.C.
11:3-20.5(e), which excludes an insurer's actual expenses from
the excess-profits calculation.
The EPL requires insurers to report the sum of profits
from underwriting operations and investment income derived from
policyholder-supplied funds. N.J.S.A. l7:29A-5.8. If actual
operating profit is more than 2.5" above the insurer's 5.3" pre-tax profit allowed under New Jersey rate regulations, an insurer
must refund excess profits to policyholders.
N.J.S.A. l7:29A-5.6(m) provides that in the calculation of
the excess profits attributable to underwriting operations,
underwriting incomeSee footnote 1 is the difference between earned premiums
and losses, loss adjustment expenses, and "other expenses
exclusive of UCJF assessments." "[T]axes, licenses, and fees"
and "general expenses" are specifically identified as "other
expenses". N.J.S.A. l7:29A-5.7(c)(3), (3)(b), (3)(e). The FAIR
surtax and assessment are "taxes," "fees," or "general expenses"
and hence should be deducted in the excess-profits calculation.
Nonetheless, the Court today upholds N.J.A.C. ll:3-20.5(e), (Reg. 20.5(e)), a regulation that requires insurers in
calculating their excess profits to exclude from "other expenses"
the assessments and surtaxes paid by insurers pursuant to the
Fair Automobile Insurance Reform Act of l990, L. l990, c. 8
(FAIR). Because the regulation's exclusion of FAIR's surtax and
assessment contravenes both the plain language and the intent of
the Excess Profits Law, N.J.S.A. l7:29A-5.6 to 5.l6, I
respectfully dissent.
No one disputes that FAIR surtaxes and assessments are
"taxes," "fees," or "general expenses" under EPL. N.J.S.A.
l7:29A-5.7c(3), (3)(b), (3)(e); In re Comm'r of Ins.,
132 N.J. 209, 225 (1993)(observing that FAIR's "`assessments' were to be
regarded as `expenses' of the insurance companies").
Likewise, EPL's plain language dictates that FAIR expenses
and most other expenses should be deducted in the excess-profits
calculation. That expenses are generally deducted is consistent
with the plain meaning of "profits," i.e. "excess of returns over
expenditure in a transaction or series of transactions."
Webster's Third New Int'l Dictionary 1811 (1976).
Additionally, the statute specifically excludes an
expense, but makes no mention of the FAIR surtax and assessment.
The statute provides that "other expenses exclusive of UCJF
assessments," ("amounts paid by the insurer to the Unsatisfied
Claim and Judgment Fund," N.J.S.A. l7:29A-5.6(n)) are deducted in
determining underwriting income. N.J.S.A. 17:29A-5.6(m)(emphasis
added). The EPL's specific exclusion of UCJF assessments from
the underwriting-income calculation is additional evidence in the
statute's plain language that the Legislature did not intend FAIR
surtaxes and assessments to be excluded. See N.J.S.A. 17:29A-5.6(m). Had the Legislature also intended to exclude FAIR's
assessments and surtaxes from the excess-profits calculation, it
would have amended the EPL.
The Legislature is presumed to be familiar with its prior enactments. See Quaremba v. Allan, 67 N.J. l, l4 (l975); County of Essex v. Comm'r, Dep't of Human Servs., 252 N.J. Super. l, l0-ll (App. Div.), certif. denied, l 27 N.J. 553 (l99l). The presumption is especially strong in this case because when the Legislature imposed the surtaxes and assessments in FAIR, it explicitly declared that FAIR was "a logical, comprehensive and complete revision of the various laws and regulatory schemes that impact, in whatever fashion, on the system and its participants." N.J.S.A. l7:33B-2(f). Nonetheless, the Legislature did not amend the Excess Profits statute in any respect. It did, however, amend virtually every law dealing with automobile insurance. A partial listing of the statutes amended through FAIR includes the New Jersey Automobile Reparations Reform Act, N.J.S.A. 39:6A-l et seq., the Compulsory Motor Vehicle Insurance Law, N.J.S.A. 39:6B-23 et seq., the New Jersey Automobile Full Insurance Availability Act, N.J.S.A. l7:30E-l et seq.; the New Jersey Automobile Insurance Reform Act of l982, N.J.S.A. l7:29A-33 et seq.; the New Jersey Property-Liability Insurance Guaranty Association Act, N.J.S.A. l7:30A-l et seq.; the Department of Insurance Act of l970, N.J.S.A. l7:lC-l et seq.; the New Jersey Antitrust Act, N.J.S.A. 56:9-l et seq., the Rules and Regulations for the Apportionment of Insurance Coverage, N.J.S.A. l7:29D-l, and the Penalty Point Acts, N.J.S.A. 39:5-30.9. It is highly unlikely that the Legislature would fail to amend the Excess Profits Act,
significantly revised just two years earlier, L. l988, c. ll8, if
it had in fact intended such an amendment.
conflicts with a statute. Barnert Memorial Hosp., supra, 92 N.J.
at 40.
To uphold a regulation, therefore, the court must
determine that the regulation is authorized and consistent with
legislative policy. Id. at 39. The regulation challenged here
is not.
The legislative history establishes that actual results
for underwriting and investments are to be used to provide a
"more accurate representation of profits." Conditional Veto
Message, supra, at 2. I am totally unpersuaded by the
Commissioner's suggestion that the new regulation is an effort to
obtain a more accurate reflection of an insurer's actual
condition.
Instead, I find that Regulation 20.5(e) precludes an
insurer from reflecting a substantial cost of conducting private
passenger-automobile business in New Jersey. Here one insurance
company reports paying approximately $60 million in surtaxes and
assessments from l990 to l992. Another reports $3l million, and
another reports $6 million. The Commissioner does not obtain an
accurate reflection of the insurers' financial conditions when
those compulsory expenses are not considered.
Likewise, I am unpersuaded that unless the surtaxes and
assessments are not excluded as deductions under the EPL,
insureds will end up actually paying the surcharges and
assessments imposed under FAIR. That is just plain wrong. Under
State Farm v. State,
124 N.J. 32 (1991), the FAIR Act fees are
already properly excluded from the ratemaking process. Thus,
insureds are guaranteed that their premiums will not increase as
a result of the assessment and surtax. To exclude the fees again
at the Excess Profits stage provides insureds with a double
benefit unauthorized by the anti-pass-through statutes. That
second exclusion may permit an insured to receive a refund check.
Such a refund check would issue even though any increased profits
could not have resulted from the surtax and assessment because
the insured never was charged and never paid a higher premium
based on the surcharge or the assessments. Under the Court's
holding, an insured could receive a refund even if an insurance
company did not have any excess profits. Such a refund is
equivalent to the Commissioner imposing an additional tax on
insurers.
"The power to raise revenue or to tax is among the most
fundamental of governmental powers." In re Comm'r of Ins.,
supra, l32 N.J. at 226. Moreover,
[t]he need not to give a "statute any greater
effect than its language allows" is
"particularly compelling" in the context of
considering the power to tax. Kingsley v.
Hawthorne Fabrics, Inc., 4l N.J. 52l, 528,
l
97 A.2d 673 (l964).
Rarely does the Legislature extend
revenue-raising authority with regulatory
authority. When it does, it closely hems in
the grant of authority. See Public Serv.
Elec. & Gas Co. v. New Jersey Dep't of Envtl.
Protection, l0l N.J. 95, l04, 50l A.2d l25
(l985) (finding that Legislature authorized
the agency to administer "cost-based" permit
program, not a "revenue-raiser").
evidence exists that the Legislature intended to repeal any
provisions of the Excess Profits Law exists.
Neither the legislative history nor the language of FAIR
even hints at an intent to repeal by implication the provisions
of EPL. Additionally, FAIR clearly dealt with the surtaxes and
assessments in the context of standard ratemaking. Excess-profit
calculation is not ratemaking, it is a retrospective review of
actual profits and losses.
Justice O'Hern joins in this dissent.
Footnote: 1Underwriting income is significant because it is a
component of actuarial gain, which amount is added in the final
calculus to determine whether an insurer has earned excess
profits. N.J.S.A. 17:29A-5.8; N.J.S.A. 17:29A-5.6(b).