NOT FOR PUBLICATION WITHOUT THE
APPROVAL OF THE APPELLATE DIVISION
SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
DOCKET NO. A-5129-97T3
IN THE MATTER OF THE
REORGANIZATION OF THE
MEDICAL INTER-INSURANCE
EXCHANGE OF NEW JERSEY
Argued November 10, 1999 - Decided February 14, 2000
Before Judges Kleiner, P.G. Levy and Carchman.
On appeal from the Department of Banking and Insurance.
H. Curtis Meanor argued the cause for appellants, Allen
B. Gold, Robert A. Goldstone, and Morton J. Seligman
(Lampf, Lipkind, Prupis, Petigrow and LaBue, attorneys;
Neil L. Prupis, on the brief).
Mitchell A. Newmark, Deputy Attorney General, argued
the cause for respondent New Jersey Department of
Banking and Insurance (John J. Farmer, Jr., Attorney
General, attorney; Joseph L. Yannotti, Assistant
Attorney General, of counsel; Mr. Newmark, on the
brief).
Hersh Kozlov argued the cause for respondent Medical
Inter-Insurance Exchange of New Jersey (Kozlov, Seaton,
Romanini, Brooks & Greenberg, attorneys; Mr. Kozlov, of
counsel; Gregory A. Lomax, Frank A. DiGiacomo and John
J. Dugan, on the brief).
David J. D'Aloia argued the cause for intervenor
Medical Society of New Jersey (Saiber Schlesinger Satz
& Goldstein, attorneys; Mr. D'Aloia, of counsel; Joan
M. Schwab and Adam S. Ravin, on the brief).
The opinion of the court was delivered by
CARCHMAN, J.A.D.
In response to the increasing burden imposed on the medical
profession by high malpractice insurance premiums, respondent
Medical Inter-Insurance Exchange of New Jersey (MIIX) was
established in 1977 as a reciprocal insurance exchange to provide
medical malpractice liability and related lines of insurance. In
1997, in an effort to "enhance its strategic and financial
flexibility" and to provide its members with marketable stock
and, in some cases, cash, MIIX's Board of Governors sought to
reorganize MIIX from a reciprocal insurer to a stock insurer.
Unlike other jurisdictions, New Jersey does not presently provide
a statutory mechanism for a direct conversion, so MIIX sought to
accomplish its corporate objectives consistent with presently
existing statutory authority. MIIX conceived of a plan to a)
create a new stock insurance company and a holding company; b)
essentially transfer the assets and liabilities of the present
company to the new company; c) acquire, for consideration,
subsidiary companies; d) allocate and distribute common stock and
cash to current and recent former MIIX members; and thereafter,
e) dissolve the reciprocal company. All of these proposed steps
would be consistent with and designed to conform to existing
statutory authority and subject MIIX to the regulatory oversight
and approval of the Commissioner of Banking and Insurance.
In March 1998, Elizabeth Randall, the then Commissioner of
the New Jersey Department of Banking and Insurance
("Commissioner" or "Department") conditionally approved a Plan of
Reorganization (Plan) authorizing MIIX's dissolution and
reorganization as a stock insurance company. New Jersey State
Medical Underwriters, Inc. (Medical Underwriters), a wholly owned
subsidiary of intervenor, the Medical Society of New Jersey
(MSNJ), contracted to act as attorney-in-fact and manage MIIX's
operations.
Appellants, Allen B. Gold, Robert A. Goldstone, and Morton
J. Seligman, three MIIX-insured doctors, challenge the
reorganization and conversion arguing that the Plan approval
should be set aside for three reasons: (1) the Department erred
because the approval was unauthorized by statute, the wrong
standards were applied, and no evidence supported the conclusion
that the stock allocation was fair and equitable; (2) the
Department violated the Administrative Procedure Act (APA) and
constitutional due process requirements by providing inadequate
notice; and (3) there was insufficient evidence to support the
agreed-upon payment to MSNJ for Medical Underwriters. In
addition to their legal arguments, appellants assert that equity
requires that current, long-term subscribers receive stock
distributions in proportion to their total contributions to
MIIX's surplus and reserves, not in proportion to the net
premiums paid during the last three years. They also express
concern that the reorganization will result in higher malpractice
premiums in the future.
We reject their contentions and affirm.
I.
The issues in this appeal arise in the following factual and
procedural context. MIIX was established in 1977 under the
auspices of MSNJ as a reciprocal insurance exchange authorized by
N.J.S.A. 17:50-1 to -19. Many initial subscribers, sometimes
referred to as founders, including appellants, made interest-free
loans (since repaid) during MIIX's startup period. At the time
this proceeding commenced, MIIX subscribers numbered
approximately 12,000 members.
In October 1997, MIIX's Board of Governors (Board) sought
approval from the Commissioner to convert to a stock insurance
company. As we have noted, no statute expressly authorized such
conversion or required the Commissioner's approval. However,
statutory authority exists for the formation of stock ownership
insurance companies,
N.J.S.A. 17:17-1 to -20, which, when such
entity is created, requires certification by the Commissioner.
N.J.S.A. 17:17-10.
MIIX filed the Plan with the Department on October 16, 1997.
On October 24, 1997, MIIX sent a letter to its members informing
them that on October 15, 1997, the Board had approved a plan to
reorganize from a reciprocal insurance exchange to a stock
company. It advised that the plan provided for MIIX to acquire
Medical Underwriters, then owned by MSNJ, and set forth reasons
in support of the change. The letter continued:
The next step in advancing the plan will
involve approval by the Commissioner of the
New Jersey Department of Banking and
Insurance in the coming months. We
anticipate this will include a public hearing
conducted by the Commissioner, and the date
will be communicated to you. Following the
Commissioner's approval, MIIX members will
receive the information they need to vote on
the plan sometime in the first half of 1998.
Finally, the letter provided a telephone contact to respond to
subscriber's questions.
On December 1, 1997, a summary of the Plan and notice of
hearing to be held on December 22, 1997, were published in the
New Jersey Register, and a copy of the notice and Plan summary
was thereafter forwarded to the members by letter dated December
12, 1997.
According to the summary, the Plan's intent was "to create
in MIIX Insurance Company a successor to MIIX that is virtually
identical to MIIX except for its form (i.e., stock insurer rather
than reciprocal). The principal purposes of reorganization were
to "enhance [MIIX's] strategic and financial flexibility" and to
provide distributees with stock of the MIIX Group, Inc. (the new
holding company that would own MIIX), or cash. After the new
MIIX had assumed the business, assets and liabilities of the
current MIIX and the holding company had acquired Medical
Underwriters and its subsidiaries, the reciprocal exchange would
be dissolved.
Of particular interest to the Commissioner and concern to
appellants was the use of a three-year look-back period for stock
distribution. Under the terms of the Plan, stock would be
allocated to distributees (those who were members during a three
year look-back period before the Plan adoption on October 15,
1997) based on the MIIX direct premium earned, less any return
premium, attributable to each member over the look-back period.
Gold and Goldstone objected in separate letters to Assistant
Banking and Insurance Commissioner Donald Bryan dated December 18
and 19, 1997. Gold argued that conversion was unnecessary and
likely to lead to higher premiums; that it would benefit the
Board more than the members; and that the short notice gave the
appearance of impropriety. Goldstone also asserted that the
notice was inadequate, and argued that the distribution scheme
penalized long-term members like him who had paid full premiums
for many years but had paid less during the Plan's proposed
three-year look-back period because they were semi-retired.
At the hearing held on December 22, 1997, with Bryan
presiding as hearing officer, Daniel Goldberg, then president and
chief executive officer of Medical Underwriters, described the
Plan and explained that the primary reason for the change was
management's belief that in the long term, the only capital
source available, retained surplus, would be insufficient to
allow necessary growth.
As explained by Kenneth Koreyva, vice-president and chief
financial officer of Medical Underwriters, the acquisition value
of Medical Underwriters, $11 million in stock and $100,000 in
cash, was based on a valuation by investment bankers Salomon
Brothers, Inc. (Salomon Brothers). Salomon Brothers provided an
opinion that the consideration to be received by the distributees
was fair to them as a group from a financial point of view.
Salomon Brothers also opined that the consideration to be paid to
acquire Medical Underwriters was fair to MIIX from a financial
point of view. MIIX rules and regulations provided that the Plan
was subject to the approval of at least two-thirds of the votes
of the members voting in person or by proxy at a special meeting.
(The Plan was subsequently approved by the membership on March
17, 1999.)
Koreyva suggested that the three-year look-back period to
determine distributees was fair and reasonable and represented a
compromise between distribution only to current members, which
was potentially unfair, and distribution to all current and
former members who might have contributed to surplus over the
life of the enterprise, which was a practical impossibility.
Various of the members had died or retired since MIIX was
established and determination of their various interests would be
problematic. The three-year look-back period also conformed to
the majority rule applied in other jurisdictions to analogous
conversions.
Neither Gold, nor Goldstone nor any other members of the
public presented comments at the hearing. The record was held
open for written comments through the end of December. After the
record was closed, appellants' counsel wrote a series of letters
to the Department in opposition to the Plan. The correspondence
was not considered.
Bryan, as hearing officer, found that the Plan accorded with
MIIX's rules of governance and satisfactorily addressed the
Department's regulatory concerns for the protection of
policyholders and the market. He noted that in the absence of a
codified statutory procedure for the Department's review, the
Department had chosen to follow the rulemaking process set forth
in N.J.S.A. 52:14B-4. The Department's analysis included
information from its records such as the formation filing,
present rating systems and previously filed periodic financial
reports.
The hearing officer found that MIIX's stated reasons for the
conversion (primarily, better access to capital markets for
growth) were important for the long-term viability of the
enterprise. He concluded that the Plan adequately protected
policyholders and claimants because the new MIIX would assume
MIIX's liabilities and receive assets sufficient to support them
and that the members would be treated fairly when the exchange
was dissolved. MIIX Group stock would be distributed to them
based on a three-year look-back, and the surviving entity would
be entirely owned and controlled by present and recent former
members, except for the portion of stock issued to MSNJ in
exchange for the assets of Medical Underwriters. He found that
the valuation of Medical Underwriters and the calculation of
stock distribution to members were both reasonable and adequately
supported by the opinion of Salomon Brothers.
Bryan then reviewed the cessation of business under the
orderly withdrawal statute, N.J.S.A. 17:17-10, and found that the
Plan satisfactorily prevented or minimized any market
disruptions. He found that the creation of a domestic stock
insurer was likely to accord with N.J.S.A. 17:17-1 to -20 and
N.J.A.C. 11:1-28. The reorganization would not prejudice MIIX's
policyholders, claimants or the insurance-buying public, but, to
the contrary, would generally benefit them. Significantly, he
found that the proposed plan of distribution is clearly
reasonable and equitable. He noted that the officers and
members of the Board would not receive any of the stock of the
MIIX Group except to the extent that they qualified as
policyholders the same as other members, and that no one person
or entity would obtain ten percent or more of the voting stock.
The hearing officer noted appellants' concern with notice,
but found the notice of the pending application consistent with
the rulemaking provisions of the APA, and that, in addition, MIIX
had given its members notice individually. Timely written
comments had been received from two interested parties, and were
given the same weight as public testimony would have been given.
He recognized appellants' complaint that long tenure as members
would not be reflected in the stock distribution plan, but
accepted Koreyva's testimony about the practical difficulty of
allocating stock based on participation dating back to MIIX's
formation. He found concerns about the distribution plan better
resolved among the MIIX membership, when MIIX approval was
considered.
On March 5, 1998, the Commissioner conditionally approved
the Plan adopting Bryan's report. Thereafter, appellants moved
for a rehearing which was denied. Appellants filed a notice of
appeal, and we, thereafter, granted MSNJ's motion to intervene.
Appellants argue that the Commissioner erred in
conditionally approving the Plan because no statute authorized
such approval, she failed to apply appropriate standards in
evaluating the Plan, and there was no evidence to support a
finding that the stock allocation would be fair and equitable.
Respondents and intervenor respond that the approval was
authorized by two statutes providing for formation of a new
company and dissolution of the old entity, and that it was not
arbitrary, capricious or unreasonable.
II.
We first address the standard of review which governs our
analysis of administrative action. An appellate court "will not
reverse an agency decision unless it is 'arbitrary, capricious or
unreasonable or is not supported by substantial credible evidence
in the record as a whole.'"
Department of Ins. v. Universal
Brokerage Corp.,
303 N.J. Super. 405, 409 (App. Div. 1997)
(quoting
Dennery v. Board of Educ.,
131 N.J. 626, 641 (1993)).
The burden of proof rests upon the challenger; the agency
decision carries a strong presumption of reasonableness, and the
court must not substitute its judgment for that of the agency.
Id. at 409-10. Moreover, the expertise of the Commissioner "in
the field of insurance must be given great weight."
In re
Assignment of Exposures to the Aetna Cas. and Surety Co.,
248 N.J. Super. 367, 376 (App. Div.),
certif. denied,
126 N.J. 385
(1991),
cert. denied,
502 U.S. 1121,
112 S. Ct. 1244,
117 L. Ed.2d 476 (1992). Applying these principles, we now examine
appellants' claims.
Appellants assert that in the absence of statutory
authorization, it was "presumptuous" for MIIX to "concoct a
process" for conversion. They cite the standards of the mutual
life insurer conversion statute,
N.J.S.A. 17:17C-1 to -14 (
L.
1998,
c. 46, effective July 1, 1998) (1998 demutualization
statute), enacted after the Commissioner's decision here and
admittedly inapplicable, contending that MIIX was precluded from
converting without comparable statutory authority and guidelines
or unanimous consent of the subscribers.
Appellants later argue that, absent an enabling statute, the
Plan could be neither adopted by MIIX, nor approved by the
Department except with the consent of all the members, and that
the deference normally accorded an agency decision is
inappropriate in the absence of sufficient statutory standards
and procedures citing
Schwarzwaelder v. German Mut. Fire Ins.
Co.,
59 N.J. Eq. 589, 591 (E. & A. 1899), which they contend is
dispositive.
Schwarzwaelder held that a mutual insurance company
lacked the right to transform itself into a joint stock company
against the will of a member who became a member before passage
of a March 6, 1899, act authorizing such a transformation.
Id.
at 594. The court observed that, "The power to change a mutual
insurance company into a joint stock company is one which, if
possessed at all, must be derived from the statute."
Id. at 591.
Schwarzwaelder does not establish that a reciprocal insurer
cannot convert to a stock company without express statutory
authority or unanimous consent of its subscribers. Even if it is
assumed that the stated proposition remains valid,
Schwarzwaelder
is not controlling. First, it applied to a mutual, not a
reciprocal, insurer. A reciprocal association differs from a
mutual company in that it has no corporate existence.
43 Am.
Jur. 2d Insurance § 77 (1982). Second, the conversion here was
made under statutory authority, though in two steps.
We first observe that MIIX was created pursuant to statutory
authority,
N.J.S.A. 17:50-1 to -19, which incorporated a
provision that exchanges created under the statute shall be
regulated by this act, and by no other statute of this State
relating to insurance, except as herein otherwise provided.
N.J.S.A. 17:50-1. We note that the statute is silent as to a
mechanism for voluntary dissolution. As the Attorney General
noted at oral argument, the Legislature could not have intended
that such reciprocals continue on in perpetuity.
Absent such statutory authority to voluntarily dissolve, we
deem it appropriate to focus on the general powers of the
Commissioner. "The Commissioner is invested with broad general
powers of administration over all the laws of the State relative
to insurance."
New Jersey State AFL-CIO v. Bryant,
55 N.J. 171,
176 (1969) (citing
N.J.S.A. 17:1-1, 2). The Department of
Banking and Insurance Act of 1996,
N.J.S.A. 17:1-13 to -24,
confers on the Commissioner broad duties and responsibilities.
For example, the Commissioner is directed to "[d]etermine all
matters of policy within the commissioner's jurisdiction;" to
"[i]nstitute or cause to be instituted the legal proceedings or
processes necessary to enforce properly and give effect to any of
the commissioner's powers or duties;" and to "[p]erform such
other functions as may be prescribed by law in this act or by any
other law."
N.J.S.A. 17:1-15(f), (g), (j).
In exercising her general regulatory authority over MIIX's
proposed conversion, the Commissioner utilized the withdrawal
statute,
N.J.S.A. 17:17-10(b), as an appropriate standard to
measure MIIX's actions against protection of the public interest.
The withdrawal statuteSee footnote 11 was enacted as part of the Fair
Automobile Insurance Act of 1990,
L. 1990,
c. 8, and was
obviously not designed for the purpose of facilitating a
reorganization or conversion. It focused on allowing the
Commissioner to exercise oversight and regulate the impact of a
carrier's withdrawal from the insurance market. While we
recognize that the statute was not designed for the purpose
utilized by the Commissioner here, we find the utilization of the
standards incorporated in the statute by analogy to be an
appropriate exercise of the Commissioner's general regulatory
power. The Commissioner's affirmative finding that policy
holders (and to a lesser extent, employees and creditors) will be
protected under the conversion satisfies any regulatory concern
for that class of persons to be protected by the Commissioner's
statutory oversight. As to the second step in the statutory
process, appellants do not dispute that the Commissioner was
vested with the authority to approve the formation of an
insurance company upon the stock plan and issue a certificate
authorizing it to transact business.
N.J.S.A. 17:17-10(a).
We conclude that under the Commissioner's general regulatory
powers and by application of the standards set forth in the
withdrawal statute, the Commissioner had appropriate statutory
authority on which to sanction the conversion.
III.
Appellants next argue that the hearing officer wrongly
failed to determine the fairness of allocation of stock among the
class of distributees based on actuarial opinion, but instead
determined only that it was reasonable. Although he did not rely
on actuarial opinion, he did find the distribution plan was both
reasonable and fair. We observe that it is by no means obvious
that the plan apparently proposed by appellants (determining the
class of distributees by a three-year look-back but allocating
stock based on total past contributions) would be more equitable
than the one adopted. It would benefit them to the detriment of
other current members.
The hearing officer found the distribution plan was "within
the bounds of reasonableness and practicality. He noted, "In
approving the plan, the Department will not substitute its
judgement [sic] for the determination of the membership as to the
best plan for distribution as expressed through its governance
mechanism. He also acknowledged analogous demutualization
statutes adopted in other states, and said, "These authorities
applied to analogous circumstances support the conclusion that
the proposed plan of distribution is clearly reasonable and
equitable.
While Salomon Brothers disclaimed any opinion on the
fairness of the allocation among distributees, it did give its
opinion that the consideration to the distributees as a group was
fair. MIIX presented proofs at the hearing that the distribution
plan was "a compromise between the potentially unfair approach of
distribution only to current members and the practically
impossible approach of distribution to all current and former
members who might have contributed to the surplus of the Company
over the life of the enterprise. According to Koreyva, the
three-year look-back approach was "fair and reasonable.
Appellants argue that the twenty-five states that have
reciprocal insurer conversion statutes require more than just a
generalized finding that the proposed allocation and distribution
must be fair and reasonable. Appellants suggest that
reciprocal conversions in those jurisdictions must be equitable
to subscribers and must give them interests in the new company
proportionate to their interests in the reciprocal. Appellants
argue that the allocation plan was presumptively inequitable and
disproportionate because long term members were the principal
source of surplus and reserves. A review of those statutes
provides little support for appellants' position.
Our review of the reciprocal conversion statutes from other
jurisdictions demonstrates that while they similarly set forth
general fairness standards consistent with those found in
demutualization statutes, they do not lend further support to
appellants' argument that the distribution here was patently
unfair. Most prescribe a one-year look-back to define the class
of distributees. None prescribes a look-back period for
allocation.
Twenty states (Alabama, Alaska, Arizona, Arkansas, Delaware,
Florida, Georgia, Hawaii, Idaho, Kentucky, Maine, Maryland,
Montana, Nevada, New Mexico, Oklahoma, Vermont, Washington, West
Virginia and Wyoming) have reciprocal insurer statutes containing
relevant provisions that are very similar to each other in both
format and language.
See Ala. Code §§ 27-31-15, -27, -28 (1999);
Alaska Stat. §§ 21.75.140, .250, .260 (Michie 1999);
Ariz. Rev.
Stat. Ann. §§ 20-778, -789, -790 (West 1999);
Ark. Code Ann. §§
23-70-112, -122, -123 (Michie 1999);
Del. Code Ann. tit. 18, §§
5724, 5725 (1999);
Fla. Stat. Ann. §§ 629.161, .281, .291 (West
1999);
Ga. Code Ann. §§ 33-17-17, -28, -30 (1999);
Haw. Rev.
Stat. Ann. §§ 431:4-422, -424, -504 (Michie 1999);
Idaho Code §§
41-2916, -2928, -2929 (1999);
Ky. Rev. Stat. Ann. §§ 304.27-260,
-270 (Banks-Baldwin 1999);
Me. Rev. Stat. Ann. tit. 24-A, §§
3874, 3875 (West 1999);
Md. Code Ann., Ins. §§ 3-201, -221
(1999);
Mont. Code Ann. §§ 33-5-202, -402, -411 (1999);
Nev. Rev.
Stat. Ann. §§ 694B.240, .250 (Michie 1999);
N.M. Stat. Ann. §§
59A-39-24, -25 (Michie 1999);
Okla. Stat. Ann. tit. 36, §§ 2917,
2928, 2929 (West 1999);
Vt. Stat. Ann. tit. 8, §§ 4854, 4855
(1999);
Wash. Rev. Code Ann. §§ 48.10.190, .320, .330 (West
1999);
W. Va. Code §§ 33-21-25, -26 (1999);
Wyo. Stat. Ann. §§
26-27-115, -127, -128 (Michie 1999).
The Alabama law is typical of this group. It provides for
merger or conversion:
(a) A domestic reciprocal insurer, upon
affirmative vote of not less than two thirds
of its subscribers who vote on such merger,
pursuant to due notice and the approval of
the commissioner of the terms therefor, may
merge with another reciprocal insurer or be
converted to a stock or mutual insurer.
(b) Such a stock or mutual insurer shall be
subject to the same capital or surplus
requirements and shall have the same rights
as a like domestic insurer transacting like
kinds of insurance.
(c)
The commissioner shall not approve any
plan for such merger or conversion which is
inequitable to subscribers or which, if for
conversion to a stock insurer, does not give
each subscriber preferential right to acquire
stock of the proposed insurer proportionate
to his interest in the reciprocal insurer, as
determined in accordance with Section 27-31
27 and a reasonable length of time within
which to exercise such right.
[
Ala. Code § 27-31-28 (1999) (emphasis
added).]
The distribution plan is described in Section 27-31-27:
Upon the liquidation of a domestic reciprocal
insurer, its assets remaining after discharge
of its indebtedness and policy obligations,
the return of any contributions of the
attorney or other persons to its surplus made
as provided in Section 27-31-15, and the
return of any unused premium, savings or
credits then standing on subscribers'
accounts, shall be
distributed to its
subscribers who were such within the 12
months prior to the last termination of its
certificate of authority, according to such
reasonable formula as the commissioner may
approve.
[
Ala. Code § 27-31-27
(emphasis added).]
Return of contributions is controlled by Section 27-31-15:
The attorney or other parties may advance to
a domestic reciprocal insurer, upon
reasonable terms, such funds as it may
require, from time to time, in its
operations. Sums so advanced shall not be
treated as a liability of the insurer and,
except upon liquidation of the insurer, shall
not be withdrawn or repaid except out of the
insurer's realized earned surplus in excess
of its minimum required surplus. No such
withdrawal or repayment shall be made without
the advance approval of the commissioner.
[
Ala. Code § 27-31-15.]
All twenty of these statutes similarly provide that the
insurance commissioner may approve no plan for conversion that is
"inequitable to subscribers," or does not give each subscriber
the preferential right to acquire stock "proportionate to his
interest in the reciprocal insurer." A majority of these states
require this interest to be determined by distributing assets
according to a "reasonable formula." Two states require only
that the distribution is done "according to such formula as may
have been approved by the Commissioner."
Haw. Rev. Stat. Ann. §§
431:4-424, -504;
Wash. Rev. Code Ann. §§ 48.10.320, .330. No
statute suggests that allocation should have been made
proportionate to total past contributions to surplus and equity,
rather than net earned premiums for the past three years. Of
particular probity is that the standard for the distribution is a
reasonable standard, the same adopted by the Commissioner here.
Nineteen of the twenty statutes provide a twelve-month look
back to define the class of distributees.See footnote 22 Appellants do not
challenge the Commissioner's use of a three-year look-back period
for that purpose, though they object to use of the same period
for the purpose of allocation.
Appellants also direct the court to reciprocal conversion
statutes in five other states _ California, Massachusetts, New
York, South Dakota and Virginia.
See Cal. Ins. Code §§ 1560
1560.19 (West 1999);See footnote 33
Mass. Gen. Laws Ann. ch. 175, § 94N (West
1999);
N.Y. Ins. Law §§ 7308-7309 (McKinney 1999);
S.D Codified
Laws § 58-34-61 (Michie 1999);
Va. Code Ann. § 38.2-1230 (Michie
1999). They do not compel a different conclusion.
California specifically provides detailed procedures for the
conversion of certain reciprocal insurers (organized after 1974
to provide medical malpractice insurance) to incorporated stock
insurers.
Cal. Ins. Code §§ 1560_1560.19. The commissioner is
charged with judging whether the conversion plan is "fair, just,
and equitable to the insurer and its policyholders."
Id. §
1560.05(a)(1).
Massachusetts provides for conversion of a reciprocal
insurance exchange to a domestic mutual insurance company upon a
two-thirds vote of subscribers of a plan approved by the
commissioner as "conforming to the requirements of this section
and as fair, reasonable and not prejudicial to the subscribers of
such exchange or to the insuring public."
Mass. Gen. Laws Ann.
ch. 175, § 94N(1)-(2). Eligible subscribers are those who were
members on the conversion date and who owned a policy in full
force (with additional conditions) "on both the December thirty
first immediately preceding the conversion date and the date the
exchange's advisory committee first votes to convert to mutual
form."
Id. § 94N(5). Each eligible subscriber shall receive
appropriate consideration in exchange for membership interests:
"Said consideration shall be determinable under a fair and
reasonable formula approved by the commissioner, and shall be
based upon the exchange's entire surplus as shown by the
exchange's financial statement . . . ."
Id. § 94N(3).
New York provides for conversion of domestic reciprocal
insurers into stock property/casualty companies or mutual
property/casualty companies.
N.Y. Ins. Law §§ 7308-7309. For
conversion into a stock company it requires that "the
superintendent shall pass upon the fairness of the terms and
conditions of the proposed conversion and of the issuance of
shares of the corporation and he shall approve or disapprove the
same."
Id. § 7308(a). Shares representing the capital and
surplus of the corporation "shall be issued to existing
subscribers . . . in proportion to their shares in the aggregate
operating reserves at the time when the proposal to convert is
adopted."
Id. § 7308(b).
South Dakota expressly prohibits conversion from a domestic
reciprocal insurer to a stock or mutual insurer.
S.D. Codified
Laws § 58-34-61.
The Virginia statute cited by appellants does not expressly
provide for conversion from a reciprocal, but requires prior
written approval of the insurance commission for all "material
transaction[s]" between a domestic reciprocal and its attorney or
affiliate that involve more than five percent of the domestic
reciprocal's assets.
Va. Code Ann. § 38.2-1230(A). The terms
must be "fair and equitable" and the Commissioner must consider
"whether the transaction adversely affect[s] the interests of the
subscribers or the solvency of the reciprocal."
Id. § 38.2
1230(A)(1), (B).
Thus, even the minority statutes, like the majority, provide
support for a general fairness requirement. Massachusetts and
New York refer to surplus as a measure of the consideration to be
exchanged for membership interests, but neither requires
distribution in direct proportion to contribution to surplus, the
principle advocated by appellants.
In sum, the cited statutes fail to demonstrate by analogy
that the Commissioner used improper procedures or applied the
wrong standards here.
Appellants also analogize to the 1998 demutualization
statute, admittedly inapplicable, which requires a fairness
determination. That statute requires that the plan of
reorganization "be fair and equitable to the policyholders of the
mutual insurer."
N.J.S.A. 17:17C-3(b)(2). Allocation of
consideration among eligible policyholders "shall reflect . . .
factors such as estimated proportionate contributions of classes
or groupings of policies and contracts to the aggregate component
of consideration being distributed to eligible policyholders or
other factors the commissioner may approve."
N.J.S.A. 17:17C
3(c)(2). However relevant this statute may be it is not
determinative. The hearing officer did find, albeit without the
benefit of an actuarial opinion, that the allocation and
distribution was fair. Consideration of net premiums paid during
the three-year look-back period was determined to be a reasonable
standard to measure contribution even under the demutualization
statute. We cannot say that such conclusion is arbitrary or
capricious. Any measure or look-back period by its very nature
will benefit one class to the detriment of another. The failure
to recognize contributions since inception, standing alone, the
only factor truly asserted by appellants, cannot demarcate the
line of reasonableness or fairness.
Appellants argue that MIIX offered no factual data or expert
opinion to support the fairness or equity of the stock allocation
formula, and contend that allocation should have been made
proportionate to total past contributions to surplus and equity,
not premiums paid during the look-back period. As we have noted,
Koreyva opined that the three-year look-back was a fair and
reasonable way to define the class of distributees. He
acknowledged that the Salomon Brothers opinion applied to the
consideration paid to distributees as a group.
Koreyva implied that both the definition of the class and
the allocation were fair. He rejected as impractical the
possibility of distributing stock to all current and former
members who had contributed to surplus. Ironically, the
allocation plan now suggested by appellants, though more
favorable to them as current long-term members, would, like the
one adopted, exclude all
former members including "founders"
beyond the three-year look-back regardless of how much they had
contributed in the past. In any event, it was not necessary for
Koreyva to explain why other possible allocations were rejected.
We conclude that the stock allocation chosen is reasonable and
meets the deferential standard of review applicable here.
IV.
Appellants argue that the notice they received of the
departmental hearing failed to comply with all the notice
requirements set forth for rulemaking in
N.J.S.A. 52:14B-4 and
deprived them of their constitutional right to due process of
law. Respondents and intervenor respond that the Department
provided the required notice via its Insurance Division mailing
list and the December 1, 1997, New Jersey Register; that MIIX had
previously provided notice of its application to its members
individually by letters dated October 24 and December 12, 1997;
and that appellants were not prejudiced, but submitted timely
objections, which the Department considered before taking action.
Appellants do not complain of inadequate notice of MIIX's
plan to reorganize. They received a letter dated October 24,
1997, that informed them of the Board approval on October 15 and
advised them of a public hearing "in the coming months.
Appellants complain, however, that the notice of the hearing date
was tardy. A notice of public hearing and Plan summary was
published in the December 1, 1997, New Jersey Register.
29 N.J.R. 5110(a) (Dec. 1, 1997). A copy of that notice and Plan
summary was enclosed with a letter sent to members between
December 12 and 15, 1997.
The Commissioner explains that no hearing was mandated in
connection with her regulatory review of MIIX's orderly
withdrawal of the reciprocal insurance exchange and formation of
the stock insurance company. Nevertheless, she held a formal
hearing, providing notice generally in accordance with the
procedure required prior to the adoption, amendment or repeal of
a rule.
N.J.S.A. 52:14B-4(a)(1). Appellants contend that some
of the APA notice procedures were omitted. However, they do not
dispute the Commissioner's assertion that the APA procedures were
not mandated.
Appellants also contend that the notice was so inadequate
that it constituted a procedural due process violation. If the
APA does not apply, there is still a requirement of
administrative due process.
George Harms Constr. Co. v. New
Jersey Turnpike Auth.,
137 N.J. 8, 19 (1994). It is satisfied if
the parties have adequate notice, a chance to know opposing
evidence, and the opportunity to respond.
Id. at 19-20. An
agency may amend the procedures and abbreviate the comment
periods as it deems reasonable.
In re Dep't of Insurance's
Order,
129 N.J. 365, 382 (1992). Only a party with
particularized property interests is entitled to an adversarial
hearing based on constitutional due process.
In re Applications
of North Jersey Dist. Water Supply Comm'n,
175 N.J. Super. 167,
203 (App. Div.),
certif. denied,
85 N.J. 460 (1980). Appellants
have not demonstrated a legitimate property interest in a larger
share of the stock distribution.
Nor have appellants demonstrated prejudice from late notice
of the hearing. Appellant Gold did not receive the Plan summary,
or notice of the December 22 hearing, until six days before the
hearing. While we agree with appellants that the December letter
provided a very short response time, they do not show that it
prejudiced them. Both Gold and Goldstone did submit timely
objections, including objections to the short notice, which were
considered. The record remained open until December 31, 1997,
for the receipt of written comments. Appellants contend that it
was impossible for them to collect the information they needed in
order to respond meaningfully before December 31, 1997. But they
do not show that, given more time, they would have presented
information that was likely to have changed the outcome.
On March 16, 1998, appellants and others who opposed the
Plan moved before the Department for a rehearing. The
certification by counsel that accompanied that motion did not set
forth the issues the objectors wished to raise on rehearing.
However, among the attachments to the certification was a
February 4, 1998, letter to Bryan from the objectors' counsel.
In that letter, counsel argued that the conversion would benefit
MIIX officers at the expense of MIIX members, and that the
allocation
of stock was unfair to long-term members. Those
issues had already been raised by Gold and Goldstone in their
timely letters of objection, which were considered by the
Department.
Moreover, although appellants did get short notice of the
hearing date, they were alerted individually two months before
the hearing that the Board had approved the conversion and that
the Department would hold a hearing "in the coming months." They
took no action until they received notice of the hearing date.
We are satisfied that appellants' claims regarding the defect in
notice is without merit.
V.
Lastly, appellants argue that the hearing officer erred by
finding sufficient support for MIIX's acquisition of Medical
Underwriters for $11 million in stock and $100,000 in cash.
Respondents and intervenor respond that the hearing officer
properly relied on the valuation by Salomon Brothers, and that
appellants improperly raise this argument for the first time on
appeal and rely on evidence outside the record.
We agree that the issue is raised too late as appellants'
actuarial certification was filed during the pendency of this
appeal. We granted MIIX's motion to strike the certification
from appellants' appendix.
In any event, Salomon Brothers opined that the consideration
to be paid for Medical Underwriters was fair. In preparing its
fairness opinion, Salomon Brothers reviewed and analyzed, among
other things, MIIX's annual statements from 1992 through 1996.
The Department was entitled to rely on that opinion.
In sum, appellants' underlying claim is that their status as
founders of this reciprocal is not being appropriately or
adequately recognized in the allocation and distribution formula.
While we understand their claim, we also recognize that MIIX was
established to provide a cost-reduction benefit to appellants and
the many other founders and members over the years. They did
contribute initial financing, since repaid, but also received the
benefit of the premium contributions of those that followed them
in providing for the viability of the enterprise.
We conclude that the Commissioner properly approved MIIX's
conversion from a reciprocal insurer to a stock insurer and that
appellants have failed to demonstrate that such action was
arbitrary, capricious or unreasonable.
Affirmed.
Footnote: 1 1N.J.S.A. 17:17-10(b) provides:
No company licensed to transact
insurance business in this State pursuant to
chapter 17 of Title 17 of the Revised
Statutes may surrender its certificate of
authority or discontinue writing or renewing
any kind or kinds of insurance specified in
the certificate, except in accordance with a
plan to be submitted by the company and
approved by the commissioner, which plan
shall provide for an orderly withdrawal from
the market and for the minimization of the
impact of the surrender of the certificate or
the discontinuance of the writing or renewing
of any kind or kinds of insurance upon the
public generally and upon the company's
policyholders in this State. No surrender or
discontinuance shall become effective until
the approved plan has been complied with. In
reviewing a plan for withdrawal submitted by
the company, the commissioner shall consider,
and may require as a condition of approval,
whether some or all other certificates of
authority issued pursuant to chapter 17 or 32
of Title 17 of the Revised Statutes held by
the company or by other companies within the
same holding company system as the company
submitting the plan shall be required to be
surrendered. The provisions of this
subsection shall apply to any request for
withdrawal, surrender or discontinuance filed
on or after January 25, 1990.
Footnote: 2 2The Maryland statute contains neither a look-back provision
nor a requirement that the distribution be done according to a
"reasonable formula." Md. Code Ann., Ins. §§ 3-201, -221.
Footnote: 3 3Appellants also list Cal. Ins. Code §§ 1550-1559, but those
sections pertain to merger, not conversion.