Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 52 Pa.B. 6342 (October 1, 2022).

31 Pa. Code § 61.6. Appeal procedures.

§ 61.6. Appeal procedures.

 (a)  An insured may request review by the Insurance Commissioner of the action of the insurer in cancelling or refusing to renew his policy by making written request therefore. This may be done by signing a copy of the ‘‘Notice of Cancellation or Refusal to Renew,’’ and sending it to one of the regional offices of the Insurance Department at one of the addresses given on the notice.

 (b)  Upon receipt of the request both the insured and the insurer will be notified that an investigation has been undertaken and they may be contacted to secure additional information as required.

 (c)  Upon completion of the investigation a copy of the investigative report will be supplied to both the insured and the insurer. Within 10 days of receipt of the report either party may submit written comments for consideration by the Insurance Commissioner.

 (d)  At the time written comments are submitted, if either the insured or the insurer desires a formal administrative hearing, the request shall be made. If so, a hearing will be scheduled as soon as possible. If not, the matter will be decided on the basis of the written comments and the investigative report.

 (e)  Hearings will be held in accordance with the following procedures:

   (1)  Upon receipt of a request for a formal administrative hearing, notice of the time and place of the hearing will be sent by certified mail to the insurer and insured, not less than 5 days prior to the hearing.

   (2)  The hearing will be recorded on tape with a stenographer. The tape and stenographer’s notes shall be prepared such that a full verbatim transcription may thereafter be made. The tape will be retained for a period of 90 days following issuance of the Insurance Commissioner’s final order in the case.

   (3)  Parties will be afforded a reasonable time following the hearing to submit written briefs in support of their position.

   (4)  Relevant evidence of reasonable probative value will be admitted into the record of the proceeding and reasonable examination and cross-examination will be permitted.

   (5)  The provisions of 1 Pa. Code Part II (relating to general rules of administrative practice and procedure) may be used where conducive to speedy and fair proceedings.

 (f)  Upon completion of a hearing, if held, or upon receipt of the written comments, the Insurance Commissioner will issue an order in conformance with his findings.

Source

   The provisions of this §  61.6 amended January 16, 1976, 6 Pa.B. 78. Immediately preceding text appears at serial page (19080).

Notes of Decisions


Arbitration

   An adjudication on the failure of an insurance carrier to renew an automobile policy was rendered by the Insurance Commissioner. Therefore, the appointment of another presiding officer for the Insurance Department some time after the conclusion of the insured’s hearing was irrelevant. Kramer v. Insurance Department, 654 A.2d 203 (Pa. Cmwlth. 1995).

   The Department of Insurance properly refused to hold a formal administrative hearing to review the cancellation of insured’s automobile insurance policy based on the insured’s failure to request a formal hearing before the Insurance Commission within 10 days from the date the insured received the Investigative Report/Order. Marconi v. Insurance Department, 641 A.2d 1240 (Pa. Cmwlth. 1994).

   An insurer was denied administrative due process, where the Commissioner-based determination of timeliness on a period beginning with the date that investigative reports were mailed. The time frame for making such requests begins not on the date the reports and orders were mailed, but on the date they were received as required by regulation. Teachers Ins. Co. v. Insurance Commissioner, 623 A.2d 388 (Pa. Cmwlth. 1993).

Cross References

   This section cited in 31 Pa. Code §  61.5 (relating to notice of cancellation or refusal to renew; requirements).



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