Sullivan Financial Group, Inc. v. Wrynn
Opinion of the Court
In January 2010, the Insurance Department
Petitioners are licensed insurance producers or organizations that represent the interests of insurance producers. They commenced this CPLR article 78 proceeding seeking to annul 11 NYCRR part 30. Supreme Court dismissed the petition and entered judgment in favor of respondent. Petitioners now appeal, arguing that respondent exceeded the scope of his authority in issuing 11 NYCRR part 30. We disagree.
As petitioners note, it is “a fundamental principle of administrative law that agencies are possessed of only those powers expressly delegated by the Legislature, together with those powers required by necessary implication” (Matter of Beer Garden v New York State Liq. Auth., 79 NY2d 266, 276 [1992]; see Finger Lakes Racing Assn. v New York State Racing & Wagering Bd., 45 NY2d 471, 480 [1978]). Even under a broad grant of authority, “[a]n agency cannot by its regulations effect its vision of societal policy choices, and may adopt only rules and regulations which are in harmony with the statutory responsibilities it has been given to administer” (Matter of Campagna v Shaffer, 73 NY2d 237, 242-243 [1989] [citations omitted]; see Matter of
In that regard, it is settled that respondent “has ‘broad power to interpret, clarify, and implement the legislative policy’ ” in administering the Insurance Law (Matter of Medical Socy. of State of N.Y. v Serio, 100 NY2d at 863-864, quoting Ostrer v Schenck, 41 NY2d 782, 785 [1977]; accord Matter of Allstate Ins. Co. v Rivera, 12 NY3d at 608; Raffellini v State Farm Mut. Auto. Ins. Co., 9 NY3d 196, 201 [2007]; see Insurance Law § 301). Moreover, “[i]n so doing, [respondent] can adopt regulations that go beyond the text of [the Insurance Law], provided [the regulations] are not inconsistent with the statutory language or its underlying purposes” (Matter of Allstate Ins. Co. v Rivera, 12 NY3d at 608 [internal quotation marks and citation omitted]; see Raffellini v State Farm Mut. Auto. Ins. Co., 9 NY3d at 201). Thus, a regulation promulgated by respondent, “ ‘if not irrational or unreasonable, will be upheld in deference to his special competence and expertise with respect to the insurance industry, unless it runs counter to the clear wording of a statutory provision’ ” (Matter of Medical Socy. of State of N.Y. v Serio, 100 NY2d at 864, quoting Matter of New York Pub. Interest Research Group v New York State Dept. of Ins., 66 NY2d 444, 448 [1985]; see Ostrer v Schenck, 41 NY2d at 785-786).
We agree with Supreme Court that respondent’s authority to issue 11 NYCRR part 30 is grounded in Insurance Law article 21, which vests respondent with authority over the licensing and discipline of insurance producers. Indeed, petitioners concede that article 21 charges respondent with ensuring that licenses are issued only to trustworthy and competent producers, as well as with disciplining licensees, including the rev
While petitioners assert that no specific legislative policy exists with respect to producer compensation inasmuch as the Legislature has yet to pass on a rule for disclosure of third-party compensation paid to insurance agents and brokers, “the absence of a specific statutory delegation of authority . . . does not bar the challenged regulations” (id. at 866). Nor does the Legislature’s consideration of and refusal to pass a bill confirm that it has not adopted any policy that could stand as a basis for 11 NYCRR part 30, as petitioners argue. “The Legislature’s failure to enact [a requirement that third-party compensation be disclosed], despite having repeatedly considered doing so, . . . evinces a legislative preference to yield to administrative expertise in filling in an interstice in the statutory scheme by the setting of such [a requirement]” (id.).
We further reject petitioners’ contentions that 11 NYCRR part 30 runs counter to the language of Insurance Law §§ 2110 and 2119, as well as sound practices previously sanctioned by the common law. Petitioners argue that Insurance Law article 21 cannot be read as authorizing respondent to regulate standards of producer conduct on an ongoing basis because it mandates that a determination of incompetence or untrustworthiness may be made only upon notice and a hearing (see Insurance Law § 2110 [a]). In our view, however, the requirement of due process in the revocation or suspension of individual licenses does not prohibit respondent from setting more general standards regarding the disclosure of third-party compensation in seeking to promote “trustworthiness” and curtail fraudulent practices, as contemplated by the statute.
Similarly, 11 NYCRR part 30 is not inconsistent with Insurance Law § 2119, which requires that a producer obtain a memorandum signed by the party to be charged if the producer
Furthermore, we agree with Supreme Court that there is no inconsistency between 11 NYCRR part 30 and the limited duties owed by a producer to an insured at common law. While petitioners are correct that, absent a special relationship, an insurance producer has no duty to disclose incentive arrangements with insurance companies (see People v Wells Fargo Ins. Servs., Inc., 16 NY3d 166, 170-171 [2011]), there is nothing in the case law forbidding respondent from requiring disclosure. Indeed, the Court of Appeals has expressly noted that “nondisclosure may be a bad practice ... A regulation, prospective in effect, is a much better way of ending a questionable but com
Thus, inasmuch as 11 NYCRR part 30 “is not in conflict with any positive provision of the Insurance Law,” the only remaining question is whether the regulation has “a rational basis” (Ostrer v Schenck, 41 NY2d 782, 789 [1977], supra). Contrary to petitioners’ argument that there is no factual predicate justifying the issuance of the regulation, the regulatory impact statement for the adoption of 11 NYCRR part 30 indicates that the need for the regulation became apparent after a joint investigation by the Insurance Department and New York State Office of the Attorney General revealed criminal bid-rigging and steering schemes involving numerous insurers and producers. The investigation demonstrated that insurance producers regularly receive incentive-based compensation from insurers, and that these payments influence producers’ recommendations to their clients. From 2005 to 2007, the Attorney General entered into settlement agreements and regulatory stipulations with a number of major insurers and brokers, resulting in more than $1 billion in compensation paid to consumers harmed by bid-rigging and improper steering. Respondent additionally learned from consumer representatives that individual purchasers of insurance are often unaware that producers are paid incentive-based compensation and do not understand the role of insurance producers.
Under these circumstances, respondent rationally determined that, while incentive-based compensation need not be banned or limited, disclosure of such compensation structures would promote needed transparency and arm consumers with relevant information regarding the role of insurance producers and the compensation that they receive. As respondent asserts, the potential for conflicts of interest and the need for greater consumer awareness are more than sufficient factual predicates for 11 NYCRR part 30. Although petitioners contend that the regulation is not likely to effectively increase transparency or protect consumers for a variety of reasons — they maintain, for example, that consumers will only be further confused by the disclosure of complex compensation arrangements and that the regulation is not cost effective or rationally limited to “untrustworthy” conduct — it is not the role of the courts to second-guess respondent’s expert judgment regarding the efficacy of the regulation in protecting consumers from bid-rigging and steering schemes (see Matter of Medical Socy. of State of N.Y. v
Petitioners’ remaining arguments are either unpreserved or, upon consideration, have been found to be lacking in merit.
Rose, Spain, Malone Jr. and McCarthy, JJ., concur.
Ordered that the judgment is affirmed, without costs.
In October 2011, the Insurance Department and Banking Department merged to form the Department of Financial Services (see Financial Services Law § 102; L 2011, ch 62, § 1).
Case-law data current through December 31, 2025. Source: CourtListener bulk data.