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This proceeding arose upon a request for hearing made by Keith Waning of Hollis Center, ME, to contest the pending nonrenewal of automobile insurance coverage provided by Concord General Mutual Insurance Company. On November 6, 2002, the insurer mailed a notice of nonrenewal effective January 12, 2003 on policy number B528138, citing, “Keith’s 2 accidents 12/27/01 and 2/23/02 each at fault and over $1000 damage” as the grounds for nonrenewal. Pursuant to 24-A M.R.S.A. §§ 2917 and 2920, Concord General Mutual Insurance Company provided the insured with proper notice and the insured's hearing request was timely.

A hearing in this matter was held on December 11, 2002 with Mary Ellen Albert sitting as designated hearing officer pursuant to 24-A M.R.S.A. §§ 210 and 2920. The purpose of the hearing was limited to establishing the existence of proof or evidence given by the insurer to support its reason for policy nonrenewal. Concord General Mutual Insurance Company submitted a sworn statement in lieu of appearing at the hearing. Keith Waning represented himself at the hearing.

FINDINGS OF FACT

The following facts have been proven by a preponderance of evidence submitted:

1. Concord General Mutual Insurance Company has insured Mr. Waning’s vehicles since January, 2000. The current policy term expires January 12, 2003.
2. The insurer had paid for the following accidents involving Keith Waning as the driver:
   12/27/01 Insured’s vehicle was stopped, waiting to cross the street. A second vehicle stopped to let the insured cross when another vehicle went around the stopped second vehicle and hit the insured’s vehicle. Concord paid a total of $3,921.84.

   2/23/02 Insured vehicle rear-ended other vehicle. Concord paid a total of $1,698.37.

ANALYSIS AND CONCLUSION OF LAW

Title 24-A M.R.S.A. § 2916-A permits nonrenewal for specific accidents or convictions which occurred during the 36 month period preceding the yearly anniversary date of the policy. Subsection 2 provides the following requirements:

“2. Accidents. When a named insured or any other person who operates a motor vehicle insured under the policy is individually or are aggregately involved in 2 or more motor vehicle accidents while operating a motor vehicle insured under the policy, resulting in either personal injury or property damage in excess of the amount defined as a reportable accident under Title 29-A, section 2251, subsection 1.” (That amount currently is $1000.)

The statute also provides four exceptions, stating that an occurrence is not considered an accident when:

• The vehicle was struck from the rear;
• The vehicle was struck while parked;
• Only the operator of the other vehicle was convicted of a crime, offense or violation contributing to the accident; or
• The insured or insurer was reimbursed by or on behalf of the person responsible for the accident, or has a judgment against that person.

Toni J. Spiegel, Personal Lines Underwriter for Concord General Mutual Insurance Company testified in her affidavit that Keith Waning had two accidents exceeding the $1000 threshold while operating a vehicle insured under the policy within the prescribed time frame. Loss records were submitted to demonstrate the specifics of those losses.

Mr. Waning argued that he felt he was not at fault in the first accident. He had been given permission to proceed and when he got to the curve, an oncoming vehicle hit him. He also indicated that he felt the second accident was caused by faulty brakes that were not properly repaired after the first accident.

The governing statute provides the four exceptions stated above, none of which fit either of the two described losses. One of the exceptions relates to vehicles that are struck from the rear, but Mr. Waning struck a vehicle from the rear; his own vehicle was not struck in such a fashion.

A review of the policy contract which the insurer submitted demonstrates that the Insuring Agreement, on page 2 of 12 of the Personal Automobile Policy, states, “We will pay damages for bodily injury or property damage for which any insured becomes legally responsible because of an auto accident …. We will settle or defend, as we consider appropriate, any claim or suit asking for these damages.” The policy contract allows the insurer to decide whether to pay a claim brought against the policy by a third party, and what amount to pay for that claim. The contract does not provide for the insured to decide how or when to settle. Therefore, the insurer was within its contractual rights when settling these claims.

The Superintendent of Insurance has jurisdiction over this matter pursuant to 24-A M.R.S.A. § 2920. Concord General Mutual Insurance Company bears the burden of proof for establishing that the statutory grounds for policy nonrenewal exist. Based on the evidence presented at the hearing, the Superintendent hereby concludes that Concord General Mutual Insurance Company has established adequate grounds for policy nonrenewal.

INDEX OF RECORD:
Exhibit 1 - Request for hearing
Exhibit 2 - Copy of the notice
Exhibit 3 - Sworn statement from Toni Spiegel
Exhibit 4 - 12/27/01 Loss Documents
Exhibit 5 - 2/23/02 Loss Documents

ORDER AND NOTICE OF APPEAL RIGHTS

The intended nonrenewal is hereby approved. Concord General Mutual Insurance Company is directed to continue coverage under policy #B528138 until March 21, 2003 at 12:01 a.m. to allow Keith Waning time to obtain other coverage.

This Decision and Order is a final agency action within the meaning of the Maine Administrative Procedure Act. It is appealable to the Superior Court in the manner provided in 24-A M.R.S.A. § 236 and M.R. Civ. P. 80C. Any party to the hearing may initiate an appeal within 30 days after receipt of this notice. Any nonparty whose interests are substantially and directly affected may initiate an appeal within 40 days of the effective date of this Decision and Order.

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