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This proceeding arose upon a request for hearing made by Susanne Andrews James to contest the pending nonrenewal of homeowners insurance coverage provided by Allstate Insurance Company. On July 22, 2003, the insurer mailed a notice of nonrenewal effective August 18, 2003 on policy number 025508239, citing the claim history as the grounds for nonrenewal, specifically referencing 01/10/1999 Liability $362.76; 07/18/2000 Lightning $2,224.25; 02/02/2001 Water/Leakage $6,031.08; and 01/09/2003 Water/Leakage $457.27. Pursuant to 24-A M.R.S.A. § 3054, the insured's hearing request was timely.

A hearing in this matter was held on August 27, 2003 with Connie Mayette sitting as designated hearing officer, pursuant to 24-A M.R.S.A. §§ 210 and 3054. 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. Staff representing Allstate Insurance Company submitted a sworn statement in lieu of appearance at the hearing. Susanne Andrews James did not appear, nor did she submit a statement.

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

1. Allstate has insured residence property for Susanne Andrews James since 1985. This particular residence has been insured since September 18, 2000. The two losses occurring before that date involved a different premises.
2. On 02/02/01, damage occurred from an ice dam resulting in a claim payment of $6,031.08. Damage involved the dining room, living room, bathroom, bedroom, and damage to the roof caused by removal of snow and ice by the insured.
3. On 01/09/03, damage occurred from an ice dam resulting in a claim payment of $457.27. Damage involved the dining room and rear entry.

ANALYSIS AND CONCLUSION OF LAW
Title 24-A M.R.S.A. § 3051 states that the reason for nonrenewal must be a good faith reason rationally related to the insurability of the property, and 24-A M.R.S.A. § 3054 requires the insurer to establish the proof or evidence of its reason for nonrenewal.

Roger Worsman, Senior Product Consultant for Allstate, stated in his affidavit that Allstate’s action is based upon adverse claim frequency and the failure of the insured to exercise prudent control over the loss exposures at the residence. Although documentation was submitted for four claims, only the two claims occurring at the residence insured by this policy will be considered. Mr. Worsman testified that the 2001 loss damaged the roof and several interior rooms, and the 2003 loss damaged interior walls and ceilings. Both losses were the result of ice dams on the roof in the same area. Although $6,031.06 was paid for the 2001 loss, there is no indication that repairs were done or were complete. The loss documents show that an additional $1,351.36 that had been depreciated could have been recovered under replacement cost if the damaged areas were repaired, rebuilt or replaced within 180 days of the claim payment. There was no indication that this amount was subsequently claimed.

The Superintendent of Insurance has jurisdiction over this matter pursuant to 24-A M.R.S.A. § 3054. Allstate 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 Allstate Insurance Company has established adequate grounds for policy nonrenewal.

The documentation from the insurer indicated that repairs from the 2001 loss might not have been fully addressed, as the policyholders did not seek payment of the replacement cost holdback amount. In addition, a subsequent loss occurred in the same general area. There was no testimony from the policyholders to contradict the evidence provided by the insurer.

INDEX OF RECORD:
Exhibit 1 – Affidavit of Rogers Worsman
Exhibit 2 – Proof of Mailing and Nonrenewal Notice
Exhibit 3 – Copy of Policy
Exhibit 4 – Loss Documents 02/02/01 Claim
Exhibit 5 – Loss Documents 01/09/03 Claim

ORDER AND NOTICE OF APPEAL RIGHTS
The intended nonrenewal is hereby approved. Allstate Insurance Company is directed to continue coverage, pursuant to 24-A M.R.S.A. § 3054, until 12:01 a.m. on November 20, 2003, to allow the policyholder an opportunity 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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