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McCarthy Finance, Inc. v. Premera

Supreme Court of Washington, En Banc

April 2, 2015

McCarthy Finance, Inc., et al., Respondents,
v.
Premera et al., Petitioners

Reconsideration denied June 3, 2015.

Argued: February 19, 2015.

Gwendolyn C. Payton and John R. Neeleman (of Lane Powell PC ); and Kathleen M. O'Sullivan and Eric G. Holmes (of Perkins Coie LLP ), for petitioners.

Joseph C. Brown Jr. (of J.C. Brown Law Office PLLC ); Frank R. Siderius, Raymond H. Siderius, and Charles R. Lonergan Jr. (of Siderius Lonergan & Martin LLP ); and Randall W. Redford (of Puckett & Redford PLLC ), for respondents.

Christian E. Mammen and Vanessa O. Wells on behalf of National Association of Mutual Insurance Companies and Property Casualty Insurance Association of America, amici curiae.

Kimberlee L. Gunning, Assistant Attorney General, on behalf of the Office of the Attorney General, amicus curiae.

AUTHOR: Justice Steven C. González. WE CONCUR: Chief Justice Barbara A. Madsen, Justice Charles W. Johnson, Justice Susan Owens, Justice Mary E. Fairhurst, Justice Debra L. Stephens, Justice Charles K. Wiggins, Justice Sheryl Gordon McCloud, Justice Mary I. Yu.

OPINION

Page 873

Steven C. González, J.

[182 Wn.2d 938] [¶1] -- In Washington, health insurance premiums are approved by the Washington State Office of the Insurance Commissioner (OIC). Under the nationally recognized court created " filed rate doctrine," once an agency approves a rate, such as a health insurance premium, courts will not reevaluate that rate because doing so would inappropriately usurp the agency's role. However, courts may consider claims that are related to rates approved by an agency but do not require the courts to reevaluate such rates. In most cases, Washington courts must consider Consumer Protection Act (CPA), chapter 19.86 RCW, claims alleging general damages merely related to agency-approved rates. In the case before us, however, the plaintiffs allege that several entities doing business in the health insurance field violated the CPA but request specific damages the award of which would require a court to reevaluate the reasonableness of health insurance premiums approved by the OIC. Because awarding the specific damages requested by the plaintiffs would require a court to inappropriately substitute its judgment for that of the OIC, we affirm the trial court's dismissal of the plaintiff's claims.

[182 Wn.2d 939] Facts

[ΒΆ2] The plaintiffs' complaint alleges that two groups of defendants, (1) Premera, Premera Blue Cross, and LifeWise Health Plan of Washington (collectively Premera) and (2) the Washington Alliance for Healthcare Insurance Trust and its trustee, F. Bentley Lovejoy (collectively WAHIT), colluded and made false and misleading representations to the plaintiffs that induced the

Page 874

plaintiffs to purchase health insurance policies under ...


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