Opinion ID: 2598249
Heading Depth: 1
Heading Rank: 20

Heading: Issue 4: Is the Commissioner's order unreasonable, arbitrary, or capricious?

Text: BCBSKS argues that the Commissioner's order is unreasonable, arbitrary, and capricious and relief may therefore be granted under K.S.A. 77-621(c)(8). While BCBSKS does identify (c)(8) as a basis for relief, its written arguments which follow that identification instead concentrate on the basis for relief in (c)(7): whether the Commissioner's determination is not supported by evidence that is substantial when viewed in light of the record as a whole. Indeed, in support of the argument that we are required to examine whether the evidence upon which the Commissioner relied is substantial, BCBSKS cites In re Providence-St. Margaret Health Center, 232 Kan. at 794: `Findings not based on evidence, but on suspicion and conjecture, are arbitrary and baseless,' and Anthem cites Vakas, 248 Kan. at 594 (arbitrary and capricious conduct is shown when an agency order is not supported by substantial evidence). As a result, while (c)(8) can cover a number of things, e.g., the reasonableness of the agency's exercise of discretion in reaching the determination, see Sunflower Racing, Inc., v. Board of Wyandotte County Comm'rs, 256 Kan. 426, 445, 885 P.2d 1233 (1994), we interpret the request by Anthem and BCBSKS as essentially the same as (c)(7). Consequently, this argument was addressed in great detail in issue 3. In its argument of this issue, BCBSKS claims that alleged speculation about the future is an improper basis for denial, citing Ginther v. Commissioner of Insurance, 427 Mass. 319, 693 N.E. 153 (1998). Ginther is distinguishable in a number of respects, however. The issue in that case was whether a witness who had testified at a public hearing opposing an insurance company acquisition had standing to file suit for himself and his company. Therefore, the court's language partially cited by BCBSKS, which is a reiteration of the trial court's findings, is dicta: Plaintiffs' alleged injuries are speculative and are not the proximate consequence of the subject acquisition. Whether Paul Revere [the acquiring insurance company] will discontinue its disability policy line, discontinue Niagara's [plaintiff's] agency, or implement a policy of resisting claims is wholly speculative. 427 Mass. at 321-22. In short, the court ruled Ginther had no standing to bring suit under Massachusetts law because he had not yet been harmed. By contrast, in the case at hand the Commissioner  who had standing  found after lengthy hearings that the likelihood of such harm existed. The Commissioner's order is not unreasonable, arbitrary, or capricious.