DocketNumber: Docket No. 17289-79
Citation Numbers: 81 T.C. 325, 1983 U.S. Tax Ct. LEXIS 38, 81 T.C. No. 25
Judges: Wilbur,Korner,Fay,Sterrett,Chabot
Filed Date: 9/19/1983
Status: Precedential
Modified Date: 10/19/2024
*38
Petitioner,*39 an insurance company, issued guaranteed renewable health and accident insurance policies during the years in issue. Under these level premium policies, petitioner could neither cancel nor refuse to renew coverage for life or to age 65, but reserved the right to adjust the scale of premiums by class based on experience. Petitioner estimated its unearned premium reserve on the basis of gross pro rata unearned premiums and the additional reserve on the mid-terminal basis. The additional reserve, which reflected petitioner's long-term obligation stemming from the guaranteed renewable feature of its policies, was computed under the 2-year preliminary term method.
*326 Respondent determined deficiencies and an addition to petitioner's Federal income taxes*41 as follows:
Addition to tax | ||
Year | Deficiency | under sec. 6653(a) |
1973 | $ 56,556.24 | |
1974 | 169,687.01 | $ 8,484.35 |
1975 | 157,315.55 | |
1976 | 177,534.31 |
After concessions, the sole question presented for decision is whether petitioner qualified as a life insurance company during the years in issue under the provisions of
FINDINGS OF FACT
Some of the facts have been stipulated, and those facts are so found. The stipulation and the exhibits attached thereto are incorporated by this reference.
Petitioner is a Missouri corporation engaged in the business of issuing policies of insurance, with its principal office in University City, Mo. It filed its Federal income tax returns for each of the calendar years 1973 through*42 1976 with the Internal Revenue Service Center at Kansas City, Mo., on Forms 1120L, together with the annual convention statement for each year.
Petitioner was incorporated in 1964 as a life insurance company under the law of the State of Missouri. Petitioner underwrites insurance in numerous States. During the taxable years in controversy, it primarily wrote guaranteed renewable *327 health and accident insurance policies (hereafter GRHA policies) and a small amount of life insurance and group accident and health insurance. Petitioner did not issue policies of insurance other than life, accident, and health insurance.
Under the terms of the individual accident and health policies written by petitioner (with minor exceptions not here material), petitioner may neither cancel nor refuse to renew coverage for life or to age 65, at a level premium. Petitioner may, however, adjust premiums by class based on experience, but at rates based upon the age and insurable condition of the insured at the original date of issue. No changes in premium rates may be based on the insured's increased age (from the time the policy was first issued), changes in health or occupation, or claims *43 made under the policy.
Guaranteed renewable individual accident and health policies are a recognized product type within the health insurance industry. For purposes of classification by the insurance industry, the contractual provisions described in the preceding paragraph distinguish a guaranteed renewable individual accident and health policy from other forms of health and accident insurance. All of petitioner's individual GRHA policies satisfy the industry definition and understanding of the guaranteed renewable product type.
All of petitioner's GRHA policies are level premium policies, as distinguished from step-rate or 1-year term policies. A level premium policy is one under which the premium is based on original issue age, and does not increase based on attained age (although the insurer may adjust premiums by class under the guaranteed renewable provision). A step-rate policy is one under which the premiums provided for in the contract increase at specified periods based on attained age.
Guaranteed renewable level premium policies, which came into use in the early 1950's, provide the insured with the benefit of a premium rate unaffected by changes in age and condition of*44 health, but also enable the insurer, through its ability to change premium rates by class, to cope with inflation and changes in health care standards affecting claim costs. These policies, like policies of life insurance, present long-term hazards extending beyond the current premium payment period. The requirement of a reserve, in addition to the *328 unearned premium reserve, recognizes that long-term or continuing risk.
At all times here relevant, petitioner was subject to regulation, supervision, and examination under the insurance laws of the State of Missouri by the Missouri Insurance Division, which was charged by State statute with the execution of laws in relation to insurance companies doing business in Missouri.
The Missouri minimum valuation standard classifies accident and health policies as type A, type B, type C, or type D, depending on the nature of the policy provisions. Type B policies are described therein as follows:
B. Policies which are guaranteed renewable for life or to a specified age * * * but under which the company reserves the right to change the scale of premiums.
With immaterial exceptions, all petitioner's individual GRHA policies satisfied*45 the above-quoted definition of a type B policy.
As a minimum reserve standard for type B policies, the Missouri minimum valuation standard authorized use of one of the following three generally recognized reserve methods:
(1) Mean reserves diminished by appropriate credit for valuation net deferred premiums;
(2) Mid-terminal reserves plus gross pro rata unearned premium reserves;
(3) Mid-terminal reserves plus net pro rata unearned premium reserves.
In 1973 through 1976, petitioner estimated its active life reserve on its individual accident and health policies using method (2) referred to above.
Active life reserves are reserves for future claims or liabilities not yet incurred; "claim reserves" are for claims and liabilities already incurred, but not yet paid. Active life reserves include (a) the "unearned premium reserve," which is a reserve for claims or liabilities which will be incurred during the remainder of the term or period for which the premium has been paid, and (b) the "additional reserve," generally designated as the "mid-terminal" reserve in technical insurance terminology, which is a reserve for claims or liabilities that will be incurred after the end of the current*46 premium period. This additional or mid-terminal reserve is normally concerned only with policies which place on the insurer a risk *329 extending beyond the current premium payment period for which future premiums at some point will be inadequate.
Premiums are treated as earned by the passage of time. A pro rata unearned premium reserve, whether gross or net, diminishes as time passes, and is necessarily reduced to zero at the end of the current policy term or premium payment period. The mid-terminal or additional reserve represents an amount held back or reserved from premiums which would otherwise be treated as earned, and remains at the end of the current premium or policy term when the unearned premium reserve is at zero.
The gross premium is the total premium actually paid by the insured. It consists of (a) the net premium or net valuation premium, which, with assumed earnings, is the amount deemed necessary to meet claims and obligations arising under the policy, and (b) the "loading" factor, which is required to pay commissions, taxes, and expenses, and (in the case of stock insurers) to provide a profit margin. The unearned premium reserve, whether computed on a *47 gross or net basis, is calculated on a pro rata basis, and no part of the unearned premium reserve is left at the termination of the premium payment period. The additional (mid-terminal) reserve remains in effect at that time, which is the reason for the "terminal" part of its designation, i.e., unlike the unearned premium reserve, it is still in effect at termination of the period for which the premium was paid. The term "mid-terminal" reflects the use of an average figure based upon the assumption that policies are sold at uniform intervals, so that all policies issued in any given calendar year may be deemed to have a mean, average, or "mid-terminal" date of July 1.
The reserve, in addition to net unearned premiums, arises from petitioner's long-term obligation stemming from the guaranteed renewable feature of the policies. This reserve is the measurement of petitioner's liability for future contingent claims -- those not yet incurred under its individual policies -- and is equal to the present value of future benefits payable under those policies minus the present value of future net level premiums receivable.
Under Missouri law and State insurance codes, generally, it is the*48 professional task of the actuary to place a sound value on the company's policy liabilities. At all times here relevant, *330 petitioner employed E. Paul Barnhart, its consulting actuary, to value, or to supervise the valuing of, the active life reserves petitioner was required to carry for all of its individual GRHA policies in force.
A variety of computational methods are available to the actuary for use in calculating the reserve in addition to unearned premiums. The method selected in a particular case is subject to actuarial judgment guided by professional standards in light of the circumstances at hand, and to the minimum requirements of State law. The actuary may use any reasonable method that will place a sound value on the company's policy liabilities, and that will produce an amount satisfying the minimum requirements of State law.
Under the Missouri minimum valuation standard, as well as good actuarial practice, the mid-terminal reserve may be computed either on a net level basis or on a preliminary term basis. The preliminary term method or basis of computing reserves is a recognized and accepted actuarial method, and has been accepted by the National Association*49 of Insurance Commissioners (hereafter NAIC) and by the pertinent regulatory agencies of those States in which petitioner does business. It is the method most commonly used for valuing reserves on individual accident and health policies with level premiums based on original age at issue. At all times here relevant, petitioner computed the mid-terminal reserves on its individual GRHA policies on a 2-year preliminary term basis, using appropriate valuation tables constructed by its actuary for this purpose and based on recognized mortality and morbidity tables and an assumed rate of interest at 3-percent compounded. Petitioner's actuary, E. Paul Barnhart, instructed company personnel in the proper use of such valuation tables to compute the mid-terminal reserve.
Mechanically, the computation of a 2-year preliminary term basis of the mid-terminal reserves with respect to petitioner's individual health and accident policies was, during the taxable years here in controversy, as follows:
(a) An outside statistical firm retained by petitioner for that purpose broke down the policies by calendar year of issue, treating all policies issued in a calendar year as being issued on July 1 of *50 that year for these purposes.
*331 (b) An amount was computed for each policy in force more than 2 years as of the valuation date by applying to each such policy the unit reserve factors (from the appropriate valuation table) which would have been applied had the net level basis of computation been used and had the policy been issued 2 years later than its actual issue date, at an issue age 2 years older than its actual issue age. If the amount so computed was positive, it was added to the mid-terminal reserves.
(c) If the amount computed as described in preceding clause (b) was zero or negative, zero was added to the mid-terminal reserves.
(d) Zero was added to the mid-terminal reserves for each policy in force 2 years or less as of the valuation date.
As an example of the foregoing computation, if an insured purchased a policy in 1971 at the age of 30, petitioner would have added zero with respect to such policy to the mid-terminal reserves computed as of December 31, 1971, and December 31, 1972. Commencing with the December 31, 1973, valuation date (assuming renewal), petitioner would have added to the mid-terminal reserves that amount (not less than zero) which would have*51 been required on a net level reserve basis had the policy been issued in 1973 to the insured at the age of 32.
The preliminary term method of valuation recognizes that an insurer's administrative expenses in the first years of a policy are much higher than those in renewal years, and that conversely, claims costs will increase with age. Thus for 2 policy years or even longer, the insurer may have a substantial unliquidated initial expense before setting up reserves. For these reasons, the recommendations of the NAIC Task Force 4, and the NAIC Industry Advisory Committee on Reserves for Individual Health Insurance Policies, provide for a preliminary period of 2 years in the minimum reserve basis for individual accident and health policies.
While the reserve is mechanically developed by applying "unit" reserve factors to "unit" benefits of single policies, separate reserves are not held on single policies. Rather, the additional reserve is an aggregate reserve and has actuarial meaning only with respect to an entire group of policies. Mortality tables are used in the calculation of unit reserve values, and a mortality table assumes a large population of *332 policyholders who*52 are expected to die or become ill according to certain yearly death rates. The additional reserves are an aggregate amount which, together with future net premiums, will meet the benefit payments arising from the group of policies valued as such benefits accrue in the future. The application of a formula for the calculation of such reserves to an individual policy (or small group of policies) does not produce a meaningful result, since few policyholders will experience average morbidity.
As required by Missouri law, petitioner prepared for each of the years 1973 through 1976, under oath, comprehensive financial information which it included on its annual statement (hereinafter referred to as the NAIC statement). For each of the years 1973 through 1976, petitioner filed the NAIC statement with the director of the Missouri insurance division.
The purpose of the NAIC statement, which is filed by insurance companies with the insurance regulatory agency of each State in which the company is doing an insurance business, as well as with the Federal income tax return, is to provide information on the solvency of the company and with respect to whether the company is conducting its affairs*53 in accordance with State legal requirements.
The NAIC form filed by life and accident and health companies contains a part called exhibit 9, and entitled "Aggregate Reserve for Accident & Health Policies." Exhibit 9 of the NAIC statement is subdivided into section A (hereafter called exhibit 9A), the active life reserve section, and section B, the claim reserve section. The first line of exhibit 9A is entitled "unearned premium reserve." The second line is entitled "additional reserves."
The entry in line 1 of exhibit 9A of the NAIC statements of petitioner in each of the taxable years in controversy consisted solely of the gross pro rata unearned premium on all of its GRHA policies in force. The entry in line 2 in each such year consisted solely of the mid-terminal reserve computed on the 2-year preliminary term basis as previously described. During the years before the Court (1973-76), petitioner's active life insurance reserve included additional reserves attributable to the guaranteed renewable feature of its policies.
Petitioner's unearned premium reserves (line 1 of exhibit 9A) and additional reserves (line 2) on its individual accident *333 and health policies, as reported*54 on its NAIC statements, amounted to the following at the dates shown below:
Date | Additional reserves | |
12/31/73 | $ 977,064.89 | $ 32,567 |
12/31/74 | 1,197,047.00 | 56,742 |
12/31/75 | 1,521,578.00 | 92,877 |
12/31/76 | 2,089,056.00 | 118,686 |
Petitioner began issuing accident and health policies in 1968. The amounts shown on line 2 as additional reserves in each of the foregoing statements reflect the fact that in those years the bulk of petitioner's accident and health policies in force were composed of policies in force 2 years or less.
Petitioner had its annual convention statement for each of the years 1973 through 1976 signed and certified by E. Paul Barnhart as consulting actuary. Mr. Barnhart's qualifications fully satisfied those prescribed*55 for a consulting actuary by the director of the Missouri insurance division. The amounts carried in petitioner's balance sheet on account of the unearned premium reserve, and the additional reserves for individual accident and health policies which contained the clause of guaranteed renewability, as shown in exhibit 9 of petitioner's NAIC statement for each of the years 1973 through 1976 --
(a) were computed in accordance with commonly accepted actuarial standards consistently applied and were fairly stated in accordance with sound actuarial principles;
(b) were based on actuarial assumptions which were in accordance with, or stronger than, those called for in policy provisions;
(c) met the requirements of the insurance laws of Missouri;
*334 (d) made good and sufficient provision for all unmatured obligations of petitioner guaranteed under the terms of its policies;
(e) were computed on the basis of assumptions consistent with those used in computing the corresponding items in the annual convention statement on the preceding yearend; and
(f) included provision for all actuarial reserves and related statement items which ought to be established.
Based on the advice of Mr. Barnhart, *56 petitioner established a premium structure for its individual guaranteed renewable policies. The annual premiums charged for these policies were approximately 20 percent higher than the annual premiums petitioner would have charged for comparable policies provided on a cancelable basis. The excess premium charged (relative to identical cancelable coverage) was introduced into the pricing of petitioner's policies in order to cover the additional cost inherent in the insurer's obligation to renew the coverage in later years when the insured is older.
There are no differences in the terms and provisions of National States' GRHA policies, or in the company's obligations thereunder based upon how long the policies have been in force. Specifically, with respect to guaranteed renewability, National States is contractually bound to precisely the same extent under a GRHA policy that has been in force for 2 years or less, as it is under a GRHA policy that has been in force for a longer period.
National States' exposure to long-term morbidity risks under its GRHA policies in force for 2 years or less was not materially different from its exposure to long-term morbidity risks under its GRHA*57 policies in force over 2 years. Both its policies of less than 2 years duration and its policies of over 2 years duration carried long-term morbidity risks, based on one and the same provision obligating the company to renew.
OPINION
We are called upon to determine whether petitioner is a life insurance company within the meaning of
(1) its life insurance reserves (as defined in subsection (b)), plus (2) unearned premiums, and unpaid losses (whether or not ascertained), on noncancellable life, health, or accident policies not included in life insurance reserves,
Accordingly, petitioner will qualify as a life insurance company if its life insurance reserves, plus unearned premiums and unpaid losses on its GRHA policies, exceed 50 percent of its total reserve (hereafter the reserve ratio test). The total reserves, as defined in
The parties have diametrically opposed interpretations of this regulation. Petitioner contends that the regulation, taken from the relevant congressional committee reports (discussed *336
Petitioner emphasizes*60 that the same long-term risks exist on all its contracts from date of issuance, whether they have been in effect less or more than 2 years. It points out that reserves are established on an aggregate basis for all its policies, and that the reserves on an individual policy basis have no actuarial meaning. The particular reserving methods adopted and the computational mechanics of that reserve, petitioner concludes, are tools the actuary uses to meet the reserve obligation arising from the nature of the contracts -- they arise from, rather than define, the nature of the contract. Accordingly, petitioner asserts its contracts qualify.
Respondent argues that the regulation reflects the intent of Congress that reserves in addition to unearned premiums be computed for all noncancelable and GRHA policies. Respondent contends that unless a policy is reserved under a method that creates these additional reserves, the unearned premiums and unpaid losses attributable to that policy cannot be included in determining whether petitioner meets the reserve ratio test qualifying it for life insurance company status. Respondent recognizes that the long-term risk inherent in petitioner's policies*61 requires reserves. But he points out that policies in effect for less than 2 years neither enter into the computation of, nor contribute to, the additional reserves. Accordingly, he concludes premium reserves on policies in force less than 2 years go into the denominator but not the numerator of the qualifying fraction. Therefore, petitioner is not a life insurance company. We agree with petitioner on this close issue of first impression. *62 *337 Since the Code directs that GRHA policies be treated in the same manner as noncancelable health policies, we begin with the legislative history of the 1942 Revenue Act. This act expanded the definition of a life insurance company to include companies issuing noncancelable contracts of health and accident insurance. The rationale for this expansion is found in the committee reports:
Technical changes are made to distinguish in a clearer manner the
Respondent recognizes the long-term risks involved, but argues that the preliminary term method is defective because reserves are not actually computed under this method during the first 2 years. However, this hardly creates a marked difference from life insurance contracts. The preliminary term method had its origin in, and is used extensively in, the life insurance field, and the use of the preliminary term method is clearly compatible with a policy's status as life insurance. Congress identified the long-term risks necessitating reserves as the characteristic that is "analogous to life insurance," and the preliminary term method has long been extensively*65 used in reserving life insurance policies against those long-term risks. Since this method has been used without any adverse tax consequences to the life insurance status of those policies, the disparity respondent introduces here is at war with the legislative history. Indeed, the analogy to life insurance is enhanced, not diminished by the use of the preliminary term method. In identifying the "types of insurance" it intended to include as "analogous to life insurance," Congress focused not on a particular reserving mechanism, but on the necessity for reserves arising from long-term risks.
In actuarial theory and practice, and as a matter of State regulation, it is the nature of an insurance contract that defines the reserve requirement. There are no differences in the terms of petitioner's GRHA policies, or in the company's obligations thereunder, based on how long the policies have been in force. Petitioner is contractually bound to the same terms and exposed to the same risks under a GRHA policy that has been in force for 2 years or less as it is under a GRHA policy that has been in force for a longer period.
Again, petitioner's exposure to long-term morbidity risks under*66 its GRHA policies in force for 2 years or less was not materially different from its exposure to long-term morbidity risks under GRHA policies in force for more than 2 years. All *339 of these policies carried long-term morbidity risks, based on the same provisions obligating the company to renew. *67 basis of policies that are reserved on the preliminary term method. It is hardly treating noncancelable and guaranteed renewable health and accident insurance policies in an analogous way to introduce a distinction solely in this area.
Additionally, Congress focused on, and adopted, the definition of a noncancelable insurance policy "as the term is used in the industry." Indeed, Congress specifically stated that "
The language of the disputed regulation is taken almost verbatim from the 1942 committee reports set out above. It is difficult to see how respondent can stipulate that petitioner's policies meet the industry definition of a guaranteed renewable contract and at the same time contend that the language of the committee report (as incorporated in the regulations) precludes petitioner from qualifying. We believe the language *340 of the committee report makes it clear that Congress intended to identify a product "type," and employed the term "noncancelable" (and guaranteed renewable) "as that term is used in the industry." The regulation, lifted virtually verbatim from the committee reports, must be interpreted accordingly.
The parties analyzed various arcane aspects of actuarial theories at some length. Petitioner argues that in accordance with the specific requirements of the actuarial authorities and State law, the additional reserves from its GRHA policies are aggregate reserves applicable to
Petitioner has the better of this argument. Both in actuarial theory and as a matter of law, the reserves computed on the preliminary term basis are applicable to
*341 The basic difference between the net level method and the preliminary term method is the amount of front-end expense allowance and the additional net premium subsequently necessary to fund this expense allowance. If petitioner's GRHA policies are viewed as 2-year term policies (for which no reserves are set up) followed by a permanent policy issued to an insured 2 years older and for a premium payment period 2 years shorter, the net premiums after the first 2 years must be larger. See D. Gregg & V. Lucas, Life and Health Insurance Handbook 165 (3d ed. 1973). The increase in the net premium (with*71 a consequent reduction of the loading element in the level gross premium) will be equal to the annual sum necessary to amortize the first 2-year reserve not established under the preliminary term method. Gradually, the reserves grade to net level over the premium paying period of the policy. Put differently, the amount ultimately accumulated will be the same under either method.
In summary, on the record before us, the two reserving methods are, over time and from the viewpoint of actuarial soundness, tweedledum and tweedledee. Neither changes the nature of the insurance policies it addresses, but responds to the identical characteristics of those policies necessitating reserves -- long-term risks. With this in mind, it is idle theoretical discourse to speculate about companies whose entire inventories of policies are over 2 years or under 2 years. Congress has legislated through the years not with theoretical constructs in mind, but for companies participating in a dynamic industry year after year. As a new company, a greater proportion of petitioner's policies were less than 2 years old, but many of its policies were more than 2 years old. As in any dynamic business, this*72 distribution would change from year to year and generally the portion attributable to policies in force 2 years or more will increase the longer a company is in business. However, a sharp increase in business for 2 years could subsequently alter the proportion again in favor of policies under 2 years in age.
Under respondent's interpretation, an admittedly qualified insurance company that branches into noncancelable health policies reserved on the preliminary term basis could lose its life insurance status. In 3 years or so, as their policies age, they could requalify. If they had a sharp increase in sales a couple *342 of years later, they would be disqualified again, only to re-requalify later. We doubt that Congress intended any such distinction between the preliminary term and net level reserving methods, particularly since it has encouraged the use of the preliminary term method. See
Possibly it was with these thoughts in mind that respondent promulgated
An insurance company writing only noncancellable*73 life, health, or accident policies and having no "life insurance reserves" may qualify as a life insurance company if its unearned premiums, and unpaid losses (whether or not ascertained), on such policies comprise more than 50 percent of its total reserves.
This language unequivocally states that a company issuing only noncancelable health policies may qualify under the reserve ratio test on the basis of its unearned premiums and unpaid losses alone.
Most life insurance companies compute their reserve funds on the basis of a level net premium. A number of life insurance companies, however, especially smaller companies in the early stages of operation, compute their reserve funds by some form of preliminary term method, such as full preliminary term, modified preliminary term (Illinois standard) or select and ultimate. These reserve standards require lower reserves in the earlier years of a policy than does the more usual level net premium method. In order to equalize the computation of the reserve earnings deduction, an additional amount equal to 7 per cent of the life insurance reserves computed on a preliminary term *76 basis is to be added in computing the adjusted reserves. [H. Rept. 2333, 77th Cong., 2d Sess. (1942),
Congress wanted to assist new and smaller companies using the preliminary term method. But if respondent is correct, this attempt at equalization is futile, since small new companies issuing principally noncancelable or guaranteed renewable *344 policies reserved on the preliminary term method would be unable to qualify as life insurance companies for several years. We are unwilling to assume an interpretation that, in addition to many other difficulties, undermines
When contracts are reserved on the preliminary term method, respondent would apply the benefits of
The parties have added embellishments to the arguments previously discussed, and we have carefully reviewed them. They do not warrant adding to the length and complexity of this opinion. Decision will be entered under Rule 155.
Korner,
In resolving this issue, we are not provided with statutory guidance since the Internal Revenue Code nowhere defines the *345 terms "noncancellable" or "guaranteed renewable" accident and health policies.
The specific terms of
There is no question that the policies under consideration are policies which the issuing company is under an obligation to renew at a specified premium or at a premium that can be adjusted only by class according to experience, and respondent does not contend otherwise. The focus of our inquiry is whether the "reserve" requirement imposed by the regulations is satisfied during the first 2 years of the policies' existence under the 2-year preliminary term method of reserving as employed by petitioner. That is, can petitioner's accident and health policies 2 years or less in force legitimately be considered to be policies "with respect to which a reserve in addition to unearned premiums must be carried" to cover petitioner's obligation to renew?
The majority answers the above question in the affirmative. In reaching this conclusion, the majority appears to rely upon two separate*80 theories. First and primarily, it seems to feel that the
I do not think that either of the above two theories represents an adequate basis for the majority's resolution of the issue presented in this case. In my opinion, the definitional regulations may only legitimately be read to require a "reserve in addition to unearned premiums" to be actually carried (i.e., computed and set aside) with respect to each policy, for each and every year the taxpayer seeks to classify a particular policy as noncancelable or guaranteed renewable for Federal tax purposes. It is my further belief that petitioner's accident and health policies in force 2 years or less failed to meet these definitional standards under the 2-year preliminary term method employed by petitioner. The reasons for my respective conclusions are set out in the following subsections.
A company which qualifies as a "life insurance company" under
*83 The unique system of Federal income taxation of life insurance companies had its genesis in the Revenue Act of 1921 *85 (hereinafter the 1921 Act). Prior to 1921, life insurance companies had been taxed under a system comparable to other corporations in that all of the income of such companies, including income derived from investments, as well as premium receipts, was subject to tax. and are required by State law to set aside current receipts or other assets in reserves to cover those risks. When a company is required to set*84 aside current receipts in reserve to pay future claims under a policy, such receipts are not currently available for general corporate purposes, or for *348 distribution to shareholders. As such, amounts required to be reserved by a life insurance company are, in the words of the Supreme Court "not true income, but * * * analogous to permanent capital investment." (Fn. ref. omitted.)
This characterization of the life insurance business led Congress to conclude that "life insurance companies" should be taxed differently from other corporations. In enacting corrective measures, however, Congress did not choose to adopt statutory provisions which ferret out each portion of an insurance company's gross receipts which were not the proper subject for current taxation. Instead, extremely broad standards were adopted. Under the 1921 Act, "life insurance companies" were allowed to exclude 100 percent of annual premium receipts from gross income. *86 and such a company was defined in the 1921 Act as:
an insurance company engaged in the business of issuing life insurance and annuity contracts * * * the reserve funds of which held for the fulfillment of such contracts comprise more than 50 per centum of its total reserve funds. any given year was the issuance of "life insurance" *349 from those companies whose predominate business for*87 any given year was the issuance of accident and health insurance. As explained by T. S. Adams, then tax adviser to the Treasury, the rationale underlying the 50-percent life insurance qualification formula was as follows:
Some companies mix with their life business accident and health insurance. It is not practicable for all companies to disassociate those businesses so that we have assumed that if the accident and health business was more than 50 percent of their business, as measured by their reserves, it could not be treated as a life insurance company. On the other hand, if their accident and health insurance were incidental and represented less than 50 percent of their business we treated them as life insurance companies. *88 to be segregated into long-term reserves, and companies whose predominate business, as measured by their reserves, consisted of the issuance of such policies should not, in Congress' view, be entitled to exclude annual premium receipts from current taxable income. That is, the "true income" of such a company could be adequately measured annually by invoking standard tax accounting conventions, since no long-term reserve requirement accompanied such policies.
As the insurance industry evolved after 1921, the accident and health business sold by life-type companies began to vary and expand considerably. *89 the *350 issuing company's experience under the policy, but could not be adjusted due to the increased age and underwriting status of the insured. Since both of these types of long-term accident and health policies impose actuarial risks upon the issuing company which will not be sufficiently offset by premium receipts in the later years of the policies, Congress perceived that a certain percentage of current premiums received with respect to such policies would be required to be segregated into long-term reserves to cover such risks. When the predominate business of a company
When*90 Congress expanded the definition of a "life insurance company" in 1942 and 1959 sole reason those policies should be treated as "life insurance policies" for purposes of the reserve ratio test of
*351 In light of the above-outlined history of taxation of life insurance companies and, in particular, the Senate Report quoted immediately above, I find that I must take issue with the majority's primary conclusion that, for purposes of resolving the issue before us, the reserves "arise from rather than define the nature of the contract." Quite to the contrary, it is apparent that the sole reason Congress considered itself justified in expanding the definition of a "life insurance company" to include companies predominately issuing noncancelable*92 and guaranteed renewable accident and health policies was because such policies "require the accumulation of substantial reserves." For purposes of determining the
Any other reading of these regulations, in my opinion, would not be in keeping with the premise underlying the expansion of the definition of a "life insurance company" to include those *352 companies issuing predominately "noncancellable" or "guaranteed renewable" accident and health policies.
The long-term liability to renew under a level premium accident and health policy may exist from the date the policy is first issued. However, such a liability can in no way be considered an "accrued" liability, since the time and amount of ultimate payment under the policy depends upon
I would therefore read
I would thus read
*353 As already stated, the policies in dispute in this case were clearly long-term policies which were renewable at the option of the insured at a level premium. Thus, in establishing the premium rate to be charged for its renewable policies, it was necessary that petitioner include both the actuarial cost of insuring the policyholder for the current periodic premium term as well as the cost of the long-term risks, actuarially computed, represented by petitioner's promise to renew the policy at a level premium. This latter amount (i.e., the amount petitioner charged which was allocable to its obligation to renew) is quite clearly that amount which Congress contemplated to be required to be set aside as a "reserve in addition*96 to unearned premiums" before a policy would be classified as noncancellable or guaranteed renewable for Federal tax purposes. As the relevant Senate report states, "reserves in addition to unearned premiums" are --
those amounts which must be reserved * * * to provide for the additional cost of carrying [noncancelable policies] in later years when the insured will be older and subject to greater risk and when the cost of carrying the risk will be greater than the premiums being received.
However, under the 2-year preliminary term method of computing mid-terminal reserves, the fact that petitioner included in its gross premium charge an amount intended to cover its obligation to renew which it admittedly incurred under its level premium policies was completely ignored for purposes of reserving. In fact, for purposes of reserving, *354 policies less than 3 years old are treated as though they were nonrenewable, short-term policies under the 2-year preliminary term method. Thus, with respect to policies 2 years or less in force, petitioner was required to establish only short-term (unearned premium and unpaid loss) reserves and no provision was made to cover petitioner's obligation to renew. (For further discussion of this point, see
This point is made clear by the mechanics an insurance company employs in computing mid-terminal reserves under the 2-year preliminary term method. Under this method, the dollar amount of that terminal*98 reserve is the excess of the present value of future benefits over the present value of future net valuation premiums on each renewable policy which has been in force for
The majority, in reaching the opposite result, appears to have been influenced by the testimony of the petitioner's experts that the 2-year preliminary term method is an actuarially sound method of computing reserves. Thus, the majority states that the net level method and the preliminary term methods of reserving are,
We are, however, not called upon in this case to determine the relative actuarial soundness of the preliminary term method of reserving vis-a-vis the net level method. Considerations which give rise to an actuary's conclusion that a particular method of reserving is "sound" in any given context are, in my view, quite irrelevant for purposes of the issue we have before us in this case. Of primary concern to actuarial theory is the solvency of a company over time. As noted above, the Internal Revenue Code provisions here involved are ultimately concerned with the proper Federal tax classification of an insurance company.
Moreover, although no one will dispute that under the 2-year preliminary term method of reserving the amount accumulated in a reserve for a particular policy will ultimately be the same as under the net level method
Policies reserved under the net level method thus meet the specific requirements of the
*103 This fundamental fact cannot be ignored. Accident and health insurance has, as a general rule, a relatively high early cancellation rate. In fact, petitioner's expert testified that something in excess of 50 percent of its renewable policies could be predicted to be canceled by the insureds before they enter their third year. This fact is, of course, considered by the actuary in determining whether a preliminary term method is "actuarially sound" since there is no actuarial reason for establishing long-term reserves with respect to policies which can be predicted to be essentially short term.
Thus, although the 2-year preliminary term method of reserving may be actuarially sound, it is clearly not so because it requires the company to establish reserves in addition to unearned premiums to cover the company's long-term obligation to renew during the policies' first 2 years. It may be actuarially sound for reasons (e.g., high early cancellation rate) which are completely irrelevant for purposes of determining the Federal tax classification of the policies with respect to which it is employed. The salient point here is that, under the method, no reserve in addition to unearned premiums*104 is required to be established to cover petitioner's obligation to renew its policies 2 years or less in force and there can, in my opinion, simply be no argument based upon the relative actuarial soundness of the preliminary term method vis-a-vis the net level method.
Petitioner argues that even though its policies in force 2 years or less did not contribute computationally to its mid-terminal reserves under the 2-year preliminary term method, it nonetheless should be considered to have maintained a reserve in addition to unearned premiums to cover its obligation to renew with respect to such policies. Petitioner argues that its mid-terminal reserves, as reflected on line 1, part 3A of schedule H of its annual statement, are properly viewed only as an aggregate liability carried
Initially, the very language of the regulations we are interpreting in this *105 case militates against such a conclusion.
As noted above, the obligation to renew a particular policy can be represented by an actuarially quantifiable dollar amount. This amount constitutes the amount by which the present value of future benefits to be paid under the policy exceeds the present value of future net valuation premiums
It can be conceded that the total dollar amount of a reserve is, in a sense, an aggregate amount, and that the term "reserve" has only limited significance when not viewed in the aggregate. To use respondent's example, the insured under a $ 1,000 face amount life insurance policy either will or will not die during the current policy year and the company's liability under the policy either will or will not mature. Thus, while the actuarial probability of death could be computed at the beginning of the policy year at, say, .00426, it would be meaningless to speak of a reserve of $ 4.26 to provide for the risk that the issuing company would have to pay a $ 1,000 death claim. The reserve simply means that the probability is that out of 1 million persons similarly situated, about 4,260 can be predicted to die within the period. Thus, the reserve is *359 simply computed by multiplying .00426 by the number of $ 1,000 *107 life exposures
However, the fundamental fact here is that the total dollar value of a reserve does not arise in a vacuum. This dollar figure is a result of the summation of actuarially computed dollar amounts derived from premiums paid on each individual policy which, under the valuation method selected by the insurer, are to contribute to the reserve. The aggregate amount thus computed represents the actuarial estimate of the amount
Petitioner's experts in this case have made much of the*108 fact that all of the assets retained in petitioner's mid-terminal reserves are potentially available to meet the claims of insureds holding any renewable policy. However, this fact should not lead to the conclusion that such reserves are carried "with respect to" petitioner's renewable policies 2 years or less in force within the intendment of
The majority found it unnecessary to address petitioner's argument that its unearned premium reserves on policies 2 years or less in force somehow*110 contained a "reserve in addition to unearned premiums." Since I feel that the theories that the majority relies upon do not support its ultimate conclusion, I find it necessary to consider this argument.
Specifically, petitioner maintains that the term "unearned premiums" as defined in
those amounts must be reserved * * * to provide for the additional cost of carrying [noncancelable] policies
Moreover, an acceptance of petitioner's interpretation of
No obligation to renew accompanies a cancelable policy, and it is therefore axiomatic that the issuer of such policies will never be required to maintain a reserve in addition to unearned premiums within the intendment of
Furthermore, petitioner's interpretation cannot withstand scrutiny even when applied to renewable policies. The loading element contained in a gross unearned premium represents that portion of the gross premium designed to cover noninsurance costs, such as commissions and administrative expenses, and also includes a margin for profit. Such amounts clearly are not carried to cover the insurer's obligation to renew or continue the policy at a specified premium, and therefore are not capable of being classified as "reserves in addition to unearned premiums" under
The fact that petitioner charged a greater premium rate in the case of renewable policies than it would have charged for policies with the same terms but without the renewable feature is, in my opinion, completely without significance for *363 purposes of the present case. Although it is clear that the premium charged with respect to petitioner's renewable policy included an amount which was intended to cover petitioner's obligation to renew at a level premium, under the 2-year preliminary method, petitioner was entitled to assume,
The entire concept of an insurance company's taxable status is based upon the qualitative nature*116 of the reserves the company is required to maintain.
Finally, notwithstanding petitioner's contention to the contrary, I think that the specific language of
The universally accepted meaning of "premium" is the amount paid by the insured for coverage. It does not refer to any particular portion of the sum paid by the insured. * * * Our interpretation is not inconsistent with * * *
See also
I would therefore reject petitioner's contention that the gross pro rata unearned premium reserve which was maintained with respect to its renewable policies contained a reserve in addition to unearned premiums as required by
The majority feels that certain other provisions of subchapter L and the regulations thereunder support its ultimate conclusion on the main issue in this case. For the reasons stated hereafter, I do not agree.
Life insurance companies, like all insurance companies, are permitted to deduct annual additions to reserves for purposes of computing taxable income.
The election under
*365 The majority asserts that our interpretation of the regulations would "undermine
This argument, in my opinion, places the cart before the horse. Only "life insurance companies" are entitled to the specific relief contained in
If it is determined that the company does not meet the "life insurance company" test of
An insurance company writing only noncancellable life, health, or accident policies
The majority believes that my interpretation of
"Life insurance reserve" is a term of art, specifically defined in
(1) It must be computed or estimated on the basis of recognized mortality or morbidity tables;
(2) It must have assumed rates of interest;
(3) It must be set aside to mature or liquidate future unaccrued*122 claims;
(4) It must involve life, health, or accident contingencies; and
(5) It must be required by law.
Whether a particular reserve established by a company qualifies as a technical "life insurance reserve" has been a much-litigated issue. See, e.g.,
However, in order to be classified as*123 a "noncancellable" or "guaranteed renewable" accident or health policy,
Of course, if the "reserve in addition to unearned premiums" does not meet the technical "life insurance reserve" definition of
Petitioner, in this case, seems to argue that it would be an "abuse of discretion" under section 7805(b) for respondent to apply to petitioner his current interpretation of the Federal tax definition of "noncancellable or guaranteed renewable." It *368 is clear, however, that petitioner was not the recipient of a written ruling wherein respondent had taken another position. Thus, a host of cases, beginning with the Supreme Court's decision in
For the above reasons, I would hold that, for Federal tax purposes, petitioner failed to meet the statutory test of a "life insurance company" for the period before us, it being conceded that it fails to meet the over-50-percent test of
1. All section references are to the Internal Revenue Code of 1954 as amended, unless otherwise stated.↩
1. The distribution of unearned premiums by policies in effect under 2 years and over 2 years, is as follows:
Gross pro rata unearned premiums | ||
computed on -- | ||
Valuation | Policies in force | Policies in force |
date | 2 years or less | more than 2 years |
12/31/73 | $ 815,912.82 | $ 161,212.07 |
12/31/74 | 939,802.58 | 257,173.65 |
12/31/75 | 1,208,063.84 | 313,514.16 |
12/31/76 | 1,707,736.80 | 381,319.20 |
2. Both parties agree that the question before us has not been the subject of prior litigation.
3. When Congress required GRHA policies to be treated the same as noncancelable health policies, it again referred to the "type of insurance contracts" it had in mind.
"
4. Petitioner on brief offers the following example. Assume petitioner sells B a GRHA policy at age 50. His twin brother purchases an identical policy 2 years later, when they are both 52. Although the obligations and risks are identical, respondent claims one is guaranteed renewable, the other is not. We agree with the petitioner that this is a thin distinction.↩
5. Guaranteed renewable policies are treated in the same manner as noncancelable policies, which are defined in
6. Petitioner emphasizes that respondent, until recently, agreed with its interpretation of
"To interpret
Petitioner notes its earlier years were closed by an agent consistent with this interpretation, and that they have now been unfairly caught in midstream by an impermissible retroactive change. In view of our decision, we need not rule on this matter.↩
7. The major argument we have avoided concerns whether some portions of petitioner's unearned premium reserves are "additional reserves."↩
1. All section references herein are to the Internal Revenue Code of 1954 as amended and in effect during the years in issue, unless otherwise expressly indicated.↩
2. Ch. 136, secs. 242-247, 42 Stat. 227, 261-264 (1921).↩
3. A special deduction was allowed for certain additions to net reserve funds. See generally 1 T. Nash, Federal Income Taxation of Life Insurance Companies, sec. 5 (1982).↩
4. See, e.g., Testimony of T. S. Adams, Senate Hearings on H.R. 8245, 67th Cong., 1st Sess. 83 (1921).↩
5. See sec. 244(a) of the 1921 Act. This approach to the taxation of "life insurance companies" was modified by the Life Insurance Income Tax Act of 1959. See Pub. L. 86-69, 73 Stat. 112 (applicable retroactively to taxable years beginning after Dec. 31, 1957). Under the 1959 Act, "life insurance companies" are effectively entitled to exclude only one-half of their underwriting income from current taxation. See secs. 802(b)(3), 815(d)(2).↩
6. See sec. 242 of the 1921 Act. 42 Stat. 227, 261.↩
7. Hearings on H. R. 8245 Before the Senate Comm. on Finance, 67th Cong., 1st Sess. 85 (1921).↩
8. See G. Lenrow, R. Milo & A. Rua, Federal Income Taxation of Life Insurance Companies , ch. 9 (3d ed. 1979).↩
9. See ch. 619, 56 Stat. 798 (1942); sec. 201(b),
10. S. Rept. 1631, 77th Cong., 2d Sess. (1942),
11. S. Rept. 1631,
12. See Report of the Advisory Committee to the National Association of Insurance Commissioners, 1964; J. Magee, Life Insurance 564 (3d. ed. 1958); J. MacLean, Life Insurance 134-140 (8th ed. 1956).↩
13. The operation of the net level method of reserving in contrast to the 2-year preliminary term method is made apparent by the following example. As noted
14. Although policies reserved under the 2-year preliminary term method will contribute to the terminal reserve at an accelerated rate vis-a-vis the net level method
15. S. Rept. 1631,
16. And this will be true even if under the actual experience of the company, the entire unearned premium reserve is not expended for current claim costs and expenses. Such excess amounts do not become part of a terminal or mid-terminal reserve, but rather become company surplus. See J. MacLean,
Helvering v. Oregon Mutual Life Insurance , 61 S. Ct. 207 ( 1940 )
Alinco Life Insurance Company v. The United States , 373 F.2d 336 ( 1967 )
Maryland Casualty Co. v. United States , 40 S. Ct. 155 ( 1920 )
Knapp-Monarch Co. v. Commissioner of Internal Revenue , 139 F.2d 863 ( 1944 )
Group Life and Health Insurance Company v. The United ... , 660 F.2d 1042 ( 1981 )
Burnet v. Guggenheim , 53 S. Ct. 369 ( 1933 )
Helvering v. Inter-Mountain Life Insurance , 55 S. Ct. 572 ( 1935 )
Superior Life Insurance Company v. United States of America,... , 462 F.2d 945 ( 1972 )
Edwin O. Bookwalter v. Joseph H. And Frances R. Brecklein , 357 F.2d 78 ( 1966 )
Maximov v. United States , 83 S. Ct. 1054 ( 1963 )
economy-finance-corporation-transferee-of-the-assets-of-national-public , 501 F.2d 466 ( 1974 )
Union Mutual Life Insurance Company, Plaintiff-Appellee-... , 570 F.2d 382 ( 1978 )
Automobile Club of Mich. v. Commissioner , 77 S. Ct. 707 ( 1957 )