Understanding the hearing process
Once you have filed a demand for hearing, the judge will schedule a prehearing conference. The prehearing conference is usually held by telephone. Participants include (1) you and/or your representative, (2) a person who represents the insurance commissioner, and (3) the judge who will be hearing your case.
Topics for discussion include basic procedures to be followed before, during and after the hearing, as well as any issues or concerns which have arisen or may arise in preparation for the hearing. No final decisions will be made during the prehearing conference. The parties may anticipate, however, that the hearing date will be scheduled during the prehearing conference, with an effort to accommodate the needs of both parties.
You may contact the Hearings Unit any time before your hearing to ask for additional prehearing conferences if you have additional questions or concerns to discuss with the judge. All parties must be present any time you meet with the judge, by telephone or otherwise.
Similar to a trial in court, the hearing will include witnesses, exhibits and rules of evidence. The hearing will be conducted in a fairly formal manner; however, it will be as flexible as possible to accommodate the needs of the parties and any witnesses which may appear. The goal is for the judge to be presented with all pertinent information in order to make the best decision. The judge will answer any questions you may have during the hearing.
The hearing begins with each party presenting an opening statement summarizing what they intend to prove. Then each party presents its evidence which normally includes documents and testimony. All evidence must be determined to be reliable by the judge before it is admitted. Witnesses give their testimony under oath and are subject to cross-examination by the other party. The judge may also question a witness. You may be a witness for yourself, and in fact, sometimes the aggrieved party is his or her only witness.
The hearing concludes with each party presenting its closing arguments summarizing what they believe they have shown. Sometimes the judge will ask the parties to present closing arguments in writing after the hearing.
A written decision is issued by the judge within 90 days of receiving all of the evidence and closing the hearing. The decision includes findings of fact, conclusions of law and a final order. The decision may be to (1) uphold the original act of the commissioner; (2) modify the action, e.g., impose a lesser penalty; or (3) set aside the original act of the commissioner; and in the case of an application which requires a hearing (4) approve or disapprove the application.
The decision of the judge is the final decision of the agency and is not subject to review by the insurance commissioner or any member of his staff. The final decision may be reviewed by the superior court if a party files a petition for review within 30 days of the mailing of the final decision.
Status of the commissioner's order or action
If a demand for hearing was filed with the Hearings Unit prior to the effective date of the commissioner's order or action, the order or action will be automatically stayed, that is, not go into effect pending the final outcome of the case. Discretionary stays may also be granted by the judge upon request, depending on the situation. When a stay is in place, you can continue to do business unless or until the judge orders otherwise.