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Mirkin v. Medical Mutual Liability Insurance Society of Maryland5/3/1990
proved that Mirkin violated the underwriting standard which was applied in this case.
Consequently, Medical Mutual was ordered to continue to insure Dr. Mirkin.
On March 1, 1989, Medical Mutual appealed this order to the Circuit Court for Baltimore City. The court (Hammerman, J.) reversed, holding that there was not substantial evidence presented at the hearing from which the Insurance Commissioner could reasonably have concluded that Dr. Mirkin did not alter his medical records. The court also ruled that the standard applied by Medical Mutual complied
with § 234A since it is related to its economic and business purposes and ordered the Insurance Commissioner to dismiss Dr. Mirkin's complaint.
Dr. Mirkin presents two issues for our review. The first is whether the circuit court erred in reversing the decision of the Insurance Commissioner based on a lack of substantial evidence. The second is whether the circuit court erred in ruling that Medical Mutual's standard is "reasonably related to economic and business purposes." We shall answer both questions in the negative and affirm the decision of the circuit court.
I.
The basic standard for judicial review of an administrative finding of the Insurance Commissioner is whether the finding is supported by substantial evidence. § 40; Lumbermen's Mut. Cas. Co. v. Insurance Comm'r., 302 Md. 248, 266, 487 A.2d 271 (1985). This means "whether a reasoning mind reasonably could have reached the factual conclusion the agency reached." Id. This standard of review "is narrow in scope and the decision of the administrative agency carries a presumption of validity." Doctor's Hosp. v. Maryland Health Resources, 65 Md. App. 656, 667, 501 A.2d 1324 (1986). In applying this test, a reviewing court should not substitute its judgment for that of the agency from which the appeal is taken. Bulluck v. Pelham Wood Apartments, 283 Md. 505, 513, 390 A.2d 1119 (1978). Of course, a reviewing court may always determine whether an administrative agency made an error of law. Baltimore Lutheran High School v. Employment Sec. Admin., 302 Md. 649, 662, 490 A.2d 701 (1985).
A careful review of the evidence on the issue of whether Dr. Mirkin altered his medical records supports Judge Hammerman's conclusion that there was no substantial evidence to support the Insurance Commissioner's decision. The only contemporaneous record of Dr. Mirkin's treatment of Bennington was the one prepared at the time
of the surgery, which, due to an oversight by Dr. Mirkin, was not accurate. But when asked to provide Bennington's attorney and Medical Mutual with his records of Bennington's treatment, he did not send them that record. Instead, he created new, more thorough "records," backdated them to make it appear as though they were prepared at the time of the treatment and transmitted them without indicating that he was withholding the original record. Furthermore, these "records" were created at a time when Dr. Mirkin "had an idea" that Bennington was planning to sue him for malpractice, and they were different from the original record in two important, self-serving ways. First, the second set of records described the excision as much larger than the original record did; also, the second set of records contained a recommendation that Bennington seek follow up care, which was not included in the original record. Significantly, whether a large enough excision was made to prevent the recurrence of cancer and whether Dr. Mirkin informed Bennington
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