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Massachusetts Superior Court Standing Order 6-80: Complaints For Judicial Review Of Surcharge Matters Under G.L. c. 175, s. 113P; Notice To The Department Of The Attorney General; Form Complaints

Applicable to All Counties Effective July 7, 1980.

[Disclaimer]

Upon filing of a complaint seeking judicial review of any finding or order made by the Board of Appeal on Motor Vehicle Liability Policies and Bonds (Board) under G.L. c. 175, s. 113P, notice shall be given to the Government Bureau, Department of the Attorney General, John F, McCormack State Office Building, One Ashburton Place, Boston, MA 02108. Such review is pursuant to G.L. c. 30A, s. 14 (see Acts of 1979, c. 182). Notice shall therefore also be given pursuant to G.L. c. 30A, s. 14(2), and Mass.R.Civ.P. 4(d)(3) to the Board and to each party to the administrative proceeding. As in any other 30A, s. 14, action, after the complaint is filed and served the defendants then have 20 days to respond.

To assist an aggrieved party seeking judicial review a pre-printed form complaint has been drafted. This form shall be made available in the respective offices of the Clerk-Magistrates in the various counties.

COMPLAINT FOR JUDICIAL REVIEW
COMMONWEALTH OF MASSACHUSETTS

Superior Court

No.____________

____________, ss.

 

 

____________ Plaintiff

vs.

____________ Insurance Company and Board of Appeal on Motor Vehicle

Liability Policies and Bonds, Defendants

COMPLAINT FOR JUDICIAL REVIEW

(In Connection With Denial Of Appeal Of a Surcharge)

1. This is a complaint seeking judicial review pursuant to G.L. c. 30A, s. 14, and G.L. c. 175, s. 113P.

2. Plaintiff ____________ is a resident in the Commonwealth of Massachusetts and lives at ____________.

3. Defendant ____________ Insurance Company (Company) is a corporation with a principal place of business at ____________.

4. Defendant Board of Appeal on Motor Vehicle Liability Policies and Bonds (Board) is an agency of the Commonwealth having its principal office at 150 Causeway Street, Boston, MA 02114.

5. Plaintiff is aggrieved by a decision of defendant Board denying plaintiffs appeal of a surcharge imposed on plaintiff by defendant Company.

6. A memorandum of the Board's decision was filed in the Office of the Commissioner of Insurance, Board of Appeal, on ____________, 19__.

7. Plaintiff's appeal is based on an assertion that defendant Board's finding was (check the applicable section and write an explanation in the blank lines following):

a. not supported by substantial evidence because

_________________________________________________________

_________________________________________________________

b. contrary to law because ____________________________

_________________________________________________________

_________________________________________________________

c. in excess of its authority because _________________

_________________________________________________________

_________________________________________________________

d. based on unlawful procedure because ________________

_________________________________________________________

_________________________________________________________

e. in violation of constitutional standards because ___

_________________________________________________________

_________________________________________________________

f. arbitrary and capricious because ___________________

_________________________________________________________

_________________________________________________________

WHEREFORE, plaintiff requests the following relief (fill in):

_________________________________________________________

_________________________________________________________

_________________________________________________________

Name: ___________________________

Address: ________________________

Telephone: ______________________

Signed under the penalties of perjury.

_______________________________________________

Dated: ____________ 19__

NOTIFY (1) GOVERNMENT BUREAU (DEPT. OF ATTY. GENERAL): (2) THE BOARD OF APPEAL, AND (3) ANY OTHER PARTY TO THE APPEAL. SEE STANDING ORDER NO. 6-80.

Adopted May 29, 1980, effective July 7, 1980.