Tovar-Mauricio v. T.R. Driscoll, Inc.
| Decision Date | 03 December 2013 |
| Docket Number | No. COA13–517.,COA13–517. |
| Citation | 753 S.E.2d 337 |
| Parties | Jorge TOVAR–MAURICIO, Edemias Deleon Morales, Mario M. Tovar, Ranulfo Deleon Vasquez, Bernabe Francisco Calixto, Tomas Martinez Guerrero and Gabriel Dominguez–Contrera, Employees, Plaintiffs–Appellees, v. T.R. DRISCOLL, INC., Employer, General Casualty Insurance Company, Carolinas Roofing and Sheet Metal Contractors Self–Insured Fund, Carrier, Defendants–Appellants. |
| Court | North Carolina Court of Appeals |
OPINION TEXT STARTS HERE
Appeals by Defendants General Casualty Insurance Company and Carolinas Roofing and Sheet Metal Contractors Self–Insured Fund from opinion and award entered by the North Carolina Industrial Commission on 21 December 2012. Heard in the Court of Appeals 24 September 2013.
Diener Law, Greenville by Cynthia E. Everson, for Plaintiffs–Appellees.
Orbock Ruark & Dillard, PC, Winston–Salem by Roger L. Dillard, Jr. and Jessica E. Lyles, for Defendant–Appellee T.R. Driscoll, Inc.
Goodman McGuffey Lindsey & Johnson, LLP, Charlotte by Adam E. Whitten, for Defendant–Appellant Carolinas Roofing and Sheet Metal Contractors Self–Insured Fund.
Teague Campbell Dennis & Gorham, LLP, Raleigh, by Brian M. Love and George H. Pender, for Defendant–Appellant General Casualty Insurance Company.
T.R. Driscoll, Inc. (“Employer”) is a company with a principal place of business in North Carolina. Employer intermittently sends its employees to work in other states, including Virginia. Employer joined the Carolinas Roofing and Sheet Metal Contractors Self–Insured Fund (“the Fund”) in the early 1980s. Employer entered into an agreement with the Fund for workers' compensation insurance “coverage for North Carolina and South Carolina operations[.]” The Davis–Garvin Agency, Inc. (“Davis–Garvin”) served as Employer's agent in purchasing insurance for “exposure not covered by the Fund.” Davis–Garvin obtained workers' compensation insurance for Employer from Capital City Insurance Company in 2005. General Casualty Insurance Company (“General Casualty”) acquired Capital City Insurance Company in 2009.
Employer sent Jorge Tovar–Mauricio, Edemias Deleon Morales, Mario M. Tovar, Ranulfo Deleon Vasquez, Bernabe Francisco Calixto, Tomas Martinez Guerrero, and Gabriel Dominguez–Contrera (“Plaintiffs”) to Virginia to work on a roofing project. Plaintiffs were injured in the course and scope of their employment when a gas line exploded on 29 November 2009. Plaintiffs filed workers' compensation claims in Virginia. General Casualty “accepted the claims as compensable pursuant to the Virginia Workers' Compensation Act and began making payments[.]” The North Carolina Industrial Commission found that, as “of November 2011, General Casualty has paid compensation and medical benefits pursuant to the Virginia Workers' Compensation Act to [Plaintiffs] in an approximate amount of $1,960,000.00.”
In September 2010, Plaintiffs filed Form 33 Requests for Hearing with the North Carolina Industrial Commission, indicating that the parties had been unable to agree, noting only “change of jurisdiction from VA to NC[.]” General Casualty responded that “it provided no coverage to [Employer] for claims filed in North Carolina and that such claims were properly covered by the Fund.”
The Commission found that Employer “had a valid workers' compensation insurance policy with General Casualty covering Georgia, Tennessee, and Virginia.” The Commission also found that Employer “was covered for workers' compensation claims filed in North Carolina by [the Fund] at the time of Plaintiffs' injuries.”
The Commission concluded that the Fund “is the insurance carrier on the risk for [Employer] for workers' compensation claims filed under the North Carolina Workers' Compensation Act[.]” The Commission did “not address the issue of Plaintiffs' disability or average weekly wages” because the hearing “was limited to the establishment of jurisdiction and carrier liability [.]” The Fund and General Casualty appeal.
“Appellate review of an award from the Industrial Commission is generally limited to two issues: (1) whether the findings of fact are supported by competent evidence, and (2) whether the conclusions of law are justified by the findings of fact.” Starr v. Gaston Cty. Bd. Of Educ., 191 N.C.App. 301, 304, 663 S.E.2d 322, 325 (2008). “Where there is competent evidence to support the Commission's findings, they are binding on appeal even in light of evidence to support contrary findings.” Id. at 304–05, 663 S.E.2d at 325. “The Commission's conclusions of law are reviewed de novo.” Id. at 305, 663 S.E.2d at 325.
The Fund first argues that the “Commission erred in concluding that the General Casualty policy affords no coverage for Plaintiffs' claims[.]” The Fund fails to specify which conclusion of law it challenges on appeal. The only conclusion concerning General Casualty's coverage of Plaintiffs' claims is conclusion 4, quoted below:
4 ..... Based upon a review of the plain language of the General Casualty policy, North Carolina was not a covered state at any time during the policy, either before or after the modification by endorsement.
We interpret the Commission's language that “North Carolina was not a covered state” as meaning that “the General Casualty policy affords no coverage for the claims before the Commission, i.e. Plaintiffs' claims that were filed in North Carolina.” We interpret the language in this manner because of the plain language in the General Casualty insurance policy: “We will pay promptly when due the benefits required of you by the workers compensation law.” According to the policy, “Workers Compensation Law means the workers or workmen's compensation law and occupational disease law of each state or territory named in Item 3.A. of the Information Page.”
The “Information Page” lists Georgia, Tennessee, and Virginia:
3A. Workers compensation insurance: Part one of the policy applies to the workers compensation law of the states listed here: GA, TN, VA
Where “the language of an insurance policy is plain, unambiguous, and susceptible of only one reasonable construction, the courts will enforce the contract according to its terms.” Walsh v. Insurance Co., 265 N.C. 634, 639, 144 S.E.2d 817, 820 (1965); see also Register v. White, 358 N.C. 691, 599 S.E.2d 549 (2004).
The General Casualty policy is plain, unambiguous, and susceptible of only one reasonable construction. The General Casualty policy applies to benefits required by the workers' compensation laws of Virginia, in this case. The Commission did not and indeed cannot award compensation except as required by the North Carolina Workers' Compensation Act. The Commission cannot award compensation under the laws of any state other than North Carolina.
The record indicates that Plaintiffs received compensation under the workers' compensation laws of Virginia. Thus, N.C. Gen.Stat. § 97–36 will apply in this case if future proceedings are instituted to determine the specific amount of compensation due Plaintiffs under our workers' compensation laws. SeeN.C. Gen.Stat. § 97–36 (2011) (). The Commission did not err in concluding that the General Casualty policy affords no coverage for Plaintiffs' claims filed in North Carolina.
The Fund requests this Court to “hold that General Casualty is liable to the Plaintiffs injured in Virginia, to the extent required by Virginia workers' compensation law, even after their claims are transferred to North Carolina for convenience.” We note that the record indicates that the Commission ordered no such “transfer.” Also, the Fund cites no provision in our General Statutes authorizing the Commission to “transfer” a claim from another state to North Carolina.
The conclusion that the General Casualty policy affords no coverage for these claims filed in North Carolina has no implications for General Casualty's liability under Virginia workers' compensation law. We therefore make no conclusions about General Casualty's past or continuing liability under Virginia law.
The Fund next argues the Commission erred in concluding that the Fund agreement affords coverage for Plaintiffs' claims. We disagree.
The Fund challenges finding of fact 28 and conclusion of law 5. Finding of fact 28 is as follows:
28. .... The Full Commission further finds that [Employer] was covered for workers' compensation claims filed in North Carolina by [the Fund] at the time of Plaintiffs' injuries.
Conclusion 5 states:
5. Under the terms of the workers' compensation insurance policy with the Fund, [Employer] was properly covered for workers' compensation claims filed in North Carolina. N.C. Gen.Stat. § 97–36[.]
The Fund directs this Court to the following language in the Fund agreement:
1. To the extent that coverage is afforded the Member under Article II of this Agreement, the Fund shall neither be obligated to pay nor incur defense costs with respect to the following:
a. Under Coverage A, for any liability, judgment or award rendered against the Member or the Fund by the governing authorities of a State not listed in the Preamble of this Agreement [.]
b. Under Coverage A, for any liability, judgment or award rendered against the Member or the Fund, pursuant to a workers' compensation law other than that identified in Article II, section 3 of this Agreement[.]
c. Under Coverages A and B, for operations conducted at or from any workplace if the Member has separate insurance for such operations[.] (emphasis added).
Coverage A refers to workers' compensation; Coverage B...
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