Duganier v. Carolina Mountain Bakery

633 S.E.2d 696, 179 N.C. App. 184, 2006 N.C. App. LEXIS 1816
CourtCourt of Appeals of North Carolina
DecidedAugust 15, 2006
DocketCOA05-1457
StatusPublished
Cited by2 cases

This text of 633 S.E.2d 696 (Duganier v. Carolina Mountain Bakery) is published on Counsel Stack Legal Research, covering Court of Appeals of North Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Duganier v. Carolina Mountain Bakery, 633 S.E.2d 696, 179 N.C. App. 184, 2006 N.C. App. LEXIS 1816 (N.C. Ct. App. 2006).

Opinion

McGEE, Judge.

Defendant-appellant Travelers Insurance Company (Travelers) issued a workers’ compensation insurance policy to defendant-employer Carolina Mountain Bakery (CMB) covering CMB from 5 June 2001 through 5 June 2002 (CMB’s policy). Joseph Duganier (plaintiff) began working at CMB in August 2001 and sustained a back injury at work on 17 December 2001.

Plaintiff filed a Form 18 with the North Carolina Industrial Commission (the Commission) on 25 April 2002, alleging he “[f]elt something pop in his back” while working at CMB on 17 December 2001. Plaintiff filed a Form 33 on 25 April 2002 requesting a hearing. Travelers filed a Form 61 on 14 May 2002, denying coverage for plaintiff’s injuries on the ground that Travelers cancelled CMB’s policy effective 5 December 2001. The parties signed a pretrial agreement on *185 16 October 2003, stipulating that plaintiff suffered a compensable injury to his back on 17 December 2001.

A deputy commissioner conducted a hearing on the matter on 16 October 2003. Evidence introduced at the hearing tended to show that Travelers mailed a “Notice of Cancellation for Non-payment of Premium” (notice of cancellation) on 15 November 2001 by certified mail to CMB’s designated mailing address. Travelers did not mail the notice of cancellation return receipt requested. The effective date of cancellation was listed as 5 December 2001 on the notice of cancellation. The notice of cancellation stated that Travelers would “reinstate this coverage if [Travelers] receive [d] [CMB’s] payment on or before the effective date of cancellation.” CMB did not make the premium payment by 5 December 2001.

At the time CMB’s policy became effective on 5 June 2001, N.C. Gen. Stat. § 97-99(a) set forth the requirements for cancellation for non-payment of premium. This statute provided, in pertinent part: “The carrier may cancel the policy for nonpayment of premium on 10 days’ written notice to the insured[.]” N.C. Gen. Stat. § 97-99(a) (1999). In Wilson v. Claude J. Welch Builders, 115 N.C. App. 384, 386, 444 S.E.2d 628, 629 (1994), our Court interpreted N.C.G.S. § 97-99(a), stating that the statute did not require “that the notice of intent to cancel due to nonpayment of premium be sent by registered or certified mail.”

The N.C. General Assembly amended the workers’ compensation insurance policy cancellation statutes in 2001 by removing the cancellation provisions from N.C.G.S. § 97-99(a) and adding N.C. Gen. Stat. § 58-36-105. N.C. Gen. Stat. § 58-36-105(b) provides the following notice requirements for cancellation of a workers’ compensation insurance policy:

Any cancellation permitted by subsection (a) of this section is not effective unless written notice of cancellation has been given by registered or certified mail, return receipt requested, to the insured not less than 15 days before the proposed effective date of cancellation. The notice shall be given by registered or certified mail, return receipt requested, to the insured and any other person designated in the policy to receive notice of cancellation at their addresses shown in the policy or, if not indicated in the policy, at their last known addresses. The notice shall state the precise reason for cancellation. Whenever notice of intention to cancel is required to be given by registered or certified mail, no *186 cancellation by the insurer shall be effective unless and until such method is employed and completed.

N.C. Gen. Stat. § 58-36-105(b) (2001). Section three of the amending Act which created N.C.G.S. § 58-36-105(b) provides: “This act becomes effective October 1, 2001, and applies to policies issued, renewed or subject to renewal, or amended on or after that date.” 2001 N.C. Sess. Laws ch. 241, § 3.

Travelers’ compliance officer, Larry Rodriguez (Mr. Rodriguez), testified at the hearing before the deputy commissioner that he was responsible for Travelers’ compliance with state laws related to cancellation and nonrenewal notices for its workers’ compensation insurance policies. Mr. Rodriguez testified that CMB’s policy was not “subject to renewal” at the time of the “cancellation” of CMB’s policy. He stated that “[Travelers] would consider a policy subject to renewal when [Travelers] start[s] [its] renewal underwriting process, which is approximately 90 days prior to the expiration date of the policy.” The expiration date of CMB’s policy was 5 June 2002.

In an opinion and award filed 31 March 2004, the deputy commissioner concluded as follows: (1) plaintiff sustained a compensable injury to his back on 17 December 2001; (2) CMB’s policy was not “subject to renewal” on or after 1 October 2001; (3) the cancellation provisions of N.C.G.S. § 97-99(a) applied to CMB’s policy at the time of Travelers’ notice of cancellation; (4) therefore, Travelers’ notice of cancellation and CMB’s failure to pay its premium by 5 December 2001 effectively cancelled CMB’s coverage; and (5) CMB was uninsured at the time of plaintiff’s injury. The deputy commissioner ordered CMB to pay plaintiff temporary total disability and all medical expenses incurred by plaintiff as a result of the injury. Plaintiff filed a notice of appeal with the Commission on 13 April 2004, and CMB filed a notice of appeal with the Commission on 14 April 2004. Plaintiff notified the Commission on 7 October 2004 that he had settled his claim with CMB but would continue his claim against Travelers on the issue of coverage.

The Commission filed an opinion and award on 4 August 2005, affirming the deputy commissioner’s decision that plaintiff’s injury was compensable but reversing the deputy commissioner’s decision that N.C.G.S. § 97-99(a) applied to CMB’s policy. Instead, the Commission concluded that CMB’s policy was “subject to renewal” on or after 1 October 2001 and therefore N.C.G.S. § 58-36-105(b) was the applicable statute governing the cancellation of CMB’s policy. The *187 Commission concluded that Travelers’ cancellation was ineffective because the notice of cancellation had not been sent by registered or certified mail, return receipt requested. The Commission ordered Travelers to pay plaintiffs temporary total disability at a rate of $253.35 per week from 17 December 2001 through 16 October 2003, the date of the hearing before the deputy commissioner. Additionally, Travelers was ordered to pay plaintiff’s medical expenses.

Travelers appeals.

Travelers appears to argue that because CMB’s policy was not “subject to renewal” prior to Travelers’ attempted cancellation date of 5 December 2001, the provisions of N.C.G.S. § 58-36-105(b) did not apply, and its cancellation of CMB’s policy was effective pursuant to the provisions of N.C.G.S. § 97-99(a). However, the issue in the present case is not whether CMB’s policy was “subject to renewal” at the time of Travelers’ attempted cancellation on 5 December 2001. Rather, the issue in the present case is whether CMB’s policy was “subject to renewal” on or after 1 October 2001 such that the provisions of N.C.G.S. § 58-36-105(b) applied to Travelers’ notice of cancellation of CMB’s policy. If CMB’s policy was “subject to renewal” on or after 1 October 2001, N.C.G.S.

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Cite This Page — Counsel Stack

Bluebook (online)
633 S.E.2d 696, 179 N.C. App. 184, 2006 N.C. App. LEXIS 1816, Counsel Stack Legal Research, https://law.counselstack.com/opinion/duganier-v-carolina-mountain-bakery-ncctapp-2006.