Godley v. County of Pitt

293 S.E.2d 167, 306 N.C. 357, 1982 N.C. LEXIS 1459
Supreme Court of North Carolina·Decided July 13, 1982·No. 87PA82·Published·Cited by 72 cases

Opinion

COPELAND, Justice.

Appellate review of opinions and awards of the Industrial Commission is strictly limited to the discovery and correction of *360 legal errors. G.S. 97-86; Barham v. Food World, 300 N.C. 329, 266 S.E. 2d 676 (1980); Byers v. Highway Comm., 275 N.C. 229, 166 S.E. 2d 649 (1969). The dispositive issue here is whether the Commission erred as a matter of law in concluding that Pitt County and its insurance carrier, U.S. Fire Insurance, were estopped from denying coverage of the employee’s work-related accident under the particular facts of this case. We affirm the Commission’s conclusion in this regard and reverse the contrary decision of the Court of Appeals.

In its broadest and simplest sense, the doctrine of estoppel is a means of preventing a party from asserting a legal claim or defense which is contrary to or inconsistent with his prior actions or conduct. See generally Dobbs, Handbook on the Law of Remedies § 2.3, at 41-44 (1973). The underlying theme of estoppel is that it is unfair and unjust to permit one to pursue an advantage or right which has not been promoted or enforced prior to the institution of some lawsuit. See McNeely v. Walters, 211 N.C. 112, 189 S.E. 114 (1937). In particular, “[t]he rule is grounded in the premise that it offends every principle of equity and morality to permit a party to enjoy the benefits of a transaction and at the same time deny its terms or qualifications.” Thompson v. Soles, 299 N.C. 484, 487, 263 S.E. 2d 599, 602 (1980).

An estoppel can arise in any legal setting, and our appellate courts have prudently and repeatedly applied the doctrine in workers’ compensation cases to thwart an insurance carrier’s subsequent attempt to avoid coverage of a work-related injury, howbeit upon a legitimate ground, when the carrier has previously and routinely accepted the payment of insurance premiums pertaining to the injured individual. Aldridge v. Motor Co., 262 N.C. 248, 136 S.E. 2d 591 (1964); Pearson v. Pearson, Inc., 222 N.C. 69, 21 S.E. 2d 879 (1942); Garrett v. Garrett & Garrett Farms, 39 N.C. App. 210, 249 S.E. 2d 808 (1978), discretionary review denied, 296 N.C. 736, 254 S.E. 2d 178 (1979); see Moore v. Electric Co., 264 N.C. 667, 142 S.E. 2d 659 (1965); Greene v. Spivey, 236 N.C. 435, 73 S.E. 2d 488 (1952); Britt v. Construction Co., 35 N.C. App. 23, 240 S.E. 2d 479 (1978); Allred v. Woodyards, Inc., 32 N.C. App. 516, 232 S.E. 2d 879 (1977). This rule is plainly consistent with the overall rationale of the remedial doctrine of estoppel, and it is so well established in our jurisdiction that it requires no explanation or elaboration here. Yet the Court of Appeals de- *361 dined to hold in the instant case that Pitt County and U.S. Fire Insurance, the undisputed payor and payee of the compensation premiums for the injured employee, were estopped to deny coverage due to its belief that estoppel in workers’ compensation cases is of the classic form, that is, “equitable” estoppel, which would require a showing of detrimental reliance by the Town of Winterville and Great American Insurance before the doctrine could operate in their favor. 54 N.C. App. at 326, 283 S.E. 2d at 431-32; see generally Bourne v. Lay & Co., 264 N.C. 33, 140 S.E. 2d 769 (1965); 5 Strong’s N.C. Index 3d, Estoppel §§ 4.5-4.6 (1977). We are not so persuaded in this case.

None of the workers’ compensation cases, which have previously applied estoppel against an insurance carrier based upon its receipt and acceptance of the required premiums (supra), have expressly denominated the estoppel so used as “equitable” or mentioned the necessity for detrimental reliance by, or the accrual of some harm to, the party who seeks to benefit from the doctrine’s application. It seems certain, as a matter of common sense, that such detriment or prejudice would perforce exist in all of these cases, in any event, since some other provision for coverage surely would have been made if the party to be estop-ped had not paid or accepted the premiums. See Aldridge v. Motor Co., supra, 262 N.C. at 252-53, 136 S.E. 2d at 594. Perhaps then, the prior pertinent decisions have omitted an express reference to detrimental reliance in such circumstances because the nature of the situation dictates that it be conclusively presumed. See 1C Larson, Workers’ Compensation Law § 46.40, at 8-223 to 227 (1980 and Supp. 1981). But see 7B Appleman, Insurance Law and Practice § 4659 (Berdal ed. 1979).

We need not specifically decide this issue of estoppel theory with respect to all workers’ compensation cases today, however. It suffices to say that we believe that the unique situation involving compensation coverage of federally paid CETA employees in this State would be best governed in every instance by a straightforward rule of “quasi” estoppel, which does not require detrimental reliance per se by anyone, but is directly grounded instead upon a party’s acquiescence or acceptance of payment or benefits, by virtue of which that party is thereafter prevented from maintaining a position inconsistent with those acts. 31 C.J.S. Estoppel § 107 (1964); 28 Am. Jur. 2d Estoppel and Waiver § 59 *362 (1966); see Corbett v. Corbett, 249 N.C. 585, 107 S.E. 2d 105 (1959); Cook v. Sink, 190 N.C. 620, 130 S.E. 714 (1925); Redevelopment Comm. v. Hannaford, 29 N.C. App. 1, 222 S.E. 2d 752 (1976). In so holding, we endorse the sound reasoning expounded by the Attorney General in his amicus brief at pages 6-8:

[Quasi estoppel is] the only acceptable rule which may be fashioned to accommodate many CETA workers and other workers similarly situated. In several CETA programs workers are assigned to job sites not controlled by the agency which holds the CETA subgrant. That agency must select the participants and provide for the benefits assured participants by the subgrant and Federal law. See, 29 USC § 823(d)(6) and 20 CFR § 676.27(a). Since the subgrantee does not supervise the participants, the logical result of the Court of Appeals decision will require separate workmen’s compensation coverage at each site supervised by an entity other than the subgrantee. While compliance with that result is not impossible, the administrative complications of the subgrantee and insurance carriers will be staggering. Under the rule proposed herein, a single carrier would provide the coverage regardless of the site or supervisor. Premiums would continue to be determined from the payroll records rather than some new system yet to be devised.
It would also avoid the second complication which is implicit in the principles of equity. Should the Court of Appeals’ opinion be upheld, the carrier will have collected premiums for workers it never covered while the liability for injuries will pass to carriers which did not collect the premiums or agree to cover the participants.

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Godley v. County of Pitt, 293 S.E.2d 167, 306 N.C. 357, 1982 N.C. LEXIS 1459 (N.C. 1982).

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