Oxendine v. Twl, Inc.

CourtNorth Carolina Industrial Commission
DecidedJune 27, 2006
DocketI.C. NOS. 269421 PH-1134
StatusPublished

This text of Oxendine v. Twl, Inc. (Oxendine v. Twl, Inc.) is published on Counsel Stack Legal Research, covering North Carolina Industrial Commission primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Oxendine v. Twl, Inc., (N.C. Super. Ct. 2006).

Opinion

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The undersigned reviewed the prior Opinion and Award, based upon the record of the proceedings before Deputy Commissioner Hall. The appealing party has not shown good ground to reconsider the evidence; receive further evidence; rehear the parties or their representatives; and having reviewed the competent evidence of record, the Full Commission affirms the Opinion and Award of Deputy Commissioner Hall with modifications.

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The Full Commission finds as fact and concludes as matters of law the following, which were entered into by the parties at the hearing before the Deputy Commissioner as:

STIPULATIONS
1. All parties are properly before the Commission and that the Commission has jurisdiction over the parties and over the subject matter.

2. All parties have been correctly designated, and there is no question as to misjoinder or nonjoinder of parties.

3. Employee-plaintiff was injured by accident, within the course and scope of employment.

4. The Employer, TWL, Inc., is, and was, at all times relevant to the claims set forth herein, an employer, as that term is defined by the North Carolina Workers' Compensation Act, and subject to the provisions of the Act.

5. Canal Insurance Company's notice of cancellation was not given to the employer by registered or certified mail, return receipt requested.

6. Plaintiff's average weekly wage is $580.58, yielding a compensation rate of $387.24 per week.

7. The medical records of plaintiff are identified as Exhibit A to the Pre-Trial Agreement, and are admissible without further foundation or proof.

8. Plaintiff's medical bills are also attached hereto as Exhibit B and those bills are subject to a determination by the Industrial Commission that medical treatment arose out of and was related to plaintiff's alleged workers' compensation claim and that the treatment was reasonably necessary to effectuate a cure, give relief, or lessen the period of disability.

9. Plaintiff's claim was accepted by defendant-employer by the payment of indemnity benefits and that the medical treatment received by plaintiff, as set out in Exhibits A and B, was necessitated by the work-related injury sustained and that all medical records and attendant billing is admitted into evidence, without the necessity of post-hearing depositions of physicians.

10. The parties stipulate that plaintiff's date of injury is January 31, 2003.

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Based upon all of the competent evidence of record and reasonable inferences flowing therefrom, the Full Commission makes the following:

FINDINGS OF FACT
1. On January 31, 2003, plaintiff was involved in an automobile accident near Richmond, Virginia. At the time of the accident, plaintiff was an employee of TWL, Inc. (hereinafter, TWL) and was in the process of delivering goods for TWL. Plaintiff's accident occurred while he was within the course and scope of his employment, and arose out of his employment with TWL.

2. As a result of the accident, plaintiff suffered serious injuries, including brain injury and resulting hemorrhage, pulmonary collapse, pneumonia, closed fracture to the patella, closed fracture to the base of the metacarpal bone, tear in the medial cartilage/meniscus of the right knee, bimalleolar fracture, closed fracture of the facial bones, and orbital hemorrhage.

3. TWL admits that plaintiff suffered a compensable injury and paid plaintiff temporary total disability benefits in the amount of $387.24 per week since October 31, 2003.

4. On or about October 30, 2003, plaintiff and defendants TWL and Robert Locklear entered into a mediated settlement agreement, which provided that TWL and Robert Locklear would pay plaintiff $14,715.12 on or before December 31, 2003, said amount representing temporary total disability benefits due to plaintiff from January 31, 2003 through October 31, 2003.

5. On or about July 10, 2002, plaintiff suffered a compensable injury to his right knee. Defendant Canal subsequently accepted the claim and entered into a mediated settlement agreement with Plaintiff in the amount of $28,000.00 on October 30, 2003. Pursuant to the settlement agreement, defendant Canal paid directly to plaintiff almost $21,000, and $7,000 to Plaintiff's counsel.

6. Plaintiff's prior workers' compensation claim for his right knee, I.C. No. 296360, was paid under the insurance policy issued by Canal to TWL with effective dates of March 20, 2002 through March 20, 2003.

7. In March 2000, TWL procured workers' compensation insurance with Canal. The policy was issued with effective dates of March 20, 2002 through March 20, 2003.

8. The payment plan identified in Canal's insurance policy required an initial payment or a "new deposit" of $14,776.00 to be paid on or about March 20, 2002, with monthly installment payments commencing on April 20, 2002 in the amount of $4,935.00. The final installment payment was due on December 20, 2002.

9. TWL made the "new deposit" payment and all installment payments through approximately mid-November 2002. The premium payments have never been refunded or returned to TWL. On November 25, 2002, Patty Watts, a member of the accounting department at Golden Isle Underwriting, Inc., Canal's managing agent, prepared and sent a letter to TWL thanking TWL for its payment of $4,935.00, which was applied toward TWL's premium. Ms. Watts' letter further states that TWL's policy will be cancelled on December 7, 2002 and remains cancelled due to "underwriting reasons."

10. On September 18, 2002, a "NOTICE OF CANCELLATION OF INSURANCE" was prepared by Canal. The Notice of Cancellation states that TWL's workers' compensation insurance policy with Canal Insurance would be cancelled effective December 7, 2002 for "underwriting reasons."

11. TWL received actual notice of the attempted cancellation through its broker, BH Insurance Services, Inc., and immediately attempted to procure additional workers' compensation insurance.

12. The owner of TWL, Robert Locklear, testified that he was not aware of any particular law or statute governing the appropriate and lawful method of cancellation, and assumed the policy was being cancelled effective December 7, 2002.

13. Cancellation of a workers' compensation insurance policy prior to the date of its expiration is governed by N.C. Gen. Stat. § 58-36-105. N.C. Gen. Stat. § 58-36-105(a)(1)(10) provides specific grounds for terminating a workers' compensation policy prior to the expiration of the term or anniversary date stated in the policy. The competent testimony before the Commission indicates none of the ten enumerated reasons for permitting premature cancellation of a workers' compensation policy were applied at the time of the attempted cancellation. The only competent evidence at the hearing of this matter was that Canal issued the Notice of Cancellation because TWL had high losses since the commencement date of the policy. An increase in losses is not one of the ten enumerated reasons permitting cancellation prior to the expiration of the term of the insurance policy.

14. N.C. Gen. Stat. § 58-36-105(b) provides the specific method for terminating a workers' compensation policy and states that a cancellation 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.

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Related

§ 55-15-02
North Carolina § 55-15-02(a)
§ 58-3-10
North Carolina § 58-3-10
§ 58-36-105
North Carolina § 58-36-105(b)
§ 97-2
North Carolina § 97-2
§ 97-25
North Carolina § 97-25
§ 97-29
North Carolina § 97-29
§ 97-86.1
North Carolina § 97-86.1(b)

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Bluebook (online)
Oxendine v. Twl, Inc., Counsel Stack Legal Research, https://law.counselstack.com/opinion/oxendine-v-twl-inc-ncworkcompcom-2006.