Tovar-Mauricio v. T.R. Driscoll, Inc.

753 S.E.2d 337, 231 N.C. App. 147, 2013 WL 6236787, 2013 N.C. App. LEXIS 1295
CourtCourt of Appeals of North Carolina
DecidedDecember 3, 2013
DocketNo. COA13-517
StatusPublished

This text of 753 S.E.2d 337 (Tovar-Mauricio v. T.R. Driscoll, Inc.) 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
Tovar-Mauricio v. T.R. Driscoll, Inc., 753 S.E.2d 337, 231 N.C. App. 147, 2013 WL 6236787, 2013 N.C. App. LEXIS 1295 (N.C. Ct. App. 2013).

Opinions

McGEE, Judge.

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 [149]*149City 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, Bemabe 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 compensa-ble 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.

I. Standard of Review

“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. [150]*150at 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.

II. The Fund’s Appeal

A. Conclusion “that the General Casualty Policy Affords No Coverage for Plaintiffs’ Claims”

i. Conclusion of Law 4

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 territoiy 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 [151]*151this 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. See N.C. Gen. Stat. § 97-36 (2011) (“[I]f an employee ... shall receive compensation or damages under the laws of any other state nothing herein shall be construed so as to permit a total compensation for the same injury greater than is provided for in this Article.”). The Commission did not err in concluding that the General Casualty policy affords no coverage for Plaintiffs’ claims filed in North Carolina.

ii. Liability under Virginia Workers’ Compensation Law

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.

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Bluebook (online)
753 S.E.2d 337, 231 N.C. App. 147, 2013 WL 6236787, 2013 N.C. App. LEXIS 1295, Counsel Stack Legal Research, https://law.counselstack.com/opinion/tovar-mauricio-v-tr-driscoll-inc-ncctapp-2013.