Justia North Carolina Supreme Court Opinion Summaries

The Supreme Court affirmed in part and reversed in part the court of appeals' decision affirming in part and dismissing in part the judgment of the trial court determining that Insurers were obligated to defend and indemnify Radiator Specialty Company (RSC) under its policies by reimbursing $1.8 million of RSC's past costs, holding that the court erred in part.RSC sought compensation from the three insurers (Insurers) remaining in this action for liabilities it incurred as a result of litigation occasioned by bodily injury caused by repeated exposure to benzene, which RSC manufactured. At issue was which insurers were obligated to pay which costs arising from RSC's benzene liabilities pursuant to the terms of the Insurers' liability insurance policies. The Supreme Court held that the trial court (1) correctly applied an exposure-based approach in determining at what point Insurers' coverage was triggered; (2) properly applied pro rata allocation based on the policies; and (3) in finding that horizontal exhaustion - rather than vertical exhaustion - applied to one insurer's duty to defend. View "Radiator Specialty Co. v. Arrowood Indemnity Co." on Justia Law

The Supreme Court reversed the decision of the court of appeals affirming an order of the trial court granting summary judgment in favor of Insureds and against Insurer in reliance upon its prior decision in N.C. Farm Bureau Mutual Insurance Co. v. Gurley, 139 N.C. App. 178 (2000), holding that the lower courts erred.Matthew Bronson, who was intoxicated, collided with a vehicle owned by Pamela Dana, resulting in serious injuries to Pamela and William Dana, who was riding in the passenger seat. Pamela died from her injuries. At the time of the accident, Pamela was insured under a policy of automobile liability insurance issued by Insurer. William, individually and as administrator of Pamela's estate, claimed to be entitled to an additional $74,750 in underinsured motorist coverage over the amount that Insurer had already tendered to them. Insurer filed a complaint seeking a declaratory judgment regarding the amount of underinsured motorist coverage it was required to provide to the Danas. The trial court entered summary judgment in favor of the Danas, and the court of appeals affirmed. The Supreme Court affirmed, holding that the application of Gurley in this case was error. View "N.C. Farm Bureau Mutual Insurance Co. v. Dana" on Justia Law

The Supreme Court reversed the decision of the court of appeals affirming the order and declaratory judgment of the superior court in favor of Defendant in this personal injury action, holding that, under the circumstances, Defendant was not entitled to collect underinsured benefits.Defendant was a North Carolina resident who sought to collect underinsured motor vehicle coverage benefits from Plaintiff, her North Carolina insurer, after she was injured while traveling in Alabama in a car owned and operated by a Tennessee resident and insured by a Tennessee insurer. Plaintiff denied the claim and initiated a declaratory judgment action seeking a ruling establishing that the UIM coverage of its politics did not apply to Defendant's injuries. The trial court concluded that Defendant was not entitled to coverage under the UIM provision of her insurance contract. The court of appeals affirmed. The Supreme Court reversed, holding that because the amount of the stacked UIM coverage limits exceeded the sum of the applicable bodily injury coverage limits, the Tennessee driver's car was an "underinsured motor vehicle" as defined under North Carolina's Financial Responsibility Act for the purposes of giving effect to Defendant's contract with Plaintiff. View "N.C. Farm Bureau Mutual Insurance Co. v. Lunsford" on Justia Law

The Supreme held that the trial court did not err in determining that Defendants were not afforded underinsured motorist and medical payments coverage under an insurance policy issued by Plaintiff, an insurance company, to a family member.Defendants argued that they were entitled to medical payments and underinsured motorist coverage under Plaintiff's policy because they were "residents" of the insured's "household." Plaintiff disputed coverage and filed a declaratory judgment action in superior court, arguing that Defendants were not residents of the insured's household at the time of the accident. The trial court entered summary judgment for Plaintiff, concluding as a matter of law that Defendants were not entitled to coverage under the policy. The court of appeals affirmed. The Supreme Court affirmed, holding that the court of appeals did not err in determining that Defendants are not entitled to coverage under the policy and that the trial court appropriately awarded summary judgment in favor of Plaintiff. View "N.C. Farm Bureau Mutual Insurance Co., Inc. v. Martin" on Justia Law

The Supreme Court reversed the court of appeals' decision affirming the North Carolina Industrial Commission's finding that the uninsured/underinsured motorist (UIM) proceeds that Plaintiff received on behalf of her husband's estate through the settlement of a wrongful death lawsuit were subject to Defendants' subrogation lien under N.C. Gen. Stat. 97-10.2, holding that the UIM proceeds recovered from the wrongful death lawsuit may not be used to satisfy Defendants' workers' compensation lien.The decedent, Plaintiff's husband and an employee of Employer, was involved in a fatal motor vehicle accident with a third party in South Carolina. The Commission ordered Defendants to pay workers' compensation benefits to Plaintiff. Plaintiff then filed a wrongful death case seeking damages from the third party driver. The parties reached a settlement agreement that included recovery in the form of UIM proceeds. The workers' compensation insurance carrier for Employer subsequently claimed a lien on the UIM proceeds that Plaintiff recovered from the wrongful death settlement. The Commission ordered the distribution of Plaintiff's entire recovery from the South Carolina wrongful death settlement, concluding that Defendants were entitled to subrogation under section 97-10.2. The Supreme Court reversed, holding that Defendants may not satisfy their workers' compensation lien by collecting from Plaintiff's recovery of UIM proceeds in her South Carolina wrongful death settlement. View "Walker v. K&W Cafeterias" on Justia Law

In this insurance dispute, the Supreme Court affirmed the judgment of the business court finding that the policy was unambiguous and dismissing Plaintiff's claim for breach of contract, holding that the term actual cash value (ACV) is not susceptible to more than one meaning and unambiguously includes the depreciation of labor.The policy at issue in this case failed explicitly to provide that labor depreciation will be deducted when calculating the ACV of the damaged property. Plaintiff's home was insured by Defendant when the home was damaged by a storm. Defendant calculated the ACV by reducing the estimated cost of repair by depreciation of property and labor. Plaintiff brought this action seeking to represent a class of all North Carolina residents to whom Defendant paid ACV payments where the cost of labor was depreciated. The business court dismissed the action. The Supreme Court affirmed, holding that the insurance policy unambiguously allowed for depreciation of the costs of labor and materials. View "Accardi v. Hartford Underwriters Insurance Co." on Justia Law

In this case concerning civil liability based on insurer conduct affecting chiropractic services, the Supreme Court affirmed the order of the trial court dismissing all claims in this case, relying on and incorporating its reasoning in a companion case, Sykes v. Health Network Solutions, Inc., __ S.E.2d __ (N.C. 2019)(Sykes I), in holding that the decision in Sykes I met the criteria for collateral estoppel.This case was one of two putative class actions alleging that defendant insurers contracted with Health Network Solutions, Inc. (HNS) to provide or restrict insured chiropractic services in violation of state insurance and antitrust laws. Plaintiffs chose to bring this action against insurers separately from their claims against against HNS and its individual owners in Sykes I, but both actions presented essentially the same claims and relied on the same theories. The trial court dismissed Plaintiffs' claims in this case. The Supreme Court affirmed, holding that collateral estoppel barred Plaintiffs from litigating these matters given the Court's resolution of the issues in Sykes I. View "Sykes v. Blue Cross & Blue Shield of North Carolina" on Justia Law

The Supreme Court remanded this case for further proceedings, holding that the trial court erred by crediting the amount of a payment made to Plaintiff under his own underinsured motorist coverage against the amount of the judgment that Plaintiff obtained against Defendant arising from a motor vehicle collision.Plaintiff filed a negligence complaint against Defendant. The jury returned a verdict finding Defendant to be negligence and awarding Plaintiff $263,000 in compensation for his personal injuries. Thereafter, Plaintiff’s insurer issued a check to Plaintiff in the amount of $145,000, representing the amount of underinsured motorist coverage to which Plaintiff was entitled. The trial court subsequently concluded as a matter of law that Defendant was entitled to credit for the $145,000 payment. The court of appeals affirmed. The Supreme Court reversed, holding that payments received as the result of the purchase of underinsured motorist coverage should not be credited against the amount of the judgment entered against Defendant in this case. View "Hairston v. Harward" on Justia Law

Douglas Lunsford was injured in an accident involving multiple tortfeasors. Lunsford filed a negligence action against Thomas Mills, Mills’ employer James Crowder, and Shawn Buchanan, who carried liability policies totaling $1,050,000. Plaintiff was covered by two underinsured motorist (UIM) policies with North Carolina Farm Bureau Mutual Insurance Company (Farm Bureau) with combined limits of $400,000. Buchanan’s provider tendered to plaintiff the $50,000 limits of Buchanan’s policy, and Plaintiff settled his claim with Mills’ and Crowder’s coverage provider for $850,000. Farm Bureau, an unnamed defendant, moved for summary judgment, arguing that Plaintiff was not entitled to UIM coverage because the combined policy limits of Defendants exceeded Plaintiff’s UIM limits. Plaintiff also moved for summary judgment, arguing that he was was entitled to recover $350,000 - Farm Bureau’s UIM policy limits minus an offset for Buchanan’s insurance payment. The trial court granted summary judgment for Lunsford. The Court of Appeals affirmed. The Supreme Court affirmed in part and reversed in part, holding (1) an insured is only required to exhaust the liability insurance coverage of a single at-fault motorist in order to trigger the insurer’s obligation to provide UIM benefits; but (2) the Court of Appeals erred in determining that Lunsford was entitled to interest and costs against Farm Bureau. View "Lunsford v. Mills" on Justia Law

Plaintiff injured his shoulder while working for Employer. Plaintiff was terminated later that year for “reduction of staff due to lack of work.” Employer accepted Plaintiff’s injury as compensable. In January 2009, Plaintiff began to receive unemployment benefits from Employer and Insurer (together, Defendants). In December 2010, Defendants sought to terminate payment of compensation, alleging that Plaintiff could no longer show he was disabled. The Industrial Commission concluded that Plaintiff was not entitled to disability payments made after December 2010 and that Defendants were entitled to a credit for any payments they had made after that date, finding that Plaintiff’s inability to find work was not due to his injury but to large-scale economic factors. The Supreme Court affirmed, holding that the Commission properly concluded that Plaintiff failed to prove that his inability to earn the same wages as before his injury resulted from his work-related injury. View "Medlin v. Weaver Cooke Constr., LLC" on Justia Law