{ "id": 11919954, "name": "JAIME RIOS MARTINEZ, Plaintiff v. DONALD RAY LOVETTE, LINDA JONES, DONALD JONES, INTEGON INSURANCE COMPANY and MARYLAND INSURANCE GROUP, Defendants", "name_abbreviation": "Martinez v. Lovette", "decision_date": "1996-03-05", "docket_number": "No. COA95-209", "first_page": "712", "last_page": "715", "citations": [ { "type": "official", "cite": "121 N.C. App. 712" } ], "court": { "name_abbreviation": "N.C. Ct. App.", "id": 14983, "name": "North Carolina Court of Appeals" }, "jurisdiction": { "id": 5, "name_long": "North Carolina", "name": "N.C." }, "cites_to": [ { "cite": "24 ALR4th 13", "category": "reporters:specialty", "reporter": "A.L.R. 4th", "opinion_index": -1 }, { "cite": "24 ALR3d 1369", "category": "reporters:specialty", "reporter": "A.L.R. 3d", "opinion_index": -1 }, { "cite": "24 ALR3d 1353", "category": "reporters:specialty", "reporter": "A.L.R. 3d", "opinion_index": -1 }, { "cite": "434 S.E.2d 625", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 1993, "pin_cites": [ { "page": "630", "parenthetical": "where we held that a workers' compensation carrier has a subrogation lien on uninsured motorist policy proceeds" } ], "opinion_index": 0 }, { "cite": "112 N.C. App. 47", "category": "reporters:state", "reporter": "N.C. App.", "case_ids": [ 8520040 ], "year": 1993, "pin_cites": [ { "page": "54", "parenthetical": "where we held that a workers' compensation carrier has a subrogation lien on uninsured motorist policy proceeds" } ], "opinion_index": 0, "case_paths": [ "/nc-app/112/0047-01" ] }, { "cite": "447 S.E.2d 385", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 1994, "pin_cites": [ { "parenthetical": "where we said \"[t]his Court recently held that an employer who has paid workers' compensation benefits to its employee is entitled to a lien on the employee's underinsured [and uninsured] motorist benefits received by the employee in an action by the employee against the tortfeasor\"" } ], "opinion_index": 0 }, { "cite": "336 N.C. 602", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 2539104, 2537890, 2538279, 2534383, 2538558 ], "year": 1994, "opinion_index": 0, "case_paths": [ "/nc/336/0602-05", "/nc/336/0602-02", "/nc/336/0602-04", "/nc/336/0602-03", "/nc/336/0602-01" ] }, { "cite": "438 S.E.2d 467", "category": "reporters:state_regional", "reporter": "S.E.2d", "weight": 2, "year": 1994, "pin_cites": [ { "page": "470" }, { "page": "470" } ], "opinion_index": 0 }, { "cite": "113 N.C. App. 354", "category": "reporters:state", "reporter": "N.C. App.", "case_ids": [ 8522201 ], "weight": 2, "year": 1994, "pin_cites": [ { "page": "360-61" }, { "page": "359" } ], "opinion_index": 0, "case_paths": [ "/nc-app/113/0354-01" ] }, { "cite": "396 S.E.2d 614", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 1990, "opinion_index": 0 }, { "cite": "327 N.C. 484", "category": "reporters:state", "reporter": "N.C.", "case_ids": [ 2496109, 2499343, 2497841, 2493556, 2494197 ], "year": 1990, "opinion_index": 0, "case_paths": [ "/nc/327/0484-05", "/nc/327/0484-04", "/nc/327/0484-02", "/nc/327/0484-03", "/nc/327/0484-01" ] }, { "cite": "392 S.E.2d 647", "category": "reporters:state_regional", "reporter": "S.E.2d", "year": 1990, "pin_cites": [ { "page": "649" } ], "opinion_index": 0 }, { "cite": "99 N.C. App. 131", "category": "reporters:state", "reporter": "N.C. App.", "case_ids": [ 8521334 ], "year": 1990, "pin_cites": [ { "page": "134" } ], "opinion_index": 0, "case_paths": [ "/nc-app/99/0131-01" ] } ], "analysis": { "cardinality": 428, "char_count": 9335, "ocr_confidence": 0.73, "pagerank": { "raw": 5.207966869300525e-08, "percentile": 0.32902844914896584 }, "sha256": "cd0a29723f31e6a0b9aab1429d8bca053d403202470a6613e4068d520e7c0e9e", "simhash": "1:3c2307fb5cfbc5ab", "word_count": 1457 }, "last_updated": "2023-07-14T20:54:48.563497+00:00", "provenance": { "date_added": "2019-08-29", "source": "Harvard", "batch": "2018" }, "casebody": { "judges": [ "Chief Judge ARNOLD and Judge MARTIN, John C., concur." ], "parties": [ "JAIME RIOS MARTINEZ, Plaintiff v. DONALD RAY LOVETTE, LINDA JONES, DONALD JONES, INTEGON INSURANCE COMPANY and MARYLAND INSURANCE GROUP, Defendants" ], "opinions": [ { "text": "EAGLES, Judge.\nWe first note that plaintiff argues this appeal should be dismissed because defendant did not order the transcript of the evidence within the time allowed by Rule 7 of the North Carolina Rules of Appellate Procedure. Plaintiff first made this motion in superior court; the superior court denied plaintiffs motion. The denial is not the subject of an assignment of error here. Accordingly, this issue is not before us.\nI.\nDefendant argues that the superior court exceeded its authority under G.S. 97-10.2 when it ordered disbursement of the funds paid by Integon. G.S. 97-10.2(g) provides that the workers\u2019 compensation carrier is subrogated to all rights and liabilities of the employer. G.S. 97-10.2(f)(l) provides in pertinent part:\nIf the employer has filed a written admission of liability for benefits under [the Workers\u2019 Compensation Act] with, or if an award final in nature in favor of the employee has been entered by the Industrial Commission, then any amount obtained by any person by settlement with, judgment against, or otherwise from the third party by reason of such injury or death shall be disbursed by order of the Industrial Commission for the following purposes and in the following order of priority:\nc. Third to the reimbursement of the employer for all benefits by way of compensation or medical compensation expense paid or to be paid by the employer under award of the Industrial Commission.\nWe have previously interpreted these two provisions of G.S. 97-10.2 to provide that the workers\u2019 compensation insurance carrier who has paid money on behalf of the injured employee has a lien on \u201cany payment, including uninsured/underinsured motorist insurance proceeds, made to the employee by or on behalf of a third party as a result of the employee\u2019s injury.\u201d Ohio Casualty Group v. Owens, 99 N.C. App. 131, 134, 392 S.E.2d 647, 649, disc. review denied, 327 N.C. 484, 396 S.E.2d 614 (1990). See Buckner v. City of Asheville, 113 N.C. App. 354, 360-61, 438 S.E.2d 467, 470, disc. review denied, 336 N.C. 602, 447 S.E.2d 385 (1994) (where we said \u201c[t]his Court recently held that an employer who has paid workers\u2019 compensation benefits to its employee is entitled to a lien on the employee\u2019s underinsured [and uninsured] motorist benefits received by the employee in an action by the employee against the tortfeasor\u201d). See also Bailey v. Nationwide Mutual Ins. Co., 112 N.C. App. 47, 54, 434 S.E.2d 625, 630 (1993) (where we held that a workers\u2019 compensation carrier has a subrogation lien on uninsured motorist policy proceeds).\nG.S. 97-10.2(j) provides that the superior court may determine the amount, if any, of the employer\u2019s lien (and accordingly the workers\u2019 compensation insurance carrier\u2019s lien) only when \u201ca judgment is obtained which is insufficient to compensate the subrogation claim of the Workers\u2019 Compensation Insurance Carrier, or . . . [when] a settlement has been agreed upon by the employee and the third party.\u201d Here, the superior court rendered judgment against the tortfeasors for $300,000 (and Integon paid into court $50,000) which was more than sufficient to compensate defendant for the $26,297.64 it had paid on behalf of plaintiff. Furthermore, plaintiff and the tortfeasors had not entered into any settlement agreement. Plaintiff argues that \u201cthird party\u201d in G.S. 97-10.2(j) includes Integon and that Integon and plaintiff entered into a settlement when Integon agreed to pay the $50,000 into court. We disagree. In Buckner, 113 N.C. App. at 359, 438 S.E.2d at 470, we interpreted \u201cthird party\u201d to mean the tortfeasor, and the applicable language of G.S. 97-10.2Q) has not been amended since Buckner was decided. On this record, we hold that the superior court did not have authority to distribute the uninsured motorist policy proceeds. In this case, the Industrial Commission, acting pursuant to G.S. 97-10.2(f)(l), was the only agency authorized to determine whether and what portion, if any, defendant was entitled to receive of the $50,000 uninsured motorist coverage as reimbursement for money defendant paid on behalf of plaintiff pursuant to the workers\u2019 compensation insurance coverage.\nReversed.\nChief Judge ARNOLD and Judge MARTIN, John C., concur.", "type": "majority", "author": "EAGLES, Judge." } ], "attorneys": [ "Bain & McRae, by Edgar R. Bain, for plaintiff-appellee.", "Teague, Campbell, Dennis & Gorham, by George W. Dennis III and Bryan T. Simpson, for defendant-appellant Maryland Insurance Group." ], "corrections": "", "head_matter": "JAIME RIOS MARTINEZ, Plaintiff v. DONALD RAY LOVETTE, LINDA JONES, DONALD JONES, INTEGON INSURANCE COMPANY and MARYLAND INSURANCE GROUP, Defendants\nNo. COA95-209\n(Filed 5 March 1996)\nInsurance \u00a7 530 (NCI4th); Workers\u2019 Compensation \u00a7 82\u2014 uninsured motorist coverage \u2014 reimbursement of workers\u2019 compensation benefits \u2014 determination by superior court error\nThe Industrial Commission and not the superior court was the only agency authorized to determine whether and what portion, if any, defendant workers\u2019 compensation carrier was entitled to receive of the $50,000 uninsured motorist coverage as reimbursement for compensation benefits defendant paid to plaintiff since the superior court may determine the amount of the employer\u2019s lien only when a judgment is obtained which is insufficient to compensate the subrogation claim of the Workers\u2019 Compensation Insurance Carrier, or when a settlement agreement has been agreed upon by the employee and the third party, and in this case the superior court rendered judgment against the tortfeasors for $300,000, which was more than sufficient to compensate defendant for the $26,297.64 in workers\u2019 compensation benefits it had paid on behalf of plaintiff, and plaintiff and the tortfeasors had not entered into any settlement agreement. N.C.C.S. \u00a7\u00a7 97-10.2(f)(l), 97-10.2Q).\nAm Jur 2d, Workers\u2019 Compensation \u00a7 56.\nUninsured motorist insurance: Reduction of coverage by amounts payable under medical expense insurance. 24 ALR3d 1353.\nUninsured motorist coverage: validity and effect of policy provision purporting to reduce coverage by amount paid under workmen\u2019s compensation law. 24 ALR3d 1369.\nUninsured and underinsured motorist coverage: recov-erability under uninsured or underinsured motorist coverage, of deficiencies in compensation afforded injured party by tortfeasor\u2019s liability coverage. 24 ALR4th 13.\nAppeal by defendant from judgment entered 8 November 1994 by Judge Robert L. Farmer in Harnett County Superior Court. Heard in the Court of Appeals 15 November 1995.\nOn 21 July 1993, plaintiff was employed by Broadwell\u2019s Nursery in Angier, North Carolina. He was operating a tractor at work when an automobile ran into the rear of the tractor, causing the tractor to roll over and crush plaintiff underneath it. Plaintiff sustained permanent and painful injuries as a result of the accident.\nOn 9 March 1994, plaintiff sued Donald Ray Lovette, who was driving the automobile, and the owners of the automobile, Donald and Linda Jones. They were uninsured. Plaintiff previously had purchased a policy of insurance from Integon Insurance Company (hereinafter Integon) which provided $50,000 in coverage to each person injured in an automobile accident caused by an uninsured motorist. Plaintiff named Integon as a party defendant in his suit to permit Integon to pay the $50,000 into court and to permit the court to distribute the money. Plaintiff also named as a defendant Maryland Insurance Group (hereinafter defendant), the workers\u2019 compensation carrier for Broadwell\u2019s Nursery, to permit the trial court to determine what portion, if any, of the $50,000 uninsured motorist coverage defendant was entitled to receive as reimbursement for money it had paid pursuant to the workers\u2019 compensation coverage on behalf of plaintiff for his medical bills.\nOn 12 April 1994, Integon moved in superior court to be permitted to pay its policy limit of $50,000 into court and be dismissed from the lawsuit. The superior court granted Integon\u2019s motion and dismissed Integon with prejudice on 19 May 1994. On 23 June 1994, defendant filed a motion to dismiss. After a hearing, the superior court allowed the motion but allowed plaintiff to amend his complaint against defendant to allege a declaratory judgment action. On 19 July 1994, plaintiff filed an amended complaint, asking the superior court to determine that defendant was not entitled to enforce its workers\u2019 compensation subrogation lien against any of the $50,000 paid by Integon as uninsured motorist coverage. Defendant answered and then filed a motion for summary judgment. On 31 October 1994 after a hearing, the superior court denied defendant\u2019s summary judgment motion. The superior court found that defendant had paid $26,297.64 on behalf of plaintiff, but the superior court concluded it had the discretion, pursuant to G.S. 97-10.2Q), to disburse $16,352.21 of the $50,000 to defendant in full satisfaction of its lien. The superior court ordered the remaining money to be distributed to plaintiff, his attorney, and the court for court costs. On 31 October 1994, the superior court also found the uninsured driver and automobile owners, Donald Ray Lovette and Donald and Linda Jones, jointly and severally liable to plaintiff for $300,000 in damages. The $50,000 in uninsured motorist coverage was distributed on 7 and 15 December 1994 pursuant to the superior court\u2019s judgment ordering disbursement.\nBain & McRae, by Edgar R. Bain, for plaintiff-appellee.\nTeague, Campbell, Dennis & Gorham, by George W. Dennis III and Bryan T. Simpson, for defendant-appellant Maryland Insurance Group." }, "file_name": "0712-01", "first_page_order": 746, "last_page_order": 749 }