{
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  "name": "TERRY BOWLES, Employee, Plaintiff v. BCJ TRUCKING SERVICES, INC., Employer, N.C. SELECTIVE FUND, RELIANCE NATIONAL INSURANCE COMPANY (DENNIS INSURANCE GROUP, Servicing Agent), and N.C. INSURANCE GUARANTY ASSOCIATION, N.C. SELF INSURANCE GUARANTY ASSOCIATION, Carriers, Defendants, and NORTH CAROLINA DEPARTMENT OF INSURANCE, Intervenor",
  "name_abbreviation": "Bowles v. BCJ Trucking Services, Inc.",
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    "judges": [
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    "parties": [
      "TERRY BOWLES, Employee, Plaintiff v. BCJ TRUCKING SERVICES, INC., Employer, N.C. SELECTIVE FUND, RELIANCE NATIONAL INSURANCE COMPANY (DENNIS INSURANCE GROUP, Servicing Agent), and N.C. INSURANCE GUARANTY ASSOCIATION, N.C. SELF INSURANCE GUARANTY ASSOCIATION, Carriers, Defendants, and NORTH CAROLINA DEPARTMENT OF INSURANCE, Intervenor"
    ],
    "opinions": [
      {
        "text": "TYSON, Judge.\nN.C. Insurance Guaranty Association (\u201cIGA\u201d) appeals from the opinion and award entered by the full North Carolina Industrial Commission (\u201cCommission\u201d) awarding Terry Bowles (\u201cplaintiff\u2019) benefits for an injury he sustained at work. We affirm.\nI. Background\nPlaintiff was injured on 3 March 1998 in the course of his employment with BCJ Trucking Services (\u201cBCJ\u201d). On 11 April 2001, plaintiff was awarded ongoing temporary total disability benefits beginning 6 December 1999 from BCJ\u2019s workers\u2019 compensation insurance company, North Carolina Selective (\u201cSelective\u201d). Selective was comprised of various employers who pool their workers\u2019 compensation liabilities to create a licensed self-insured group.\nSelective began experiencing financial trouble in early 1997. On 29 April 1997, the North Carolina Department of Insurance (\u201cNCDOI\u201d) informed Selective of its financial concerns and by letter dated 21 January 1998 informed Selective of its need to obtain additional capital or a commitment from a commercial insurance company to rein-sure them. Shortly thereafter, NCDOI informed Selective it would be in the \u201cbest interest\u201d of the public and Selective\u2019s members to transfer its obligations and liabilities to a commercial insurer.\nSelective entered into a NCDOI approved assumption reinsurance agreement with Reliance National Insurance Company (\u201cReliance\u201d) effective 31 December 1998. Selective transferred and Reliance assumed 100 percent of Selective\u2019s workers\u2019 compensation liability claims and obligations. Reliance began and continued to- pay plaintiff\u2019s benefits per the assumption agreement.\nReliance was an active member of IGA, which is a statutorily created reinsurance association which covers claims of insolvent insurance companies pursuant to N.C. Gen. Stat. \u00a7 58-48-1 et seq. On 3 October 2001, Reliance became insolvent and was ordered into liquidation by the Pennsylvania Commonwealth Court. After Reliance was liquidated, IGA assumed payments of plaintiffs benefits.\nIGA commenced this action by filing a Form 33 request with the Commission to determine its responsibility for paying plaintiffs claim. The Commission issued an opinion and award holding IGA responsible for paying plaintiffs workers\u2019 compensation claim. The Commission held: (1) the claim arose when Selective was the insurance carrier for BCJ; and (2) Reliance had assumed the insurance contract through novation and IGA was liable for the claim due to Reliance\u2019s insolvency. IGA appeals.\nII.Issues\nIGA argues the Commission erred by: (1) finding plaintiff\u2019s claim met the definition of a \u201ccovered claim\u201d under N.C. Gen. Stat. \u00a7 58-48-20; and (2) finding plaintiff\u2019s claim was within IGA\u2019s obligations by N.C.- Gen. Stat. \u00a7 58-48 et seq.\nIII.Abandoned Assignments of Error\nIGA\u2019s assignments of error asserting the Commission erred in its finding of fact number seven and its order assessing costs to IGA were not argued and are deemed abandoned. Brown v. Kroger Co., 169 N.C. App. 312, 316, 610 S.E.2d 447, 450 (2005) (\u201cPursuant to N.C.R. App. P. 28(b)(6) (2004), the omitted assignments of error are deemed abandoned\u201d).\nIV.Standard of Review\n\u201cOpinions and awards of the Commission are reviewed to determine whether competent evidence exists to support the Commission\u2019s findings of fact, and whether the findings of fact support the Commission\u2019s conclusions of law.\u201d Bondurant v. Estes Express Lines, Inc., 167 N.C. App. 259, 263, 606 S.E.2d 345, 348 (2004) (citing Deese v. Champion Int\u2019l Corp., 352 N.C. 109, 114, 530 S.E.2d 549, 552 (2000)). As IGA failed to take exception to the Commission\u2019s findings of fact, they are binding on appeal. Creel v. Town of Dover, 126 N.C. App. 547, 552, 486 S.E.2d 478, 480-81 (1997) (citing Mabe v. Granite Corp., 15 N.C. App. 253, 255, 189 S.E.2d 804, 806 (1972)). Our review is limited to a de novo review of the Commission\u2019s conclusions of law. Allen v. Roberts Elec. Contr\u2019rs, 143 N.C. App. 55, 63, 546 S.E.2d 133, 139 (2001) (quoting Lewis v. Sonoco Prods. Co., 137 N.C. App. 61, 68, 526 S.E.2d 671, 675 (2000)).\nV. Covered Claim\nIGA argues the Commission erred in finding plaintiffs claim met the definition of a \u201ccovered claim\u201d as defined by N.C. Gen. Stat. \u00a7 58-48-20.\nN.C. Gen. Stat. \u00a7 58-48-20(4) (2003) defines a \u201ccovered claim\u201d as\nan unpaid claim, including one of unearned premiums, which is in excess of fifty dollars ($50.00) and arises out of and is within the coverage and not in excess of the applicable limits of an insurance policy to which this Article applies as issued by an insurer, if such insurer becomes an insolvent insurer ....\nAn insolvent insurer is:\n(i) an insurer licensed and authorized to transact insurance in this State either at the time the policy was issued or when the insured event occurred and (ii) against whom an order of liquidation with a finding of insolvency has been entered after the effective date of this Article by a court of competent jurisdiction in the insurer\u2019s state of domicile or of this State under the provisions of Article 30 of this Chapter, and which order of liquidation has not been stayed or been the subject of a writ of supersedeas or other comparable order.\nN.C. Gen. Stat. \u00a7 58-48-20(5) (2003).\nThe Commission concluded IGA\u2019s liability for plaintiffs claim arose when Reliance assumed Selective\u2019s obligations and rested its conclusion on applying the law of novation.\nIt is well established that\n\u201c[t]he essential requisites of a novation are a previous valid obligation, the agreement of all the parties to the new contract, the extinguishment of the old contract, and the validity of the new contract\u201d .... \u201cOrdinarily... in order to constitute a novation the transaction must have been so intended by the parties.\u201d\nAnthony Marano Co. v. Jones, 165 N.C. App. 266, 269, 598 S.E.2d 393, 395 (2004) (quoting Tomberlin v. Long, 250 N.C. 640, 644, 109 S.E.2d 365, 368 (1959) (citations omitted)).\nNovation may be defined as a substitution of a new contract or obligation for an old one which is thereby extinguished . [n] ovation implies the extinguishment of one obligation by the substitution of another. Where the question of whether a second contract dealing with the same subject matter rescinds or abrogates a prior contract between the parties depends solely upon the legal effect of the latter instrument, the question is one of law for the courts ....\nTomberlin, 250 N.C. at 644, 109 S.E.2d at 367-68 (quotations omitted).\nHere, the Commission found as fact:\n[t]he Assumption Reinsurance Agreement approved by the Commissioner of Insurance that became effective on December 31, 1998 resulted in a novation of the original contract for insurance entered into by the Selective Fund and BCJ Trucking Services, Inc. Reliance National Indemnity Company substituted for the Selective Fund as a party to the original contract for insurance between the Selective Fund and BCJ Trucking Services, Inc. No new contract of insurance was formed as a result of this novation. No separate negotiations between Reliance National Indemnity Company and BCJ Trucking Services, Inc. took place resulting in a new and separate contract for insurance between the parties.\nThe Commission concluded as a matter of law the novation resulted only in a change of the parties to the original contract, while the terms and obligations of the original insurance contract remained unchanged.\nAs noted above, IGA failed to make exceptions to the Commission\u2019s findings of fact and they are binding on appeal. Creel, 126 N.C. App. at 552, 486 S.E.2d at 480-81 (citation omitted). The Commission found as fact the assumption reinsurance agreement was a novation. It held the novation extinguished the contract between Selective and BCJ and that Reliance expressly assumed 100 percent of Selective\u2019s obligations. Tomberlin, 250 N.C. at 644, 109 S.E.2d at 367-68. The agreement did not create a new contract for insurance coverage but solely substituted a new party, Reliance for Selective, to the contract. Through novation, Reliance is deemed to have replaced Selective as if Reliance had issued the original contract of insurance to BCJ. Id. The novation replaced the parties to the contract, did not change the obligations under the contract for insurance itself, and the agreement did not operate retroactively to cover known or unknown losses.\nPlaintiff\u2019s claim for injury occurred after the original contract for insurance was entered into by BCJ and Selective, now BCJ and Reliance. Reliance, through novation, became BCJ\u2019s insurance company beginning 1 November 1994 to the time of plaintiff\u2019s claim. Plaintiffs claim is a \u201ccovered claim\u201d within the coverage of the insurance policy issued by Reliance, a direct insurer as defined by N.C. Gen. Stat. \u00a7 58-48-20. After Reliance became insolvent and was ordered into liquidation by the Pennsylvania Commonwealth Court, IGA became liable for all covered claims issued by an insolvent direct insurer. N.C. Gen. Stat.\u00a7 58-48-20; N.C. Gen. Stat. \u00a7 58-48-35(a)(l) (2003). The Commission correctly concluded plaintiffs claim met the definition of a \u201ccovered claim\u201d under N.C. Gen. Stat. \u00a7 58-48-20 and holding IGA to be liable for plaintiffs claim. This assignment of error is overruled.\nVI. Statutory Obligation of IGA\nIGA argues the Commission erred in finding plaintiffs claim rests within the statutory obligations of IGA under the North Carolina Insurance Guaranty Association Act. N.C. Gen. Stat. \u00a7 58-48 et seq.\nUnder N.C. Gen. Stat. \u00a7 58-48-20(4), a \u201c \u2018Covered claim\u2019 means an unpaid claim, . . . arises out of and is within the coverage . . . [of] an insurance policy to which this Article applies as issued by an insurer, if such insurer becomes an insolvent insurer . . . .\u201d Under N.C. Gen. Stat. \u00a7 58-48-20(5), an \u201c \u2018Insolvent insurer\u2019 means (i) an insurer licensed and authorized to transact insurance in this State either at the time the policy was issued or when the insured event occurred and (ii) against whom an order of liquidation with a finding of insolvency has been entered . . . .\u201d\nUnder N.C. Gen. Stat. \u00a7 58-48-35(a)(2), IGA stepped into the shoes of the insurance company found to be insolvent and is deemed the insurer having \u201call rights, duties, and obligations of the insolvent insurer as if the insurer had not become insolvent.\u201d (Emphasis supplied).\nUnder N.C. Gen. Stat. \u00a7 58-48-35, IGA is liable for all claims on policies of direct insurance companies which have been found insolvent. Reliance is a direct insurance company who is deemed to have issued, an insurance policy to BCJ and is an active member of IGA. Plaintiff\u2019s claim is a \u201ccovered claim\u201d in that it arose out of Reliance\u2019s coverage of BCJ. The Pennsylvania Commonwealth Court found Reliance insolvent and ordered it liquidated. After Reliance was found to be insolvent, IGA stepped into the shoes of Reliance and must pay its claims. The Commission properly concluded plaintiff\u2019s claim is within the statutory obligations of IGA. This assignment of error is overruled.\nVIL Conclusion\nThe original insurance policy between BCJ and Selective became a direct insurance obligation when Reliance expressly assumed Selective\u2019s book of business. Through novation, Reliance is deemed to have issued the insurance policy. Reliance is a \u201cdirect insurer\u201d placing it within the obligations of IGA by N.C. Gen. Stat. \u00a7 58-48-35. Reliance became insolvent triggering the application of N.C. Gen. Stat. \u00a7 58-48-1 et seq. to IGA. Plaintiffs claim is a \u201ccovered claim\u201d issued by an \u201cinsolvent insurer\u201d and became IGA\u2019s obligation. The Commission properly concluded plaintiff\u2019s claim is within the statutory obligations of IGA. The Commission\u2019s opinion and award is affirmed.\nAffirmed.\nChief Judge MARTIN and Judge LEVINSON concur.",
        "type": "majority",
        "author": "TYSON, Judge."
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    ],
    "attorneys": [
      "Janet H. Downing, PA, by Janet H. Downing, for plaintiff-appellee.",
      "Chariot F. Wood, for defendant-appellee BCJ Trucking Services, Inc.",
      "Johnston, Allison & Hord, P.A., by Patrick E. Kelly, for defendant-appellee N. C. Selective Fund.",
      "Nelson Mullins Riley & Scarborough, LLP, by Christopher J. Blake and Joseph W. Eason, for defendant-appellant N.C. Insurance Guaranty Association.",
      "Stuart Law Firm, PLLC, by Catherine R. Stuart and Charles C. Kyles, for defendant-appellee N.C. Self Insurance Guaranty Association.",
      "Attorney General Roy Cooper, by Assistant Attorney General E. Clementine Peterson, for intervenor-appellee."
    ],
    "corrections": "",
    "head_matter": "TERRY BOWLES, Employee, Plaintiff v. BCJ TRUCKING SERVICES, INC., Employer, N.C. SELECTIVE FUND, RELIANCE NATIONAL INSURANCE COMPANY (DENNIS INSURANCE GROUP, Servicing Agent), and N.C. INSURANCE GUARANTY ASSOCIATION, N.C. SELF INSURANCE GUARANTY ASSOCIATION, Carriers, Defendants, and NORTH CAROLINA DEPARTMENT OF INSURANCE, Intervenor\nNo. COA04-1059\n(Filed 2 August 2005)\n1. Appeal and Error\u2014 preservation of issues \u2014 failure to argue\nDefendant Insurance Guaranty Association\u2019s (IGA) assignments of error asserting the Industrial Commission erred in a workers\u2019 compensation case by its finding of fact number seven and its order assessing costs to IGA were not argued and are deemed abandoned pursuant to N.C. R. App. P. 28(b)(6).\n2. Insurance; Workers\u2019 Compensation\u2014 assumption reinsurance agreement \u2014 novation\u2014insolvent insurer \u2014 liability of IGA\nPlaintiff\u2019s workers\u2019 compensation claim was a \u201ccovered claim\u201d under N.C.G.S. \u00a7 58-48-20 for which the Insurance Guaranty Association was responsible where plaintiff was injured in the course of his employment with BCJ Trucking Services (BCJ) and was awarded temporary total disability benefits; BCJ\u2019s workers\u2019 compensation insurer, Selective, experienced financial difficulties and entered into an assumption reinsurance agreement with Reliance under which Selective transferred and Reliance assumed 100 percent of Selective\u2019s workers\u2019 compensation liability claims and obligations; Reliance became insolvent and was ordered into liquidation by a Pennsylvania court; and the Insurance Guaranty Association thereafter assumed payment of plaintiff\u2019s benefits. The assumption reinsurance agreement constituted a novation which did not create a new contract for insurance coverage but substituted a new party, Reliance, for Selective as if Reliance had issued the original contract of insurance to BCJ, Reliance is thus a \u201cdirect insurer,\u201d and the Insurance Guaranty Association is liable for all claims on policies of direct insurance companies which have been found insolvent. N.C.G.S. \u00a7 58-48-35(a)(2).\nAppeal by defendant N.C. Insurance Guaranty Association from opinion and award entered 16 April 2004 and order entered 21 April 2004 by Commissioner Dianne C. Sellers for the North Carolina Industrial Commission. Heard in the Court of Appeals 9 May 2005.\nJanet H. Downing, PA, by Janet H. Downing, for plaintiff-appellee.\nChariot F. Wood, for defendant-appellee BCJ Trucking Services, Inc.\nJohnston, Allison & Hord, P.A., by Patrick E. Kelly, for defendant-appellee N. C. Selective Fund.\nNelson Mullins Riley & Scarborough, LLP, by Christopher J. Blake and Joseph W. Eason, for defendant-appellant N.C. Insurance Guaranty Association.\nStuart Law Firm, PLLC, by Catherine R. Stuart and Charles C. Kyles, for defendant-appellee N.C. Self Insurance Guaranty Association.\nAttorney General Roy Cooper, by Assistant Attorney General E. Clementine Peterson, for intervenor-appellee."
  },
  "file_name": "0149-01",
  "first_page_order": 179,
  "last_page_order": 186
}
