NORMAN J. LEVASSEUR, Plaintiff-Appellee v. BILLY JOE LOWERY,
Defendant BEAM ELECTRIC CO., INC., Intervenor-Appellant KEY RISK
MANAGEMENT SERVICES INC., Intervenor-Appellant
1. Jurisdiction--automobile accident--workers' compensation lien--underinsured
motorist coverage--subrogation
The trial court did not err in assuming jurisdiction under N.C.G.S. § 97-10.2(j) to
determine the amount of an employer's workers' compensation lien in an action where plaintiff-
employee was injured in an automobile accident in the course of his employment while driving a
company vehicle, because: (1) the unnamed defendant underinsured motorist carrier is a third
party based on plaintiff's injury being caused under circumstances creating a liability in some
person to pay damages therefor, N.C.G.S. § 97-10.2(a); (2) the trial judge is given jurisdiction
where the judgment is insufficient to compensate the subrogation claim of the workers'
compensation carrier or where a settlement has been agreed upon by the employee and the third
party; (3) the settlement agreement reached by plaintiff and the third party in the instant case gave
the trial court jurisdiction; and (4) even though the Industrial Commission assumed jurisdiction
over disbursement of the $25,000 recovery, the trial court is not precluded from assuming
jurisdiction as a result of the settlement reached between plaintiff and the third party.
2. Insurance--automobile--underinsured motorist policy--subrogation--workers'
compensation lien
The trial court erred by concluding intervenor-employer did not have a lien on plaintiff-
employee's settlement with the employer's underinsured motorist (UIM) carrier in an action
where plaintiff-employee was injured in an automobile accident in the course of his employment
while driving a company vehicle, because: (1) the settlement merely allowed the insurance carrier
to reduce the arbitration award by the amount of the employer's workers' compensation lien; (2)
the issue of whether the employer was entitled to a workers' compensation lien on the UIM
proceeds in addition to the insurance carrier reducing the UIM proceeds by the lien amount was
irrelevant to the settlement; and (3) once the lien was established, the trial court abused its
discretion by stating it was eliminating the lien in order to prevent an injustice, based on the trial
court's failure to make a reasoned choice and enter findings and conclusions which could provide
for meaningful review on appeal as required by N.C.G.S. § 97-10.2(j).
3. Costs--attorney fees--contingent fee agreement
The trial court did not abuse its discretion by approving the contingent fee agreement
between plaintiff and his attorneys for one-third of plaintiff's recovery in an action where plaintiff-
employee was injured in an automobile accident in the course of his employment while driving a
company vehicle, because N.C.G.S. § 97-10.2(f)(1) provides that the attorney fees can be up to
one third of the amount obtained or recovered.
Judge GREENE concurring in part and dissenting in part.
Appeal by intervenors from order entered 15 January 1999 by
Judge Jesse B. Caldwell, III, in Gaston County Superior Court.
Heard in the Court of Appeals 22 February 2000.
Arthurs & Foltz, by Nancy E. Foltz and Douglas P. Arthurs,for plaintiff-appellee.
Womble Carlyle Sandridge & Rice, a Professional Limited
Liability Company, by Clayton M. Custer and Laura M. Wolfe,
for intervenors-appellants.
WALKER, Judge.
Plaintiff, an employee of appellant Beam Electric Co., Inc.
(Beam), was injured in an automobile accident in the course of
his employment. Defendant Lowery, the negligent third party, was
covered by a liability automobile insurance policy in the amount
of $25,000.00, issued by State Farm Mutual Automobile Insurance
Company (State Farm). At the time of the accident, plaintiff was
operating a vehicle owned by Beam which was insured by an
underinsured motorist (UIM) policy from Travelers Insurance
Companies (Travelers), with policy limits of $1,000,000.00.
Appellant Key Risk Management Services, Inc. (Key Risk)
administers Beam's workers' compensation claims.
As a result of plaintiff's injuries, Beam paid $92,723.45 in
medical expenses, $5,754.93 in rehabilitation expenses, and
$92,625.58 in indemnity benefits, for a total workers'
compensation lien of $191,103.96, as it appeared on Form 28B
dated 9 December 1998. Plaintiff received $65,000.00 in workers'
compensation benefits for his permanent partial disability
ratings from the injuries. Additionally, plaintiff's attorney
was awarded a fee of $16,250.00 from the Industrial Commission
(Commission) based on the $65,000.00 benefit payment.
On 1 July 1997, plaintiff filed suit against defendant
Lowery and unnamed defendant Travelers. Prior to the filing ofthe lawsuit, State Farm tendered its policy limits of $25,000.00.
The
$25,000.00 was then advanced by Travelers to protect its
subrogation rights under N.C. Gen. Stat. § 20-279.21(b)(4).
Pursuant to N.C. Gen. Stat. § 97-10.2, Beam gave notice of
appearance and notice of lien to the trial court on 17 October
1997. The Commission distributed the $25,000.00 recovery one-third
($8,333.33) to plaintiff, one-third to Beam, and one-third to
plaintiff's counsel for attorney fees. On 11 March 1998, plaintiff moved the case against Travelers
to binding arbitration. Plaintiff and Travelers agreed that the
arbitrators would not decide:
the issue of what amount is recoverable under
the UIM policy issued by Travelers because
they will not decide any offsets for credits
for payment by any liability carrier and any
offsets for any credit for payments by the
carrier pursuant to any workers' compensation
claim [plaintiff] has made, or the limits of
the UIM policy, if any.
Instead, the issue of damages was limited to what amount is the
plaintiff entitled to recover as damages for his personal injuries
from Travelers? The arbitration resulted in an award of
$625,000.00 to plaintiff.
Thereafter, Travelers took the position that no UIM proceeds
were payable to plaintiff until his workers' compensation claim was
closed. On 29 September 1998, plaintiff moved, in the underlying
action (97 CVS 2452), for a judgment on the arbitration award and
to extinguish Beam's workers' compensation lien.
On 29 December 1998, prior to a hearing on plaintiff's motion,
plaintiff and Travelers entered into an agreement whereby Travelers
would reduce its payment of the arbitration award by the amount of
Beam's workers' compensation lien, receive credit for the
$25,000.00 recovery from State Farm, and make a net payment of
$450,000.00 to plaintiff in full payment of the arbitration award.
The parties determined Beam's lien to be $185,349.03, as opposed to
the $191,103.96 appearing on the Form 28B. All the parties,
including Beam, stipulated that plaintiff, Travelers and State Farmresolved all matters and things in dispute between them thro
ugh
this agreement.
On 15 January 1999, the trial court ordered that (1) Beam's
workers' compensation lien did not attach to the proceeds from
plaintiff's agreement with Travelers; and alternatively, (2) the
trial court extinguished the lien in its discretion in the event it
was later determined that Beam did have a lien on the plaintiff's
settlement proceeds.
Recently, in Liberty Mut. Ins. Co. v. Ditillo, 348 N.C. 247,
253, 499 S.E.2d 764, 768 (1998), our Supreme Court specifically
declined to decide whether a workers' compensation carrier has a
right under N.C. Gen. Stat. § 97-10.2 to a lien on uninsured
motorist (UM) benefits paid to an employee in a case where the UM
coverage limits exceed the amount of workers' compensation
benefits. We are now presented with a case where the UIM benefits
paid to an employee exceed the amount of workers' compensation
benefits.
[1]Beam first argues that the trial court lacked jurisdiction
to determine the amount of the workers' compensation lien and
distribute the third party recovery under N.C. Gen. Stat. § 97-
10.2(j).
To determine whether the trial court had jurisdiction under
N.C. Gen. Stat. § 97-10.2(j), we first consider whether Travelers
is a third party within the meaning of N.C. Gen. Stat. § 97-10.2.
Under the statute, third party is defined as follows:
The right to compensation and other benefits
... shall not be affected by the fact that theinjury ... was caused under circumstances
creating a liability in some person other than
the employer to pay damages therefor, such
person hereinafter being referred to as the
third party.
N.C. Gen. Stat. § 97-10.2(a)(Cum. Supp. 1998)(emphasis added).
In Creed v. R.G. Swaim and Son, Inc., 123 N.C. App. 124, 128-
29, 472 S.E.2d 213, 216 (1996), this Court held that, under N.C.
Gen. Stat. § 97-10.2, payments made by the UIM carrier as well as
the tort-feasor are from a third party, and that the workers'
compensation carrier has a lien on the proceeds of plaintiff's
underinsured motorist policy under the statute.
Here, the policy states that Travelers will pay all sums the
plaintiff is legally entitled to recover as damages from the
underinsured motorist. This Court has held that an action under a
UIM policy is based on the tort of the other motorist and that UIM
coverage is a type of liability coverage. See Ensley v. Nationwide
Mut. Ins. Co., 80 N.C. App. 512, 515, 342 S.E.2d 567, 569, cert.
denied, 318 N.C. 414, 349 S.E.2d 594 (1986)(stating the UIM carrier
assumed ... the liability of the uninsured motorist for damages
which the plaintiff is legally entitled to recover from the
uninsured motorist). Traveler's liability to plaintiff, while
derivative, exists by reason of defendant Lowery's negligence. See
Baxley v. Nationwide Mutual Ins. Co., 104 N.C. App. 419, 424, 410
S.E.2d 12, 15 (1991), affirmed, 334 N.C. 1, 430 S.E.2d 895
(1993)(holding that an action under a UIM policy is actually one
for the tort allegedly committed by the [underinsured] motorist)
(citations omitted). Therefore, Travelers is a third party inthat plaintiff's injury was caused under circumstances crea
ting a
liability in some person ... to pay damages therefor. N.C. Gen.
Stat. § 97-10.2(a).
N.C. Gen. Stat. § 97-10.2(j) establishes when the superior
court is given jurisdiction. The statute, as in effect at the time
of the present case, provides in part:
Notwithstanding any other subsection in this
section, in the event that a judgment is
obtained which is insufficient to compensate
the subrogation claim of the Workers'
Compensation Insurance Carrier, or in the
event that a settlement has been agreed upon
by the employee and the third party, either
party may apply to the resident superior court
... to determine the subrogation amount.
N.C. Gen. Stat. § 97-10.2(j)(1998)
(See footnote 1)
. Accordingly, there are two
instances whereby the trial court is given jurisdiction: (1) where
the judgment is insufficient to compensate the subrogation claim of
the workers' compensation carrier, or (2) where a settlement has
been agreed upon by the employee and the third party.
Beam contends the trial court erred in assuming jurisdiction
since the agreement between plaintiff and Travelers was not a valid
settlement as recognized by the statute, but merely an attempt to
circumvent it.
The trial court found in part:
16. The plaintiff, Travelers and the
defendant have resolved all issues in dispute
among them concerning the payment of thearbitration award, issues of setoff under the
Travelers policy for workers' compensation
benefits paid, pre- and post-judgment
interest, and all other issues, by way of an
Agreement dated December 29, 1998. Said
Agreement is part of the record of this case.
17. The settlement agreement provides that
Travelers, pursuant to the language of its
policy and recent North Carolina Supreme Court
cases interpreting that policy language, is
entitled to a setoff or credit for amounts
paid to the plaintiff by workers' compensation
....
The parties to the agreement do not contest its validity. We
agree with the trial court's findings and conclusion that the
settlement agreement reached by the plaintiff and the third party
gave the trial court jurisdiction.
Beam also argues that since plaintiff agreed to invoke the
jurisdiction of the Commission for the interim disbursement of the
$25,000.00 recovery, the Commission had exclusive jurisdiction.
Beam cites Buckner v. City of Asheville, 113 N.C. App. 354, 438
S.E.2d 467, disc. review denied, 336 N.C. 602, 447 S.E.2d 385
(1994), for the proposition that once the request for disbursement
is submitted to the Commission, the superior court no longer has
jurisdiction.
In Buckner, the plaintiff-employee, while in the course of his
employment, was injured in an automobile accident by a tortfeasor.
The employer provided UIM coverage for the employee. The employee,
employer, and tortfeasor executed a consent judgment and submitted
the matter to the superior court for disbursement. Id. at 356-57,
438 S.E.2d at 468. To give the superior court jurisdiction, N.C.
Gen. Stat. § 97-10.2(j), as in effect at that time, required thatthe employee-third party settlement be entered when the action
[was] pending on a trial calendar and the pretrial conference with
the judge ha[d] been held. Since there was no evidence that the
settlement occurred at such a time, this Court held that the
superior court did not have jurisdiction and exclusive jurisdiction
was therefore assumed by the Commission. Id. at 360, 438 S.E.2d at
470.
Under N.C. Gen. Stat. § 97-10.2, the distribution issue can
be decided in some instances by either the Commission or the trial
court, with 'a different standard for disbursement when the case is
before the Superior Court than that for cases before the Industrial
Commission.' Id. at 359, 438 S.E.2d at 470 (quoting Pollard v.
Smith, 90 N.C. App. 585, 588, 369 S.E.2d 84, 86 (1988), reversed on
other grounds, 324 N.C. 424, 378 S.E.2d 771 (1989)).
Here, even though the Commission assumed jurisdiction over
disbursement of the $25,000.00 recovery, this does not preclude the
superior court from properly assuming jurisdiction as a result of
the settlement reached between plaintiff and Travelers.
[2]Next, Beam argues the trial court erred in concluding it
did not have a lien on the plaintiff's settlement with Travelers.
In McMillian v. N.C. Farm Bureau Mut. Ins. Co., 347 N.C. 560,
565, 495 S.E.2d 352, 354-55 (1998), our Supreme Court held that UM
carriers are entitled under N.C. Gen. Stat. § 20-279.21(e)
(See footnote 2)
toreduce coverage by the amount of workers' compensation benefits
received by the employee. The plaintiff in McMillian filed a
declaratory judgment action to determine the coverage available
under a UM policy and a policy which provided UM and UIM coverage.
The McMillian court held that UM carriers are entitled to reduce
coverage ... by the amount of workers' compensation ... already
received. Id. In so holding, the McMillian court rejected the
analysis of Ohio Casualty Group v. Owens, 99 N.C. App. 131, 392
S.E.2d 647, disc. review denied, 327 N.C. 484, 396 S.E.2d 614
(1990), which focused on the entity who provided the UM/UIM
policies. See Liberty Mutual, 348 N.C. at 252, 499 S.E.2d at 767
(noting that McMillian overruled Ohio Casualty in part).
However, the Ohio Casualty Court also interpreted N.C. Gen.
Stat. § 97-10.2, and stated that:
N.C. Gen. Stat. § 97-10.2 provides for the
subrogation of the workers' compensation
insurance carrier ... to the employer's right,
upon reimbursement of the employee, to any
payment, including uninsured/underinsured
motorist proceeds, made to the employee by or
on behalf of a third party as a result of the
employee's injury.
Ohio Casualty, 99 N.C. App. at 134, 392 S.E.2d at 649 (emphasis
added).
Additionally, this Court in McMillian, 125 N.C. App. 247, 254,
480 S.E.2d 437, 441 (1997), interpreted N.C. Gen. Stat. § 97-10.2
such that:
the workers' compensation insurance carrier
... is entitled to be subrogated, upon
reimbursement of the employee, to any payment,
including UM/UIM motorist insurance proceeds,
made to the employee by or on behalf of a
third party as a result of the employee's
injury.
These constructions of N.C. Gen. Stat. § 97-10.2 by this Court were
not addressed by our Supreme Court in McMillian. Accordingly,
pursuant to N.C. Gen. Stat. § 97-10.2, McMillian, and Ohio
Casualty, Beam's workers' compensation lien attached to plaintiff's
settlement proceeds from Travelers.
Plaintiff argues that his UIM benefits have already been
reduced by the amount of the lien and to now allow Beam's lien
would result in a double penalty.
Plaintiff and Travelers reached a settlement as to the amount
of UIM proceeds to which plaintiff was entitled. Travelers did not
reduce its liability by operation of its policy provisions or the
law. Rather, plaintiff's settlement with Travelers allowed the
insurance carrier to reduce the arbitration award by the amount of
the employer's workers' compensation lien. Since plaintiff and
Travelers settled, the issue of whether Beam was entitled to a
workers' compensation lien on the UIM proceeds in addition to
Travelers reducing the UIM proceeds by the lien amount isirrelevant. Plaintiff cannot now contend that his private
settlement with Travelers operated to extinguish his employer's
workers' compensation lien.
Next, Beam contends that the trial court abused its discretion
in eliminating the lien. Under N.C. Gen. Stat. § 97-10.2(j), the
judge shall determine, in his discretion, the amount, if any, of
the employer's lien ....
(See footnote 3)
However, this Court has held that the
power given the trial court in N.C. Gen. Stat. § 97-10.2(j) is not
unbridled or unlimited, rather:
the trial court is to make a reasoned choice,
a judicial value judgment, which is factually
supported. We hold that the trial court, in
considering a request for disbursement under
subsection (j), must enter an order with
findings of fact and conclusions of law
sufficient to provide for meaningful appellate
review.
Allen v. Rupard, 100 N.C. App. 490, 495 S.E.2d 330, 333 (1990)
(citations omitted).
The trial court made findings concerning the extent of
plaintiff's injuries. The trial court concluded Beam did not havea lien on plaintiff's settlement but that if Beam were later
determined to have a lien, then the trial court, in its discretion,
eliminated the lien to prevent an injustice.
The findings and conclusions of the trial court do not comport
with the requirements set forth in Allen, supra. Once the lien is
established and the trial court considers a request for
disbursement, it must make a reasoned choice, a judicial value
judgment and enter findings and conclusions which can provide for
meaningful review on appeal.
[3]Finally, Beam argues the trial court erred in awarding an
unreasonable attorney fee to plaintiff, which was one-third of
plaintiff's recovery from Travelers.
Plaintiff and his attorneys entered a contingent fee agreement
which provided that the attorney fee would be one-third of the
amount recovered after suit was filed plus costs. N.C. Gen. Stat.
§ 97-10.2(f)(1) requires the Commission to disburse monies as
prioritized in the statute and provides for the attorney fee not
[to] exceed one third of the amount obtained or recovered of the
third party. While the trial court is not bound by this
subsection, it supports the trial court's approval of the
contingency fee agreement. Accordingly, we find no abuse of
discretion in the trial court's approval of the attorney fee
agreement.
In sum, Travelers is a third party within the meaning of
N.C. Gen. Stat. § 97-10.2 and the trial court properly assumed
jurisdiction of the matter pursuant to N.C. Gen. Stat. § 97-10.2(j). The trial court did not err in approving the fee
agreement between plaintiff and his attorneys. The trial court
erred in concluding that Beam did not have a lien on the UIM
benefits recovered by plaintiff from Travelers, and we remand this
case for further proceedings consistent with this opinion.
Affirmed in part; reversed in part and remanded.
Judge TIMMONS-GOODSON concurs.
Judge GREENE concurs in part and dissents in part.
NORMAN J. LEVASSEUR,
Plaintiff, Appellee,
v
.
&
nbsp;Gaston County
&
nbsp; No. 97 CVS 2452
BILLY JOE LOWERY,
Defendant,
BEAM ELECTRIC CO., INC.,
Intervenor-Appellant,
KEY RISK MANAGEMENT
SERVICES INC.,
Intervenor-Appellant.
GREENE, Judge, concurring in part and dissenting in part.
I do not agree Beam's workers' compensation lien attached to
plaintiff's settlement proceeds from Travelers.
This case presents for the first time the issue of whether a
workers' compensation carrier/employer is entitled to a lien on the
employee/plaintiff's personal injury proceeds received from a UIM
carrier, when the UIM carrier has been given a credit in the amount
of the payments made by the workers' compensation carrier/employer
to the insured/employee. Our Supreme Court has held a UIM carrier
is entitled to reduce its UIM coverage to its insured by the amount
of workers' compensation the insured/employee has already received.
McMillian v. N.C. Farm Bureau Mut. Ins. Co., 347 N.C. 560, 565, 495
S.E.2d 352, 354-55 (1998). In so holding, the McMillian court
overruled this Court's holding in Ohio Casualty Group v. Owens, 99N.C. App. 131, 392 S.E.2d 647 (1990) that the UIM carrier was not
entitled to a credit for the workers' compensation payments made to
the insured/employee. McMillan, 347 N.C. at 565, 495 S.E.2d at
355. The McMillian court did not address the question of whether
the workers' compensation carrier/employer was also entitled to a
lien on the UIM proceeds received by the insured/employee.
Accordingly, left undisturbed was that portion of the Ohio Casualty
opinion that the workers' compensation carrier/employer was
entitled to a lien on the UIM proceeds received by the
insured/employee. Ohio Casualty, 99 N.C. App. at 137, 392 S.E.2d
at 651.
Beam, plaintiff's employer in this case, argues and the
majority agrees McMillian and Ohio Casualty, when read together,
hold the UIM carrier is entitled to a credit for workers'
compensation payments made and the workers' compensation
carrier/employer is entitled to a lien on the proceeds received by
the insured/employee. I disagree.
That portion of the Ohio Casualty opinion relating to the
workers' compensation lien must be read in the context of its
holding that the UIM carrier was not entitled to a credit for
payments made by the workers' compensation carrier/employer.
(See footnote 4)
To
allow both a credit to the UIM carrier and a lien to the workers'
compensation carrier/employer would penalize the insured/employeeand thus deny him the full compensation for his injuries to which
he is entitled under the law.
(See footnote 5)
Therefore, McMillian must be read,
in the context of a case where the UIM carrier has previously been
given a credit for the workers' compensation payments, to overrule
that portion of Ohio Casualty providing for a workers' compensation
lien on the UIM proceeds received by the insured/employee.
(See footnote 6)
Accordingly, because Travelers received a credit for the workers'
compensation payments made by Beam in its payment to plaintiff,
Beam was not entitled to a lien on the proceeds received by
plaintiff from Travelers.
(See footnote 7)
As I fully concur with the majority on the other issues
addressed in its opinion, I would affirm the order of the trial
court in all respects.
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