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NO. COA01-726
NORTH CAROLINA COURT OF APPEALS
Filed: 21 May 2002
THE COUNTRY CLUB OF
JOHNSTON COUNTY, INC.,
Plaintiff
v
.
Johnston County
No. 95 CVS 114<
br>
UNITED STATES FIDELITY
& GUARANTY COMPANY,
Defendant
Appeal by defendant from judgment and orders entered 27
November 2000 by Judge Jack A. Thompson in Johnston County Superior
Court. Heard in the Court of Appeals 13 March 2002.
W. Brian Howell, P.A., by W. Brian Howell and T. Cooper
Howell; Armstrong & Armstrong, P.A., by L. Lamar Armstrong,
Jr., for plaintiff-appellee.
Wilson & Iseman, by G. Gray Wilson and Kevin B. Cartledge, for
defendant-appellant.
HUNTER, Judge.
Defendant-appellant Unites States Fidelity and Guaranty
Company (USF&G) appeals the entry of judgment based upon a jury
verdict concluding that USF&G committed an unfair and deceptive act
or practice in violation of N.C. Gen. Stat. § 75-1.1 (1999), and
awarding treble damages, and orders denying its motions and
awarding costs and attorney's fees. For reasons stated herein, wehold the trial court did not err in denying USF&G's motions and in
concluding that USF&G's actions as found by the jury amounted to a
violation of N.C. Gen. Stat. § 75-1.1.
This is the fourth appeal to this Court involving these
parties and stemming from an incident which occurred 18 October
1991. On that date, a member of plaintiff-appellee The County Club
of Johnston County, Inc. (the Club) consumed several alcoholic
beverages at the Club following a golf tournament. While driving
home, the member struck another vehicle, killing its driver and
seriously injuring a passenger. On the date of the accident, the
Club was insured by USF&G under a master insurance policy including
commercial general liability coverage (the policy). In May 1993,
the family of the decedent instituted an action against the member
and the Club in Wake County Superior Court. See Sanders, et al. v.
Upton, 93 CVS 4415 (Sanders). USF&G defended the Club in Sanders
under a reservation of rights regarding coverage, and the case was
ultimately settled.
In July 1993, USF&G filed a declaratory judgment action
seeking a determination that the policy afforded no coverage to the
Club for the damages alleged in Sanders because of a liquor
liability exclusion in the policy (hereinafter Exclusion C).
(See footnote 1)
The Club filed an answer and a counterclaim alleging USF&G
negligently failed to provide an extension of its coverage despite
knowledge of the Club's alcohol practices. While an appeal to this
Court was pending, the Club voluntarily dismissed its counterclaim
without prejudice and instituted the present action on 23 January
1995. The amended complaint alleged, among other things, claims
against USF&G for bad faith and unfair and deceptive practices in
violation of N.C. Gen. Stat. § 75-1.1.
In July 1995, this Court rendered an opinion in USF&G's
declaratory judgment action. See U.S. Fidelity & Guaranty Co. v.
Country Club of Johnston County, 119 N.C. App. 365, 458 S.E.2d 734,
disc. review denied, 341 N.C. 656, 462 S.E.2d 527 (1995) (USF&G
I). In USF&G I, we reversed the trial court's entry of summary
judgment in favor of USF&G, holding that although the policy
contained a liquor liability coverage exclusion, there remained
genuine issues of material fact as to whether USF&G was precluded
from denying coverage under the doctrines of estoppel and waiver.
Id. at 374-75, 458 S.E.2d at 740-41. On remand, the trial court
granted summary judgment in favor of the Club, finding that USF&G
waived its right to enforce Exclusion C as a matter of law. In
June 1997, this Court affirmed that judgment, and the Supreme Court
denied review, thereby establishing that the Club was entitled to
coverage. See U.S. Fidelity and Guaranty Co. v. Country Club ofJohnston Co., 126 N.C. App. 633, 491 S.E.2d 569 (unpublished
opinion), disc. review denied, 347 N.C. 141, 492 S.E.2d 38 (1997)
(USF&G II).
Following our decision in USF&G II, in November 1997, USF&G
filed a motion to dismiss the Club's complaint in the present case
under N.C. Gen. Stat. § 1A-1, Rule 12(b)(1) and (6) (1999). The
motion was denied, and USF&G filed an appeal with this Court, which
we dismissed as interlocutory. See Country Club of Johnston
County, Inc. v. U.S. Fidelity and Guar. Co., 135 N.C. App. 159, 519
S.E.2d 540 (1999), disc. review denied, 351 N.C. 352, 542 S.E.2d
207 (2000) (Country Club I). The Club's claims proceeded to
trial.
The evidence presented at trial tended to show that in April
1991, USF&G directed its underwriters to attach to the policies of
insureds who serve alcohol an amendment further restricting
coverage for liquor liability. The amendment, called CG-2150,
amended Exclusion C, the policy's general liquor liability coverage
exclusion, which excluded coverage for insureds in the business
of selling or furnishing alcohol. The CG-2150 amendment was
intended to clarify that, as to insureds who regularly serve
alcohol, the general liability coverage under their policy would
not be enough to provide coverage for their alcohol practices, and
that they would be required to pay an additional premium if theywished to have coverage for such practices. Under the CG-2150
amendment, the exclusion would also apply to insureds who [s]erve
or furnish alcoholic beverages without a charge, if a license is
required for such activity.
In August 1991, shortly before the accident, senior USF&G
underwriter Catherine Davis reviewed the Club's underwriting report
which contained details regarding its alcohol practices, including
that the Club had a brown-bagging alcohol license. Davis made
handwritten notes on the report indicating that because the Club
had an alcohol license, the CG-2150 endorsement must be applied to
its policy to inform the Club that it would be required to procure
additional insurance if it desired coverage for its alcohol
practices. Despite Davis' notation that CG-2150 should attach to
the Club's policy due to its liquor license, the Club maintained
that it was not informed by USF&G that its general policy did not
provide coverage for its alcohol activities or that it would be
required to purchase additional coverage. The Club produced Davis'
notes from a September 1991 telephone conversation with USF&G agent
David Grady, also a member of the Club, wherein Grady informed
Davis that Club members only brown bag approximately six times
per year. Thus, Davis concluded that the Club did not appear to
be a large exposure, and that she was going to delete CG-2150.
Davis later maintained that Grady had failed to inform her, andthat she was unaware, that Club members could also purchase beer at
the Club. Following the accident, Davis sent a letter to the Club
informing it that USF&G would now be attaching the CG-2150
amendment to its policy.
The Club also presented evidence establishing that when the
claim was made, the matter was examined by claims supervisor
Douglas Funk, who determined that Exclusion C, the original liquor
liability coverage exclusion, did not bar coverage. Funk testified
that according to his notes dated 19 November 1991, he recommended
that USF&G not send a reservation of rights letter on the basis
that Exclusion C applied, and noted that the Club did not appear to
be in the business of serving or furnishing alcohol. On 20
November 1991, USF&G did send a reservation of rights letter
stating that USF&G believed Exclusion C might apply to bar
coverage, and that the matter would be further investigated. The
following day, 21 November 1991, a USF&G home office claims
examiner concluded that we are going to take the position of no
coverage.
Don Roinestad, who testified as an insurance expert in the
fields of underwriting and claims handling, concluded that USF&G
had failed to follow acceptable claims practices throughout the
handling of the Club's claim. He testified that by failing to
attach the CG-2150 amendment further restricting liquor liabilitycoverage, Davis, and as a result USF&G, automatically accepted that
there was coverage under the policy as it existed. He further
testified that the sending of a reservation of rights letter in
part based upon the applicability of Exclusion C was totally
inappropriate because the claims people . . . already knew at
th[at] time that Cathy Davis and the agent [David Grady] agreed to
provide this coverage for the insured. Roinestad also testified
that USF&G failed to properly document its claims process,
observing that key conversations regarding the Club's claim were
never documented and placed in its file.
On 15 August 2000, the jury returned a verdict in favor of the
Club as to damages and proximate cause, answering the following
four special interrogatories in the affirmative:
a. Did USF&G prematurely and improperly
determine that it was going to deny
coverage prior to conducting a meaningful
investigation?
b. Did USF&G misrepresent that it was
investigating the application of
Exclusion C when USF&G had determined
that it was going to deny coverage?
c. Did USF&G solicit an opinion letter from
counsel after having already made a
decision to deny coverage?
d. Did USF&G unfairly or improperly send a
reservation of rights letter on
11/20/91 citing Exclusion C, without
having an adequate or documented basis to
reverse Mr. Funk's position to notreserve rights as to Exclusion C
documented on 11/19/91?
The jury answered the remaining two interrogatories in favor of
USF&G, declining to find the insurer responsible for its attorney's
conduct of removing Davis' handwritten notes regarding the CG-2150
amendment from the copy of USF&G's underwriting report provided to
the Club during discovery in the declaratory judgment action:
e. Did USF&G participate in an unfair or
deceptive alteration of Cathy Davis'
handwritten notes on page two of the
underwriting report?
f. Did USF&G participate in an unfair or
deceptive use of the underwriting report
that had been altered by the deletion of
Cathy Davis' handwritten notes?
The jury awarded the Club $90,000.00 in damages. With the
Club's consent, the trial court entered a remittitur on 27 November
2000 which reduced the damage award to $43,312.53, the amount which
both parties agreed was what the Club had expended in attorney's
fees defending USF&G's declaratory judgment action. By this order,
the trial court also denied USF&G's post-trial motions for judgment
notwithstanding the verdict, or in the alternative, a new trial.
By judgment entered 27 November 2000, the trial court concluded as
a matter of law, based on the jury's interrogatories and the
court's independent review of the evidence, that USF&G committed an
unfair and deceptive act or practice in violation of N.C. Gen.Stat. § 75-1.1. The trial court trebled the damages to $129,937.59
pursuant to N.C. Gen. Stat. § 75-16 (1999). In a separate order,
the trial court made extensive findings of fact with respect to
costs and attorney's fees and taxed $12,530.52 in costs and
$154,078.75 in attorney's fees to USF&G. USF&G appeals from the
verdict and judgment, from the denial of its post-trial motions,
and from the order taxing costs and attorney's fees.
USF&G brings forth several assignments of error on appeal,
which we address within the following five issues: whether the
trial court erred in failing to grant USF&G's motions to dismiss,
for directed verdict, and for judgment notwithstanding the verdict
or new trial because (1) the Club's complaint was barred by the
rule against claim-splitting and because its claims were compulsory
counterclaims in USF&G's declaratory judgment action; (2) a claim
under N.C. Gen. Stat. § 75-1.1 cannot be maintained in the absence
of a contractual right to coverage under the policy; (3) the Club's
claim under N.C. Gen. Stat. § 75-1.1 cannot stand where the Club
failed to plead and prove a claim under N.C. Gen. Stat. § 58-63-
15(11) (1999); (4) the Club failed to show any misconduct or
aggravated circumstances sufficient to support a claim under N.C.
Gen. Stat. § 75-1.1; and (5) attorney's fees and costs were
unwarranted under N.C. Gen. Stat. § 75-16.1 (1999), and were
unreasonable in amount. We conclude the trial court did not err indenying any of USF&G's motions and in determining, as a matter of
law, that USF&G's actions as found by the jury constituted an
unfair and deceptive act or practice in violation of N.C. Gen.
Stat. § 75-1.1, thereby warranting treble damages, attorney's fees,
and costs.
Preliminarily, we note that the standard of review on a motion
to dismiss under Rule 12(b)(1) for lack of jurisdiction is de novo.
Fuller v. Easley, 145 N.C. App. 391, 395, 553 S.E.2d 43, 46 (2001).
For a motion based on Rule 12(b)(6), the standard is whether,
construing the complaint liberally, 'the allegations of the
complaint, treated as true, are sufficient to state a claim upon
which relief may be granted under some legal theory.' Block v.
County of Person, 141 N.C. App. 273, 277, 540 S.E.2d 415, 419
(2000) (citation omitted). Our standard of review for a ruling on
motions for directed verdict and judgment notwithstanding the
verdict are the same: whether, 'upon examination of all the
evidence in the light most favorable to the nonmoving party, and
that party being given the benefit of every reasonable inference
drawn therefrom, the evidence is sufficient to be submitted to the
jury.' Stamm v. Salomon, 144 N.C. App. 672, 679, 551 S.E.2d 152,
157 (2001) (citation omitted), appeal dismissed and disc. review
denied, 355 N.C. 216, 560 S.E.2d 139 (2002). Moreover, '[t]he
trial court's determination on the grant or denial of analternative new trial is reversible only for an abuse of
discretion.' In re Buck, 350 N.C. 621, 627, 516 S.E.2d 858, 862
(1999) (citation omitted).
I.
USF&G first argues that the trial court erred in denying its
motions both because the Club's complaint should have been barred
by the rule against claim-splitting and because the Club's claims
were required to be brought as compulsory counterclaims in USF&G's
declaratory judgment action. We disagree with both arguments.
First, USF&G argues that the Club's claims in this case should
be barred by res judicata, and specifically, the rule against
claim-splitting because the Club knew of the claims which it brings
forth here at the time USF&G filed its declaratory judgment action.
Thus, USF&G argues, the Club was required to have brought forth its
claims in the declaratory judgment action because they arose out of
the same factual background and transactions addressed in that
action, and the claims are now barred from being litigated in this
case.
[T]he common law rule against claim-splitting is based on the
principle that all damages incurred as the result of a single wrong
must be recovered in one lawsuit. Bockweg v. Anderson, 333 N.C.
486, 492, 428 S.E.2d 157, 161 (1993). Where the second action
between two parties is upon the same claim, the prior judgmentserves as a bar to the relitigation of all matters that were or
should have been adjudicated in the prior action. Id. However,
if the second action involves a different claim, the prior
judgment serves as a bar only as to issues actually litigated and
determined in the original action. Id. While it is true that a
'judgment is conclusive as to all issues raised by the pleadings,'
the judgment is not conclusive as to issues not raised by the
pleadings which serve as the basis for the judgment. Id. at 492,
428 S.E.2d at 161-62 (citation omitted).
Thus, in Bockweg, our Supreme Court determined that where the
negligence claims at issue were previously dismissed voluntarily
from a prior federal court action and were not the basis of the
prior judgment, the prior judgment could not operate to bar
subsequent prosecution of the claims in state court. Id. at 493,
428 S.E.2d at 162. The defendants in Bockweg advocated application
of the transactional approach to claim-splitting wherein all
issues arising out of 'a transaction or series of transactions'
must be tried together as one claim. Id. The Supreme Court
declined to adopt this approach and concluded that the subsequent
action, which involved a claim arising out of a separate instance
of negligence, could not be barred by the prior federal court
judgment since the pleadings upon which the judgment in the prioraction was based did not raise the claim now presented. Id. at
496, 428 S.E.2d at 164.
We have previously observed that the courts of this State have
not adopted the transactional approach to claim-splitting. See
Northwestern Financial Group v. County of Gaston, 110 N.C. App.
531, 537, 430 S.E.2d 689, 693, disc. review denied, 334 N.C. 621,
435 S.E.2d 337 (1993). The defendants in Northwestern attempted to
distinguish Bockweg (which involved two separate instances of
negligence) from their case, which involved two claims based upon
the same wrongful act of denying a permit. Id. at 538, 430 S.E.2d
at 694. The defendants argued that the second action did not raise
anything new, but instead simply changed the legal argument and the
remedy sought. Id. Nevertheless, this Court held that the second
action was permissible, stating:
Though it is true that both Northwestern's
suits arise out of the same set of facts and
circumstances, Northwestern alleges that its
claims for damages could not have been known
until after it was granted the mandatory
injunction. We believe that this is a pivotal
distinction. It is well established that all
of a party's damages resulting from a single
wrong must be recovered in a single
action. . . . However, for this rule to
apply, logic and common sense require that
both remedies must have been available at the
time the first action was commenced.
Id. at 538-39, 430 S.E.2d at 694. In the present case, aside from the fact that the Club
voluntarily dismissed its sole counterclaim prior to its being
litigated, we agree with the Club's position that the instant
action involves different claims than those involved in the
declaratory judgment action. The declaratory judgment action
involved issues of coverage such as waiver and estoppel, and not
the issues presented in this suit, namely, bad faith and unfair and
deceptive practices. To the extent the Club's counterclaim in the
declaratory judgment action, which simply alleged USF&G's
negligence in failing to provide adequate coverage for the Club's
alcohol practices, addressed USF&G's actions, it did not assert a
claim for unfair and deceptive practices, and it did not address
USF&G's handling of the claim after the accident, which was the
basis for the judgment in the instant case. Indeed, the amended
complaint in the present case contains factual allegations far
exceeding those in the declaratory judgment action, including
several allegations regarding USF&G's handling of the Club's claim,
which were neither pled nor at issue in the declaratory judgment
action.
Moreover, the Club maintains that it did not assert its claims
for bad faith and unfair and deceptive practices in the declaratory
judgment action because at that time it was not and could not have
been fully aware of the facts which now form the basis of itsclaims, nor the extent of its damages. The record supports the
Club's assertion that it began to discover the facts surrounding
USF&G's handling of its policy and its claim as discovery proceeded
in the declaratory judgment action. Thus, as we observed in
Northwestern, logic and common sense require the conclusion that
the Club cannot be required to have brought a claim of which it
could not have reasonably known at the time of the first action.
Even USF&G acknowledges in its brief that a party is required to
try his whole cause of action at one time only when the party has
full knowledge of his damages as well as the facts giving rise to
his cause of action. Although USF&G argues that the Club knew at
the time it filed its answer and counterclaim of all facts
necessary to bring its entire cause of action against USF&G,
including its claim for unfair and deceptive practices, USF&G has
failed to persuasively establish that such was the case. Contrary
to USF&G's assertion, the Club did not plead claims relating to
USF&G's failure to investigate in its answer to the declaratory
judgment action.
We conclude that the Club's complaint in the present case was
not barred by res judicata because it did not bring forth claims
which had already been litigated. Rather, it brought forth
entirely different claims, based in part upon USF&G's actions in
handling the Club's claim, which were not at issue in thedeclaratory judgment action and which were not fully known to the
Club at that time. For the same reasons, we overrule USF&G's
related argument that the present claims were required to have been
brought as compulsory counterclaims in the declaratory judgment
action.
Under N C. Gen. Stat. § 1A-1, Rule 13(a) (1999), a party is
required to plead as a counterclaim
any claim which at the time of serving the
pleading the pleader has against any opposing
party, if it arises out of the transaction or
occurrence that is the subject matter of the
opposing party's claim and does not require
for its adjudication the presence of third
parties of whom the court cannot acquire
jurisdiction.
Under this rule, a counterclaim is compulsory only when it is in
existence at the time of the serving of the pleading. U.S. Fire
Ins. Co. v. Southeast Airmotive Corp., 102 N.C. App. 470, 472, 402
S.E.2d 466, 468, disc. review denied, 329 N.C. 505, 407 S.E.2d 553
(1991).
Thus, where a claim is not mature at the time of the filing of
the action, failure to bring it as a counterclaim does not serve as
a bar to subsequent litigation on that claim. Stines v.
Satterwhite, 58 N.C. App. 608, 614, 294 S.E.2d 324, 328 (1982).
Moreover, even where the claim matures after the pleadings have
been filed but during the pendency of the action, the pleader isnot required to supplement the pleadings with a compulsory
counterclaim. Id. Therefore, in Stines, we held that where the
complaint in the subsequent action averred that material facts were
not known at the time of the preceding action, the claims based
thereon could not have been compulsory counterclaims, and the
plaintiffs were not barred from bringing the subsequent action.
Id. We observed that the plaintiffs cannot be expected to plead
that which they did not know. Id. Likewise, in Driggers v.
Commercial Credit Corp., 31 N.C. App. 561, 230 S.E.2d 201 (1976),
we held that:
Since there is no showing that
[plaintiff] knew or by the exercise of
reasonable diligence should have known of his
alleged claim for fraud at the time he served
answer in the prior action, his claim falls
within the exception to Rule 13(a) and
constitutes a permissive, not compulsory,
counterclaim. His failure to assert his claim
in the prior action is therefore not a bar to
his present action.
Id. at 565, 230 S.E.2d at 203.
In this case, USF&G has failed to establish that the claims
presented here are compulsory counterclaims because, as previously
discussed, it has failed to establish that the Club knew or
reasonably should have known of all material facts necessary to
assert all claims. To the contrary, the Club asserts, and the
record supports, that the true extent of USF&G's actions and thefacts which constitute the basis of the Club's claims in this case
were not fully known to the Club at the time the declaratory
judgment action was filed, but rather, became clear to the Club
throughout the pendency of that action. None of the allegations in
the Club's answer or counterclaim in the prior action reveals that
the Club had any knowledge regarding the manner in which USF&G
handled the investigation of its claim. Moreover, the amended
complaint in this case avers that it was not until 1996 that the
Club discovered that Catherine Davis originally determined the CG-
2150 amendment should apply to the Club's policy due to its liquor
license, and that USF&G had deleted Davis' notes from the copy of
the underwriting report previously provided to the Club during
discovery (which fact helped form the basis for the Club's bad
faith claim). The trial court did not err in denying USF&G's
motions on these grounds. These assignments of error are
overruled.
II.
USF&G next argues that the trial court erred in denying its
motions because the Club cannot maintain a claim under N.C. Gen.
Stat. § 75-1.1 where there is no contractual right to coverage
under the policy. Specifically, USF&G argues that such claims are
grounded in and arise from the contractual relationship betweeninsurer and insured, and because the Club's policy did not provide
coverage, it cannot maintain an extracontractual claim.
We need not engage in a discussion of whether a claim under
N.C. Gen. Stat. § 75-1.1 in this context must be grounded in
contract, as USF&G's argument is based on the faulty premise that
the Club's policy did not provide coverage for the accident at
issue. In fact, in Country Club I, this Court rejected this same
argument and squarely established that the policy provided coverage
to the Club. See Country Club of Johnston County, Inc., 135 N.C.
App. at 165, 519 S.E.2d at 545. In that case, we noted that USF&G
has continued to insist the policy afforded no coverage and that
the Club therefore may not assert a bad faith claim, despite the
fact that such argument was already addressed and rejected in USF&G
II. Id. at 165, 519 S.E.2d at 544. We went on to clarify:
USF&G also overlooks the estoppel effect
of conduct comprising waiver. It is not that
the conduct of USF&G and that of its agents
has operated to write into the policy coverage
previously excluded; rather, conduct
comprising waiver has created a disability on
the part of USF&G thereby precluding it from
thereafter denying that such coverage is
included within the policy.
. . .
In short, the issue in the instant case
is no longer one of coverage . . . .
Id. at 165, 519 S.E.2d at 545. We have therefore previously
established that the policy at issue provided coverage to the Club,
and have already rejected the argument which USF&G has brought
forth again here. This argument is overruled.
III.
USF&G further contends that the Club cannot maintain a claim
under N.C. Gen. Stat. § 75-1.1 where it failed to plead and prove
a claim under N.C. Gen. Stat. § 58-63-15(11), which sets forth
various acts which constitute unfair claims settlement practices in
the insurance industry. USF&G argues that in order to maintain a
claim under Chapter 75, the Club was required to have established
an unfair claims settlement practice under N.C. Gen. Stat. § 58-63-
15(11), which also requires a showing that the act was committed
with such frequency as to indicate a general business practice.
N.C. Gen. Stat. § 58-63-15(11). We likewise reject this argument.
This Court has noted that unfair and deceptive acts in the
insurance area are not regulated exclusively by Article 63 of
Chapter 58, but are also actionable under N.C. Gen. Stat. § 75-1.1
(1988). Golden Rule Insurance Co. v. Long, 113 N.C. App. 187,
196, 439 S.E.2d 599, 604, appeal dismissed and disc. review denied,
335 N.C. 555, 439 S.E.2d 145 (1993). In Gray v. N.C. Ins.
Underwriting Ass'n, 352 N.C. 61, 529 S.E.2d 676, reh'g denied, 352
N.C. 599, 544 S.E.2d 771 (2000), our Supreme Court observed that[a]lthough N.C.G.S. § 58-63-15(11) does regulate settlement claims
in the insurance industry, insurance companies are not immune to
the general principles and provisions of N.C.G.S. § 75-1.1. Id.
at 71, 529 S.E.2d at 683. In Gray, the Supreme Court held that an
insurer's act of failing to attempt in good faith to effectuate
prompt and fair claims settlements is a violation of N.C. Gen.
Stat. § 75-1.1 separate and apart from any violation of N.C.G.S.
§ 58-63-15(11). Id. at 73, 529 S.E.2d at 684. The Court noted
that having determined the insurer could violate N.C. Gen. Stat. §
75-1.1 separate and apart from N.C. Gen. Stat. § 58-63-15(11), it
was unnecessary to determine whether the plaintiffs had established
that the acts occurred with such frequency as to constitute a
general business practice, as is required to show a violation of
N.C. Gen. Stat. § 58-63-15(11). Id. at 74, 529 S.E.2d at 684.
This Court has also summarized the relationship between the
two statutes:
An unfair or deceptive trade practice claim
against an insurance company can be based on
violations of either section 75-1.1 or section
58-63-15. A violation of section 58-63-15,
however, constitutes a violation of section
75-1.1. Furthermore, the remedy for a
violation of section 58-63-15 is the filing of
a section 75-1.1 claim. There is no
requirement, however, that a party bringing a
claim for unfair or deceptive trade practices
against an insurance company allege a
violation of section 58-63-15 in order to
bring a claim pursuant to section 75-1.1.
Lee v. Mut. Community Sav. Bank, 136 N.C. App. 808, 811 n.2, 525
S.E.2d 854, 857 n.2 (2000) (citations omitted) (emphasis added).
Moreover, federal courts interpreting North Carolina law have
also recognized that a party may bring an independent claim under
N.C. Gen. Stat. § 75-1.1 against an insurer. In High Country Arts
and Craft v. Hartford Fire Ins., 126 F.3d 629 (4th Cir. 1997), the
United States Court of Appeals for the Fourth Circuit observed that
[w]hile proof of unfair claims practices does
constitute per se proof of an unfair or
deceptive trade practice under N.C. Gen. Stat.
§ 75-1.1, failure to prove unfair claims
practices [under N.C. Gen. Stat. § 58-63-
15(11)] does not independently necessitate
judgment as a matter of law against a related
claim for unfair trade practices.
Id. at 635 (citations omitted).
In U.S. Fire Ins. Co. v. Nationwide Mut. Ins. Co., 735 F.
Supp. 1320 (E.D.N.C. 1990), the Unites States District Court for
the Eastern District of North Carolina observed that our courts
have held that Chapter 58 is not the exclusive state remedy for
unfair trade practices in the insurance industry. Id. at 1327.
In that case, the insurer argued, as does USF&G in this case, that
the plaintiffs were required to allege a violation of Chapter 58 in
order to show a violation of Chapter 75. The Court rejected the
argument, stating that [a]bsent an explicit holding by the North
Carolina courts that a plaintiff must prove a Chapter 58 violationto prove a Chapter 75 violation, this court will not impose such a
requirement. Id.
In this case, USF&G has failed to cite any persuasive
authority from this jurisdiction which would lead us to the
conclusion that the Club had to establish a claim under N.C. Gen.
Stat. § 58-63-15(11) in order to succeed on its claim under N.C.
Gen. Stat. § 75-1.1. To the contrary, the case law cited herein
establishes that an insurer may violate N.C. Gen. Stat. § 75-1.1
separate and apart from any violation of Chapter 58, and that a
plaintiff need not prove a violation of Chapter 58 in order to
recover for unfair and deceptive practices. Accordingly, this
argument is overruled.
IV.
We next address USF&G's claim that the Club failed to
establish any misconduct on the part of USF&G or any aggravated
circumstances necessary to support a claim under N.C. Gen. Stat. §
75-1.1. In order to establish a violation of N.C.G.S. § 75-1.1,
a plaintiff must show: (1) an unfair or deceptive act or practice,
(2) in or affecting commerce, and (3) which proximately caused
injury to plaintiffs. Gray, 352 N.C. at 68, 529 S.E.2d at 681.
'[A] practice is unfair when it offends established public policy
as well as when the practice is immoral, unethical, oppressive,
unscrupulous, or substantially injurious to consumers.' Id.(citation omitted). When 'an insurance company engages in conduct
manifesting an inequitable assertion of power or position,'
including conduct which can be characterized as 'unethical,' that
'conduct constitutes an unfair trade practice.' Johnson v. First
Union Corp., 128 N.C. App. 450, 458, 496 S.E.2d 1, 6 (1998)
(citation omitted) (holding insurer's act of altering an agreement
and misrepresenting the plaintiff's work duties sufficient to
support claim under N.C. Gen. Stat. § 75-1.1).
As we have held, a plaintiff is not required to prove a
violation of N.C. Gen. Stat. § 58-63-15(11) in order to succeed on
an independent claim under N.C. Gen. Stat. § 75-1.1. Nevertheless,
we may look to the types of conduct prohibited by N.C. Gen. Stat.
§ 58-63-15(11) for examples of conduct which would constitute an
unfair and deceptive act or practice. Gray, 352 N.C. at 71, 529
S.E.2d at 683. In Gray, the Supreme Court determined that when an
insurer is guilty of failing to attempt in good faith to effectuate
prompt and fair claims settlements where liability is reasonably
clear, an act prohibited by N.C. Gen. Stat. § 58-63-15(11)(f), the
insurer also engages in conduct that embodies the broader
standards of N.C.G.S. § 75-1.1 because such conduct is inherently
unfair, unscrupulous, immoral, and injurious to consumers. Id.
Thus, such an act constitutes a violation of N.C. Gen. Stat. § 75-
1.1 without the necessity of an additional showing of frequencyindicating a 'general business practice,' as is required under
N.C. Gen. Stat. § 58-63-15(11)(f). Id. It follows that the other
prohibited acts listed in N.C. Gen. Stat. § 58-63-15(11) are also
acts which are unfair, unscrupulous, and injurious to consumers,
and that such acts therefore fall within the broader standards of
N.C. Gen. Stat. § 75-1.1.
In the present case, the trial court determined, as a matter
of law, that USF&G's acts constituted a violation of N.C. Gen.
Stat. § 75-1.1. See Gray, 352 N.C. at 68, 529 S.E.2d at 681 (the
determination of whether an act or practice is an unfair or
deceptive practice that violates N.C. Gen. Stat. § 75-1.1 is a
question of law for the court, and may be based on the facts as
determined by the jury). The trial court noted that it based its
determination upon the jury's verdict with respect to the
interrogatories, and the Court's independent review of the
evidence presented. As set forth in the interrogatories, the jury
determined that USF&G prematurely and improperly determined it
would deny the Club's claim prior to conducting a meaningful
investigation; that USF&G misrepresent[ed] to the Club that it
would investigate the claim and specifically, the application of
Exclusion C when it had already concluded it would deny the claim;
that USF&G unfairly and improperly sent a reservation of rights
letter based on Exclusion C without having an adequate ordocumented basis to reverse Mr. Funk's position to not reserve
rights as to Exclusion C documented on 11/19/91; and that USF&G
solicited an opinion letter from counsel only after having made its
decision regarding coverage.
In addition, in its order taxing attorney's fees and costs,
the trial court made the following relevant findings of fact which
are supported by the evidence: that USF&G willfully engaged in
the acts or practices at issue because, in its acts found by the
jury, USF&G intended to deceive [the Club]; USF&G decided to deny
coverage, documented this decision internally, and then
misrepresented to [the Club] that USF&G was investigating
coverage; USF&G knew that it prematurely and improperly denied
[the Club] coverage without conducting a meaningful investigation
and prior to obtaining an opinion letter from counsel; that [a]t
the same time, USF&G misrepresented to [the Club] that USF&G was
investigating the application of Exclusion C; and that despite
knowledge that the Club's claim had merit and that the Club simply
sought restitution, USF&G engaged in an unwarranted refusal to
fully resolve the claims constituting the basis for this suit.
We hold that the evidence presented and the jury's verdict
warrants a conclusion that USF&G's actions constituted a violation
of N.C. Gen. Stat. § 75-1.1. We find support for this conclusion
particularly in looking to N.C. Gen. Stat. § 58-63-15(11) forguidance as to what types of acts are inherently unfair,
unscrupulous, and injurious to consumers. See Gray, 352 N.C. at
71, 529 S.E.2d at 683 (courts may look to types of conduct
prohibited by N.C. Gen. Stat. § 58-63-15(11) for examples of
conduct constituting unfair and deceptive acts under N.C. Gen.
Stat. § 75-1.1). USF&G's conduct arguably violates at least one of
the following acts prohibited by N.C. Gen. Stat. § 58-63-15(11):
(1) [r]efusing to pay claims without conducting a reasonable
investigation based upon all available information, N.C. Gen.
Stat. § 58-63-15(11)(d); (2) [f]ailing to promptly provide a
reasonable explanation of the basis in the insurance policy in
relation to the facts or applicable law for denial of a claim,
N.C. Gen. Stat. § 58-63-15(11)(n) (emphasis added); (3) [n]ot
attempting in good faith to effectuate prompt, fair and equitable
settlements of claims in which liability has become reasonably
clear, N.C. Gen. Stat. § 58-63-15(11)(f); and (4)
[m]isrepresenting pertinent facts or insurance policy provisions
relating to coverages at issue, N.C. Gen. Stat. § 58-63-15(11)(a).
Moreover, the jury's verdict that USF&G improperly
determined it would deny coverage, misrepresent[ed] the nature of
its investigation to the Club, and unfairly and improperly
cited Exclusion C as its basis to send a reservation of rights
letter supports a conclusion that the insurer's acts were unethicaland involved an unfair assertion of its power. Such acts also
support the conclusion that a violation of N.C. Gen. Stat. § 75-1.1
has occurred. See Johnson, 128 N.C. App. at 458, 496 S.E.2d at 6;
see also Miller v. Nationwide Mutual Ins. Co., 112 N.C. App. 295,
435 S.E.2d 537 (1993) (insurer's act in uniformly denying certain
claims without first establishing a proper basis for refusal to pay
sufficient to support claim under N.C. Gen. Stat. § 75-1.1), disc.
review denied, 335 N.C. 770, 442 S.E.2d 519 (1994).
In summary, we uphold the trial court's conclusion of law that
the evidence and the jury's verdict support a determination that
USF&G violated N.C. Gen. Stat. § 75-1.1, notwithstanding that the
jury returned two of six interrogatories in favor of USF&G. The
trial court therefore did not err in denying USF&G's motions to
dismiss, for directed verdict, and for judgment notwithstanding the
verdict or new trial on this ground.
V.
Finally, USF&G maintains the trial court erred in taxing
attorney's fees and costs under N.C. Gen. Stat. § 75-16.1 and
asserts that the amount of fees and costs was unreasonable. Under
N.C. Gen. Stat. § 75-16.1, a trial court has discretion in actions
based upon a violation of N.C. Gen. Stat. § 75-1.1 to award
attorney's fees where the trial court determines that [t]he party
charged with the violation has willfully engaged in the act orpractice, and there was an unwarranted refusal by such party to
fully resolve the matter which constitutes the basis of such suit.
N.C. Gen. Stat. § 75-16.1(1). An award or denial of attorney's
fees under this section is within the sound discretion of the trial
court.
Southern Bldg. Maintenance v. Osborne, 127 N.C. App. 327,
335, 489 S.E.2d 892, 897 (1997).
In this case, the trial court made extensive findings,
including the required findings regarding the willful nature of
USF&G's acts and its unwillingness to facilitate a resolution of
the matter. Based on its extensive findings, the trial court
concluded that USF&G had both willfully engaged in the acts at
issue and engaged in an unwarranted refusal to fully resolve the
Club's claims. Given our review of the evidence, we cannot
conclude that the trial court's findings and conclusion are wholly
unsupported or that the decision to award fees was either
'manifestly unsupported by reason' or 'so arbitrary that it
could not have been the result of a reasoned decision.'
See
Williams v. McCoy, 145 N.C. App. 111, 117, 550 S.E.2d 796, 801
(2001) (citation omitted) (defining abuse of discretion standard).
In addition, the trial court must make findings as to whether
the amount of attorney's fees is reasonable.
Barbee v. Atlantic
Marine Sales & Service, 115 N.C. App. 641, 648, 446 S.E.2d 117,
122,
disc. review denied, 337 N.C. 689, 448 S.E.2d 516 (1994). Tothat end, appropriate findings would include those addressed to the
time and labor expended by the attorney, the skill required to
perform the services rendered, the experience and ability of the
attorney, and the customary fee for like work.
Id.
The trial court in this case made all required findings,
including (1) that the case involved difficult issues which
warranted the involvement of more than one attorney for the Club;
(2) that USF&G had at least two and sometimes three attorneys
assisting with its case; (3) that it was reasonable for the Club to
seek the legal assistance of the counsel involved in the trial, as
both attorneys had prior involvement in the case and possessed
significant knowledge of the facts and legal issues that were
crucial to successful prosecution of the Club's claims; (4) that
the Club's attorneys have extensive experience and provided high
quality legal services that enabled the Club to obtain a favorable
judgment in a very difficult case; (5) that the attorneys' rates
were reasonable and consistent with those charged by attorneys with
equivalent expertise and experience; (6) that the Club's attorneys
divided duties in a reasonable manner so as to avoid duplication of
services; (7) that the affidavits provided by both attorneys
accurately reflect the services provided; and (8) that these
services were reasonable and necessary for prosecution of theClub's claims. The trial court also made findings regarding the
exact time expended by each attorney.
The trial court's extensive findings are sufficiently
supported by evidence in the record. USF&G has failed to persuade
us that the trial court's award of attorney's fees is manifestly
unsupported by reason or wholly arbitrary. Accordingly, and for
all reasons stated herein, we uphold the decisions of the trial
court with respect to the denials of USF&G's motions, and we
conclude that the trial was free of error.
No error.
Judges WALKER and BRYANT concur.
Footnote: 1 Although Exclusion C is entitled Amendment of Liquor
Liability Exclusion, we note that the exclusions applied to all
alcoholic beverages.
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