An unpublished opinion of the North Carolina Court of Appeals does not constitute controlling legal authority. Citation is disfavored, but may be permitted in accordance with the provisions of Rule 30(e)(3) of the North Carolina Rules of Appellate Proced
ure.
NO. COA02-681
NORTH CAROLINA COURT OF APPEALS
Filed: 18 March 2003
KENNETH R. McKINNON,
Employee,
Plaintiff
v
.
Industrial Commission
No. 901411
L&S HOLDING CO.,
T/A WOODLAND FARMS,
Employer
and
KEY BENEFIT SERVICES,
Carrier,
Defendants.
Appeal by defendant-carrier from the Opinion and Award of the
North Carolina Industrial Commission filed 20 February 2002. Heard
in the Court of Appeals 12 February 2003.
No brief filed for employee-plaintiff.
Teague, Campbell, Dennis & Gorham, L.L.P., by Dayle A.
Flammia, for defendant-appellee-employer.
Orbock Bowden Ruark & Dillard, PC, by Barbara E. Ruark and
Stephanie B. Woods, for defendant-appellant-carrier.
TYSON, Judge.
Key Benefit Services (Key) appeals from the findings and
award of the North Carolina Industrial Commission (Commission)
which concluded that Key was estopped from denying coverage for
Kenneth R. McKinnon's (plaintiff) injuries. We affirm.
I. Background
On 21 December 1998, plaintiff was employed by Woodland Farms(Woodland) working at its Liberty Cotton Gin facility (Liberty)
as a press operator when his thumb and all of the fingers on his
right hand were amputated. L&S Holding Company (L&S) operated
several business entities, including Woodland. Liberty was an
unincorporated activity, part of Woodland, and operated on a
seasonal basis. Defendants stipulated that plaintiff was entitled
to compensation under the Workers' Compensation Act but disputed
who owed the money. Without prejudice to its right to assert
entitlement to insurance coverage, L&S paid all of plaintiff's
medical expenses and the equivalent of temporary total disability
to plaintiff prior to the hearing before the Commission.
The Commission found that Woodland and Liberty operated out
of two bank accounts, the Woodland Farms payroll account and the
Woodland Farms, Inc. DBA Liberty Gin account. Profits from
Liberty went into both accounts. Liberty had been a part of
Woodland since 1986 and remained a part when Woodland was merged
into L&S prior to 1998. Woodland's operation included the growing
of cotton which was processed at Liberty as a part of Woodland's
overall operation. The Commission expressly found Woodland Farms
and Liberty Gin are not separate entities.
Ben Singleton, an insurance agent, had obtained workers'
compensation insurance for L&S in the past. Singleton and Key use
classification codes to assess risk prior to coverage. These codes
are unique to the insurance industry and require special knowledge
to determine which codes to use for different employees. The
Commission found: Mr. Singleton was aware of how jobs were
grouped together by defendant-employer and was
familiar with defendant-employer's operations
from past dealings and never informed
defendant-employer to group jobs in any other
manner. Defendant-employer provided
information that Mr. Singleton requested and
relied on him to instruct defendant-employer
how to place jobs within the classification
codes. Defendant-employer used the codes as
instructed by Mr. Singleton.
L&S obtained workers' compensation insurance from Key through
Singleton for Woodland. Plaintiff's salary as well as that of
secretaries at Liberty were included in the computation of premiums
for that insurance. L&S relied on Singleton in the placement of
plaintiff's job under hay, grain and feed dealer classification
because of the seasonal nature of his job.
The payments for the insurance came from the Woodland Farms,
Inc. DBA Liberty Gin checking account. The Commission found that
Key had notice of the cotton gin from the Experience Rating
provided by the Rate Bureau and from Singleton who was aware of the
cotton gin.
The Commission concluded that Key was estopped from denying
workers' compensation coverage. The Commission ordered Key to pay
plaintiff disability, to pay all of his medical expenses, and to
reimburse L&S for payments it made for medical expenses and
compensation to plaintiff.
II. Issue
Key contends the Commission erred in finding that it provided
insurance coverage to Liberty and ordering Key to provide coverage
for plaintiff's workers' compensation award.
III. Standard of Review
This Court's review of an award from the Commission is limited
to whether there is any competent evidence to support the
Commission's findings of fact and whether those findings support
the Commission's conclusions of law. Effingham v. Kroger Co., 149
N.C. App. 105, 109, 561 S.E.2d 287, 291 (2002). The findings of
fact are conclusive on appeal if there is competent evidence to
support them, even if evidence is presented to the contrary. Id.
The Commission's conclusions of law are reviewable de novo. Id.
IV. Coverage
A. Code Classifications
Key contends that the Commission erred in finding it provided
insurance coverage to Liberty and its employees and argues (1) no
evidence shows L&S requested Key to insure Liberty and (2) Liberty
was a separate entity from Woodland. We disagree.
There is competent evidence in the record to support the
findings of the Commission. Both Murphy Evans, president of L&S,
and Priscilla Christian, secretary for Woodland, testified that
Woodland Farms had two bank accounts: Woodland Farms payroll
account and Woodland Farms d/b/a Liberty Gin. Liberty's profits
went into both accounts. Liberty, Woodland, and L&S operate under
the same tax number. Woodland had owned Liberty since 1986 and
continued to own Liberty when L&S acquired Woodland prior to 1998.
To acquire workers' compensation insurance, employee
classification codes are assigned based upon the job description
and risk level. Singleton, the insurance agent who procured thepolicy with Key, testified that he had intimate knowledge of the
insurance classification codes and advised L&S regarding workers'
compensation insurance and classification codes. Woodland's policy
listed the classification codes for which Key contracted to provide
insurance coverage. Singleton testified he completed forms based
upon conversations with L&S owners but did not remember where the
exact conversations occurred. The code for cotton gin employees
was not listed on the insurance.
After Woodland was insured by Key for the first year, Key's
representative contacted Ms. Christian for a phone audit.
Christian was to review the letter and contract to make sure it was
correct. Payroll amounts, used to determine the premiums, were
corrected during this audit. The code for cotton gin workers was
again not present. Ms. Christian testified that Woodland Farms had
grouped the cotton gin employees under hay, grain or feed dealer
category and she was not aware of a separate code for cotton gin.
Singleton testified that although he was trained in assigning
classifications, he would not expect a layperson to know the proper
classifications because the class code identifier is not always
descriptive. He further testified that part of his job was to
advise the insured on insurance and classification codes. He
stated that it's very difficult for someone like Ms. Christian to
know that a cotton gin employee was not covered by the codes
listed.
During 1997 and 1998, Key accepted premium payments from a
bank account for Woodland Farms, Inc. d/b/a Liberty Gin whichthey deposited. Plaintiff's salary was included in the
calculations for the workers' compensation premium under the
classification of hay, grain and feed dealer. Plaintiff's only
employment with Woodland Farms and L&S was to work at Liberty.
Singleton admitted that he knew L&S operated a cotton gin prior to
the accident. Competent evidence in the record supports the
findings of the Commission.
B. Estoppel
Estoppel has long been used to require an insurance company to
provide coverage in a workers' compensation claim. Aldridge v.
Motor Co., 262 N.C. 248, 251, 136 S.E.2d 591, 593 (1964).
An estoppel can arise in any legal setting,
and our appellate courts have prudently and
repeatedly applied the doctrine in workers'
compensation cases to thwart an insurance
carrier's subsequent attempt to avoid coverage
of a work-related injury, howbeit upon a
legitimate ground, when the carrier has
previously and routinely accepted the payment
of insurance premiums pertaining to the
injured individual.
Godley v. County of Pitt, 306 N.C. 357, 360, 293 S.E.2d 167, 169
(1982). See also, Moore v. Electric Co., 264 N.C. 667, 142 S.E.2d
659 (1965); Aldridge, supra; Greene v. Spivey, 236 N.C. 435, 73
S.E.2d 488 (1952); Pearson v. Pearson, Inc., 222 N.C. 69, 21 S.E.2d
879 (1942); Garrett v. Garrett & Garrett Farms, 39 N.C. App. 210,
249 S.E.2d 808 (1978), disc. rev. denied, 296 N.C. 736, 254 S.E.2d
178 (1979); Britt v. Construction Co., 35 N.C. App. 23, 240 S.E.2d
479 (1978); Allred v. Woodyards, Inc., 32 N.C. App. 516, 232 S.E.2d
879 (1977). In order to estop a party from asserting a defense,
the party who desires to take advantage of the estoppel must showthat in reliance on the other party's action, he changed his
position to his detriment. Blackwelder v. City of Winston-Salem,
332 N.C. 319, 324-25, 420 S.E.2d 432, 436 (1992).
Here, L&S relied on the expert knowledge of Singleton to
acquire workers' compensation insurance for all of Woodland Farms
employees including those who worked at the Liberty cotton gin.
Based on this reliance, plaintiff was included under a
classification code which did not specifically include cotton gin
workers. Key accepted the benefits of this reliance when it (1)
accepted premium payments derived from calculations which included
plaintiff's salary and (2) accepted those payments from Woodland
Farms d/b/a Liberty Gin. The Commission correctly concluded that
Key was estopped from denying coverage for plaintiff.
IV. Conclusion
We hold that competent evidence in the record supports the
Commission's findings of fact. The findings support the
Commission's conclusion of law that Key was estopped from denying
workers' compensation coverage to plaintiff.
Affirmed.
Judge MCCULLOUGH and CALABRIA concur.
Report per Rule 30(e).
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