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All opinions are subject to modification and technical correction prior to official publication in the North Carolina Reports and North Carolina Court of Appeals Reports. In the event of discrepancies between the electronic version of an opinion and the print version appearing in the North Carolina Reports and North Carolina Court of Appeals Reports, the latest print version is to be considered authoritative.
F. BARRY DIGH, Plaintiff, v. NATIONWIDE MUTUAL FIRE INSURANCE
COMPANY, Defendant
NO. COA07-153
Filed: 18 December 2007
Insurance_boat insurer--delayed notice of claim--not reasonable
An insurer had no duty to cover a loss from damage to a boat where the policy language
about notice was ambiguous and the notice given was purposefully delayed through bad faith (a
desire to keep premiums from increasing).
Appeal by Plaintiff from judgment entered 31 October 2006 by
Judge Richard Doughton in Catawba County Superior Court. Heard in
the Court of Appeals 12 September 2007.
Homesley Goodman & Wingo, PLLC, by Andrew J. Wingo, for
Plaintiff-Appellant.
Robinson Elliott & Smith, by William C. Robinson, for
Defendant-Appellee.
STEPHENS, Judge.
On 31 May 2002, Defendant Nationwide Mutual Fire Insurance
Company (Nationwide) issued an insurance policy to Plaintiff F.
Barry Digh (Digh) to cover Digh's 1998 Eliminator 25-foot
powerboat. The front page of the policy assured Digh that he now
[had] a different kind of insurance policy. One that's readable,
understandable, straight-forward. Nevertheless, after Digh's boat
was damaged in an accident on Lake Norman in July 2002, Nationwide
and Digh find themselves engaged in a dispute over the meaning of
the notice provision in the policy's Physical Damage Coverage
section:
SECTION I _ CONDITIONS
. . . .
2. Your Duties after Loss. In case of a
loss, you must:
a) give notice to us or our agent, and
in case of theft also to the police as
soon as possible.
Nationwide contends this provision obligated Digh to notify
Nationwide of the damage to the boat as soon as possible after
the accident. Digh, on the other hand, argues he was only
obligated to give notice as soon as possible to the police in
case of theft, and that the provision is silent as to when he was
required to give notice to Nationwide in case of a loss. From the
trial court's grant of summary judgment in favor of Nationwide,
Digh appeals.
BACKGROUND
On 28 July 2002, Digh was operating his boat on Lake Norman
when, according to Digh, a four or five-foot rogue wave hit the
boat, launching the boat probably four to six feet out of the
water and ejecting Digh into the lake. Upon getting back on board
the boat, Digh saw that the boat had suffered stress cracks in
the fiberglass of the cockpit area and that the engine was not
quite what it was before the encounter with the wave, in that he
had to turn the key in the ignition several times to get it to
start. Digh drove the boat back to his boathouse, covered it, and
raised it out of the water on his boat lift in his boathouse. At
that point, Digh knew some work would have to be done on the boat
to fix the stress cracks and engine damage, but Digh thought the
cost of repairs would be about fifteen hundred dollars plus theengine. Digh did not file a claim with Nationwide because he
wanted to keep [his] insurance from going up. The boat remained
undisturbed on the boat lift for the next five months.
Around December 2002, Digh brought the boat to Admiral Marine
Service (Admiral) to have it winterized. Digh kept the boat at
Admiral until November 2004 because he was trying to save enough
money to fix it [himself]. In November 2004, he brought the boat
to Performance Engines (Performance) to have the engine repaired.
Performance removed and fixed the engine at a cost of approximately
eighty-three hundred dollars. About three weeks after bringing the
boat to Performance, Digh brought the boat back to Admiral. At
Admiral, Digh discovered a softball-sized hole in the boat's hull.
The cost to repair the stress cracks and the hole was estimated to
be between fifteen and twenty-four thousand dollars.
In March 2005, Digh filed a claim with Nationwide for damage
to the boat from the July 2002 accident. The parties did not
settle Digh's claim, and, on 11 July 2005, Digh filed a complaint
against Nationwide in which he asserted five causes of action: (1)
breach of contract, (2) breach of contract duty to settle covered
claim, (3) breach of fiduciary relationship, (4) bad faith refusal
to settle, and (5) unfair and deceptive trade practices. On 10
October 2006, Nationwide filed a motion for summary judgment. On
31 October 2006, the trial court granted summary judgment in favor
of Nationwide on all of Digh's causes of action.
STANDARD OF REVIEW
As a preliminary matter, Digh, in his brief, does not
specifically argue that the trial court erred in granting summary
judgment on any one particular claim which he advanced before the
trial court. It is evident, however, that the extent of Digh's
argument to this Court is that the trial court erred in entering
summary judgment on his first cause of action: breach of contract.
Accordingly, we affirm summary judgment in favor of Nationwide on
Digh's other four claims and limit our review to the trial court's
entry of summary judgment on Digh's breach of contract claim. See
N.C. R. App. P. 28(a) (The function of all briefs required or
permitted by these rules is to define clearly the questions
presented to the reviewing court and to present the arguments and
authorities upon which the parties rely in support of their
respective positions thereon. Review is limited to questions so
presented in the several briefs.).
Summary judgment is appropriate if the pleadings,
depositions, answers to interrogatories, and admissions on file,
together with the affidavits, if any, show that there is no genuine
issue as to any material fact and that [a] party is entitled to a
judgment as a matter of law. N.C. Gen. Stat. § 1A-1, Rule 56(c)
(2005). On appeal of a trial court's allowance of a motion for
summary judgment, we consider whether, on the basis of materials
supplied to the trial court, there was a genuine issue of material
fact and whether the moving party is entitled to judgment as a
matter of law. Summey v. Barker, 357 N.C. 492, 496, 586 S.E.2d
247, 249 (2003). Evidence presented by the parties is viewed inthe light most favorable to the non-movant. Id. (citing Dobson v.
Harris, 352 N.C. 77, 83, 530 S.E.2d 829, 835 (2000)).
BREACH OF CONTRACT
We begin by noting that insurance policies are considered
contracts between two parties.
Allstate Ins. Co. v. Shelby Mut.
Ins. Co., 269 N.C. 341, 152 S.E.2d 436 (1967). [I]t is the duty
of the court to construe an insurance policy as it is written, not
to rewrite it and thus make a new contract for the parties.
Id.
at 346, 152 S.E.2d at 440 (citations omitted). Insurance
contracts are construed according to the intent of the parties, and
in the absence of ambiguity, we construe them by the plain,
ordinary and accepted meaning of the language used.
Integon Gen.
Ins. Corp. v. Universal Underwriters Ins. Co., 100 N.C. App. 64,
68, 394 S.E.2d 209, 211 (1990) (citing
Williams v. Nationwide Mut.
Ins. Co., 269 N.C. 235, 238, 152 S.E.2d 102, 105-06 (1967)).
An ambiguity exists where, in the opinion of the court, the
language of the policy is fairly and reasonably susceptible to
either of the constructions asserted by the parties.
Maddox v.
Colonial Life & Accident Ins. Co., 303 N.C. 648, 650, 280 S.E.2d
907, 908 (1981) (citing
Wachovia Bank & Trust Co. v. Westchester
Fire Ins. Co., 276 N.C. 348, 172 S.E.2d 518 (1970)). The fact
that a dispute has arisen as to the parties' interpretation of the
contract is some indication that the language of the contract is,
at best, ambiguous.
St. Paul Fire & Marine Ins. Co. v.
Freeman-White Assocs., Inc., 322 N.C. 77, 83, 366 S.E.2d 480, 484
(1988) (citing
Mazza v. Med. Mut. Ins. Co., 311 N.C. 621, 630, 319S.E.2d 217, 223 (1984)). The words used in the policy having been
selected by the insurance company, any ambiguity or uncertainty as
to their meaning must be resolved in favor of the policyholder, or
the beneficiary, and against the company.
Wachovia Bank & Trust
Co., 276 N.C. at 354, 172 S.E.2d at 522 (citations omitted).
Generally, '[i]f no time for the performance of an obligation
is agreed upon by the parties, then the law prescribes that the act
must be performed within a reasonable time.'
Int'l Minerals &
Metals Corp. v. Weinstein, 236 N.C. 558, 561, 73 S.E.2d 472, 474
(1952) (quoting
Rocky Mt. Sav. & Trust Co. v. Aetna Life Ins. Co.,
199 N.C. 465, 469, 154 S.E. 743, 745 (1930) (citations omitted)).
In the opinion of this Court, the language of the notice
provision at issue is fairly and reasonably susceptible to either
of the constructions advanced by the parties and, thus, this
language is ambiguous:
2.
Your Duties after Loss. In case of a
loss,
you must:
a) give notice to us or our agent,
and in case of theft also to the
police as soon as possible.
To clearly and unambiguously achieve the result espoused by
Nationwide, the provision could be phrased as is the notice
provision in the policy's Liability Coverages section:
(See footnote 1)
4.
Duties after Loss. In case of an accident
or
occurrence, the
insured will perform the
following duties that apply. You willcooperate with us in seeing that these duties
are performed:
a) Give notice to us or our agent
as soon as practicable[.]
As written, however, the notice provision in the policy's Physical
Damage Coverage section is ambiguous and uncertain.
(See footnote 2)
As
any
ambiguity or uncertainty . . . must be resolved in favor of the
policyholder,
Wachovia Bank & Trust Co.,
276 N.C. at 354, 172
S.E.2d at 522, the interpretation advanced by Digh must prevail.
That is, Digh was not obligated to give notice to Nationwide as
soon as possible, and the contract does not specify a time for the
performance of Digh's obligation. There being no time specified,
however, Digh was required to give notice to Nationwide of the loss
within a reasonable time.
Int'l Minerals & Metals Corp.,
supra.
DELAYED NOTICE
Both parties contend that the proper resolution of this case
depends on our application of the test announced by our SupremeCourt in
Great Am. Ins. Co. v. C. G. Tate Constr. Co., 303 N.C.
387, 279 S.E.2d 769 (1981) (
Great American I). In that case, a
controversy arose after an automobile accident which an injured
third-party asserted was caused by the fault of the insured. The
insurer sought declaratory relief that it had no obligation to
defend or indemnify the insured in any suit arising out of the
accident because the insured failed to give notice to the insurer
as soon as practicable, as the insurance contract unambiguously
required.
Id. at 390, 279 S.E.2d at 771. Overruling a long line
of cases,
(See footnote 3)
the Supreme Court held that the insured's failure to
give notice, by itself, did not relieve the insurer of its
obligations under the policy.
Instead, the Court
create[d] a three-step test for determining
whether the insurer is obliged to defend.
When faced with a claim that notice was not
timely given, the trier of fact must first
decide whether the notice was given as soon as
practicable. If not, the trier of fact must
decide whether the insured has shown that he
acted in good faith,
e.g., that he had no
actual knowledge that a claim might be filed
against him. If the good faith test is met
the burden then shifts to the insurer to show
that its ability to investigate and defend was
materially prejudiced by the delay.
Great American I, 303 N.C. at 399, 279 S.E.2d at 776. In
Great Am.
Ins. Co. v. C. G. Tate Constr. Co., 315 N.C. 714, 340 S.E.2d 743
(1986) (
Great American II), the Court emphasized that an insureronly has the burden of showing prejudice if the insured has shown
that he acted in good faith.
Th[e] test of lack of good faith involves a
two-part inquiry:
1) Was the insured aware of his possible
fault, and
2) Did the insured purposefully and
knowingly fail to notify the insurer?
Great American II, 315 N.C. at 720, 340 S.E.2d at 747. Nationwide
argues that Digh delayed giving notice of the loss and that the
delay was in bad faith. Digh, on the other hand, argues that the
delay was in good faith and that Nationwide suffered no resulting
prejudice.
Before applying the
Great American test to the facts of this
case, we note that the language of the
test suggests that it is to
be applied in cases involving third-party claims against an
insured.
See Great American I, 303 N.C. at 399, 279 S.E.2d at 776
(stating that the trier of fact must decide whether the insured had
actual knowledge that a claim might be filed
against him[,] and
that, if so, the burden then shifts to the insurer to show that
its ability to investigate and
defend was materially prejudiced
by the delay) (emphasis added);
Great American II, 315 N.C. at
720, 340 S.E.2d at 747 (Was the insured aware of his possible
fault . . . ?) (emphasis added). However, the Supreme Court has
also applied the
test in a case involving a first-party claim
brought by the insured against the insurer.
Liberty Mut. Ins. Co.
v. Pennington, 356 N.C. 571, 573 S.E.2d 118 (2002). In
Pennington,
the insured sought to recover from the insurer under the insurancepolicy's underinsured motorist provisions after the insured was
injured in an automobile accident. The insurer sought declaratory
relief that it was not required to provide coverage because the
insured did not comply with the policy's notice provision which
required the insured to [p]romptly send [the insurer] copies of
the legal papers if a suit is brought.
Id. at 578, 573 S.E.2d at
123. In applying the
Great American test, the Court clearly stated
that the
test is to be used in determining whether late notice to
an insurer bars recovery[.]
Id. at 580, 573 S.E.2d at 124.
The Court's decisions in
Great American I and
II and
Pennington guide and instruct our resolution of the case at bar.
Accordingly, the first step in the
Great American test simply
requires the trial court to determine whether there has been any
delay in notifying the insurer.
Great American II, 315 N.C. at
719, 340 S.E.2d at 747 (footnote omitted). The loss in the case
sub judice occurred on 28 July 2002. Digh did not give notice of
the loss to Nationwide until March 2005. It is beyond dispute that
there was a delay in notifying the insurer. Thus, we must
determine if Digh acted in good faith.
While Digh was not aware of the full extent of the damage
until December 2004, Digh acknowledges that he was aware of the
loss on the day it occurred. Digh further admits that the only
reason he delayed notice was to prevent his insurance premiums from
increasing. In other words, Digh was aware of the loss and he
purposefully and knowingly delayed giving notice to Nationwide.
Thus, Digh's delay was not in good faith, and Nationwide,therefore, had no duty to cover the loss to Digh's boat. The trial
court properly entered summary judgment in favor of Nationwide on
Digh's breach of contract claim.
AFFIRMED.
Judges McCULLOUGH and CALABRIA concur.
Footnote: 1
Digh's claim against Nationwide did not arise under the
Liability Coverages section of the policy. This section only
applies to claims made or suits brought
against Digh because of an
occurrence or property damage caused by the use of the boat.
Footnote: 2
Alternatively, the provision might include a well-placed
comma, as such:
2. Your Duties after Loss. In case of a
loss, you must:
a) give notice to us or our agent,
and in case of theft also to the
police, as soon as possible.
Or, the provision might be re-phrased as follows:
2. Your Duties after Loss. In case of a
loss, you must, as soon as possible:
a) give notice to us or our agent,
and in case of theft also to the
police.
Footnote: 3
Fleming v. Nationwide Mut. Ins. Co., 261 N.C. 303, 134 S.E.2d
614 (1964);
Muncie v. Travelers Ins. Co., 253 N.C. 74, 116 S.E.2d
474 (1960);
Peeler v. U.S. Cas. Co., 197 N.C. 286, 148 S.E. 261
(1929).
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