TONY R. LLOYD, d/b/a EPOTHANE
FLOORING SYSTEMS,
a Proprietorship,
Plaintiff
v
.
Iredell County
No. 05 CVS 02048
GRAIN DEALERS MUTUAL INSURANCE
COMPANY,
Defendant
Eisele, Ashburn, Greene & Chapman, PA, by Douglas G. Eisele,
for plaintiff-appellant.
Kilpatrick Stockton, LLP, by Susan H. Boyles and Corena A.
Norris-McCluney, for defendant-appellee.
CALABRIA, Judge.
Tony R. Lloyd (plaintiff), trading and doing business as
Epothane Flooring Systems (EFS), appeals from a summary judgment
entered in favor of the defendant, Grain Dealers Mutual Insurance
Company (defendant) based upon plaintiff's alleged failure to
file a claim within the three year statute of limitations period
for losses suffered by plaintiff after a fire at plaintiff's place
of business. We affirm.
On 13 May 2000, EFS purchased a Business Owner's insurance
policy from defendant which included coverage for loss of business
income in the event of a suspension of business operations. On 7March 2001, a fire damaged EFS' office building. The next day, 8
March 2001, defendant's claims adjuster visited EFS and spoke with
plaintiff regarding the coverage provisions of EFS' policy,
including the provision for loss of business income. Plaintiff
received a payment from defendant for the property damage only.
In March of 2002, plaintiff completed the repairs to the
building and EFS resumed business operations. In October of 2002,
plaintiff submitted a letter to defendant on behalf of EFS,
claiming a loss of income in the amount of $107,944.75. After
reviewing the letter, defendant hired an accounting firm to analyze
the claim. On 9 April 2003, the accounting firm completed a report
regarding plaintiff's claim and concluded EFS lost $4,968.83 in
business income. On 22 April 2003, defendant offered plaintiff
$4,968.83 as satisfaction for EFS' loss of income claim. Plaintiff
rejected defendant's offer and informed defendant that he would
discuss the matter further after his accountant reviewed
defendant's report. Plaintiff never accepted defendant's offer or
submitted a counteroffer to defendant.
On 12 August 2005, plaintiff filed a complaint against
defendant seeking damages to recover loss of business income due to
the 7 March 2001 fire. On 3 February 2006, defendant filed a
motion for summary judgment alleging plaintiff's claim was not
brought within the time specified in the insurance contract and was
barred by the statute of limitations. Summary judgment was entered
in favor of defendant on 6 March 2006. Plaintiff appeals from the
order granting summary judgment in favor of defendant. Summary judgment is appropriate only when there is no genuine
issue of material fact and the moving party is entitled to judgment
as a matter of law. Marshburn v. Associated Indemnity Corp., 84
N.C. App. 365, 368, 353 S.E.2d 123, 125 (1987). The burden of
establishing the lack of any triable issue of material fact is on
the party moving for summary judgment. Id. However, when a
defendant has properly pled a statute of limitations, the burden is
placed upon the plaintiff to show that the action was instituted
within the prescribed period. See Little v. Rose, 285 N.C. 724,
727, 208 S.E.2d 666, 668 (1974).
Under N.C. Gen. Stat. § 1-52(1) (2005), a cause of action for
breach of contract must be brought within three years of the
breach. Id. Plaintiff contends that under N.C. Gen. Stat. § 1-
15(a) the limitations period prescribed in N.C. Gen. Stat. § 1-
52(1) does not begin to toll until after the cause of action has
accrued. N.C. Gen. Stat. § 1-15(a) (2005).
[A]n insurance policy is a contract and its provisions govern
the rights and duties of the parties thereto. Fidelity Bankers
Life Ins. Co. v. Dortch, 318 N.C. 378, 380, 348 S.E.2d 794, 796
(1986). The language in the policy is to be construed as written
without rewriting the contract or disregarding the express language
used. Herring v. Liner, 163 N.C. App. 534, 538, 594 S.E.2d 117,
120 (2004) (internal citations and quotations omitted). Where
there is no ambiguity in a policy's language, the courts must apply
the plain meaning of the policy language and enforce the policy aswritten. Trivette v. State Farm Mut. Auto. Ins. Co., 164 N.C.
App. 680, 684, 596 S.E.2d 448, 451 (2004).
According to the provisions of the insurance policy, in the
case sub judice, any legal action against defendant must be
brought within three years after the date the physical loss or
damage occurred. The language in the insurance contract was
clear, an action must be brought within three years after the date
on which the physical loss or damage occurred. The date of the
fire was 7 March 2001, and EFS resumed operations in March 2002.
Plaintiff filed the lawsuit 12 August 2005. Even assuming, without
deciding, that the statute of limitations ran for the last date of
business income loss in March 2002, plaintiff's lawsuit was not
timely filed.
Plaintiff argues that a cause of action does not accrue under
the business owners' insurance policy until after a sworn proof of
loss form containing the information regarding the loss has been
returned to defendant. Plaintiff concludes, that because defendant
did not send a sworn proof of loss form, defendant did not comply
with the claims procedure in its policy and thereby breached the
insurance contract. We disagree.
[A]n insurance contract provision requiring the insured party
to file a proof of loss with the insurance carrier should be
construed as existing for the benefit of the insurer. Magnolia
Mfg. of North Carolina, Inc. v. Erie Ins. Exchange, ___ N.C. App.
___, ___, 633 S.E.2d 841, 844 (2006). Further, an insurer may
waive a provision or condition in an insurance policy which is forits own benefit. Id. (quoting Brandon v. Nationwide Mut. Fire
Ins. Co., 301 N.C. 366, 370, 271 S.E.2d 380, 383 (1980)).
Generally, the waiver is not effectuated by a single act, but
rather by a series of acts or a course of conduct inconsistent with
an intention to enforce the requirement. Brandon, 301 N.C. at
372, 271 S.E.2d 380 at 384. Some of the relevant factors to
consider are: (1) whether the insurer had actual knowledge of the
loss; (2) whether an agent or adjuster made representations to the
insured indicating that no proofs need be filed; and (3) whether
the insurer made partial payment or otherwise indicated a
recognition of liability by assurances that an adjustment would be
made. Id.
In the case before us, we know that defendant had actual
knowledge of plaintiff's loss because defendant immediately hired
an accounting firm to investigate plaintiff's claim after receipt
of plaintiff's claim for loss of business income. When tendering
a settlement offer to plaintiff, the offer was not preceded by a
request for a completed proof of loss form. Further, defendant's
conduct indicated liability for the loss because defendant
attempted to settle plaintiff's claim by submitting an offer of
settlement to plaintiff based upon the report generated by the
accounting firm. Here, as in Brandon, defendant's series of acts
and course of conduct was inconsistent with an intention to enforce
the requirement that a proof of loss form be submitted. See
Brandon, 301 N.C. at 372, 271 S.E.2d 380 at 384. Therefore,
defendant effectively waived the proof of loss requirement byaccepting and acting upon plaintiff's October 2002 letter claiming
a loss of business income. See Meekins v. Aetna Ins. Co., 231 N.C.
452, 456, 57 S.E.2d 777, 781 (1950). Since defendant had
discretion to waive the requirement for completion of a proof of
loss form, defendant's decision to waive the requirement was not a
breach of contract.
Plaintiff relies upon F&D Co. v. Aetna Ins. Co., 305 N.C. 256,
287 S.E.2d 867 (1982), to support its contention that the cause of
action did not accrue until defendant failed to supply plaintiff
with the proof of loss form. In F&D, a provision of the
plaintiff's insurance contract required that a lawsuit be brought
within the twelve months next following the date of the physical
loss or damage out of which such claim arose. Id., 305 N.C. at
263, 287 S.E.2d at 871. The policy also required that proof of
loss be submitted to the insurance company and that payment be made
for such loss within thirty days after receipt of the proof of
loss. Also, F&D involved a statute that prevented an insurance
policy from limiting the time period to bring an action to less
than one year. Our Supreme Court held that the limitations period
in the policy violated the applicable statute. However, because
the policy also included a clause which provided that if the
limitations period was invalid, the limitations period would become
the shortest period possible under applicable law, the Supreme
Court held that the limitations period did not begin until the
cause of action accrued. The cause of action accrued either thirty
days after submission of proof of loss or when the insurancecompany rejected the claim. Id., 305 N.C. at 264, 287 S.E.2d at
871.
F&D is distinguishable from the case before us because in F&D
the limitations period in the insurance contract was invalidated by
statute. In the case before us, the limitation period provided in
the insurance contract is valid and complies with N.C. Gen. Stat.
§ 58-3-35 (2005) (time to commence action against insurer cannot be
less than period prescribed by law) and N.C. Gen. Stat. § 1-52(1)
(three year statute of limitations for claims arising under
contracts). Additionally, in F&D, the insurance company did not
waive the proof of loss requirement. Here, defendant effectively
waived the proof of loss requirement by accepting plaintiff's
claim, investigating plaintiff's claim, and offering to settle
plaintiff's claim. Further, unlike F&D, plaintiff's cause of
action in the case sub judice, arose at the time of the loss.
Specifically, plaintiff's cause of action was not postponed until
defendant's time to respond expired or until defendant rejected
plaintiff's claim.
For the reasons stated herein, we affirm the order of the
trial court.
Affirmed.
Judges GEER and JACKSON concur.
Report per Rule 30(e).
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