Case Title: Morgan v Morgan Motor Company of Albemarle

Citation: 

Docket Number: 21A14

State: north-carolina

Court: North Carolina Supreme Court

Date: 2015-06-11T00:00:00Z

Document:
NO. COA13-517 
NORTH CAROLINA COURT OF APPEALS 
Filed: 3 December 2013 
 
 
 
JORGE TOVAR-MAURICIO, EDEMIAS 
DELEON MORALES, MARIO M. TOVAR, 
RANULFO DELEON VASQUEZ, BERNABE 
FRANCISCO CALIXTO, TOMAS MARTINEZ 
GUERRERO and GABRIEL DOMINGUEZ-
CONTRERA, 
 
Employees, 
 
Plaintiffs-Appellees, 
 
 
 
 
v. 
 
North Carolina  
Industrial Commission 
I.C. Nos. W89564, W74586, 
W74595, W74600, X05359, X06247, 
X41552 
T.R. DRISCOLL, INC., 
 
Employer, 
 
GENERAL CASUALTY INSURANCE 
COMPANY, CAROLINAS ROOFING AND 
SHEET METAL CONTRACTORS SELF-
INSURED FUND, 
 
Carrier, 
 
Defendants-Appellants. 
 
 
 
 
 
Appeals by Defendants General Casualty Insurance Company 
and Carolinas Roofing and Sheet Metal Contractors Self-Insured 
Fund from opinion and award entered by the North Carolina 
Industrial Commission on 21 December 2012.  Heard in the Court 
of Appeals 24 September 2013. 
 
Diener 
Law, 
by 
Cynthia 
E. 
Everson, 
for 
Plaintiffs-
Appellees. 
-2- 
 
Orbock Ruark & Dillard, PC, by Roger L. Dillard, Jr. and 
Jessica E. Lyles, for Defendant-Appellee T.R. Driscoll, 
Inc. 
 
Goodman McGuffey Lindsey & Johnson, LLP, by Adam E. 
Whitten, for Defendant-Appellant Carolinas Roofing and 
Sheet Metal Contractors Self-Insured Fund. 
 
Teague Campbell Dennis & Gorham, LLP, by Brian M. Love and 
George H. Pender, for Defendant-Appellant General Casualty 
Insurance Company. 
 
 
McGEE, Judge. 
 
 
T.R. Driscoll, Inc. (“Employer”) is a company with a 
principal place of business in North Carolina.  Employer 
intermittently sends its employees to work in other states, 
including Virginia.  Employer joined the Carolinas Roofing and 
Sheet Metal Contractors Self-Insured Fund (“the Fund”) in the 
early 1980s.  Employer entered into an agreement with the Fund 
for workers’ compensation insurance “coverage for North Carolina 
and South Carolina operations[.]”  The Davis-Garvin Agency, Inc. 
(“Davis-Garvin”) served as Employer’s agent in purchasing 
insurance for “exposure not covered by the Fund.”  Davis-Garvin 
obtained workers’ compensation insurance for Employer from 
Capital City Insurance Company in 2005.  General Casualty 
Insurance Company (“General Casualty”) acquired Capital City 
Insurance Company in 2009. 
-3- 
Employer sent Jorge Tovar-Mauricio, Edemias Deleon Morales, 
Mario M. Tovar, Ranulfo Deleon Vasquez, Bernabe Francisco 
Calixto, Tomas Martinez Guerrero, and Gabriel Dominguez-Contrera 
(“Plaintiffs”) to Virginia to work on a roofing project.  
Plaintiffs were injured in the course and scope of their 
employment when a gas line exploded on 29 November 2009.  
Plaintiffs filed workers’ compensation claims in Virginia.  
General Casualty “accepted the claims as compensable pursuant to 
the 
Virginia 
Workers’ 
Compensation 
Act 
and 
began 
making 
payments[.]”  The North Carolina Industrial Commission found 
that, 
as 
“of 
November 
2011, 
General 
Casualty 
has 
paid 
compensation and medical benefits pursuant to the Virginia 
Workers’ Compensation Act to [Plaintiffs] in an approximate 
amount of $1,960,000.00.” 
In September 2010, Plaintiffs filed Form 33 Requests for 
Hearing 
with 
the 
North 
Carolina 
Industrial 
Commission, 
indicating that the parties had been unable to agree, noting 
only “change of jurisdiction from VA to NC[.]”  General Casualty 
responded that “it provided no coverage to [Employer] for claims 
filed in North Carolina and that such claims were properly 
covered by the Fund.” 
The Commission found that Employer “had a valid workers’ 
compensation insurance policy with General Casualty covering 
-4- 
Georgia, Tennessee, and Virginia.”  The Commission also found 
that Employer “was covered for workers’ compensation claims 
filed in North Carolina by [the Fund] at the time of Plaintiffs’ 
injuries.” 
The Commission concluded that the Fund “is the insurance 
carrier on the risk for [Employer] for workers’ compensation 
claims filed under the North Carolina Workers’ Compensation 
Act[.]”  The Commission did “not address the issue of 
Plaintiffs’ disability or average weekly wages” because the 
hearing “was limited to the establishment of jurisdiction and 
carrier liability[.]”  The Fund and General Casualty appeal. 
I. Standard of Review 
“Appellate 
review 
of 
an 
award 
from 
the 
Industrial 
Commission is generally limited to two issues: (1) whether the 
findings of fact are supported by competent evidence, and 
(2) whether the conclusions of law are justified by the findings 
of fact.”  Starr v. Gaston Cty. Bd. Of Educ., 191 N.C. App. 301, 
304, 663 S.E.2d 322, 325 (2008).  “Where there is competent 
evidence to support the Commission’s findings, they are binding 
on appeal even in light of evidence to support contrary 
findings.”  Id. at 304-05, 663 S.E.2d at 325.  “The Commission’s 
conclusions of law are reviewed de novo.”  Id. at 305, 663 
S.E.2d at 325. 
-5- 
II. The Fund’s Appeal 
A. Conclusion “that the General Casualty Policy Affords No 
Coverage for Plaintiffs’ Claims” 
 
i. Conclusion of Law 4 
 
 
The Fund first argues that the “Commission erred in 
concluding that the General Casualty policy affords no coverage 
for Plaintiffs’ claims[.]”  The Fund fails to specify which 
conclusion of law it challenges on appeal.  The only conclusion 
concerning General Casualty’s coverage of Plaintiffs’ claims is 
conclusion 4, quoted below: 
4. . . . .  Based upon a review of the plain 
language of the General Casualty policy, 
North Carolina was not a covered state at 
any time during the policy, either before or 
after the modification by endorsement. 
 
We interpret the Commission’s language that “North Carolina 
was not a covered state” as meaning that “the General Casualty 
policy affords no coverage for the claims before the Commission, 
i.e. Plaintiffs’ claims that were filed in North Carolina.”  We 
interpret the language in this manner because of the plain 
language in the General Casualty insurance policy: “We will pay 
promptly when due the benefits required of you by the workers 
compensation 
law.” 
 
According 
to 
the 
policy, 
“Workers 
Compensation Law means the workers or workmen’s compensation law 
and occupational disease law of each state or territory named in 
Item 3.A. of the Information Page.” 
-6- 
The “Information Page” lists Georgia, Tennessee, and 
Virginia: 
3A. Workers compensation insurance: Part one 
of 
the 
policy 
applies 
to 
the 
workers 
compensation law of the states listed here: 
GA, TN, VA 
 
Where “the language of an insurance policy is plain, 
unambiguous, 
and 
susceptible 
of 
only 
one 
reasonable 
construction, the courts will enforce the contract according to 
its terms.”  Walsh v. Insurance Co., 265 N.C. 634, 639, 144 
S.E.2d 817, 820 (1965); see also Register v. White, 358 N.C. 
691, 599 S.E.2d 549 (2004). 
The General Casualty policy is plain, unambiguous, and 
susceptible of only one reasonable construction.  The General 
Casualty policy applies to benefits required by the workers’ 
compensation laws of Virginia, in this case.  The Commission did 
not and indeed cannot award compensation except as required by 
the North Carolina Workers’ Compensation Act.  The Commission 
cannot award compensation under the laws of any state other than 
North Carolina. 
The record indicates that Plaintiffs received compensation 
under the workers’ compensation laws of Virginia.  Thus, N.C. 
Gen. Stat. § 97-36 will apply in this case if future proceedings 
are instituted to determine the specific amount of compensation 
due Plaintiffs under our workers’ compensation laws.  See N.C. 
-7- 
Gen. Stat. § 97-36 (2011) (“[I]f an employee . . . shall receive 
compensation or damages under the laws of any other state 
nothing herein shall be construed so as to permit a total 
compensation for the same injury greater than is provided for in 
this Article.”).  The Commission did not err in concluding that 
the General Casualty policy affords no coverage for Plaintiffs’ 
claims filed in North Carolina. 
ii. Liability under Virginia Workers’ Compensation Law 
The Fund requests this Court to “hold that General Casualty 
is liable to the Plaintiffs injured in Virginia, to the extent 
required by Virginia workers’ compensation law, even after their 
claims are transferred to North Carolina for convenience.”  We 
note that the record indicates that the Commission ordered no 
such “transfer.”  Also, the Fund cites no provision in our 
General Statutes authorizing the Commission to “transfer” a 
claim from another state to North Carolina. 
The conclusion that the General Casualty policy affords no 
coverage for these claims filed in North Carolina has no 
implications for General Casualty’s liability under Virginia 
workers’ compensation law.  We therefore make no conclusions 
about General Casualty’s past or continuing liability under 
Virginia law. 
-8- 
B. Finding of Fact 28 and Conclusion of Law 5 
 
The Fund next argues the Commission erred in concluding 
that the Fund agreement affords coverage for Plaintiffs’ claims.  
We disagree. 
 
The Fund challenges finding of fact 28 and conclusion of 
law 5.  Finding of fact 28 is as follows: 
28. . . . .  The Full Commission further 
finds 
that 
[Employer] 
was 
covered 
for 
workers’ compensation claims filed in North 
Carolina by [the Fund] at the time of 
Plaintiffs’ injuries. 
 
Conclusion 5 states: 
5. 
Under 
the 
terms 
of 
the 
workers’ 
compensation insurance policy with the Fund, 
[Employer] was properly covered for workers’ 
compensation claims filed in North Carolina.  
N.C. Gen. Stat. § 97-36[.] 
 
 
The Fund directs this Court to the following language in 
the Fund agreement: 
1. To the extent that coverage is afforded 
the 
Member 
under 
Article 
II 
of 
this 
Agreement, 
the 
Fund 
shall 
neither 
be 
obligated to pay nor incur defense costs 
with respect to the following: 
 
a. Under Coverage A, for any liability, 
judgment 
or 
award 
rendered 
against 
the 
Member 
or 
the 
Fund 
by 
the 
governing 
authorities of a State not listed in the 
Preamble of this Agreement[.] 
 
b. Under Coverage A, for any liability, 
judgment 
or 
award 
rendered 
against 
the 
Member or the Fund, pursuant to a workers’ 
compensation law other than that identified 
-9- 
in 
Article 
II, 
section 
3 
of 
this 
Agreement[.] 
 
c. Under Coverages A and B, for operations 
conducted at or from any workplace if the 
Member 
has 
separate 
insurance 
for 
such 
operations[.]  (emphasis added). 
 
Coverage A refers to workers’ compensation; Coverage B refers to 
“damages because of bodily injury or death[.]”  The Fund 
agreement further states: 
Coverage A - Workers’ Compensation.  The 
Fund will pay promptly from the funds 
received from or on behalf of the Members 
when due all compensation and other benefits 
which the Member is ordered to pay by the 
governing authorities of the state(s) listed 
in the Preamble, pursuant to the Workers’ 
Compensation 
law 
named 
in 
Article 
II, 
paragraph 3 of this Agreement.  (emphasis 
added). 
 
Article II, section 3 refers to the “Preamble.”  The “Preamble” 
lists North Carolina and South Carolina. 
The Fund agreement plainly states that the exclusions in 
subparts “a” and “b” apply to awards rendered by States other 
than North and South Carolina.  Thus, we consider whether the 
exclusion in subpart “c” applies.  The Fund concedes it would 
“be liable for any excess liability above the liability owed 
under Virginia law.”  The Fund contends that “any such coverage 
is nevertheless extinguished by the operation of” subpart “c.”  
However, the record indicates that Employer has no separate 
insurance for the Virginia operations for the purpose of claims 
-10- 
filed with the North Carolina Industrial Commission.  For the 
claims in this case, which were claims filed with the North 
Carolina Industrial Commission, only the Fund agreement is 
applicable.  The Commission did not err in the finding or the 
conclusion regarding the Fund’s coverage in North Carolina. 
C. Parol Evidence 
The Fund further argues the Commission erred in considering 
parol evidence to determine the intent of the General Casualty 
policy. 
The Fund again fails to specify a finding of fact or 
conclusion of law to challenge on appeal.  As stated above, our 
appellate review is limited to two issues: “(1) whether the 
findings of fact are supported by competent evidence, and 
(2) whether the conclusions of law are justified by the findings 
of fact.”  Starr, 191 N.C. App. at 304, 663 S.E.2d at 325; see 
also Clark v. Wal-Mart, 360 N.C. 41, 43, 619 S.E.2d 491, 492 
(2005); Hendrix v. Linn-Corriher Corp., 317 N.C. 179, 186, 345 
S.E.2d 374, 379 (1986). 
Because the Fund fails to challenge a finding of fact as 
unsupported by competent evidence or a conclusion of law as not 
justified by the findings of fact, this argument falls outside 
the well-established scope of our review on appeal. 
-11- 
D. Agency Relationship 
The Fund next argues the Commission erred in relying upon 
the 
alleged 
agency 
relationship 
between 
Davis-Garvin 
and 
Employer to determine the intent of the General Casualty policy. 
The Fund again fails to specify a finding of fact or 
conclusion of law to challenge on appeal.  Rather, the Fund 
contends that the issue “permeates the entire decision of the 
Full Commission.”  The Fund argues that evidence of “the 
knowledge or intent of Davis-Garvin . . . should not have formed 
the basis for the erroneous conclusions of law concerning the 
intent of the General Casualty policy and the efficacy of the 
attempted retroactive endorsement thereto.” 
However, the Commission held as follows: 
8. As the Full Commission concludes that 
North Carolina was not a covered state 
either 
under the terms of the General 
Casualty policy, either before or after the 
modification 
by 
endorsement, 
the 
issues 
regarding the retroactive application of the 
amended endorsement and reformation of the 
contract are moot and not addressed by this 
Opinion and Award. 
 
Because of our holding in Section II.A., affirming the 
Commission’s conclusion as to General Casualty’s lack of 
coverage over claims filed in North Carolina, we do not address 
this argument.  Even if the Fund could demonstrate some error in 
a finding regarding agency, the Fund could not demonstrate that 
-12- 
the finding undermined a conclusion of law such that it 
justified reversal of the Commission’s order. 
III. General Casualty’s Appeal 
 
General Casualty’s sole argument on appeal is that the 
Commission 
erred 
in 
failing 
to 
award 
General 
Casualty 
“reimbursement for benefits it paid to Plaintiffs after they 
transferred 
their 
workers’ 
compensation 
claims 
to 
North 
Carolina.” 
General Casualty challenges only the following conclusion: 
There is no legal or contractual basis under 
the North Carolina Workers’ Compensation Act 
that would entitle General Casualty to be 
reimbursed by the Fund for compensation 
already paid to Plaintiffs. 
 
 
General Casualty cites N.C. Gen. Stat. § 97-86.1(d), quoted 
below: 
In any claim under the provisions of this 
Chapter wherein one employer or carrier has 
made 
payments 
to 
the 
employee 
or 
his 
dependents pending a final disposition of 
the 
claim 
and 
it 
is 
determined 
that 
different 
or 
additional 
employers 
or 
carriers are liable, the Commission may 
order any employers or carriers determined 
liable to make repayment in full or in part 
to any employer or carrier which has made 
payments to the employee or his dependents. 
 
N.C. Gen. Stat. § 97-86.1(d) (2011). 
General Casualty seems to imply that General Casualty has 
paid some compensation to Plaintiffs beyond that ordered by 
-13- 
Virginia.  However, the Commission made no such finding.  The 
Commission 
found 
only 
that 
“General 
Casualty 
has 
paid 
compensation and medical benefits pursuant to the Virginia 
Workers’ Compensation Act to [Plaintiffs] in an approximate 
amount of $1,960,000.00.”  (emphasis added).  N.C.G.S. § 97-
86.1(d) does not permit repayment for compensation paid under 
the order of another state.  Rather, the statute refers only to 
where a carrier makes payments pending a final disposition of 
“any claim under the provisions of this Chapter[.]”  N.C.G.S. 
§ 97-86.1(d). 
The Commission did not err in making the challenged 
conclusion 
denying 
General 
Casualty 
reimbursement 
for 
compensation already paid to Plaintiffs. 
IV. Conclusion 
 
As to the Fund’s appeal, the Commission did not err in its 
findings and conclusions relating to General Casualty’s coverage 
in North Carolina or the Fund’s coverage in North Carolina.  As 
to General Casualty’s appeal, the Commission did not err in 
failing to award General Casualty reimbursement for amounts paid 
to Plaintiffs. 
Affirmed. 
Judge McCULLOUGH concurs. 
-14- 
Judge DILLON concurs in part and dissents in part by 
separate 
opinion.
NO. COA13-517 
NORTH CAROLINA COURT OF APPEALS 
Filed: 3 December 2013 
 
 
JORGE TOVAR-MAURICIO, EDEMIAS 
DELEON MORALES, MARIO M. TOVAR, 
RANULFO DELEON VASQUEZ, BERNABE 
FRANCISCO CALIXTO, TOMAS MARTINEZ 
GUERRERO and GABRIEL DOMINGUEZ-
CONTRERA, 
 
Employees, 
     Plaintiffs-Appellees, 
 
 
 
 
v. 
 
North Carolina     
Industrial Commission 
I.C. Nos. W89564, W74586, 
W74595, W74600, X05359, X06247, 
X41552 
T.R. DRISCOLL, INC., 
Employer, 
 
GENERAL CASUALTY INSURANCE 
COMPANY, CAROLINAS ROOFING AND 
SHEET METAL CONTRACTORS SELF-
INSURED FUND, 
     Carrier, 
     Defendants-Appellants. 
 
 
 
 
 
DILLON, Judge, concurring in part and dissenting in part. 
 
 
I concur with Section III of the majority’s opinion 
affirming the Commission’s order with respect to the issues 
raised in the cross-appeal filed by General Casualty Insurance 
Company (“General Casualty”).  However, I respectfully dissent 
from Section II with respect to the appeal filed by the Sheet 
Metal Contractors Self-Insurance Fund (the “Fund”) to the extent 
-2- 
 
 
the majority holds that General Casualty is not obligated under 
its policy to provide coverage to its insured, T.R. Driscoll, 
Inc. (the “Employer”), for benefits that Plaintiffs may be 
awarded that would otherwise have been required to be paid under 
Virginia workers’ compensation law had Plaintiffs sought said 
benefits in Virginia.   
I. Background 
In 
this 
action, 
Plaintiffs 
are 
seeking 
workers’ 
compensation benefits under North Carolina law arising from 
injuries that occurred while they were working on a job in 
Virginia.  At the time of the accident, the Employer, which is 
based in North Carolina, was covered for workers’ compensation 
claims under two separate insurance contracts, one provided by 
the Fund and the other by General Casualty.   
In its order, the Commission determined that the Fund was 
solely liable to provide the Employer coverage for any benefits 
that the Commission may award Plaintiffs arising from the 
Virginia accident; and, therefore, dismissed General Casualty as 
a party to the proceeding.  
The majority affirmed the 
Commission’s order, holding that “[t]he Commission did not err 
in concluding that the General Casualty policy affords no 
coverage for Plaintiffs’ claims filed in North Carolina.”  The 
-3- 
 
 
issues encompassed in the Commission’s order were, however, 
limited to “the establishment of jurisdiction and carrier 
liability1[.]”  In other words, the Commission has yet to 
determine 
the 
exact 
nature 
and 
amount 
of 
benefits 
that 
Plaintiffs will ultimately be awarded in the North Carolina 
proceeding.   
I believe General Casualty’s insurance contract provides 
coverage to the Employer for workers’ compensation benefits that 
would be due under Virginia law for an accident occurring in 
Virginia, even if those benefits are ultimately sought and 
awarded under the laws of another state.  Therefore, since it is 
unknown at this stage of the proceeding whether Plaintiffs will 
seek any benefits that would have been due under Virginia law 
had Plaintiffs sought those benefits in a Virginia proceeding, I 
believe the Commission was premature in concluding that the Fund 
is solely liable, to the exclusion of General Casualty, to 
                     
1 
The 
interpretation 
of 
insurance 
contract 
language 
is, 
generally, determined by a trial court.  However, our Supreme 
Court has held that the Commission is authorized, pursuant to 
N.C. Gen. Stat. § 97-91, to hear “‘all questions arising under’ 
the Compensation Act [which include] . . . the right and duty to 
hear and determine questions of fact and law respecting the 
existence of insurance coverage and liability of the insurance 
carrier.”  Greene v. Spivey, 236 N.C. 435, 445, 73 S.E.2d 488, 
495-96 (1952); see also Smith v. First Choice Servs., 158 N.C. 
App. 244, 248, 580 S.E.2d 743, 747, disc. review denied, 357 
N.C. 461, 586 S.E.2d 99 (2003).   
-4- 
 
 
provide coverage to the Employer for all the benefits that the 
Commission may award the Plaintiffs.  
II. Analysis 
The Fund’s contract provides coverage, inter alia, for 
benefits the Employer is “ordered to pay by the governing 
authorities of [North Carolina,]” but excludes from coverage, 
those “operations conducted at or from any workplace if [the 
Employer] has separate insurance for such operations.”  The 
Fund, here, argues that the Employer “has separate insurance” – 
provided by General Casualty – to provide benefits arising from 
the Plaintiffs’ Virginia accident.   
The provision at issue in the General Casualty policy 
provides that General Casualty will pay benefits as “required of 
[the Employer] by the workers compensation law [of Virginia].”  
General Casualty argues that this provision limits its exposure 
to pay benefits arising from claims actually filed in Virginia, 
and otherwise does not extend to any benefits awarded in an 
action filed in another state, even where the accident occurs in 
Virginia and Virginia law would require benefits to be paid.   
The Fund, on the other hand, argues that this provision is 
merely a “choice of law” provision; and, accordingly, General 
Casualty’s obligation to provide the Employer coverage as 
-5- 
 
 
required under Virginia workers’ compensation law is not 
obviated simply because Plaintiffs chose to file for benefits 
for the Virginia accident in a state other than Virginia.   
Neither party has cited a North Carolina case that is on 
point regarding the proper interpretation of the language in 
General Casualty’s coverage provision.  Rather, the parties cite 
cases from other jurisdictions in their briefs which illustrate 
the difference in judicial opinion throughout the United States 
regarding this issue.  An Illinois appellate court has explained 
this difference as follows: 
[This coverage question has] produced two 
divergent lines of decisions.  One line of 
cases 
agrees 
with 
[the 
employer] 
that 
alleged territorial limitation provisions 
are in fact choice of law provisions, not 
limiting 
coverage 
based 
on 
where 
the 
employee chooses to file his claim, but only 
to restrict benefit eligibility and to set 
indemnification limits based on the state 
law specified in the policy.  This line of 
cases includes Smith & Chambers Salvage v. 
Insurance Management Corp., 808 F. Supp. 
1492 (E.D. Wash. 1992); Sieman v. Postorino 
Sandblasting & Painting Co., 111 Mich. App. 
710, 314 N.W.2d 736 (1981); American Mutual 
Insurance Co. v. Duvall, 117 N.H. 221, 372 
A.2d 263 (1977); Toebe v. Employers Mutual 
of Wausau, 114 N.J. Super. 39, 274 A.2d 820 
(App. Div. 1971); Kacur v. Employers Mutual 
Casualty Co., 253 Md. 500, 254 A.2d 156 
(1969); and Weinberg v. State Workmen’s 
Insurance Fund, 368 Pa. 76, 81 A.2d 906 
(1951).  The other line of cases agrees with 
[the 
insurer] 
that, 
for 
there 
to 
be 
-6- 
 
 
coverage, the claim must actually be filed 
in the state whose law is made to apply in 
defining the term “worker’s compensation 
law.”  This line of cases includes Travelers 
Insurance Co. v. Industrial Accident Comm’n, 
240 Cal. App. 2d 804, 809-10, 50 Cal.Rptr. 
114, 118-119 (1966); Lumber Transport, Inc. 
v. International Indemnity Co., 203 Ga. App. 
588, 590, 417 S.E.2d 365, 366-67 (1992); 
Foster Wheeler Corp. v. Bennett, 1960 OK 
186, 
354 
P.2d 
764, 
768 
(Okla. 
1960); 
Consolidated Underwriters v. King, 160 Tex. 
18, 20, 325 S.W.2d 127, 129, 2 Tex. Sup. Ct. 
J. 338 (1959); Rood v. Nelson, 14 Misc. 2d 
859, 860-861, 178 N.Y.S.2d 969, 971 (1958); 
Jones v. Henessy, 232 La. 786, 793, 95 So.2d 
312, 314 (1957); Mandle v. Kelly, 229 Miss. 
327, 345, 90 So.2d 645; 649-50 (1956); and 
Miller Brothers Construction Co. v. Maryland 
Casualty Co., 113 Conn. 504, 519-20, 155 A. 
709, 714,-15 (1931). 
 
Szarek, Inc. v. Maryland Cas. Co., 357 Ill. App. 3d 584, 588, 
829 N.E.2d 871, 875 (2005) (construing the policy language at 
issue as a “choice of law” provision).   
 
Our Supreme Court has held “[a] difference of judicial 
opinion regarding proper construction of policy language is some 
evidence” that the policy language is ambiguous.  Brown v. 
Lumbermens Mut. Cas. Co., 326 N.C. 387, 392, 390 S.E.2d 150, 153 
(1990) (citations omitted).  I believe the language in General 
Casualty’s policy is ambiguous on the issue; and, accordingly, I 
would hold that the General Casualty policy does provide 
coverage for the claims sought in North Carolina by Plaintiffs 
-7- 
 
 
to the extent that the benefits would be required under Virginia 
workers’ compensation law.  See W&J Rives, Inc. v. Kemper Ins. 
Group, 92 N.C. App. 313, 316, 374 S.E.2d 430, 433 (1988), disc. 
review denied, 324 N.C. 342, 378 S.E.2d 809 (1989) (holding that 
“an insurance contract should be construed as a reasonable 
person in the position of the insured would have understood it 
[and that if] the language used in the policy is reasonably 
susceptible to different constructions, it must be given the 
construction most favorable to the insured”).  I believe that 
the word “require” in the coverage provision could reasonably be 
construed to allow for either interpretation asserted by the two 
lines of cases described in Szarek, supra.  I believe it is 
reasonable for the Employer to have assumed that the language in 
the General Casualty policy would provide coverage for accidents 
occurring in Virginia, to the extent that the listed state would 
require the insured to pay benefits, and that General Casualty 
could 
not 
avoid 
providing 
this 
coverage 
simply 
because 
Plaintiffs chose to file for benefits in another state that may 
also have jurisdiction.  
 
If the interpretation propounded by General Casualty is 
adopted, then it is conceivable that a North Carolina employer 
who had policy with this provision – but providing coverage for 
-8- 
 
 
benefits required under North Carolina law – would be afforded 
no coverage under its policy for an accident occurring in North 
Carolina where the employee chose to file for benefits in 
another state that might also have jurisdiction.  For instance, 
another state may assert jurisdiction because the injured 
employee originally accepted the employer’s offer of employment 
while in the that state.  See Murray v. Ahlstrom Indus. 
Holdings, Inc., 131 N.C. App. 294, 506 S.E.2d 724 (1998) 
(holding that North Carolina has jurisdiction over a claim 
arising from an accident in Mississippi because the original 
offer of employment was accepted over the telephone while the 
employee was in North Carolina).  
General Casualty, which drafted the policy language, could 
have included language to clearly state that it was providing 
coverage only for claims “filed” in Virginia or, alternatively, 
for benefits that the Employer would be ordered to pay “by the 
regulating body” in Virginia.  Indeed, the Fund’s policy 
contains very specific language indicating that it would provide 
coverage to the Employer only as ordered “by the governing 
authorities of [North Carolina].”  However, General Casualty 
chose not to include such language in its policy.  Therefore, 
because I believe that the coverage language is ambiguous, I 
-9- 
 
 
would construe this ambiguity against the insurer, General 
Casualty, and hold that the policy provides coverage for the 
claims filed in North Carolina to the extent that Virginia 
workers’ compensation law would require General Casualty to 
provide benefits.