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You are here: Home / Arbitration / Court Decisions / Reinsurance Claims / INSURANCE GUARANTY ASSOCIATION MUST PAY WORKERS’ COMPENSATION CLAIMS OF A FORMER, NON-MEMBER GROUP SELF-INSURER

INSURANCE GUARANTY ASSOCIATION MUST PAY WORKERS’ COMPENSATION CLAIMS OF A FORMER, NON-MEMBER GROUP SELF-INSURER

February 2, 2015 by Carlton Fields

The North Carolina Court of Appeals has held that the state’s Insurance Guaranty Association is obligated to pay for workers’ compensation claims made or incurred against CompTrust, a former group self-insurer that issued workers’ compensation insurance policies to certain employer members. CompTrust was never an Association member, but had converted itself into the CAGC Insurance Company, a North Carolina licensed direct insurer, and CAGC joined the Association. Only CAGC survived the merger and members of CompTrust were converted into CAGC policyholders. CAGC had assumed liability for all claims previously held by CompTrust but was liquidated in January 2014. At issue were workers’ compensation claims that occurred when CompTrust was still in business and responsible for the relevant insurance policies. The Association argued that it should not be obligated for those claims because, in part, they did not arise under policies of direct insurance issued by CAGC and were therefore outside the scope of the Association’s statutory obligations.

The appellate court disagreed. All of CompTrust’s debts and obligations were transferred to CAGC “to the same extent as if said debts, liabilities, and duties had been incurred or contracted” by CAGC. The court found no difference between the merger agreement at issue and the assumption reinsurance agreement at issue in a prior North Carolina case whereby Reliance National Insurance assumed a self-insurer’s responsibilities and the Association was then obligated, upon Reliance’s insolvency, to workers’ compensation obligations that originated with the self-insurer. CAGC was a direct insurer placing it within the Association’s statutory obligations and, therefore, when CAGC became insolvent the covered claims became the Association’s responsibility. The appellate court reversed the trial court’s decision and remanded with directions to enter judgment that the Association was estopped from denying its obligations for any pre-merger workers’ compensation claims made or incurred against CompTrust. Goodwin v. CAGC Insurance Co., No. COA14-445 (N.C. Ct. App. Jan. 20, 2015).

This post written by Renee Schimkat.

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