Justia Insurance Law Opinion Summaries

The case revolves around a dispute over no-fault personal protection insurance (PIP) benefits. Charles Williamson was injured when he was hit by a car and applied for PIP benefits from the Michigan Automobile Insurance Placement Facility (MAIPF), which operates the Michigan Assigned Claims Plan (MACP). The MAIPF assigned Williamson’s claim to AAA, but AAA refused to pay. After Williamson's death, his daughters, Porsha Williamson and Lateshea Williamson, continued the lawsuit as co-personal representatives of his estate. The Estate claimed benefits for attendant care that was purported to have been provided after Charles Williamson’s death. AAA moved for summary disposition, arguing that the Estate knowingly presented material misrepresentations in support of its claim for no-fault benefits and was therefore barred from recovering all no-fault benefits.The trial court granted AAA’s motion, but the Court of Appeals reversed the decision. The Court of Appeals held that statements made during discovery cannot constitute fraudulent insurance acts under the no-fault act. AAA then applied for leave to appeal in the Michigan Supreme Court.The Michigan Supreme Court, in a unanimous opinion, held that false statements submitted during discovery, after a lawsuit for recovery has been filed, may be statements offered in support of a claim to the MAIPF or the assigned insurer. The court disagreed with the Court of Appeals' ruling that only prelitigation statements can constitute statements in support of a claim under MCL 500.3173a(4). The court concluded that the Estate’s interrogatory answers, which indicated that the Estate sought no-fault benefits for services rendered after Williamson passed away, were in support of a demand for coverage under the MACP based on bodily injury sustained in a motor vehicle accident. The case was reversed and remanded for further proceedings. View "Estate Of Williamson v. AAA Of Michigan" on Justia Law

The case revolves around a dispute over who should pay for the personal injury protection (PIP) benefits of Justin Childers, who was severely injured in a car accident. Initially, Childers' PIP benefits were covered by American Fellowship Mutual Insurance Company, but the company was declared insolvent in 2013. The Michigan Property and Casualty Guaranty Association (MPCGA) then assumed responsibility for Childers' PIP benefits. The MPCGA, after an investigation, concluded that Progressive Marathon Insurance Company was next in line to provide Childers' PIP benefits. However, Progressive denied Childers' claim.The trial court granted summary disposition to Progressive, ruling that while the actions were not time-barred, Progressive was not within statutory priority for Childers' benefits. The Court of Appeals reversed this decision, concluding that the one-year limitations period did not apply because the MPCGA is not generally subject to the no-fault act, and the MPCGA did not bring the action under the no-fault act. Instead, the Court of Appeals reasoned that the MPCGA’s right to proceed against Progressive came from the guaranty act, which allows the MPCGA to claim reimbursement from another insurer in the chain of designated priority insurers.The Michigan Supreme Court, however, disagreed with the Court of Appeals. It held that the one-year limitations period in MCL 500.3145(1) applies where either an insured or the MPCGA brings an action for PIP benefits against a lower priority no-fault insurer after the higher priority insurer becomes insolvent. The court concluded that both the action brought by Childers' conservator and the MPCGA's action were time-barred. The court reversed part of the Court of Appeals' opinion, vacated the remainder, and remanded the case to the trial court for further proceedings. View "Childers v. Progressive Marathon Insurance Company" on Justia Law

This case involves a dispute between Darren Findling, a professional guardian, and Auto-Owners Insurance Company. Findling was appointed as the guardian for two individuals, Mary Ann Malloy and Dana Jenkins, who were incapacitated due to automobile accidents. Findling, along with employees of his law firm, provided various guardianship services to Malloy and Jenkins, and sought reimbursement from Auto-Owners for these services under the no-fault act. Auto-Owners declined to reimburse for the services performed by the employees of Findling’s law firm, arguing that the services were not lawfully rendered.The Oakland County Probate Court granted Findling’s motions for partial summary disposition, ruling in favor of Findling. Auto-Owners appealed, but the Court of Appeals initially denied the appeal. The Supreme Court then remanded the cases to the Court of Appeals for consideration. On remand, the Court of Appeals affirmed in part and reversed in part, holding that a guardian is only required to comply with certain statutory provisions to lawfully delegate guardianship powers, but not duties, to employees.The Supreme Court of Michigan, in a unanimous opinion, held that a professional guardian cannot, without executing a power of attorney complying with certain statutory provisions, lawfully delegate to employees their final decision-making authority over a guardianship “power” that is explicitly listed in the statute or over any guardianship task that alters or impairs the incapacitated individual’s rights, duties, liabilities, or legal relations. However, a professional guardian may lawfully have employees assist in exercising a guardianship power and may have employees perform any other guardianship task on behalf of the professional guardian. The Supreme Court vacated the decisions of the lower courts and remanded the cases for further proceedings. View "In Re Guardianship Of Mary Ann Malloy" on Justia Law

Michael Andary, conservator and guardian of Ellen Andary; Ronald Krueger, guardian of Philip Krueger; and Moriah, Inc., doing business as Eisenhower Center, brought an action against USAA Casualty Insurance Company and Citizens Insurance Company of America, seeking a declaratory judgment that the Michigan Legislature’s 2019 amendments of the no-fault act, MCL 500.3101 et seq., that placed new limitations on in-home family-provided attendant care in MCL 500.3157(10) and the non-Medicare fee schedule of MCL 500.3157(7) could not be applied to limit or change plaintiffs’ rights to benefits under the insurance policies defendants had issued to them before the 2019 amendments. Andary and Krueger, suffered traumatic injuries in automobile accidents before 2019, had been provided uncapped lifetime medical care covered by personal protection insurance (PIP) benefits under insurance policies and the no-fault act in effect at the time of their injuries. Plaintiffs argued that the retroactive application of the 2019 amendments to them was improper and would also violate their constitutional rights under the Contracts Clause of Const 1963, art 1, § 10 and their due-process and equal-protection rights. Additionally, plaintiffs all challenged the prospective application of the 2019 amendments on behalf of future motor vehicle accident victims and medical providers. Defendants moved to dismiss the case, and the trial court granted defendants’ motion. Plaintiffs appealed, and the Court of Appeals affirmed in part, reversed in part, and remanded the case to the circuit court. The Michigan Supreme Court found that the 2019 no-fault amendments of MCL 500.3157 did not impact services and care that were already being provided to Andary and Krueger and that had been reimbursable prior to the amendments. Andary’s and Krueger’s rights to the PIP benefits at issue in this case were both contractual and statutory in nature, and the 2019 no-fault amendments did not retroactively modify their vested contractual rights. Plaintiffs’ constitutional challenges to prospective application of the amended statutes were dismissed. View "Andary v. USAA Casualty Insurance Company" on Justia Law

Adora Wilmore-Moody, individually and as next friend of her minor son, brought an action against Mohammed Zakir and Everest National Insurance Company, alleging that Zakir had negligently rear-ended her vehicle, and sought personal protection insurance benefits from Everest for the injuries she and her son incurred as a result of the collision. Everest did not pay the benefits but instead rescinded plaintiff’s policy on the ground that plaintiff had failed to disclose that she had a teenaged granddaughter living with her when she applied for the insurance policy. Everest then brought a counterclaim seeking declaratory relief and moved for summary judgment of plaintiff’s claim against it under MCR 2.116(C)(10), arguing that it was entitled to rescind plaintiff’s policy because she had made a material misrepresentation in her insurance application. The trial court granted Everest’s motion. After this ruling, Zakir also moved for summary judgment, arguing that plaintiff was barred from recovering third-party noneconomic damages from him under the Michigan no-fault act because once Everett rescinded plaintiff’s insurance policy, she did not have the security required by statute at the time the injury occurred. The trial court granted Zakir summary judgment too. The Court of Appeals affirmed the grant of summary judgment to Everest, reversed as to Zakir, and remanded the case for further proceedings. Zakir appealed. The Michigan Supreme Court affirmed the appellate court: an insurer’s decision to rescind a policy post-accident does not trigger the exclusion in MCL 500.3135(2)(c). "Rescission is an equitable remedy in contract, exercised at the discretion of the insurer, and does not alter the reality that, at the time the injury occurred, the injured motorist held the required security. Rescission by the insurer post-accident is not a defense that can be used by a third-party tortfeasor to avoid liability for noneconomic damages." View "Wilmore-Moody v. Zakir" on Justia Law

Willie Griffin filed suit against Trumbull Insurance Company, the Michigan Assigned Claims Plan (the MACP), Allstate Insurance Company, Esurance Property and Casualty Insurance Company, and an unnamed John Doe insurance company, seeking personal protection insurance (PIP) benefits for injuries plaintiff sustained while riding a motorcycle. In May 2016, Griffin was driving a motorcycle when a large truck merged into his lane. Griffin swerved to avoid the truck. While there was no physical collision, Griffin’s motorcycle went down, it was damaged, and he was badly injured. The responding police officer recorded the truck driver’s name, personal telephone number, and residential address in the crash report; however, the officer did not record the license plate number or VIN of the truck, the insurer of the truck, the owner of the truck, or any other identifying information regarding the truck. Days after the accident, Griffin’s attorney sent a letter to the truck driver using the address in the crash report. Trumbull, Griffin's insurer, made numerous unsuccessful attempts to contact the truck driver before closing its investigation in late December 2016. In December 2016, Griffin submitted a separate PIP benefits claim to the MACP through the Michigan Automobile Insurance Placement Facility (the MAIPF). Griffin also submitted claims to Esurance and Allstate, which were both lower-priority insurers. In April 2017, Griffin then filed this lawsuit seeking payment of his PIP benefits. During discovery, the parties learned that the truck had been owned by Pavex Corporation and insured by Harleysville Insurance. Trumbull moved for summary judgment, arguing that it was not liable to pay PIP benefits because Harleysville was the highest-priority insurer. The MACP also moved for summary judgment (Allstate, Esurance, and the John Doe insurance company were dismissed by stipulation), and those orders were not appealed. The trial court granted the two summary judgment motions, holding that Harleysville was the highest-priority insurer and that Griffin had not exercised reasonable diligence in attempting to timely locate Harleysville. The Michigan Supreme Court reversed in part, finding that Griffin properly filed a claim under the no-fault act against all insurers who were identifiable prior to the expiration of the limitations period and that Trumbull’s delaying a decision on payment or denial of Griffin’s claim until after the limitations period expired did not excuse it from liability to pay PIP benefits. The trial court erred by granting Trumbull’s summary-disposition motion, and the Court of Appeals erred by affirming on the basis that a previously unidentifiable higher-priority insurer became identifiable during litigation well after the one-year notice and limitations period in MCL 500.3145 had expired. View "Griffin v. Trumbull Insurance Co." on Justia Law

Meemic Insurance Company filed a subrogation claim against Angela Jones, seeking to recover from Jones money it had paid to CitiMortgage, Inc., the mortgagee of a residential house owned by Jones and insured by Meemic, after fire damaged the property. In September 2015, Jones was living at the house when it was damaged by a fire. Meemic paid her $2,500 in partial payment of the claim for insurance benefits. During Meemic’s ensuing investigation, Jones admitted that at the time she secured the policy in 2014, she did not reside at the house but, instead, rented it to a third party. Meemic claimed that Jones’s failure to disclose in the initial policy that her home was being rented to others constituted a material misrepresentation. On the basis of the misrepresentation, Meemic rescinded and voided the insurance policy from its inception and returned Jones’s policy payments. After rescinding the policy, Meemic paid $53,356.49 to CitiMortgage under the lienholder contract of the policy. Jones filed an action against Meemic, claiming breach of contract and sought to recover under the insurance policy. Meemic moved for summary judgment, arguing that it had properly rescinded the policy given Jones’s misrepresentation in the initial policy. The motion was ultimately granted, and Jones' complaint was dismissed with prejudice. In 2018, Meemic filed the underlying action against Jones seeking to recover the $2,500 advance payment made to Jones and the $53,356.49 it had paid to CitiMortgage under the lienholder contract. Jones moved for summary judgment, arguing that she was relieved from any obligations under the insurance policy because Meemic had rescinded the insurance policy; Meemic opposed the motion and filed a countermotion for summary judgment. The Court of Appeal reversed the trial court's grant of summary judgment in favor of Meemic, and Meemic appealed. The Michigan Supreme Court held: an insurer who rescinds a homeowner’s insurance policy that contains a mortgage clause may seek subrogation from the insured under its rescinded policy for the amount paid to the mortgagee under the lienholder contract. The Court of Appeals judgment was reversed because it erred by concluding that Meemic’s rescission of the risk contract precluded it from denying payment to Jones and then asserting rights under the subrogation provision of the lienholder contract. View "Meemic Insurance Co. v. Jones" on Justia Law

Mecosta County Medical Center, d/b/a Spectrum Health Big Rapids (and others) sued Metropolitan Group Property and Casualty Insurance Company and State Farm Mutual Automobile Insurance Company at the Kent Circuit Court, seeking personal protection insurance (PIP) benefits related to a single-car crash involving Jacob Myers. Myers co-owned the vehicle involved in the crash with his girlfriend; his girlfriend’s grandmother had purchased a no-fault insurance policy on the vehicle through Metropolitan Group. Myers assigned plaintiffs his right to collect PIP benefits in the amount of his treatment bills. After the assignment, Myers sued Metropolitan Group and State Farm at the Wayne Circuit Court for PIP benefits related to other costs arising from the crash. Plaintiffs sued defendants at the Kent Court to recover on the assigned claim. Defendants moved for summary judgment against Myers at the Wayne Court. State Farm argued that because Myers did not live with the State Farm policyholders he was not covered by their policy. Metropolitan Group asserted that Myers was not entitled to coverage because he did not personally maintain coverage on the vehicle. The Wayne Court granted both motions and dismissed Myers’s PIP claim with prejudice. Myers did not appeal. While defendants’ motions were pending with the Wayne Court, Metropolitan Group also moved for summary judgment at the Kent Court on the same basis as its motion in the Wayne Court. However, the Wayne Court granted defendants’ motions before the Kent Court considered Metropolitan Group’s motion. After the Wayne Court granted summary judgment for defendants, defendants filed additional motions for summary judgment at the Kent Court, arguing plaintiffs’ claims were barred under the doctrines of res judicata and collateral estoppel because the Wayne Court had concluded that Myers was ineligible for PIP benefits. The Kent Court granted the motion, holding that plaintiffs’ claims were barred by res judicata and collateral estoppel. Plaintiffs appealed, and the Court of Appeals reversed in a split, unpublished opinion. The appellate majority held that an assignee was not bound by a judgment against an assignor in an action commenced after the assignment occurred. The Michigan Supreme Court affirmed, finding that plaintiffs were not in privity with Myers with respect to the judgment entered subsequently to the assignment, and therefore, plaintiffs could not be bound by that judgment under the doctrines of res judicata and collateral estoppel. View "Mecosta County Medical Center v. Metropolitan Group Property, et al." on Justia Law

Ingham, Jackson, and Calhoun County, Michigan (collectively, the Counties) filed an action alleging that they had a right to receive a decade’s worth of surplus contributions (surplus equity) made to the Michigan County Road Commission Self-Insurance Pool (the Pool). The Counties believed they were the successors in interest to their dissolved road commissions and, as such, were entitled to the surplus equity that the commissions might have received had they not been dissolved and withdrawn from the Pool. Jackson County made one other argument: because its road commission never formally withdrew from the Pool, the county said it had a right to receive surplus equity on the same terms as any current member. The Pool disagreed, contending the Counties had no right to surplus equity because the documents governing the Pool’s operations and its contracts with its various members provided the Pool with discretion in distributing surplus equity. This included, the Pool contended, the power to exclude former members should a distribution be made. The Court of Appeals sided with the Counties, holding that the Counties were the successors in interest to their dissolved road commissions and, as a matter of public policy, the Counties had a right to receive surplus equity for fiscal years in which their road commissions were members of the Pool. The Court of Appeals also determined that the dissolution of the Jackson County Road Commission did not disqualify Jackson County from membership in the Pool, and therefore, the county could receive surplus equity regardless of any public-policy considerations. The Michigan Supreme Court reversed. The Court agreed with the Pool that the Counties did not have a contractual right to receive surplus equity and that such an arrangement was not contrary to public policy. For Jackson County, the Court held that the dissolution of its county road commission did not transfer membership in the Pool from the road commission to the county itself, so the Pool could exclude Jackson County from post-dissolution distributions. View "County Of Ingham v. Michigan County Road Commission Self-Insurance Pool" on Justia Law

Plaintiff Esurance Property & Casualty Insurance Company (Esurance) paid personal injury protection (PIP) benefits to claimant, Roshaun Edwards (Edwards), pursuant to a no-fault automobile insurance policy, issued to another person, that was later declared void ab initio. Thereafter, Esurance filed this suit against defendants, the Michigan Assigned Claims Plan (MACP) and the Michigan Automobile Insurance Placement Facility (MAIPF), seeking reimbursement under a theory of equitable subrogation for the PIP benefits that Esurance had paid to Edwards under Michigan’s no-fault act before the policy was rescinded. The Michigan Supreme Court held that an insurer who erroneously pays PIP benefits could be reimbursed under a theory of equitable subrogation when the insurer was not in the order of priority and the payments were made pursuant to its arguable duty to pay to protect its own interests. On the facts alleged in this case, Esurance could stand in Edwards’s shoes and pursue a claim for equitable subrogation because it was not in the order of priority and also was not a “mere volunteer” under Michigan law when it paid Edwards’s PIP benefits. Accordingly, the Supreme Court reversed the decision of the Court of Appeals and remanded this case to that court for further proceedings. View "Esurance Prop. & Casualty Ins. Co. v. Michigan Assigned Claims Plan" on Justia Law