Justia Insurance Law Opinion Summaries

A commercial truck driver was injured in an accident while operating a tractor-trailer in Missouri. The tractor was registered in Michigan and titled to a limited liability company (LLC) solely owned by the plaintiff, while the trailer was owned by a different LLC. Under a lease agreement, the plaintiff’s LLC leased the tractor to the other LLC, and the plaintiff exclusively operated the tractor. Insurance coverage for the tractor was provided by a policy that excluded personal protection insurance (PIP) when the vehicle was used to transport cargo, and the other LLC’s insurance did not cover PIP for the tractor. The plaintiff, who lived with his parents in Michigan, was not a named insured on his father’s auto policy, nor was the tractor listed as a covered vehicle.After the accident, the plaintiff sued several insurers, arguing that one of them should provide PIP benefits under Michigan’s no-fault act. The Wayne Circuit Court denied summary disposition to one insurer and dismissed others from the case. On appeal, the Michigan Court of Appeals affirmed, finding insufficient evidence to classify the plaintiff as the tractor’s owner or registrant. It ruled that the plaintiff’s claim for PIP benefits was not barred and that his father’s insurer was the highest priority insurer.The Michigan Supreme Court, in reviewing the case, held that the plaintiff was an “owner” of the tractor under MCL 500.3101(3)(l)(i) because he had the right to use the vehicle in a manner consistent with ownership for more than 30 days. The Court found that his exclusive, regular use and control of the tractor, as the sole member and agent of the LLC, satisfied the statutory definition of ownership. Because he failed to maintain the required insurance, the plaintiff was excluded from recovering PIP benefits under MCL 500.3113. The Supreme Court reversed the Court of Appeals and remanded the case to the trial court. View "Abdulla v. Progressive Southeastern Insurance Company" on Justia Law

The plaintiff purchased an auto insurance policy covering two vehicles, providing information about her address, where the vehicles were typically garaged, and who resided with her. After being injured as a passenger in an accident involving an unidentified driver, the plaintiff sought personal protection insurance benefits from her insurer. The insurer investigated and discovered that the plaintiff had not accurately disclosed the garaging location of the vehicles and the presence of other resident-relatives in her household. These misstatements would have resulted in a significantly higher insurance premium had they been truthfully reported. As a result, the insurer rescinded the policy from its inception and refunded all premium payments to the plaintiff.The plaintiff then filed suit in the Washtenaw Circuit Court, arguing that the insurer had unlawfully denied her benefits and breached the contract. The insurer moved for summary disposition, asserting the policy was void due to material misrepresentations. The trial court denied this motion and instead ordered reformation of the policy to reflect the correct address and an increased premium, requiring the plaintiff to repay the difference. The insurer appealed. The Michigan Court of Appeals reversed the trial court’s order, finding that the plaintiff’s misrepresentations were material and that the equities favored rescission, not reformation. The plaintiff’s motion for reconsideration was granted as to clarifying the applicable standard of review but the appellate court again ruled for the insurer.Upon further appeal, the Michigan Supreme Court affirmed the Court of Appeals. It clarified that appellate courts should review the trial court's grant or denial of rescission for abuse of discretion, not de novo, after first ensuring there is no genuine issue of material fact. The Court held that rescission was the proper remedy given the plaintiff’s material misrepresentations and the absence of any wrongdoing by the insurer, and that the trial court had abused its discretion in ordering reformation. View "Sherman v. Progressive Michigan Insurance Company" on Justia Law

The case concerns an individual who was injured in an automobile accident while driving a car borrowed from a friend without seeking or obtaining permission. The driver did not have a valid license or insurance at the time. After the accident, she applied for personal protection insurance (PIP) benefits through the Michigan Assigned Claims Plan, and her claim was assigned to an insurer, which denied coverage. The insurer argued that her claim was barred under MCL 500.3113(a) because the vehicle was allegedly taken unlawfully and she did not have a reasonable belief that she had permission to use it.The Wayne Circuit Court denied the insurer’s motion for summary disposition and denied reconsideration. On appeal, the Michigan Court of Appeals reversed, concluding that the driver was not entitled to PIP benefits because her lack of a valid driver’s license meant she was unlawfully operating the vehicle at the time of the accident. The appellate court found that, since operating without a license is a criminal offense, this constituted an unlawful taking under the relevant statute.The Supreme Court of Michigan reviewed the decision and held that the appellate court misinterpreted MCL 500.3113(a). The Supreme Court clarified that the statute bars PIP benefits only if the vehicle was “taken unlawfully,” which is distinct from being “operated unlawfully.” The focus should be on how possession of the vehicle was gained, not on unlawful operation, such as driving without a license. The Supreme Court reversed the appellate court’s ruling and remanded the case for further proceedings to consider whether the driver’s actions constituted an unlawful taking of the vehicle, as opposed to unlawful operation. View "Swoope v. Citizens Insurance Co Of The Midwest" on Justia Law

Jose Cruz-Muniz and Sandra Cruz were injured in a car accident in 2018 and received treatment from C-Spine Orthopedics, PLLC. They assigned their rights to seek personal protection insurance (PIP) benefits from Progressive Michigan Insurance Company to C-Spine. C-Spine then assigned its accounts receivable, including the claims for unpaid benefits, to several factoring companies. Progressive argued that C-Spine lacked standing to seek payment because it had assigned its rights to the factoring companies. C-Spine countered with signed counter-assignments from the factoring companies, purportedly restoring its right to bring suits. The trial court initially denied Progressive's motion but later granted it, concluding that C-Spine lacked standing when the complaints were filed.In a separate case, Parie Wallace was injured in a bus accident and received treatment from several providers, including C-Spine. Wallace assigned her rights to seek PIP benefits to these providers. She later filed a lawsuit against Suburban Mobility Authority for Regional Transportation (SMART) seeking payment of PIP benefits. SMART argued that Wallace could not bring the action because she had assigned her rights to the providers. The trial court allowed Wallace to obtain revocations of the assignments, which she did, and then denied SMART's motion for summary disposition. The Court of Appeals reversed, holding that Wallace was not the real party in interest when she filed her complaint and that her claims were barred by the one-year-back rule.The Michigan Supreme Court held that both C-Spine and Wallace had standing to file their lawsuits but were not the real parties in interest at the time they filed suit because they had assigned their claims. The Court ruled that defects in real party in interest status could be cured after filing a lawsuit. In C-Spine's case, the Court of Appeals' judgment was affirmed on alternate grounds, and the case was remanded to the trial court for further proceedings. In Wallace's case, the Court of Appeals' judgment was affirmed in part, reversed in part, and vacated in part, and the case was remanded for the trial court to consider whether equitable rescission was warranted and whether the real party in interest defect could be cured. View "C-Spine Orthopedics PLLC v. Progressive Michigan Insurance Company" on Justia Law

C-Spine Orthopedics, PLLC, filed two actions in the Macomb Circuit Court against Progressive Michigan Insurance Company to recover personal protection insurance (PIP) benefits for care provided to Jose Cruz-Muniz and Sandra Cruz, who were injured in a 2018 car accident. Jose and Sandra assigned their rights to seek PIP benefits to C-Spine, which then assigned its accounts receivable, including these claims, to factoring companies. Progressive moved for summary disposition, arguing C-Spine lacked standing as it had assigned its rights. The trial court initially denied but later granted the motion, concluding C-Spine lacked standing when the complaints were filed. The Court of Appeals reversed, holding C-Spine retained its claims for PIP benefits under MCL 500.3112.Parie Wallace filed an action in the Wayne Circuit Court against Suburban Mobility Authority for Regional Transportation (SMART) seeking PIP benefits after being injured in a bus accident. Wallace assigned her rights to PIP benefits to her medical providers. SMART moved for summary disposition, arguing Wallace could not bring the action due to the assignments. The trial court allowed Wallace to obtain revocations of the assignments, which she did, and then denied SMART’s motion. The Court of Appeals reversed, holding Wallace was not the real party in interest when she filed her complaint and that her claims were barred by the one-year-back rule.The Michigan Supreme Court held that both C-Spine and Wallace had standing to file their lawsuits but were not real parties in interest at the time of filing due to their assignments. The Court ruled that defects in real party in interest status could be cured after filing. In C-Spine’s case, the Court of Appeals’ judgment was affirmed on alternate grounds, and the case was remanded to the trial court to consider whether C-Spine could cure the defect. In Wallace’s case, the Court of Appeals’ judgment was affirmed in part, reversed in part, and vacated in part, and the case was remanded for the trial court to consider whether equitable rescission was warranted and whether the real party in interest defect could be cured. View "Wallace v. Smart" on Justia Law

Darnell Hairston was seriously injured while operating machinery at Zeeland Farm Soya, Inc. He sued Zeeland Farm Services, Inc. (ZFS) and an employee, later adding Specialty Industries, Inc. as a defendant for negligence and products liability. ZFS settled, but the case against Specialty Industries proceeded to trial, resulting in a jury awarding Hairston over $13 million. Specialty Industries had insurance policies with Burlington Insurance Company and Evanston Insurance Company, which paid their policy limits, leaving a significant portion of the judgment unpaid.The Ottawa Circuit Court denied Hairston and Specialty Industries' motion for supplemental proceedings to pursue a bad-faith refusal to settle claim against the insurers, suggesting they file a separate lawsuit. Hairston then served writs of garnishment on the insurers, which the trial court quashed, stating there was no judgment of bad faith. The trial court also imposed sanctions on Hairston for filing the writs.The Michigan Court of Appeals reversed the trial court's decision to quash the writs, relying on the precedent set in Rutter v King, which allowed bad-faith refusal to settle claims to be litigated through garnishment. However, the Court of Appeals affirmed the sanctions against Hairston.The Michigan Supreme Court reviewed the case and held that unresolved claims of bad-faith refusal to settle are not subject to garnishment under MCR 3.101(G)(1) because they are not sufficiently liquidated. The Court found that the Court of Appeals erred in relying on Rutter, which was decided before the current court rules were adopted. The Supreme Court reversed the Court of Appeals' decision and remanded the case to the trial court for further proceedings consistent with its opinion. View "Hairston v. Lku" on Justia Law

Jeremy Woods was injured in a car accident in 2017 and received medical care from Spine Specialists of Michigan PC. Woods assigned his right to payment of personal protection insurance (PIP) benefits to Spine Specialists, but MemberSelect Insurance Company refused to pay. Spine Specialists sued MemberSelect for payment. MemberSelect argued that the claims were barred by the one-year-back rule, which requires claims to be filed within one year of the medical services being rendered. The trial court granted MemberSelect's motion for summary disposition for services rendered before June 11, 2019, but denied it for services rendered between June 11, 2019, and August 12, 2020.The Court of Appeals affirmed the trial court's decision, reasoning that the tolling provision added to the one-year-back rule in 2019 did not apply to claims that accrued before the amendment's effective date. The court held that PIP benefits accrue when the medical services are rendered, not when payment is denied.The Michigan Supreme Court reviewed the case and held that the tolling provision added to MCL 500.3145 in 2019 does not apply retroactively to causes of action that began to accrue before the amendment became effective on June 11, 2019. The court affirmed the judgment of the Court of Appeals, concluding that the claims for services rendered between June 11, 2019, and August 12, 2020, were barred by the one-year-back rule. The court emphasized that the Legislature did not indicate an intent for the tolling provision to apply retroactively and that applying it retroactively would impose new obligations on insurers for past transactions. View "Spine Specialists Of Michigan PC v. Memberselect Insurance Company" on Justia Law

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