Allstate Insurance Co v. State Farm Mutual Automobile Insurance Co
Allstate Insurance Co v. State Farm Mutual Automobile Insurance Co
Opinion
Markey, J
*546 Plaintiff, Allstate Insurance Company, an assigned claims insurer, appeals by right the trial court's order granting defendant State Farm Mutual Automobile Insurance Company (defendant), the insurer of the at-fault driver, Lorenzo Causey, summary disposition under MCR 2.116(C)(7) (statute of limitations) and (10) (no genuine issue of a material fact). 1 Because plaintiff's reimbursement action was timely under MCL 500.3175(3) and because plaintiff was entitled to reimbursement from defendant for all the no-fault benefits, we reverse and remand.
I. SUMMARY OF FACTS AND PROCEEDINGS
On October 31, 2012, Causey was driving a motor vehicle when he struck Amanda Pettaway as she was crossing the road at an intersection, causing her injuries. Pettaway applied for personal protection insurance (PIP) benefits through the Michigan Assigned Claims *547 Plan. In a letter dated April 10, 2013, the Michigan Assigned Claims Plan informed Pettaway's attorney that Pettaway's claim had been assigned to plaintiff.
Plaintiff retained Data Surveys, Inc. (Data Surveys) to investigate Pettaway's claim. Data Surveys' report dated May 10, 2013, confirmed that Causey was the owner of the vehicle involved in the accident but indicated that the company had not been able to directly contact him. The Data Surveys report stated that Causey "refused to come to the front door and was conveying information through his daughter to the investigator," specifically, "that the involved vehicle reportedly was his only automobile" and that the vehicle was not insured.
On November 20, 2014, plaintiff brought suit against Causey, seeking to recover under MCL 500.3177(1) 2 for all the no-fault benefits it had paid to or on behalf of Pettaway. On February 25, 2015, Causey's counsel filed an appearance and plaintiff *498 learned that Causey was, in fact, insured by State Farm on the date of the accident. On May 27, 2015, an order was entered reflecting the parties' stipulation to plaintiff's filing an amended complaint identifying State Farm as a party defendant, which was filed with the stipulation. Plaintiff asserted in the amended complaint that it was entitled under MCL 500.3175 and MCL 500.3177 to recover $40,974.42 from defendant as the amount of no-fault benefits it had paid to or on Pettaway's behalf.
Defendant asserted that plaintiff's claim was untimely and barred by MCL 500.3175(3). This statute, *548 which pertains to insurers' assigned claims under the Michigan Assigned Claims Plan, states, in part, that "[a]n action to enforce rights to indemnity or reimbursement against a third party shall not be commenced after the later of 2 years after the assignment of the claim to the insurer or 1 year after the date of the last payment to the claimant." MCL 500.3175(3).
Causey also moved for summary disposition under MCR 2.116(C)(10) on the basis that plaintiff could not recover benefits from him because it was undisputed that his vehicle was insured by defendant on the date of the accident and, therefore, he was not an "uninsured" motorist under MCL 500.3177. Plaintiff opposed Causey's motion, asserting that Causey was a necessary party to the action because Causey "fraudulently concealed the identity of his insurer" and that the tolling provisions of MCL 600.5855 should be applied to its claim. On September 14, 2015, after hearing oral argument, the trial court granted Causey's motion and dismissed Causey from the case without prejudice.
On November 18, 2015, defendant moved for summary disposition under MCR 2.116(C)(7) and (10) on the ground that the amended complaint did not comply with MCL 500.3175(3) because it was filed more than two years after the assignment of Pettaway's claim and had not brought within "1 year after the date of the last payment to the claimant." Defendant argued that the only payments plaintiff made relating to Pettaway's claim within one year of the amended complaint were made on July 3, 2014 ($814.92) and August 11, 2014 ($2037.30) to Van Dyke Spinal Rehabilitation. Defendant further asserted that it had "issued payments" in those amounts to plaintiff's attorneys and the MACP. Thus, defendant argued, no *549 controversy existed because defendant had already reimbursed plaintiff for the payments plaintiff had made within the year before filing the amended complaint.
In response to defendant's motion, plaintiff asserted that it, rather than defendant, was entitled to summary disposition under MCR 2.116(I)(2). Plaintiff maintained that the limitations period was tolled because Causey fraudulently concealed that State Farm provided insurance coverage for Causey and his vehicle. Plaintiff also argued that the payments it had made to Pettaway's medical providers within one year of filing its amended complaint satisfied the requirements of MCL 500.3175(3). Plaintiff asserted that defendant's position-that a one-year-back rule applies to an assigned insurer's right to reimbursement-was without merit.
On January 8, 2016, the trial court heard oral argument on defendant's motion. The first part of the hearing focused on whether the statute of limitations could be tolled because of Causey's purportedly "fraudulent" behavior. The parties argued over whether plaintiff could prove its allegations because plaintiff had not attached any affidavits to its motion. The trial court indicated that it "begrudgingly" had to grant defendant's motion, apparently on the basis of plaintiff's failure to present evidence that would be admissible to prove *499 fraud. The parties then argued the limitations period found in MCL 500.3175(3). Plaintiff argued that because defendant had reimbursed plaintiff for the payments to VanDyke Spinal Rehabilitation made in July and August 2014 that defendant also was obligated to reimburse plaintiff for all the payments that plaintiff had made on Pettaway's PIP claim. The trial court disagreed with this argument and granted *550 defendant's motion for summary disposition "for the reasons stated on the record." An order to that effect was entered on January 8, 2016.
Plaintiff moved the trial court to reconsider, arguing that under
Farm Bureau Ins. Co. v. Chukwueke
(
Chukwueke I
), unpublished per curiam opinion of the Court of Appeals, issued January 17, 2013 (Docket No. 306827),
Plaintiff now appeals by right.
II. ANALYSIS
A. STANDARD OF REVIEW / PRINCIPLES OF LAW
This Court reviews de novo a ruling on a motion for summary disposition.
Nuculovic v. Hill
,
MCR 2.116(C)(7)"permits summary disposition where the claim is barred by an applicable statute of limitations."
Nuculovic
, 287 Mich.App. at 61,
"If it appears to the court that the opposing party, rather than the moving party, is entitled to judgment, the court may render judgment in favor of the opposing party." MCR 2.116(I)(2). "The trial court appropriately grants summary disposition to the opposing party under MCR 2.116(I)(2) when it appears to the court that the opposing party, rather than the moving party, is entitled to judgment as a matter of law."
Rossow v. Brentwood Farms Dev., Inc.
,
"The primary goal of statutory interpretation is to give effect to the intent of the Legislature."
Atchison v. Atchison
,
B. APPLYING MCL 500.3175(3)
We conclude that the trial court erred by granting defendant summary disposition and by denying plaintiff summary disposition. Plaintiff's reimbursement action was timely under MCL 500.3175(3), and plaintiff was entitled to reimbursement from defendant for all the no-fault benefits it paid on Pettaway's behalf.
The purpose of the no-fault act, MCL 500.3101
et seq.
, "is to ensure the compensation of persons injured in automobile accidents."
Hill v. Aetna Life & Cas. Co.
,
In this case, neither Pettaway nor any relative domiciled in her household was a named insured in a no-fault insurance policy. MCL 500.3114(1). So defendant, as the insurer of the vehicle involved in the motor vehicle-pedestrian accident, was in the highest order of
*553
priority to pay Pettaway's claim for PIP benefits under MCL 500.3115(1). But because Pettaway did not know that Causey had no-fault insurance, she sought PIP benefits through the Michigan Assigned Claims Plan. "If no insurance is available, a person may obtain benefits through the Assigned Claims Plan, which serves as the insurer of last priority."
Titan Ins. Co. v. American Country Ins. Co.
,
The parties also rely on MCL 500.3172(1) as the source of plaintiff's right to reimbursement. That subsection also provided for Pettaway's initial claim for PIP benefits from the Michigan Assigned Claims Plan. MCL 500.3172(1) provides:
A person entitled to claim because of accidental bodily injury arising out of the ownership, operation, maintenance, or use of a motor vehicle as a motor *501 vehicle in this state may obtain personal protection insurance benefits through the assigned claims plan if no personal protection insurance is applicable to the injury, no personal protection insurance applicable to the injury can be identified, the personal protection insurance applicable to the injury cannot be ascertained because of a dispute between 2 or more automobile insurers concerning their obligation to provide coverage or the equitable distribution of the loss, *554 or the only identifiable personal protection insurance applicable to the injury is, because of financial inability of 1 or more insurers to fulfill their obligations, inadequate to provide benefits up to the maximum prescribed. In that case, unpaid benefits due or coming due may be collected under the assigned claims plan and the insurer to which the claim is assigned is entitled to reimbursement from the defaulting insurers to the extent of their financial responsibility. [Emphasis added.]
In
Allen v. Farm Bureau Ins. Co.
,
An assigned claims insurer's
general
right to reimbursement is found in MCL 500.3175, which provides "recourse" "to an assigned-claim insurer that later discovers a higher priority insurer."
Spencer v. Citizens Ins. Co.
,
*555
Thus, an assigned claims insurer "has both the authority and the duty to enforce any available rights to indemnity or reimbursement that could have been pursued by claimants against third parties."
Auto-Owners Ins. Co. v. Mich. Mut. Ins. Co.
,
In this case, the dispute centers on the limitations period found in MCL 500.3175(3), which provides that "[a]n action to enforce rights to indemnity or reimbursement against a third party shall not be commenced after the later of 2 years after the assignment of the claim to the insurer or 1 year after the date of the last payment to the claimant." Plaintiff does not dispute that its amended complaint identifying State Farm as a party defendant was filed more than two years after it was assigned Pettaway's claim. Hence, plaintiff's reimbursement action must have been commenced within "1 year after the date of the last payment to the claimant" to be timely under MCL 500.3175(3).
1. CLAIMANT
"No provision of the no-fault act expressly defines 'claimant.' "
*502
Covenant Med. Ctr.
,
Personal protection insurance benefits are payable to or for the benefit of an injured person or, in case of his death, to or for the benefit of his dependents. Payment by an insurer in good faith of personal protection insurance benefits, to or for the benefit of a person who it believes is entitled to the benefits, discharges the insurer's liability to the extent of the payments unless the insurer has been notified in writing of the claim of some other person. [ MCL 500.3112.]
Of course, our Supreme Court's recent decision in
Covenant Med. Ctr.
,
Pertinent to this case, the plaintiff in
Covenant Med. Ctr.
also relied on MCL 500.3148(1), which provides that "[a]n attorney is entitled to a reasonable fee for advising and representing a claimant in an action for personal or property protection insurance benefits which are overdue," and MCL 500.3145, which provides the limitations period for the recovery of PIP benefits "payable under this chapter" and specifically refers to "the claimant."
Covenant Med. Ctr.
,
Plaintiff's reliance on the references to "claimant" rather than "injured person" in MCL 500.3145(1) and MCL 500.3148 is helpful to plaintiff's argument only if healthcare providers are proper claimants under the no-fault act. The provisions cited by plaintiff do not establish that providers possess a claim *503 under the act. Because MCL 500.3145(1) and MCL 500.3148 do not create rights to PIP benefits that do not otherwise exist, plaintiff's reliance on these provisions is misplaced. [ Id . ]
The Court also noted that "[t]he relevant dictionary definitions of 'claim' include 'a demand for something due or believed to be due' and 'a right to something.' "
Covenant Med. Ctr.
,
Important to this case, our Supreme Court in
Covenant Med. Ctr.
was not interpreting MCL 500.3175(3) or directly addressing the issue of whether "claimant," as used under the no-fault act, includes medical providers. But the Court's implicit ruling that a healthcare provider does not have a right to claim benefits from a no-fault insurer apparently precludes a healthcare provider from being a "claimant" under the no-fault act. Although a healthcare provider may request and receive payment from a no-fault insurer for services furnished to an injured person, MCL 500.3112 ;
Covenant Med. Ctr.
,
We note that this interpretation of "claimant" if applied to MCL 500.3175(3) does not lead to the term "claimant" being interpreted synonymously with "the injured person," as the panel in Chukwueke I feared, because the no-fault act specifically provides that a claimant may not always be an injured person. For example, MCL 500.3105(4) provides, in part, that "[b]odily injury is accidental as to a person claiming personal protection insurance benefits unless suffered intentionally by the injured person or caused intentionally by the claimant." So that subsection contemplates that the claimant could intentionally cause the injured person bodily injury.
Another obvious example of a claimant being different from the injured person is when the injured person dies as a result of the accident. See, e.g., *559 MCL 500.3108(1) (providing that PIP "benefits are payable for a survivor's loss which consists of a loss, after the date on which the deceased died, of contributions of tangible things of economic value"); MCL 500.3112 (providing that PIP "benefits are payable to or for the benefit of an injured person or, in case of his death, to or for the benefit of his dependents"). When the injured person dies, the person claiming no-fault benefits will necessarily be a different person from the one who was injured.
In this case, the claimant is Pettaway because she had a right to PIP benefits from plaintiff. MCL 500.3172(1) ; MCL 500.3175(1). The next issue pertains to identifying "the date of the last payment to the claimant." MCL 500.3175(3). The record indicates that plaintiff made payments to Pettaway's healthcare or service providers, as permitted by MCL 500.3112. If read in isolation, one could interpret MCL 500.3175(3) as requiring an assigned claims insurer to bring a reimbursement action within one year of the last payment made directly to the claimant. But a word or phrase in a statute must not be read in a
*504
vacuum; it must be harmonized with the whole statute.
G.C. Timmis & Co. v. Guardian Alarm Co.
,
Our conclusion that a no-fault insurer's payment to a healthcare provider who provides necessary services to the injured person constitutes a payment "to the claimant" for purposes of MCL 500.3175(3) is grounded on our reading of this provision in harmony with the no-fault act as a whole,
G.C. Timmis & Co.
,
2. SCOPE OF RELIEF
Having determined that plaintiff's action was timely, we must consider the question of what damages it may recover. Plaintiff argues that this Court should determine that plaintiff is entitled to reimbursement of all no-fault benefits paid to or on behalf of Pettaway if any single benefit is paid within one year of filing the reimbursement action. Defendant argues that when a plaintiff commences a reimbursement action more than two years after the assignment of the claim, as in this case, MCL 500.3172 should be read together with MCL 500.3175(3) to limit reimbursement to payments made within one year before the filing of the complaint.
Defendant does not assert that the one-year-back rule of MCL 500.3145 applies to the present reimbursement action, but consideration of that provision sheds light *505 on the instant matter. MCL 500.3145(1) provides, in pertinent part, as follows:
An action for recovery of personal protection insurance benefits payable under this chapter for accidental bodily injury may not be commenced later than 1 year after the date of the accident causing the injury unless written notice of injury as provided herein has been given to the insurer within 1 year after the accident or unless the insurer has previously made a payment of personal protection insurance benefits for the injury. If the notice has been given or a payment has been made, the action may be commenced at any time within 1 year after the most recent allowable expense, work loss or survivor's loss has been incurred. However, the claimant may not recover *562 benefits for any portion of the loss incurred more than 1 year before the date on which the action was commenced. [Emphasis added.]
Under the emphasized language, "even where the period of limitations is tolled under the notice of injury or payment of benefits exceptions, an insured can only recover benefits for losses incurred within one year preceding the commencement of the action."
Hudick v. Hastings Mut. Ins. Co.
,
Unlike MCL 500.3145(1), MCL 500.3175(3) does not limit the damages that may be recovered in a timely action. Instead, MCL 500.3175(3) is a statute of limitations, not a statute that limits the period during which payments may be reimbursed. If the Legislature had intended to preclude assigned claims insurers from recovering reimbursement of no-fault benefits that were paid more than a year before the filing of the action, MCL 500.3145(1) shows that it clearly knew how to do so. See
People v. Houston
,
Furthermore, MCL 500.3172 highlights that higher priority insurers are to fully reimburse no-fault benefits wrongly paid through the Michigan Assigned Claims Plan. When a dispute over coverage for PIP benefits arises between two insurers, " MCL 500.3172(3) establishes a procedure by which a claimant is provided personal protection insurance benefits while the insurers resolve their dispute."
Spectrum Health v. Grahl
,
To be clear, MCL 500.3172(3) does not apply to this case because plaintiff's assignment did not arise out of a coverage dispute between insurers. But the section is illustrative of how the statute considers that the no-fault insurer with the highest priority provide reimbursement for "all benefits and costs paid or incurred by the Michigan automobile insurance placement facility and all benefits and costs paid or incurred by insurers determined not to be obligated to provide applicable personal protection insurance benefits," which would include assigned insurers.
As a statutory scheme, the no-fault act contemplates that the higher priority insurer will fully reimburse the Michigan Automobile Insurance Placement Facility and the assigned claims insurer; consequently, there is no restriction on the recoverable damages in a timely filed reimbursement action that can be read into MCL 500.3175(3). Thus, we hold that plaintiff is entitled to recover all no-fault benefits paid on Pettaway's behalf for which defendant was, in fact, responsible as the higher priority insurer.
*564
Defendant argues that plaintiff's reading of the statute would frustrate the primary purposes of statutes of limitations of "(1) encouraging the plaintiffs to diligently pursue claims and (2) protecting the defendants from having to defend against stale and fraudulent claims."
Wright v. Rinaldo
,
In sum, MCL 500.3175(3) only pertains to when a reimbursement action must be brought. In contrast to MCL 500.3145(1), it does not preclude reimbursement for benefits paid more than a year before the filing of the action. Although MCL 500.3172(3)(f) is not directly applicable to the matter before us, no provision of the no-fault act suggests that an assigned claims insurer should not be fully reimbursed. Thus, reading the no-fault act as a whole,
City of Rockford
,
Here, plaintiff's claim was timely because it was brought within a year of its last payment "to the *565 claimant" for purposes of MCL 500.3175(3). Accordingly, plaintiff was entitled to recover from defendant all the no-fault benefits it paid to Pettaway or on her behalf. Consequently, we hold that the trial court erred by granting defendant summary disposition; it instead should have granted plaintiff summary disposition under MCR 2.116(I)(2).
Given our holding regarding MCL 500.3175(3), we decline to address the parties' arguments concerning tolling. "An issue is moot if this court cannot fashion a remedy."
Silich v. Rongers
,
We reverse and remand this matter to the trial court for further proceedings consistent with this opinion. Plaintiff, as the prevailing party, may tax its cost under MCR 7.219. We do not retain jurisdiction.
Beckering, P.J., and Riordan, J., concurred with Markey, J.
Because the parties do not appeal the trial court's previous grant of summary disposition to Lorenzo Causey, this opinion will refer to State Farm as "defendant."
"MCL 500.3177(1) allows an insurer paying benefits in a case involving an uninsured vehicle to seek reimbursement from the owner of that vehicle[.]"
Cooper v. Jenkins
,
MCL 500.3109(2) defines "injured person" as "a natural person suffering accidental bodily injury."
Case-law data current through December 31, 2025. Source: CourtListener bulk data.