Michigan Court of Appeals; Docket # 340287; Unpublished
Judges O’Connell, Cavanaugh, Servitto per Curiam
Official Michigan Reporter Citation: Not Applicable; Link to Opinion
STATUTORY INDEXING:
Entitlement to PIP Benefits: Arising Out of / Causation Requirement [§3105(1)]
TOPICAL INDEXING:
CASE SUMMARY:
In this unanimous unpublished per curiam opinion, the Court of Appeals upheld the trial court’s grant of summary disposition in favor of Defendant Freemont Insurance Company (“Freemont”) regarding causation between Plaintiff Marion McConckey’s (“McConckey”) injuries and her motor vehicle accident. The Court of Appeals upheld the trial court because McConckey had not presented sufficient medical evidence to create a genuine issue of material fact regarding whether her claims for benefits arose from the injuries she sustain in the accident.
McConckey was involved in an auto accident on June 9, 2014. At the time of the accident McConckey was 79 years old with a history of dementia and Parkinson’s Disease. Immediately after the June 9, 2014 accident, McConckey was taken to Bixby Medical Center Adrian, Michigan. According to the emergency responders, McConckey did not lose consciousness during the ambulance ride and her chief complaint was a “breathing problem.” McConckey was transferred to the University of Michigan Hospital in Ann Arbor (“Michigan”) the same day. At Michigan, the medical staff noted that evaluating McConckey’s mental state was difficult given her dementia; however, the staff indicated that McConckey was not suffering post-concussion symptoms and McConckey’s mental lapses were possibly due to her pre-accident diminished mental state. McConckey’s granddaughter said that McConckey was at “her baseline mentally” at Michigan. The family noted that prior to the accident McConckey was independent in her daily living activities.
On March 23, 2015, Freemont notified McConckey that it would not be providing further PIP benefits. Freemont based this decision on Dr. Buszek’s medical opinion that there was no structural aggravation to McConckey’s brain brought on by the accident. McConckey brought an action for first-party PIP benefits after Freemont denied benefits. In support of her action McConckey’s primary care physician offered a generalized letter, which indicated that automobile accidents can have a deteriorating effect on the brain. McConckey also supplied testimony from family and friends who claimed that McConckey suffered from a deteriorated mental state after the accident. Freemont moved for summary disposition and the trial court granted the motion. McConckey appealed arguing that a genuine issue of material fact existed regarding the causal relationship between the injuries she sustained in the accident and her need for long-term care in a nursing facility after the accident.
The Court found insufficient evidence connecting McConckey’s mental decline to the accident. The Court first explained there are two causation requirements under MCL 500.3105(1) for an individual to receive first party PIP benefits. The first is related to “accidental bodily injury” and the second is related to “arising out of.” The Court reasoned that this case only concerned the first component. Here, McConckey initially only suffered chest, rib, and lung injuries in the accident. Although medical examiners at Michigan noted that diagnosing a brain injury was difficult, there was unrebutted evidence that McConckey never lost consciousness during or after the accident, had no obvious head trauma, and had normal behavior after the accident. Second, while McConckey was showing signs of deteriorated mental status after the accident, it was noted that she was taken off her Parkinson’s medication, her pre and post MRI’s showed no structural aggravation to her brain brought on from the accident, and her mental deterioration was consistent with an individual suffering from dementia. Third, McConckey’s primary care physician had not treated McConckey after the accident and did not state that the accident caused McConckey’s deteriorated mental status. Because the primary care physician did not offer an individualized opinion for McConckey the Court rejected his statement as medical evidence connecting the mental decline to the accident. Fourth, the Court reasoned that statements from family and friends indicating McConckey suffered worsening mental conditions after the accident were insufficient to connect the mental deterioration to the accident.
“The only documented injuries that plaintiff suffered from the car accident were chest, lung, and rib injuries. She did not sustain a head injury. Defendant’s referral physicians even questioned whether the car accident accelerated plaintiff’s mental and physical decline, but the MRI results confirmed that the accident did not impact the structure of plaintiff’s brain. . . .Plaintiff argues that there was an abundance of lay testimony from her relatives and friends which showed that before the accident she was independent and self-sufficient, and that after the accident plaintiff significantly declined. Plaintiff asserts that viewing this evidence in a light most favorable to her, a jury could find a causal nexus between the accident and plaintiff’s need to live in a nursing facility. But plaintiff cannot establish a genuine issue of material fact regarding medical causation by relying on lay testimony from her friends and family . . . . This issue involves medical questions that are “beyond the scope of lay knowledge,” and thus lay testimony is insufficient to prove a causal connection.”
Therefore, the Court upheld the lower court’s order for summary disposition because there was insufficient evidence connecting McConckey’s mental change to the accident.
