Michigan Court of Appeals; Docket # 344773; Unpublished
Judges Gadola, Stephens, and Shapiro; Per curiam
Official Michigan Reporter Citation: Not Applicable; Link to Opinion
STATUTORY INDEXING:
Not Applicable
TOPICAL INDEXING:
Actual Fraud
Fraud/Misrepresentation
SUMMARY:
In this unanimous unpublished per curiam decision, the Court of Appeals affirmed the trial court’s denial of the defendant’s motion for summary disposition, in which the defendant, Farm Bureau General Insurance Company, sought dismissal of the plaintiff’s first-party action to recover no-fault PIP benefits. The Court of Appeals determined that a question of fact existed as to whether the plaintiff committed fraud with regard to her claims for replacement services, despite surveillance footage showing her performing the same activities listed in those claims. The Court noted that the plaintiff’s position all along, including in her forms for replacement services, was not that she was “entirely incapable” of performing those activities, just that she often needed help with them. The surveillance footage, therefore, “[did] not establish that the form requesting replacement services necessarily contained a false statement.”
The plaintiff, Deborah DeHaven, was injured in a motor vehicle collision and sought no-fault PIP benefits from her insurer, Farm Bureau General Insurance Company. In her claims for replacement services, DeHaven alleged that her husband performed the following household chores: “house cleaning, cooking, dishwashing, bed making, laundry, grocery shopping, driving, running errands, and caring for her horse.” On June 3 and June 4, 2015, specifically, DeHaven claimed that her husband performed “horse care, driving, errands, and making beds/changing linens.” Farm Bureau ordered for surveillance of DeHaven on those dates, and she was observed in the surveillance footage performing a myriad of activities, including caring for her horse, herself. Farm Bureau denied DeHaven’s claims for PIP benefits, and in her subsequent first-party lawsuit, Farm Bureau moved for summary disposition, arguing that it was entitled to void DeHaven’s policy altogether because she had violated its fraud exclusion provision. In response to Farm Bureau’s motion, DeHaven argued “that she had never stated that she could not perform the activities that she was seen performing, but rather that she could only perform those activities to a limited extent, and that her husband had in fact performed the services claimed on the days in question.” The trial court denied Farm Bureau’s motion, and the jury ultimately returned a verdict in DeHaven’s favor. Farm Bureau then filed a motion for judgment notwithstanding the verdict, which the trial court also denied.
On appeal, Farm Bureau argued that the trial court erred in denying its motion for summary disposition, because the surveillance video proved that the defendant made misrepresentations that triggered the fraud provisions in her policy. The Court of Appeals disagreed, finding that reasonable jurors could reach different conclusions as to whether DeHavan made material misrepresentations, considering she never testified that she was entirely incapable of performing the activities in question. Rather, she merely testified that she often needed help performing those activities.
We conclude that the trial court’s denial of defendant’s motion for summary disposition is supported by the record. Although the surveillance video shows plaintiff driving, walking, shopping, and caring for her horse on June 3 and 4, 2015, the video does not establish that the form requesting replacement services necessarily contained a false statement. Again, a genuine issue of material fact exists when, giving the benefit of reasonable doubt to the non-moving party, the record leaves open an issue on which reasonable minds could differ. Allison, 481 Mich at 425. Here, plaintiff’s explanation regarding the video evidence is not contradictory to her statements made in requesting replacement services reimbursement. Her position is that she never said she was entirely incapable of driving, walking, or running errands, only that she often needs help to do these activities. She argues that her abilities vary from day to day, and that she is attempting to improve her condition by doing tasks to the extent that she can.
The Court of Appeals affirmed the trial court’s denial of Farm Bureau’s motion for a directed verdict for the same reason, and also affirmed the trial court’s award of case evaluation sanctions in favor of DeHavan. As to the case evaluation sanctions, the Court of Appeals determined that the trial court did not abuse its discretion by determining the amounts to be awarded for the services of DeHavan’s counsel’s paralegal and law clerk, despite Dehavan’s counsel presenting no evidence to establish the reasonable hourly rates for those positions. The trial court followed the correct procedure in determining the appropriate amounts to be awarded.
