Michigan Court of Appeals; Docket # 347112; Unpublished
Judges Murray, Ronayne Krause, and Tukel; Per Curiam
Official Michigan Reporter Citation: Not Applicable; Link to Opinion
STATUTORY INDEXING:
General/Miscellaneous [§500.3173a]
TOPICAL INDEXING:
Not Applicable
SUMMARY:
In this unanimous unpublished per curiam decision, the Court of Appeals reversed the trial court’s denial of the defendant’s motion for summary disposition and remanded to the trial court for entry of an order granting summary disposition in the defendant’s favor. The plaintiff, Daisian Wright, misrepresented her employment status on her application for no-fault PIP benefits through the Michigan Automobile Insurance Placement Facility (MAIPF), and thus the Court of Appeals held that she was ineligible for benefits through the MAIPF pursuant to the former MCL 500.3173a(2).
Daisian Wright was injured in a motor vehicle collision on April 7, 2016, and subsequently filed an application for no-fault PIP benefits with the MAIPF. On her application for benefits, Wright stated that she was employed at both IHOP and Marshalls at the time of the accident, and that the injuries she sustained in the collision caused her to miss time from work. The MAIPF ultimately assigned her claim to Farm Bureau, and Wright filed this claim against Farm Bureau for PIP benefits almost one year later.
During the course of Wright’s lawsuit, Farm Bureau deposed Wright and reached out to the owner and operator of the IHOP at which she purportedly worked. In Wright’s deposition, she stated that she worked every weekend for nine hours per day, and that she received a raise from $8.75 per hour to $9 per hour just before the collision. The owner and operator of the IHOP, however, informed Farm Bureau that Wright had resigned from her job at IHOP on March 27, 2016—approximately two weeks before the subject collision—that she was never paid as much as she claimed in her deposition, and that she had never worked as many hours in a shift as she claimed in her deposition. Farm Bureau thus moved for summary disposition, arguing that Wright was ineligible for benefits because her claim was based, in part, on fraudulent statements, but the trial court denied Farm Bureau’s motion.
The Court of Appeals reversed the trial court’s denial of Farm Bureau’s motion and remanded to the trial court for entry of summary disposition in Farm Bureau’s favor. The Court reasoned that Wright’s uncontroverted fraud related to her employment status at IHOP at the time of the collision constituted a “fraudulent insurance act” under the former MCL 500.3173a(2) and pursuant to the Court of Appeals’ prior decision in Chandler v. Farm Bureau Mut. Ins. Co. of Mich., 321 Mich. App. 772 (2017). In Chandler, the Court listed five factors that must be considered in determining what constitutes a “fraudulent insurance act” under MCL 500.3173a(2):
[A] person commits a fraudulent insurance act under this statute when (1) the person presents or causes to be presented an oral or written statement, (2) the statement is part of or in support of a claim for no-fault benefits, and (3) the claim for benefits was submitted to the MAIPF. Further, (4) the person must have known that the statement contained false information, and (5) the statement concerned a fact or thing material to the claim. [Id. (footnote omitted)]
With regard to these factors, the Court in this case provided:
Addressing the elements of “a fraudulent insurance act” outlined in Candler, 321 Mich App at 779-780, first, plaintiff submitted a signed application to the MACP that contained statements about income that plaintiff was allegedly earning at IHOP at the time of the accident and she made statements mirroring those statements at her deposition. Consequently, this act alone fulfilled the first three prongs of the “fraudulent insurance act” test in Candler. See id.
As for the final two prongs of the test, plaintiff must have known that she resigned from IHOP before the accident. Furthermore, she also must have known that she was paid $8.50 per hour, not $9.00 per hour as she claimed, and that she did not actually work from 9:00 a.m. to 6:00 p.m. on a regular basis. Indeed, the employment logs defendant obtained showed that defendant never worked more than 5.88 hours on a given day from February 6, 2016 to April 10, 2016. Finally, plaintiff’s false statements would have affected how much she could have recovered in lost wages. As such, these statements were material. See Bahri, 308 Mich App at 425 (“A statement is material if it is reasonably relevant to the insurer’s investigation of a claim.”). Thus, plaintiff committed a fraudulent insurance act when she applied for PIP benefits and made erroneous statements about her employment at IHOP. See Candler, 321 Mich App at 779-780.
