Michigan Court of Appeals; Docket # 348146; Unpublished
Judges Ronayne Krause, Sawyer, and Boonstra; Per curiam
Official Michigan Reporter Citation: Not Applicable; Link to Opinion
STATUTORY INDEXING:
Not Applicable
TOPICAL INDEXING:
Physical Contact Requirement
SUMMARY:
In this unanimous unpublished per curiam decision, the Court of Appeals affirmed the trial court’s summary disposition order dismissing the plaintiff’s claims for uninsured motorist benefits. The Court of Appeals held that the plaintiff, Jude Candella, failed to provide any evidence to corroborate his allegation that he was involved in a motor vehicle collision, and thus dismissed his claim against the defendant, Liberty Mutual Insurance Company, for uninsured motorist benefits, pursuant to a clause in his insurance policy stipulating that, “[i]f there is no direct physical contact with the hit-and-run vehicle the facts of the accident must be proved. Only accept competent evidence other than the testimony of a person making a claim under this or any similar coverage.”
Candella alleged that he was injured in a hit-and-run collision while stopped at a red light. He wrote down a license plate number for the vehicle that struck him, but the number did not match any registered vehicle. He did not take any photographs of either vehicle after the collision, and he was unable to identify the at-fault driver. Three weeks after the collision, he reported the collision to police, and upon examination of Candella’s vehicle, the responding officer “observed there was no damage.” Candella subsequently sought both PIP benefits and uninsured motorist benefits from his insurer, Liberty Mutual, who denied Candella’s claims. Ultimately, the parties stipulated to a dismissal of Candella’s claim for PIP benefits, and the trial court granted summary disposition in Liberty Mutual’s favor as to Candella’s claim for uninsured motorist benefits.
The Court of Appeals affirmed the trial court’s summary disposition order in Liberty Mutual’s favor, noting that Candella’s insurance policy included the aforementioned stipulation that mere testimony by the insured, without any corroborating evidence, would be insufficient to support a claim for uninsured motorist benefits. Since uninsured motorist benefits are governed entirely by contract, the Court of Appeals was required to give full weight to this stipulation. And, since Candella failed to provide any actual evidence that a hit-and-run collision occurred, summary disposition was properly granted in Liberty Mutual’s favor.
Plaintiff provided testimony that direct physical contact did occur between his vehicle and the hit-and-run vehicle, although there was no physical damage to plaintiff’s vehicle. Plaintiff argues that based on this testimony, the clause requiring additional evidence did not become triggered. Defendant disagrees and points to the second sentence of the clause, arguing that “evidence other than the testimony of a person making a claim” is not limited to only claims with “no direct physical contact,” but applies to “this or any similar coverage,” including the claim at issue. Plaintiff argues that insurance policies are strictly construed against insurers, but overlooks that contra proferentem is a “last resort” rule of construction, applicable only where contractual language is ambiguous and no other means can be found to determine the intent of the parties. Klapp v United Ins Group Agency, Inc, 468 Mich 459, 470-472; 662 NW2d 447 (2003). We find no ambiguity that the second sentence of the endorsement clause stands alone, given its stated applicability to any “claim under this or any similar coverage” and its omission of any reference to a particular topic of the evidence.
Defendant argues that allowing plaintiff to be excused from the evidence requirement because of his own testimony would defy the purpose of including the requirement in the policy. We agree. The “direct physical contact” provision is designed to protect insurers against fraud. Hill v Citizens Ins Co of America, 157 Mich App 383, 394; 403 NW2d 147 (1987). The possibility of fraud is substantially diminished by tangible physical evidence. Id. Allowing testimony by the person making the claim to satisfy the physical contact requirement would make the requirement obsolete and would have the potential to increase the number of fraudulent claims to be brought against insurance companies.
Next, plaintiff argues that records from medical providers provided sufficient additional evidence of the accident as they reflect that his injury was suffered as a result of the accident. We disagree. The records only indicate that plaintiff reported to medical professionals that he was injured in a vehicular accident, not that the medical professionals concluded independently that he was involved in an accident. We agree with the trial court that a medical opinion that supported the cause of plaintiff’s injury would have been necessary to provide the requisite evidence of the accident. Evidence beyond conjecture is required to prove that the accident occurred. “Parties opposing a motion for summary disposition must present more than conjecture and speculation to meet their burden of providing evidentiary proof establishing a genuine issue of material fact. A conjecture is simply an explanation consistent with known facts or conditions, but not deducible from them as a reasonable inference.” Libralter Plastics, Inc v Chubb Group of Ins Cos, 199 Mich App 482, 486; 502 NW2d 742 (1993) (internal citations omitted). The medical professionals’ mention of the vehicle accident in their records is not “evidence other than the testimony of a person making a claim” because the medical professionals did not independently conclude that the injuries occurred from an accident; rather, they diagnosed plaintiff’s slap tear as degenerative. It fails to satisfy the evidence requirement to establish a genuine issue of fact.
