Michigan Court of Appeals; Docket #357195; Published
Judges Rick, O’Brien, and Patel; Per Curiam
Official Michigan Reporter Citation: Forthcoming; Link to Opinion; Link to Concurrence
Fraudulent Insurance Acts [§3173a]
In this unanimous, published, per curiam decision (Jansen, concurring), the Court of Appeals affirmed the trial court’s summary disposition order dismissing Plaintiff Oliver Bakeman’s action for no-fault PIP benefits against Defendant Citizens Insurance Company of the Midwest (“Citizens”). The Court of Appeals held that Bakeman committed a “fraudulent insurance act” for purposes of MCL 500.3173a(2) (currently MCL 500.3173a(4)), by signing attendant care claim forms which were submitted to Citizens on his behalf, and which claimed reimbursement for more attendant care than he had actually received.
Oliver Bakeman sustained serious injuries while traveling as a passenger in a vehicle driven by his ex-wife, which was involved in a single-vehicle crash. After a six-week hospitalization, Bakeman was discharged with a prescription for 12 hours of attendant care per day, seven days per week, as well as a prescription for physical therapy. Bakeman went to Five Star Comfort Care for his physical therapy, and Joe Awada, Five Star Comfort Care’s owner and operator, arranged for Bakeman to receive attendant care from Awada’s then-mother-in-law, Lura Watson.
Neither Bakeman nor his ex-wife had no-fault insurance at the time of the crash, and thus Bakeman filed a claim for no-fault PIP benefits with the Michigan Automobile Insurance Placement Facility (“MAIPF”). The MAIPF assigned his claim to Citizens, to whom Awada would submit attendant care claim forms on Bakeman’s behalf. Citizens paid Bakeman’s PIP benefits initially, but eventually stopped altogether, presumably suspecting Bakeman of submitting fraudulent claim forms.
Bakeman proceeded to file suit against Citizens, and in his deposition, he testified that he received eight hours of attendant care per day, five days per week, for the period from March 29, 2019 through May 31, 2019. The claim forms Awada submitted for that period, however, claimed 12 hours of care per day, seven days per week. Bakeman explained that the forms were given to Watson by Awada to fill out, and that, every week when he would attend physical therapy, Bakeman would pick up the forms from Watson and deliver them to Awada, who, in turn, would submit them to Citizens on Bakeman’s behalf. The forms were signed by Bakeman, although Bakeman initially testified that his signature had been copied onto the forms by someone else. Then, toward the end of the deposition, when shown a specific signature and asked how it came to be on the form, Bakeman stated, “I put it there.”
Based on this testimony, Citizens moved for summary disposition, arguing that Bakeman had committed a “fraudulent insurance act” for purposes of MCL 500.3173a(2) (currently MCL 500.3173a(4)), and that he was therefore barred from receiving PIP benefits. Bakeman argued, in response, that his conflicting testimony regarding whether he had signed the claim forms, or whether his signature had been copied, created a question of fact as to whether he’d committed a fraudulent insurance act. The trial court, however, agreed with Citizens and granted its motion.
The Court of Appeals affirmed the trial court’s summary disposition order, holding, first, that if Bakeman signed the claim forms, he committed a “fraudulent insurance act” for purposes of MCL 500.3173a(2) (currently MCL 500.3173a(4)).
“Regarding the former argument, ‘the law is clear that one who signs an agreement, in the absence of coercion, mistake, or fraud, is presumed to know the nature of the document and to understand its contents, even if he or she has not read the agreement.’ . . . Therefore, if plaintiff signed the forms, he cannot rely upon a lack of knowledge of the forms’ contents. In other words, if plaintiff signed the attendant care forms, then he committed a fraudulent insurance act.”
Turning, then, to Bakeman’s self-conflicting testimony about how his signature came to be on the claim forms, the Court noted that Michigan appellate courts have not resolved the question about whether conflicting statements within a single deposition create a question of fact on a specific issue. In this case, Bakeman initially testified that he had not signed any of the forms, and that, while the signature on each of the forms was his, it was the product of copying. Later in the same deposition, however, when shown a specific form and asked how his signature came to be on it, he stated “I put it there.”
Regarding this conflicting testimony, the Court of Appeals found that “it is plainly apparent that plaintiff was not a sophisticated party, and any conflicting testimony was the product of confusion, some of it undoubtedly due to the remote connection problems and some of it undoubtedly due to poorly-crafted questions posed by counsel.” However, “when the testimony is reviewed as a whole, and the remainder of the record is also considered, reasonable minds could not differ that plaintiff actually signed the attendant care forms.” The Court reviewed the signatures on the forms and found that they all contained slight variations, belying Bakeman’s claim that they were all copied. Moreover, the Court noted that Bakeman failed to present any additional evidence to support his claim that the signatures were copies. The Court concluded that under these circumstances, Bakeman committed a fraudulent insurance act under MCL 500.3173(4), and that summary disposition was properly granted in favor of Citizens.
“As discussed above, plaintiff first denied having signed any of the forms, expressing the belief that someone else had copied his signature onto the forms. At the end of his deposition, he unequivocally stated that he put his signature on the forms. Throughout the deposition, he otherwise maintained that it was indeed his signature on the forms. Notably, he initially denied signing any of the forms, but he was later asked to clarify whether the signature on a particular exemplar form was ‘[his] actual signature or . . . the one [he] said that they copied,’ and he affirmed that it was ‘[his] signature.’ Although that question could have been better articulated, we have also reviewed the actual attendant care claim forms, which resolve any possible lingering doubts. Notably, plaintiff never claimed his signatures were forged—rather, he consistently maintained that the signatures were his. Each of plaintiff’s signatures on the forms features the kind of slight variations indicative of signing each one individually; signatures that had been copied would, obviously, all be identical. Furthermore, several of the signatures intersect the signature-line, rendering it difficult to imagine how they could have been copied onto the forms. Finally, plaintiff never took the opportunity to provide any further clarification at the end of his deposition, and he never offered any evidence, from an expert or otherwise, to substantiate his speculation that his signature had been copied.
. . .
We conclude that, where a deponent’s testimony is inherently self-contradictory, a court may not, at the summary disposition stage of proceedings, blindly assume that one statement is true and the other is false. In the absence of an objective basis for concluding that one or the other of the statements must have been the true statement, doing so constitutes an impermissible credibility assessment. We also conclude that if plaintiff actually signed the attendant care forms under circumstances that did not involve coercion, mistake, or fraud, then it is immaterial whether he read those forms, and he committed a fraudulent insurance act for purposes of MCL 500.3173(4). Under the circumstances, and after careful review of the entire deposition and of the record, we conclude that plaintiff’s seemingly self-contradictory deposition testimony can only be resolved with the determination that plaintiff did personally sign the forms. He therefore committed a fraudulent insurance act, and summary disposition was properly granted in favor of defendant.”
Judge Jansen concurred, but wrote separately to emphasize that “the burden to prove such a forgery . . . rests on [Bakeman], and not on the insurance company.” Thus, because “[Bakeman] provided no evidence that his signature had been copied on the form,” summary disposition was proper.