Michigan Court of Appeals; Docket No. 302226; unpublished
Judges Kelly, Wilder, and Shapiro; unanimous; per curiam
Official Michigan Reporter Citation: Not Applicable; Link to Opinion
STATUTORY INDEXING:
One-Year Notice Rule Limitation [§3145(1)]
Required Content of Notice / Sufficiency of Notice [§3145(1)]
TOPICAL INDEXING:
Equitable Estoppel
In this unanimous unpublished per curiam Opinion, the Court of Appeals held for the second time in this case that the trial court erred when it granted summary disposition in Defendant’s favor based on the one-year statute of limitations MCL 500.3145(1) even though plaintiff did not make a claim for no-fault benefits for approximately thirteen months, because there existed a question of fact regarding whether “the one-year statute of limitations may have been affected by defendant’s negligence, in which case equitable estoppel will apply,” and because there existed a question of fact regarding whether an earlier claim for hospitalization benefits that plaintiff made under another policy within the one-year period constituted sufficient notice of an injury under the no-fault act. In this case, the plaintiff was seriously injured while she was attempting to load pigs into a trailer that was connected to a 2005 Dodge Ram pickup truck. At some point, after backing the trailer into a barn to load the pigs, the trailer’s ramp fell on her, “and broke her arm and back.” At the time of the accident, plaintiff possessed multiple insurance policies that were sold and serviced through captive State Farm agents, including polices for homeowners, automobile no-fault, and hospitalization insurance.
Following the incident, plaintiff’s husband contacted their State Farm insurance agent by telephone to report the accident. Plaintiff’s husband spoke with the agent’s office manager (Gregg Hughes), and told him about the accident. Gregg Hughes then forwarded plaintiff a claim form – but for the hospitalization insurance only. Plaintiff then filed the claim for hospitalization, which was paid out at the maximum benefit amount of $1,000. Approximately thirteen months later, plaintiff filed a complaint against State Farm alleging that the incident should have been covered under her no-fault insurance policy.
State Farm then moved for summary disposition, arguing that the claim was barred under MCL 500.3145(1). The Plaintiff filed a motion for summary disposition arguing that the filing of her claim for the hospitalization benefits satisfied the notice requirements of § 3145(1). The trial court then granted defendant State Farm’s motion for summary disposition, finding that the plaintiff failed to comply with notice requirements of § 3145(1). The plaintiff appealed for the first time. The Court of Appeals held in Albretch I that “there [was] an issue of fact regarding Gregg’s negligence in this matter. While he certainly never intentionally misled plaintiff and her husband, the matter of whether his actions served to negligently misinform plaintiff requires more factual development” explaining that:
“According to plaintiff, her husband called agent Gregg Hughes to report the accident. Justin testified that he told Gregg that “my wife had been backing up my pickup truck and my trailer into the barn to load up the hogs. She had parked the pickup truck, walked around it, and was trying to open the door and slipped and fell . . . the trailer door had fallen on her.” Gregg stated that he was only told that a trailer door fell on Jennifer, but that he was never told that the trailer was attached to a motor vehicle insured by State Farm. He stated that he assumed that the trailer was either detached from the vehicle, or attached to a different vehicle that was not insured by State Farm. As a result, he only submitted the claim as a health insurance claim, and never submitted the claim as a no-fault auto insurance claim. He told plaintiff that he phoned Assurant, and that they would be sending her the claims forms.”
Then, without a ruling on the issue of whether plaintiff’s claim for hospitalization benefits constituted sufficient notice under the Michigan No-Fault Act, the Court of Appeals remanded the case back to the trial court for further factual development. Then on remand, after little further factual development, the trial court again granted summary disposition in defendant’s favor, citing the previous opinion of the Court of Appeals “requiring further factual development as well as plaintiff’s acknowledgement that there was little more factual development and that it simply never occurred to Gregg that there may be a no-fault claim.” This second appeal then followed, and the Court of Appeals again reversed the trial court’s grant of summary disposition in defendant’s favor.
In reversing the trial court for the second time, the Court of Appeals applied the law of the case doctrine and concluded that:
“To the degree that no further facts were developed, we read this Court’s prior opinion as holding that there is an issue of fact that must be decided by a trial. As this Court’s previous opinion determined, any noncompliance by plaintiff with the one-year statute of limitations may have been affected by defendant’s negligence, in which case equitable estoppel will apply. A question of fact based on competing evidence regarding this issue exists, and the issue is for the trier of fact to decide. Thus, the trial court erred when it granted summary disposition in favor of defendant.”
The Court further found that a question of fact existed regarding whether plaintiff’s claim for hospitalization benefits actually did constitute sufficient notice of an injury under the Michigan No-Fault Act. In this regard, the court explained:
“[T]his Court has previously held that where a no-fault insurer also provides other insurance policies, a written claim under one of the other policies is sufficient to constitute written notice of an injury under the no-fault act.” (citing State Farm Mut Auto Ins Co v Ins Co of N Am, 166 Mich App 133, 140-41; (1988).
Accordingly, because the foregoing questions of fact still remained, The Court of Appeals again remanded the case for further proceedings consistent with its opinion.
