Michigan Supreme Court; Docket Nos. 107661 and 107662; Published
Opinion by Justice Taylor; Unanimous (with Justices Cavanagh and Kelly Concurring)
Official Michigan Reporter Citation: 458 Mich 459; Link to Opinion 
STATUTORY INDEXING:
Not Applicable
TOPICAL INDEXING:
Uninsured Motorist Benefits
Private Contract (Meaning and Intent)
Revised Judicature Act – Tolling of Statutes of Limitations (MCL 600.5851 – 600.5856)
CASE SUMMARY:
In this unanimous Opinion with Justice Taylor writing for the majority and Justices Cavanagh and Kelly concurring separately, the Supreme Court held that plaintiffs had waived their claim for uninsured motorist benefits by failing to submit their claim for uninsured motorist benefits within three years of the date of the accident, as required by the specific terms of the insurance policy. In affirming the Court of Appeals, the Supreme Court held that the insurance contract "unambiguously requires that the insured make a claim for uninsured motorist benefits within three years of the accident," and where such a claim was not made, uninsured motorist benefits are not payable.
At the time of the accident in question, plaintiffs were insured by defendant ACIA with a no-fault policy that also contained uninsured motorist benefits coverage. Plaintiffs also were under the impression that the tortfeasor who caused the accident, was also insured by defendant ACIA. Plaintiffs submitted a claim for no-fault PIP benefits to defendant, and in the course of processing the no-fault claim, gave defendant notice of the date and fact of the accident, along with information concerning plaintiffs' injuries and plaintiffs' tort claim. Approximately one year and six months after the accident, defendant ACIA informed the plaintiffs that it did not insure die tortfeasor. Moreover, defendant disagreed with a portion of plaintiffs' claim for no-fault PIP benefits. Plaintiffs filed a lawsuit against defendant for PIP benefits, but did not make mention of any claim for uninsured motorist benefits in this lawsuit. In addition, plaintiffs never submitted a claim for uninsured motorist benefits to defendant within the first three years of the accident. Approximately one year after the accident, plaintiffs filed a lawsuit against the tortfeasor, and eventually obtained a default judgment against him. It was not until approximately three years and nine months after the accident, that plaintiffs claimed, for the first time, entitlement to uninsured motorist coverage under their policy. Defendant denied the claim on the basis that the plaintiffs did not comply with a provision in the insurance policy which stated that if the insured and the insurer do not agree that the insured is entitled to damages from an uninsured tortfeasor, or if there is disagreement as to the amount of the damages, "a demand for arbitration must be filed within three years from the date of the accident" or uninsured motorist benefits are not payable.
In rejecting the plaintiffs' argument that the three year notice requirement was ambiguous, the majority stated:
"While the contract does not spell out the manner in which a claim for benefits should be made, what cannot be in doubt is that some indication that the insured felt entitled to utilize this coverage had to be sent, and that there was no timely indication in any form or manner submitted by the insureds here that they felt so entitled Simply stated, no claim was made.... Further, this Court has noted, in the similar context of no-fault insurance benefits required by statute, that an insured must make a specific claim for benefits sought. [Citing Welton v Carriers Insurance Company, 421 Mich 571 (1985) (Item No. 801)] Moreover, plaintiffs demonstrated that they were capable of filing a sufficient claim. Thus, construing this contract by resolving any ambiguity in plaintiffs’ 'favor demonstrates that plaintiffs were required to do no more or less than what they eventually, albeit belatedly, did do, that is, submit a request for the payment of the uninsured motorist benefits they believed they were entitled to under the contract."
Justice Cavanagh concurring separately agreed that the insurance policy was not ambiguous. However, plaintiffs did not know until almost one year and six months after the accident, that defendant was contending that the tortfeasor was uninsured. Therefore, Justice Cavanagh would remand the matter to the Court of Appeals to determine if the three year uninsured motorist notice provision was tolled from the date of the accident until the date the defendant notified plaintiff that it disagreed with plaintiffs' allegation that the tortfeasor was insured.
