Michigan Court of Appeals; Docket No 87638; Unpublished
Judges Wahls, Maher, and Boyle; Unanimous; Per Curiam
Official Michigan Reporter Citation: Not Applicable; Link to Opinion 
STATUTORY INDEXING:
Requirement That Benefits Were Unreasonably Delayed or Denied [§3148(1)]
Bona Fide Factual Uncertainty / Statutory Construction Defense [§3148]
TOPICAL INDEXING:
Not Applicable
CASE SUMMARY:
In this unanimous per curiam Opinion, the Court of Appeals denied an award of attorney fees to a plaintiff who obtained a jury verdict for no-fault work loss benefits. The Court concluded that mere was a "bona fide factual uncertainty" regarding plaintiff’s claim, and as a result, defendant's refusal to pay benefits was not "unreasonable" as required by the attorney fee provisions of §3148 In this case, the question was whether or not plaintiff sustained a compensable back injury in a slip and fall accident while alighting from a bus. The defendant insurance company had the plaintiff examined by a so-called independent medical examiner who concluded that plaintiff’s injury was not related to this fall. Plaintiff produced several physicians who testified to the contrary. In rejecting plaintiff’s contention that defendant was unreasonable in relying upon the medical examiner, the Court made several observations. First, the Court stated that defendant's examiner (an orthopaedic surgeon) was sufficiently well qualified to testify about the results of various radiology examinations. Second, the Court said there was inadequate evidence on the record to support plaintiff’s assertion that defendant's examiner only performs examinations for insurance companies and has never found a patient to have a continuing disability. The Court did comment, however, that "we would indeed be disturbed if either of those assertions were correct. However, there is no evidence of record to support them."
