Michigan Supreme Court; Docket Nos. 4127 and 72940; Published
Opinion by Justice Williams
Official Michigan Reporter Citation: 426 Mich 93; Link to Opinion 
STATUTORY INDEXING:
One-Year Back Rule Limitation [§3145(1)]
Tolling of Limitations Upon Submission of Claim [§3145]
TOPICAL INDEXING:
Not Applicable
CASE SUMMARY:
This Opinion by Justice Williams considers the question of whether the "one year back" limit on recovery of no-fault insurance benefits contained in §3145(1) should be tolled from the date a claimant makes a specific claim for benefits until the date the insurer formally denies liability. This case answers the question which the Supreme Court declined to specifically answer in its decision in Welton v Carriers Insurance Company, 421 Mich 571; 365 NW2d 170 (1985) (Item No. 801).
In its decision following the rule announced in Richards v American Fellowship Mutual Insurance Company, 84 Mich App 629; 270 NW2d 670 (1978) (Item No. 101), the Supreme Court held that the one year back rule of §3145 is tolled from the date of a specific claim for benefits to the date of a formal denial of liability. The majority held that this result effectively preserves the Legislature's purpose when it adopted §3145(1), to require that an insured submit a timely and specific claim.
The facts in Lewis concerned an accident occurring on November 13,1978, for which specific claim to benefits was made on March 10,1979. After quit was commenced on February 22,1980, the defendant moved for accelerated judgment based upon the one year back rule. The defendant had never formally denied plaintiff’s claim. The facts in Dionne involved an accident occurring on July 9, 1975, for which notice was given to the defendant on July 2,1976. A claim for medical benefits was submitted on July 8, 1976, and suit was commenced on the claim on July 7,1978. The trial court granted accelerated judgment based on the one year back rule.
Noting that the Welton (supra) case had been decided on other grounds (insufficient specificity in the notice of claim), the majority stated that it was now answering the reserved question in Welton concerning the tolling rule first announced in Richards v American Fellowship. In formally adopting the rule announced in Richards (supra), the Supreme Court added the important caveat that the insured must seek reimbursement with reasonable diligence or lose the right to claim the benefit of a tolling of the limitations period. This additional requirement that the claimant exercise reasonable diligence in pursuit of the claim should alleviate the defendant's fear that adoption of the tolling principle will result in "open-ended" liability in cases in which the claimant, having made a specific claim for benefits, thereafter refuses to respond to the insurance company's legitimate requests for more information needed to process the claim.
In his dissent, Justice Brickley, joined by Justice Riley, would hold that adoption of the tolling rule announced in this decision is in violation of the unambiguous language of §3145(1).
