Michigan Court of Appeals; Docket No. 68105; Published
Judges Hood, Brennan, and Deegan; Unanimous
Official Michigan Reporter Citation: 137 Mich App 464; Link to Opinion 
STATUTORY INDEXING:
Standards for Deductibility of State and Federal Governmental Benefits [§3109(1)]
State Workers Compensation Benefits [§3109(1)]
One-Year Notice Rule Limitation [§3145(1)]
One-Year Back Rule Limitation [§3145(1)]
Required Content of Notice / Sufficiency of Notice [§3145(1)]
Tolling of Limitations Upon Submission of Claim [§3145]
Bona Fide Factual Uncertainty / Statutory Construction Defense [§3148]
TOPICAL INDEXING:
Workers Disability Compensation Act (MCL 418.1, et seq.)
CASE SUMMARY:
In this unanimous Opinion by Judge Deegan, the Court of Appeals rendered several significant holdings regarding the no-fault one year statute of limitations.
First, the Court held that the defendant no-fault carrier received adequate notice in compliance with §3145(1) when plaintiff filed a complaint with the Michigan Insurance Bureau against defendant alleging that plaintiff had been unjustly denied no-fault benefits and/or workers' compensation benefits. The Court stated that this complaint "was designed to and did in fact appraise defendant of the pendency of a possible no-fault claim. The notice was sufficient under §3145(1)."
Second, the Court agreed with the reasoning of those cases which had embraced the holding in Richards v American Fellowship and held that the no-fault one year statute of limitations is tolled from the time a claimant provides notice of injury until the insurer formally denies payment of a claim. In so holding, the Court stated, "for the reasons stated in those decisions, we hold that the period of limitations provided in the statute is tolled from the time written notice of injury is provided to the insurer until the time the insurer formally denies the no-fault claim."
Third, the Court held that the trial court was correct in denying defendant's motion to set off workers' compensation benefits against no-fault work-loss benefits under §3109(1) where, at the time of trial, plaintiff’s claim for workers' compensation benefits was pending before the Workers' Compensation Appeal Board awaiting decision. Citing the Supreme Court's recent opinion in Perez v State Farm (item number 605), the Court noted that the plaintiff had "made every reasonable effort to obtain workers' compensation benefits." However, because the claim was still pending before the Workers' Comp. Appeal Board, there were no. benefits which were "provided or required to be provided" under the law. It was defendant's burden at the time of trial to prove its entitlement to a setoff under §3109(1). Defendant was unable to do so and thus, is not entitled to a setoff under the statute. The Court did note however, "that there is nothing to prohibit the trial court from entering a judgment preventing duplicative recovery by requiring plaintiff to reimburse defendant in the event workers' compensation benefits are ultimately provided or required to be provided to plaintiff." Also, the Court held that the trial court did not commit error in denying defendant's motion to adjourn trial and hold the case in abeyance pending resolution of the workers' compensation appeal.
Finally, the Court affirmed the trial court's decision to not award attorney fees under §3148 for the reason that the dispute in this case involved legitimate questions of statutory construction and complicated questions concerning medical causation. Therefore, defendant's conduct in denying the claim was not unreasonable.
