Michigan Court of Appeals; Docket #311699; Unpublished
Judges M.J. Kelly, Cavanagh, and Fort Hood, 2-1 (Judge Fort Hood dissenting); Per Curiam
Official Michigan Reporter Citation: Not Applicable; Link to Opinion 
Link to Dissent
STATUTORY INDEXING:
Relevancy of Fault [§3105(2)]
PIP Benefits Defined; Waiver of Work Loss Benefits [§3107]
Serious Impairment of Body Function Definition (McCormick Era: 2010 – present) [§3135(5)]
Important Body Function Element of Serious Impairment (McCormick Era: 2010 – present) [§3135(5)]
General Ability/Normal Life Element of Serious Impairment (McCormick Era: 2010 – present) [§3135(5)]
Liability for Economic Loss Caused by Uninsured Tortfeasors [§3135]
One-Year Notice Rule Limitation [§3145(1)]
TOPICAL INDEXING:
Not Applicable
CASE SUMMARY:
In this non-unanimous unpublished per curiam Opinion (with Judge Fort Hood dissenting) involving plaintiff’s claim for uninsured motorist (UM) benefits, the Court of Appeals held that res judicata did not bar plaintiff’s action for UM benefits because he was not required to bring the claim in his prior lawsuit seeking PIP benefits. It was “not practical” for plaintiff to bring his UM benefits claim within the prior PIP suit, the Court of Appeals ruled, because the claims involved two different evidentiary standards.
Plaintiff was struck and injured by an uninsured motorist. He sought PIP benefits under his mother’s no-fault policy, issued by defendant State Farm, and that claim settled. Plaintiff then filed an action against defendant for additional PIP benefits, as well as UM coverage. The trial court held that res judicata barred plaintiff’s UM suit because he could have litigated that claim in his first action for PIP benefits. The parties settled the claim for additional PIP benefits, and plaintiff appealed the dismissal of his UM claim.
In reversing the trial court, the Court of Appeals said the question was whether plaintiff’s claim for UM benefits could have been resolved in the initial PIP suit. The court acknowledged there was a “substantial overlap” in the facts of both cases, but said there were also significant differences. The court stated:
“A person injured in an accident arising from the ownership, operation, or maintenance of a motor vehicle as a motor vehicle is immediately entitled to PIP benefits without the need to prove fault. … The PIP benefits are designed to ensure that the injured person receives timely payment of benefits so that he or she may be properly cared for during recovery. … Moreover, the injured person has a limited period within which to sue an insurer for wrongfully refusing to pay PIP benefits. … Because an injured person is immediately entitled to PIP benefits without regard to fault, requires those benefits for his or her immediate needs, and may lose the benefits if he or she does not timely sue to recover when those benefits are wrongfully withheld, the injured person has a strong incentive to bring PIP claims immediately after an insurer denies the injured person’s claim for PIP benefits.”
The Court of Appeals explained that, to establish a right to UM benefits, plaintiff had to prove fault, which meant he had to show the uninsured motorist caused his injuries and was liable for damages. According to the court:
“Significantly, this means that the injured person must plead and be able to prove that he or she suffered a threshold injury. … [W]hile an injured person will likely have all the facts necessary to make a meaningful decision to pursue a PIP claim within a relatively short time after an accident, the same cannot be said for the injured person’s ability to pursue a claim for uninsured motorist benefits.”
The Court of Appeals further noted that a UM claim involves compensation for past and future pain and suffering, and other economic and noneconomic losses, while a PIP claim involves compensation for immediate expenses related to care and recovery. Thus, the court said that a PIP claim “differs fundamentally” from a UM claim both in the “nature of the proofs” and the “motivation for the claim.”
Accordingly, the appeals court said:
“Because Miles could assert a PIP claim without the need to prove fault and without having to establish the full extent of his injuries, he could assert his PIP claim within a short time of State Farm’s decision to deny his claims. Indeed, because he required those benefits for his care and recovery, he had a powerful motivation to bring the claims as soon as practical. Further, in order to establish those claims, he only had to present evidence that his claims arose from the accident and met the other criteria provided under MCL 500.3107. … Because his claim for uninsured motorist benefits required evidence to establish the nature and extent of his injuries and proof that the injury affected his ability to lead his normal life and the original dispute involved only whether Miles’ injuries were causally related to the accident at issue, we conclude that it was not practical for Miles to bring his claim for uninsured motorist benefits in his original suit.”
In a separate dissenting opinion, Judge Fort Hood said the Court of Appeals did not have jurisdiction to decide the case because the parties had stipulated to dismissal with prejudice, and the order of dismissal did not reserve the right to appeal the UM claim.
