Michigan Court of Appeals; Docket # 323891; Unpublished
Judges Stephens, Hoekstra, and Servitto; Unanimous; Per Curiam
Official Michigan Reporter Citation: Not Applicable; Link to Opinion 
STATUTORY INDEXING:
Tort Liability for Noneconomic and Economic Loss [§3135]
Reasonable Proof Requirement [§3142(2)]
TOPICAL INDEXING:
Evidentiary Issues
CASE SUMMARY:
In this unanimous unpublished per curiam Opinion, the Court of Appeals held that plaintiff did not have to file a no-fault claim and actually have it denied before bringing a claim against the same defendant-insurer for unpaid benefits, because there is no such prerequisite in the No-Fault Act.
Plaintiff in this case was riding her bicycle when she was struck by a vehicle driven by defendant, Sherre Solomon. After the accident, plaintiff did not return to work for three months. During that time, plaintiff’s son assisted her with running errands and with household chores. Because plaintiff resided with her son, State Farm, his no-fault insurer, paid most of plaintiff’s medical expenses. Plaintiff brought this action to obtain payment of her remaining medical bills, wage loss, and replacement services. She also filed a claim for UM benefits. State Farm moved for summary disposition, which the trial court granted, finding that plaintiff’s claim had to be dismissed because she failed to produce evidence that she had notified State Farm about the unpaid medical expenses or that State Farm had denied her claim for benefits.
The Court of Appeals reversed, finding that plaintiff presented sufficient evidence that she had unpaid medical expenses that would be compensable under the State Farm policy. In this regard, the court said:
“[T]he trial court dismissed plaintiff’s claim for PIP benefits because it concluded that plaintiff had not submitted the expenses at issue to State Farm and plaintiff had not received a denial from State Farm. Contrary to the trial court’s reasoning, we are unaware of a provision in the no-fault act that would require plaintiff to submit her expenses to State Farm and wait for a denial of those claims before filing a lawsuit for PIP benefits.”
The Court of Appeals rejected State Farm’s reliance on MCL 500.3142 for the proposition that, as a prerequisite to filing suit, plaintiff had to provide reasonable proof of loss and then wait 30 days, at which time benefits would be overdue if not paid. Looking to the statute, the court said:
“[W]e see nothing in MCL 500.3142 that requires an insured to submit proof of loss to an insurer before filing suit. Instead, while MCL 500.3142 dictates when PIP benefits will be considered ‘overdue,’ it does so for purposes of defining when an insured may be eligible for interest on overdue benefits. Certainly, plaintiff is not entitled to interest under MCL 500.3142 because it appears that she did not submit reasonable proof of her claims to State Farm and thus PIP benefits are not ‘overdue.’ But, we know of no authority to support the proposition that plaintiff’s inability to claim interest precludes plaintiff’s suit for PIP benefits altogether. Quite simply, MCL 500.3142 does not prohibit plaintiff from filing suit and the trial court erred by dismissing her claim for PIP benefits on this basis.”
Regarding plaintiff’s UM claim, the Court of Appeals said plaintiff was entitled to UM benefits if she could make a third-party claim against the uninsured at-fault party, which required a showing of a threshold injury under MCL 500.3135. In this regard, the court reasoned:
“Given the evidence presented by plaintiff to establish that she suffered an objectively manifested injury of an important body function that affected her general ability to lead her normal life, the trial court erred by concluding as a matter of law that she had not suffered a threshold injury within the meaning of MCL 500.3135. Consequently, the trial court erred by granting summary disposition on this basis.”
Accordingly, the Court of Appeals remanded the case for further proceedings.
