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Jones v Auto Club Group Insurance Association; (COA-UNP, 8/23/2005, RB #2590)

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Michigan Court of Appeals; Docket #261089; Unpublished
Judges Zahra, Cavanagh, and Owens; unanimous; per curiam
Official Michigan Reporter Citation: Not applicable, Link to Opinion courthouse graphic


STATUTORY INDEXING:
Not applicable

TOPICAL INDEXING:
Private Contract (Meaning and Intent)
Uninsured Motorist Benefits: Exclusions from Uninsured Motorist Benefits


CASE SUMMARY:
In this unanimous unpublished per curiam opinion, the Court of Appeals reversed and remanded the trial court’s determination that language in the subject insurance policy did not bar plaintiff’s claim for uninsured motorist benefits, even though plaintiff had allegedly made several material misrepresentations in connection with her claim for PIP benefits under the same policy.

The language of the insurance contract provided that the entire policy is void if an insured person has intentionally concealed or misrepresented any material fact or circumstance relating to:

“a. this insurance;

b. the application for it.

We do not provide coverage for any insured person if an insured person has intentionally concealed or misrepresented any material fact or circumstances relating a claim for which coverage is sought under this Policy.”
(emphasis added)

After filing suit to enforce the provisions of the uninsured motorist contract, defendant responded by asserting the contract language precluded coverage because of plaintiff’s alleged misrepresentations in connection with her PIP claim. Plaintiff moved for partial summary disposition on the ground no misrepresentation connected with her claim for PIP benefits could afford a basis for denying benefits under the uninsured motorist benefits provision of the contract.

In granting plaintiff’s motion, the trial court distinguished the contract language herein from the Supreme Court decision in Cohen v Auto Club Insurance Association, 463 Mich 525 (2001). The trial court determined the contract language in the instant case refers to claims “under this policy,” in contrast to the reference in Cohen to insurance in general or any claim made under it. Because the claim for uninsured motorist benefits was not “under this policy” the trial court determined the contract provision did not void plaintiff’s claim for uninsured motorist benefits.

In reversing and remanding, the Court of Appeals held the operative words in this case are indistinguishable from the operative words in Cohen, supra, and the decision in that case is controlling. The language in the contract provision refers to misrepresentations “relating to a claim for which coverage is sought under this policy.” Had the exclusion referred to “the claim” instead of “a claim,” plaintiff’s argument would have merit. However, by use of the indefinite article, the contract affords defendant the broadest protections in response to a material misrepresentation or omission in connection with any claim under the policy. Therefore, plaintiff’s material misrepresentation made in connection with her PIP claim affected her uninsured motorist claim as well.

Finally, the court noted its decision concerns “not statutorily mandated no-fault provisions,” but optional uninsured motorist coverage and, therefore, the decision that the exclusion in this case applies to plaintiff’s claim for uninsured motorist claim does not concern itself with the no-fault claim.


Michigan auto accident attorney Stephen Sinas is the lead editor of the appellate case summaries published on this site regarding the Michigan auto insurance law. To learn more about how Stephen Sinas and how the Sinas Dramis Law Firm can help you if you have been injured in a Michigan auto accident, visit SinasDramis.com.

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