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Rose v State Farm Mutual Automobile Insurance Company and Titan Insurance Company and Farmers Insurance Exchange; (COA-UNP, 12/19/2006, RB #2827)

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Michigan Court of Appeals; Docket #262606; Unpublished
Judges Whitbeck, Saad, and Schuette; unanimous; per curiam
Official Michigan Reporter Citation: Not applicable, Link to Opinion courthouse graphic


STATUTORY INDEXING:
Allowable Expenses: Reasonable Necessity Requirement [3107(1)(a)]

TOPICAL INDEXING:
Not applicable


CASE SUMMARY:
In this unanimous unpublished per curiam opinion, the Court of Appeals reversed a trial court order granting plaintiff a declaratory judgment regarding future personal injury protection benefits and remanded for a new trial in order for the jury to determine what future benefits are reasonable and necessary.

The plaintiff in this case was injured in three motor vehicle accidents: one in 1982, one in 1995, and one in 2001. In the 1982 accident, plaintiff was insured by State Farm and sustained multiple contusions and abrasions on her face, a knee injury, and a comminuted fracture of her left ulna. In the 1995 accident, plaintiff was insured by State Farm and sustained a closed head injury. In the 2001 accident, plaintiff was insured by Farmers Insurance. Although she claims she was injured in the 2001 accident, she did not receive emergency care. Plaintiff filed this action for declaratory judgment regarding her future personal injury protection benefits. At trial, numerous physicians and neuropsychologists testified that she suffered a closed head injury in each of the accidents. The jury found that plaintiff was entitled to damages and declaratory relief. The trial court entered an order which provided that plaintiff is entitled to future medical treatment for care related to the motor vehicle accidents to be overseen by the trial court.

On appeal, defendants argued that the trial court violated the No-Fault Act by submitting the issue of future benefits to the jury without requiring the jury to specify what benefits were reasonable and necessary. The Court of Appeals agreed and reversed. In finding for defendants, the court referenced Manley v Detroit Automobile Inter-Insurance Exchange, 425 Mich 140 (1986) [RB #908], where the Supreme Court determined that a grant of future benefits is proper as long as the court makes a specific determination regarding the reasonable costs for reasonable services. In this case, although the issue of whether plaintiff was entitled to future benefits was decided by the jury, the jury was not asked to make a specific determination. In this regard, the Court of Appeals stated:

Our Supreme Court in Manley . . . noted that grant for future benefits is appropriate as long as the court makes a specific determination regarding the reasonable costs for necessary services. . . . Here, the trial court submitted the issue to the jury. However, the jury was not asked to make a specific determination regarding the future benefits that are reasonable and necessary. . . . If the jury, . . . does not specifically determine the award of future benefits, neither the plaintiff nor the insurer can ascertain if the expenses incurred are reasonable and necessary. . . . We reverse the trial court’s declaratory judgment and remand this case for a new trial for the jury to determine what future benefits are reasonable and necessary.”


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