Michigan Court of Appeals; Docket No. 299395; unpublished
Judges Murphy, Talbot, and Murray; unanimous; per curiam
Official Michigan Reporter Citation: Not Applicable, Link to Opinion 
STATUTORY INDEXING:
Reasonable Proof Requirement [§3142(2)]
12% Interest Penalty on Overdue Benefits – Nature and Scope [§3142(2) (3)]
Requirement That Benefits Were Overdue [§3148(1)]
Requirement That Benefits Were Unreasonably Delayed or Denied [§3148(1)]
TOPICAL INDEXING:
Not Applicable
CASE SUMMARY:
In this unanimous unpublished per curiam opinion, the Court of Appeals affirmed summary disposition in favor of the defendant and held that penalty interest and attorney fees were not awardable to the plaintiff because payments of survivors lost benefit claims made by the defendant were not overdue or unreasonably delayed.
In this case, William Ramsey was killed in an automobile accident on January 16, 2009. An application for no-fault benefits along with a copy of the accident report was sent on January 22, 2009 to the defendant Affirmative. On February 4, 2009, 19 days after the accident, the plaintiff filed a complaint against the defendant for failure to pay personal protection insurance benefits within 30 days of receiving reasonable proof of the fact and amount of loss. The plaintiff then subsequently filed a demand letter on February 19, 2009 but attached only a funeral bill and a copy of the death certificate. Numerous subsequent attempts to obtain additional information resulted in what the court described as partial and haphazard responses by the plaintiff.
The court held that there was no question that PIP benefits were delayed for over 30 days from the time that the plaintiff applied for benefits, but the court did not find that they were delayed more than 30 days from the “time reasonable proof of the fact and amount of loss sustained had been submitted” as required by MCL 500.3142(2). Although the plaintiff demanded $88,000.00 in survivor’s loss benefits, that included lost wages, replacement services, and the value of insurance policies as well as funeral costs. Other than the funeral expense receipt and death certificate, no other documentation of these expenses were submitted to the defendant.
In denying the plaintiff’s claim for attorney fees under Section 500.3148(1) the court concluded that while payment of benefits to the plaintiff was “often frought with delays, those delays were the uniform result of plaintiff’s failure to provide defendant with basic and standard proof of the fact and amount of loss sustained.”
Accordingly, the court found that the payments made by defendant were not overdue or unreasonably delayed.
