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Wynn v State Automobile Mutual Insurance Company; (USD-PUB, 6/23/1994; RB #1731)

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United States District Court for the Eastern District of Michigan; Docket No. 93-73797;   
Judge Paul V. Gadola; Published 
Official Michigan Reporter Citation:  856 F Supp 330; Link to Opinion alt    


STATUTORY INDEXING:  
Allowable Expenses for Attendant Care [§3107(1)(a)]

TOPICAL INDEXING:  
Not Applicable     


CASE SUMMARY:  
In this written Opinion, Judge Gadola held that §3107(a) of the no-fault statute clearly obligates a no-fault insurer to pay family members for extraordinary services they render to a severely injured child. Michigan case law further indicates that the legal duty of parents to support their children has no effect on whether services performed by a parent for a child are an allowable expense under the no-fault law. Furthermore, the statute does not require that the services be supplied by trained medical personnel. Questions dealing with the rate of compensation that should be paid to the parents are questions of fact for the jury. 

Judge Gadola further held that under Michigan law, a no-fault insurance company does not have a duty to advise its insureds of benefits which are recoverable under the statute. The court stated:

"The duty owed plaintiff by Mutual Insurance arises out of the insurance contract between plaintiff and Mutual Insurance and out of the Michigan no-fault act that governs such contracts. Neither the insurance contract nor the Michigan statute creates any duty on the party of Mutual Insurance to act as plaintiffs advisor with respect to informing him of the insurance benefits that are covered by the insurance contract or provided by statute."

Furthermore, Judge Gadola held that if the insurance company does not have a duty to advise plaintiffs of their no-fault benefits, then neither does a case management company hired by the insurer to manage the claim. Thus, plaintiffs claims against Recovery Unlimited for failure to advise plaintiff of benefits payable under the statute and failure to see that maximum benefits were paid to plaintiff do not create viable causes of action against Recovery Unlimited. The court further noted that there was an absence of fact to suggest that agents of Recovery Unlimited engaged in any act of misrepresentation or fraud or undertook any extra contractual obligation to plaintiff to provide and pay for medical treatment Therefore, the claim against Recovery Unlimited was properly dismissed.  


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