Michigan Court of Appeals; Docket No. 109392; Unpublished
Judges Michael Kelly, Holbrook, and Shepherd; 2-1 (with Judge Kelly, Dissenting); Per Curiam
Official Michigan Reporter Citation: Not Applicable; Link to Opinion
No-Fault Insurer Claims for Reimbursement
In this 2-1 per curiam Opinion, the Court of Appeals affirmed the trial court's ruling that plaintiff was not legally entitled to recover no-fault benefits when he allegedly ruptured his Achilles tendon while exiting his motor vehicle. As a result of its holding, the Court of Appeals affirmed the trial court's ruling that Farm Bureau (the insurer paying the no-fault benefits) was entitled to be reimbursed on the basis that the payments were made due to a mistake of fact.
In ruling that the Achilles tendon injury was not compensable under the Act, the majority stated: "The motor vehicle need not be the proximate cause of the injury, but there must be a causal connection between the injury sustained and the ownership, maintenance or use of the automobile as a motor vehicle… The causal connection must be more than incidental, fortuitous or but for. The injury must be one which is foreseeably identifiable with the normal use of the vehicle. There is no allegation that defendant tripped on any object while alighting or that he had any contact with the automobile which would have caused his injury. It is apparent that defendant's injury would have occurred in the same manner regardless of the location of the seat he was alighting from."
With regard to the reimbursement issue, the majority cited Adams v Auto Club (Item No. 9S0) and held, "An insurer may recover payments made to an insured due to a mistake of fact provided the payment has not caused such a change that it would be unjust to require a refund Furthermore, it was not argued in the trial court or in this court that the payment to plaintiff has caused such a change that to require a refund would be unjust."
Judge Kelly dissented. He disagreed with the majority that the injury to the Achilles tendon was not reasonably identifiable with the process of putting one's foot on the ground while stepping out of a vehicle. He also stated: “That it could have been just as easily identifiable with stepping off a porch or out of a chair seems to meld the analysis with a proximate cause analysis. We would not say that such an injury in a tennis match would be unrelated to the contest How can we say here it is unrelated to exiting the motor vehicle?"