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Lighthouse Neurological Rehabilitation Center, Inc v Allstate Ins Co; (USD-UNP, 3/7/2012; RB #3314)

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United States District Court, Eastern District of Michigan; Case #10-10154-BC  
Hon. Thomas L. Ludington  
Official Michigan Reporter Citation: Not Applicable; Opinion Not Available alt  


STATUTORY INDEXING:
Disqualification for Intentionally Suffered Injury [§3105(4)]

TOPICAL INDEXING:
Not Applicable  


CASE SUMMARY:
In this written Opinion involving whether the intentionally suffered exclusion in MCL 500.3105(4) applied to prevent plaintiffs from collecting PIP benefits, Federal Judge Thomas L. Ludington used a subjective analysis to hold the §3105(4) exclusion did not prevent plaintiffs from recovering benefits because the insured, who was injured when thrown from the roof of a vehicle, did not intend both his act and his injury.

In making the ruling, Judge Ludington denied the insurer’s request to use an objective standard to determine whether the insured’s injury was intentionally suffered under §3105(4). He also said the insurer bears the burden of proving an intentional injury occurred.

Plaintiffs, a hospital and rehab facility, brought an action against defendant for PIP benefits for services they provided after the insured fell off a moving vehicle. Defendant claimed it was not obligated to pay benefits because the insured’s injuries were not accidental and, therefore, coverage was precluded under the intentionally suffered injury exclusion in §3105(4). Defendant argued an objective analysis should be applied to determine whether the §3105(4) exclusion applied: that the insured was a “reasonable person” who engaged in the “reckless conduct” of jumping onto the roof of a moving vehicle and, therefore, he should have “objectively” known that an injury was “substantially certain” to occur. Plaintiffs asserted that a subjective analysis should be applied to determine whether the injury was intentional: the insured must have actually intended both the act and the injury and, in this case, the insured did not intend his injury.

Before making a decision in the case, Judge Ludington certified the question to the Michigan Supreme Court, asking it to clarify whether the “intentionally suffered injury” exclusion in §3105(4) requires a subjective or an objective analysis. In denying the request for certification, Chief Justice Robert Young Jr. concurred and wrote separately, saying:

“I see no basis to conclude that an injury is suffered intentionally, and that personal protection insurance benefits may be denied, where a person engages in an intentional act where injury is substantially certain to occur.”

Therefore, Judge Ludington said it was reasonable to conclude that the Supreme Court would agree with the existing line of Michigan Court of Appeals cases holding that a subjective analysis is used to determine whether an injury is intentional. According to Judge Ludington:

“Under Michigan’s no-fault act, an injury is suffered intentionally only if the actor subjectively intended both the act and the injury.”

Judge Ludington further ruled that, pursuant to §3105(4), the insurer bears the burden of proving that an intentional injury occurred. Employing a subjective analysis, the judge said defendant did not present sufficient evidence that the insured intended both his act and his injury and, as a result, plaintiffs were entitled to PIP benefits.

Accordingly, Judge Ludington granted plaintiffs’ motion for summary judgment and denied defendant’s motion for summary judgment.


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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