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Blacksher v State Farm Mut Automobile Ins Co; (COA-UNP, 12/4/2014; RB #3390)

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Michigan Court of Appeals; Docket #312107; Unpublished  
Judges Gleicher, Servitto, and Ronayne Krause; Unanimous; Per Curiam 
Official Michigan Reporter Citation: Not Applicable; Link to Opinion alt 


STATUTORY INDEXING:
Entitlement to PIP Benefits: Arising Out of/Causation Requirement [§3105(1)]
Allowable Expenses for Attendant Care [§3107(1)(a)]
Allowable Expenses for Medical Treatment [§3107(1)(a)]
Work Loss Benefits: Nature of the Benefit [§3107(1)(b)]
Replacement Service Expense Benefits: Nature of the Benefit [§3107(1)(c)]
Insurer’s Right to Penalty Attorney Fees for Fraudulent/Excessive Claims [§3148(2)]

TOPICAL INDEXING:
Not Applicable  


CASE SUMMARY:
In this unanimous unpublished per curiam Opinion, the Court of Appeals upheld a jury award for PIP benefits that were less than what the insured had sought, finding that the award was not against the great weight of the evidence or inconsistent. The Court of Appeals further held the trial court properly denied the insurer’s request for penalty attorney fees under MCL 500.3148(2) because the insured’s claim for allowable expenses was “not unreasonable or fraudulent.”

Plaintiff in this case suffered a closed head injury in an auto accident. Defendant State Farm was her no-fault insurer. After paying plaintiff $53,000 in PIP benefits, which included her medical bills, attendant care, replacement services, and wage loss, State Farm ceased paying benefits. Plaintiff then filed this action for additional benefits. McLaren Regional Medical Center then intervened as a plaintiff, seeking coverage of various unpaid medical bills. Following a jury trial, plaintiff was awarded $8,012.80 — which was apparently significantly less than what plaintiff had requested. Further, the jury did not award anything related to any other category of claimed expenses and also determined that none of the claimed benefits were overdue. Following the jury verdict, plaintiffs filed a motion for JNOV or new trial, claiming the verdict was against the great weight of the evidence and was inconsistent — which the trial court denied. Given the result at trial, State Farm sought to recover attorney fee under §3148(2), which was also denied by the trial court.

The Court of Appeals affirmed both of these rulings.

Regarding plaintiffs’ argument that the verdict was against the weight of the evidence, the Court of Appeals said:

“Our review of the record does not support plaintiffs’ claims that the jury verdict was against the great weight of the evidence. The jury concluded that Blacksher incurred some allowable expenses in relation to her automobile accident injuries. The jury could award benefits only to the extent that it found by a preponderance of the evidence that the services were reasonably necessary. … And the jury was limited to awarding only those benefits left unpaid after State Farm’s $53,000 remittance on Blacksher’s behalf. The jury concluded that State Farm had already paid nearly all of Blacksher’s allowable expenses. The conclusion that Blacksher was injured and therefore was entitled to some benefits is supported by the testimony …. However, State Farm presented evidence that Blacksher’s injuries were not as severe or long lasting as she claimed. … We may not interfere with the jury’s assessment and weight of the various testimony and medical opinions. … Accordingly, we discern no grounds for granting a new trial or a JNOV, and the trial evidence rendered moot Blacksher’s pretrial motion for summary disposition.”

In further rejecting plaintiff’s claim that the verdict was inconsistent, the Court of Appeals said:

“[T]he evidence revealed that State Farm had already made some payments to [the two doctors that treated plaintiff]. [Testimony revealed] that the $53,000 in benefits paid by State Farm ‘encompassed medical bills’ as well as ‘some attendant care pay, wage loss benefits and a week of replacement services.’ [It was] asserted that State Farm had paid some but not all of [one doctor’s] bills. State Farm provided payment to [that doctor] through May 12, 2008. And [testimony showed] that State Farm recompensed [another doctor] for approximately $1,500 in treatment. From this evidence, a reasonable jury could determine that State Farm had already met its duty of paying allowable expenses incurred with these doctors. … McLaren cites no authority establishing that a verdict must be deemed inconsistent unless the parties or the court can mathematically reconstruct precisely how the jury determined the amount that it awarded.”

Despite the fact that the jury verdict was significantly less than what plaintiff had requested, the Court of Appeals nonetheless found that State Farm did not meet the threshold for awarding attorney fees to an insurer under §3148(2). In this regard, the court reasoned:

“As noted previously, there was conflicting evidence regarding the existence and severity of Blacksher’s injuries. Accordingly, plaintiffs’ quest for allowable expenses was not unreasonable or fraudulent. The small size of the jury’s award also does not support that plaintiffs’ claim was unreasonable or excessive. Although the disparity between the amount demanded and the ultimate award may comprise evidence that the initial claims were excessive, that does not mean that the disparity conclusively established that the claims were excessive. Given the conflicting medical testimony presented to the jury, the trial court did not clearly err by rejecting State Farm’s contention that plaintiff’s claims were so excessive as to lack a reasonable foundation.”


Lansing car accident lawyer 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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