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Dillon v State Farm Mutual Auto Ins Co; (COA - PUB; 5/3/2016; RB # 3533)

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Michigan Court of Appeals; Docket # 324902; Published
Judges Sawyer, Murphy, and Ronayne Krause; unanimous Opinion by Judge Sawyer
Official Michigan Reporter Citation: Not Applicable; Link to Opinion alt


STATUTORY INDEXING:
One-Year Notice Rule Limitation [§3145(1)]
Required Content of Notice / Sufficiency of Notice [§3145(1)]

TOPICAL INDEXING:
Not Applicable


CASE SUMMARY:
In this unanimous published Opinion by Judge Sawyer, the Court of Appeals held the notice that plaintiff gave her no-fault insurer under MCL 500.3145(1), which said she "suffered physical injuries in a motor vehicle accident," was sufficient to trigger PIP benefits, even though the notice did not specifically identify the injuries she sustained.

Plaintiff was in a car accident in 2008 and notified her no-fault insurer, defendant State Farm, that she had sustained lower back and left shoulder injuries. State Farm paid PIP benefits for these injuries. In 2011, plaintiff began having hip pain and sought treatment, eventually having arthroscopic hip surgery. She attributed her hip problem to the 2008 car accident and sought additional PIP coverage from State Farm, which denied benefits. State Farm maintained that it did not receive notice of the hip injury within one year of the accident, and that it only received timely notice of the lower back and left shoulder injuries. Plaintiff filed suit against State Farm, seeking coverage for her hip treatment and surgery. The trial court denied State Farm's motion for summary disposition, and a jury found in plaintiff's favor. State Farm appealed, arguing it properly denied the hip injury claim, because the injury was not specifically identified in the notice it received in 2008.

The Court of Appeals disagreed with State Farm's argument and affirmed the trial court ruling. In so doing, the Court focused on MCL 500.3145(1), which says that an action for PIP benefits:

"may not be commenced later than 1 year after the date of the accident causing the injury unless written notice of injury as provided herein has been given to the insurer within 1 year after the accident or unless the insurer has previously made a payment of personal protection insurance benefits for the injury. ... The notice of injury required by this subsection may be given to the insurer or any of its authorized agents by a person claiming to be entitled to benefits therefor, or by someone in his behalf. The notice shall give the name and address of the claimant and indicate in ordinary language the name of the person injured and the time, place and nature of his injury."

In particular, the Court of Appeals had to determine what is meant by the phrase "the time, place and nature" of the injury, in the last sentence of §3145(1).

To support its argument that plaintiff's notice was untimely, State Farm relied on several unpublished appellate opinions, including Mousa v State Auto Ins Co (185 Mich App 293 [1990]) and Welton v Carriers Ins Co (421 Mich 571 [1984]). However, the Court said these cases did not support State Farm's argument:

"[I]f any conclusion can be reached it would be that Mousa stands for the proposition that the notice of loss does not need to identify the specific injury. ... While hardly definitive of the question before us, it would seem that the Welton Court ... viewed the notice of injury required by the statute in much more general terms than defendant proposes or than did this Court in the unpublished decisions relied upon by defendant."

The Court of Appeals then turned to the language of §3145(1). Reviewing the first sentence, the Court said that if the Legislature intended for a notice to specifically identify a particular injury, such as a left hip injury, "rather than the mere fact that an accident resulted in some injury, it would have provided that 'notice of the injury' must be given."

The Court further examined the last sentence of §3145(1) and said:

"[T]he Legislature tells us that, among other things, the notice shall give the 'nature of his injury.' Merriam-Webster's in this context defines 'nature' as 'a kind or class usu. distinguished by fundamental or essential characteristics.' Thus, we see reference to the general, not the specific."

Based on the foregoing, the Court of Appeals held the notice required by §3145(1) did not have to specify plaintiff's hip injury, and it was sufficient that State Farm received notice that plaintiff had "suffered physical injuries in a motor vehicle accident."

The Court of Appeals concluded that, because plaintiff provided an adequate notice of injury within one year of the accident, §3145(1) permitted her to recover PIP benefits "for any loss incurred within one year of the commencement of the action."


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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