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James v AAA Insurance Company; (COA-UNP, 7/28/2009, RB #3077)

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Michigan Court of Appeals; Docket #284277; Unpublished
Judges Talbot, Fitzgerald, and Hoekstra; unanimous; per curiam
Official Michigan Reporter Citation: Not available, Link to Opinion courthouse graphic


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

TOPICAL INDEXING:
Not applicable


CASE SUMMARY:
In this unanimous unpublished per curiam opinion, the Court of Appeals reversed the circuit court’s determination that defendant AAA was liable for the plaintiff’s hospital expenses in this action to recover personal injury protection benefits where the expenses were not incurred as required by MCL 500.3107(1)(a), and where the expenses were discharged in bankruptcy.

In reversing, the court explained that an expense is incurred only where there is a legal responsibility to pay for it. Although plaintiff was hospitalized for three days after the accident and was charged $23,000, the court concluded the expense was not incurred because it was discharged in bankruptcy. In this regard, the court stated:

An expense is incurred within the meaning of §3107(1)(a) only if there is a legal responsibility to pay it. . . .  It is undisputed that the St. John Hospital charges were discharged in bankruptcy. Thus, there is no legal obligation to pay the charges and, therefore, they have not been incurred within the meaning of §3107(1)(a). Accordingly, the district court properly directed a verdict for defendant with respect to the St. John Hospital medical expenses, and the circuit court erred in reversing that portion of the district court’s decision.”

However, the court also affirmed the circuit court’s decision that defendant was liable for plaintiff’s care with her treating physician and attendant care where the treating physician testified that plaintiff sustained a closed head injury in a motor vehicle accident. In so finding, the court noted that plaintiff sought treatment from Dr. Allen Cushingberry one week after the motor vehicle accident. Based upon his examination, Dr. Cushingberry determined that plaintiff’s symptoms were consistent with a closed head injury and diagnosed the plaintiff with post-traumatic stress disorder. Dr. Cushingberry also restricted plaintiff from participating in several activities and prescribed 24-hour attendant care. The court concluded that this evidence was sufficient to establish that plaintiff sustained a bodily injury in the motor vehicle accident and was, therefore, entitled to PIP benefits in regard to this claim. In this regard, the court stated:

Plaintiff presented evidence that she injured her head in the automobile accident. She was examined a week later by Dr. Cushingberry, who stated that plaintiff’s injury was consistent with a closed head injury and that plaintiff was suffering from post-traumatic stress disorder. Plaintiff’s sister testified that plaintiff became depressed and experienced behavioral changes after the accident. Dr. Cushingberry disabled plaintiff from participating in several activities and prescribed 24-hour attendant care. This evidence, viewed most favorably to plaintiff, was sufficient to establish the bodily injury element of plaintiff’s claims. Accordingly, the circuit court did not err in reversing the district court’s decision directing a verdict with respect to these claims.”


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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