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Goethals v Farm Bureau Insurance; (COA-UNP, 3/23/2004, RB #2448)

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Michigan Court of Appeals; Docket No. 242422; Unpublished    
Judges Hoekstra, Fitzgerald and Talbot; unanimous; per curiam
Official Michigan Reporter Citation: Not applicable, Link to Opinion


STATUTORY INDEXING: 
One-Year Back Rule Limitation [3145(1)] 
Limitations Period for PPI Claims [3145(2)] 

TOPICAL INDEXING: 
Not applicable 


CASE SUMMARY: 
In this unanimous unpublished per curiam opinion, the Court of Appeals held that the provisions of §3145(2) required that an action for recovery of property protection insurance benefits shall not be commenced later than one year after the accident, and that the one year period for filing an action to recover for property damaged in an automobile accident is not subject to tolling during negotiations between the parties. Further, the court held that under the circumstances of this case, the insurance company was not estopped from asserting the statute of limitations as a bar to bringing an action to recover PPI benefits.

Plaintiff and her father were struck by a pickup truck on August 5, 1998 while riding bicycles near Suttons Bay in Leelanau County. The driver of the pickup truck notified his insurance company, Farm Bureau Insurance Company, of the accident and the matter was assigned to a claims adjuster. Although the adjuster requested information regarding property damage to the bicycles, such information was not forthcoming. On February 7, 2000, plaintiff’s third lawyer submitted a medical bill to the adjuster and requested payment. On January 8, 2001, this action was commenced seeking both property protection and PIP benefits. The court ruled that the communication from the adjuster in which he stated that the insurance company would pay for property damage to the bicycles and helmets satisfied the doctrine of equitable estoppel. The court ruled that the one year back rule did not preclude plaintiff’s claim for PIP benefits, because there was no formal declination letter declining the benefits more than a year before the filing of the suit.

On appeal, the Court of Appeals held that the property damage claim was untimely under the provisions of §3145(2). The court rejected plaintiff’s argument that the one year period for filing an action to recover such benefits was subject to tolling during negotiations between the parties. The court further rejected plaintiff’s contention that the doctrine of equitable estoppel tolled the statute. The statement by the adjuster with regard to payment for the property damage of the bicycles was not an agreement to waive the one year limitation period.

With regard to plaintiff’s claim for PIP benefits, the court held the submission of medical records in support of plaintiff’s tort claim was not sufficient to be a “specific claim for benefits” and, therefore, plaintiff’s claim was barred because she failed to provide sufficient notice to toll the one year statute of limitations under §3145(1). In this regard, the court held:

“The one-year back rule may be tolled from the date that an insured makes a specific claim for benefits to the date that the insurer formally denies liability. Lewis v DAIIE, 426 Mich 93, 101 393 NW2d 167 (1986). If the one-year cap is tolled, it extends back in time the period for which the insured may recover. Welton v Carriers Ins Co, 421 Mich 571, 576; 365 NW2d 170 (1984). Tolling under the rule depends on a triggering event sufficient to warrant tolling. US Fidelity & Guaranty Co v Amerisure Ins Co, 195 Mich App 1, 6; 489 NW2d 115 (1992). A triggering event for tolling is one that informs the insurer of the expenses incurred, whether the expenses were covered losses, and whether the claimant would file a claim. Welton, supra at 578. ‘This cannot occur unless a claim for a specific amount of benefits has been submitted to the insurer.’”


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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