Justia Michigan Supreme Court Opinion Summaries

The issues before the Supreme Court in this case was whether the services provided by plaintiff's wife constituted services "for an injured person's care," whether the Court of Appeals properly remanded this case to the circuit court for findings of fact regarding the extent to which expenses for services for plaintiff's care were actually incurred, and whether the circuit court erred by awarding an hourly rate that corporate agencies charge for rendering services, rather than an hourly rate that individual caregivers receive for those services. Upon review, the Court held that "allowable expenses" must be "for an injured person's care, recovery, or rehabilitation." Because the Michigan no-fault act does not create different standards depending on who provides the services, this requirement applies equally to services that a family member provides and services that an unrelated caregiver provides. For this case, the Supreme Court held that the Court of Appeals correctly determined that plaintiff may recover "allowable expenses" to the extent that they encompass services that are reasonably necessary for plaintiff's care when the care is "related to [plaintiff's] injuries." However, because the circuit court erred by awarding damages for allowable expenses without requiring proof that the underlying charges were actually incurred, the Court agreed with the decision of the Court of Appeals to remand this case to the circuit court for a determination whether charges for allowable expenses were actually incurred. In determining the hourly rate for attendant care services, the circuit court "clearly erred" by ruling that plaintiff was entitled to an hourly rate of $40 for attendant care services because that rate was entirely inconsistent with the evidence of an individual's rate of compensation, including the compensation that plaintiff's wife, actually received as an employee hired to care for plaintiff. The case was remanded to the circuit court for further proceedings. View "Douglas v. Allstate Insurance Co." on Justia Law

In July 2004, while walking through a gas station parking lot, plaintiff was struck by a motor vehicle driven by defendant, who was insured by Allstate Property and Casualty Insurance Company. At the time, plaintiff lived with Harrietta Johnson, her ex-mother-in-law. Neither woman owned a vehicle, and neither was insured. Plaintiff filed a third-party tort claim against defendant, seeking damages for replacement services pursuant to MCL 500.3135(3)(c). The trial court granted summary judgment in defendant's favor, concluding that plaintiff could not recover damages for replacement services pursuant to MCL 500.3135(3)(c).The Supreme Court granted leave to appeal to consider whether, in a third-party tort action, damages for replacement services are recoverable pursuant to MCL 500.3135(3)(c). Because "replacement services" is not among the categories listed in MCL 500.3135(3)(c), damages for replacement services are not recoverable in such an action. Accordingly, the Supreme Court reversed the Court of Appeals' judgment in part and reinstated the trial court's grant of summary disposition in defendant's favor on plaintiff's economic damages claim for replacement services expenses. View "Johnson v. Recca" on Justia Law

The issue before the Supreme Court in this case concerned whether insurer Defendant-Appellant Allstate Insurance Company was liable to Plaintiff Mona Lisa Frazier for personal protection benefits under the state no-fault act. Plaintiff was injured when she slipped and fell on a patch of ice while closing the passenger door of her car. She placed a few items inside, and fell when she closed the door. The Court concluded Plaintiff was not entitled to benefits under the no-fault act because her injury did not arise out of the use of a parked vehicle under MCL 500.3106(1). "Before her injury, plaintiff had been standing with both feet planted firmly on the ground outside of the vehicle; she was entirely in control of her body’s movement, and she was in no way reliant upon the vehicle itself. Therefore, she was not in the process of 'alighting from' the vehicle." Because of these circumstances, Defendant did not owe benefits to Plaintiff, and its refusal to pay them was not unreasonable. The Court reversed the appellate court's decision and remanded the case to the trial court for further proceedings. View "Frazier v. Allstate Ins. Co." on Justia Law

Plaintiff Kevin Krohn suffered a severe spinal fracture that left him a paraplegic. Plaintiff brought suit under the state no-fault act seeking personal protection insurance benefits from Defendant Home-Owners Insurance Company to cover costs incurred for a surgical procedure performed in Portugal. The procedure was experimental and was not considered a generally accepted treatment for Plaintiff's injury. The issue before the Supreme Court was whether the experimental procedure was a reasonably necessary service for Plaintiff's care, recovery or rehabilitation under state law. Upon review of the record below, the Court concluded that if a medical treatment is experimental and not generally accepted within the medical community, an insured seeking reimbursement for the treatment must present objective and verifiable medical evidence to establish that the treatment was efficacious. In this case, the Court found the procedure was an "understandable" personal decision that offered Plaintiff only a medically unproved "possibility" for an efficacious result. The Court held the procedure was not an allowable expense for insurance reimbursement. The Court affirmed the appellate court that ruled in favor of Defendant. View "Krohn v. Home-Owners Insurance Co." on Justia Law

This appeal challenged the small employer group health coverage act (Act), which establishes requirements for insurance carriers to offer health insurance benefit plans to small employers in Michigan. Priority Health sought a declaratory judgment from the Office of Financial and Insurance Services (OFIS) so that it could allocate a small portion of insurance premiumsâ costs to employers, lessening the financial burden on employees. Priority Health would not renew contracts with employers who did not agree to pay a portion of the premiums. Both the Court of Appeals and the Commissioner of the Office of Financial and Insurance Services (OFIS) concluded that âminimum employer contribution provisionsâ are inconsistent with the Act. They reasoned that an employerâs failure to pay a minimum percentage of its employeesâ premiums is not among the reasons in the Act that a carrier can use to refuse to renew an insurance plan. The Supreme Court disagreed with the appellate court and OFISâ interpretation of the Act. The Court found that just because the Michigan Legislature did not include an employerâs refusal to pay according to a minimum contribution provision as among the reasons for not renewing a contract for benefits, the [Priority Health] provision was unreasonable or inconsistent with the Act. In general, âunless a provision directly conflicts with the enumerated reasons [of the Act], it may be included in a plan so long as it is reasonable and not inconsistent.â The Court remanded the case to the OFIS for further proceedings.