20231207_C361693_51_361693.Opn.Pdf

CourtMichigan Court of Appeals
DecidedDecember 7, 2023
Docket20231207
StatusUnpublished

This text of 20231207_C361693_51_361693.Opn.Pdf (20231207_C361693_51_361693.Opn.Pdf) is published on Counsel Stack Legal Research, covering Michigan Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
20231207_C361693_51_361693.Opn.Pdf, (Mich. Ct. App. 2023).

Opinion

If this opinion indicates that it is “FOR PUBLICATION,” it is subject to revision until final publication in the Michigan Appeals Reports.

STATE OF MICHIGAN

COURT OF APPEALS

MATTHEW GEDDA, Guardian for SG, a legally UNPUBLISHED incapacitated person, December 7, 2023

Plaintiff-Appellee,

v No. 361693 Washtenaw Circuit Court STATE FARM MUTUAL AUTOMOBILE LC No. 22-000152-NF INSURANCE COMPANY,

Defendant-Appellant.

Before: LETICA, P.J., and HOOD and MALDONADO, JJ.

PER CURIAM.

Defendant, State Farm Mutual Automobile Insurance Company (State Farm), appeals by leave granted1 the trial court’s grant of a preliminary injunction to plaintiff, Matthew Gedda. The preliminary injunction requires State Farm, during the pendency of Gedda’s case against it, to process and pay personal-protection-insurance (PIP) benefits for Gedda’s brother, SG, as they existed at the time of his July 2011 motor-vehicle accident. We affirm.

I. BACKGROUND

This case originates from a motor vehicle wreck that rendered SG a quadriplegic who now requires constant medical care. In mid-July 2011, a semi-truck rear-ended SG’s vehicle, knocking it off the road. SG, then 43 years old, suffered a traumatic brain injury and spinal cord injury as a result of the accident. The spinal cord injury rendered him a quadriplegic and he now requires 24/7 “high-tech” care and nursing care. Livingston Helping Hands (LHH) provides SG’s care, which includes wound care, skin assessment, medication management and administration, catheter maintenance, bowel and bladder care, and help with the activities of daily life. SG also has a

1 Gedda v State Farm Mut Auto Ins Co, unpublished order of the Court of Appeals, entered August 11, 2022 (Docket No. 361693).

-1- tracheotomy, needs a ventilator to breath, and has a colostomy bag. SG has a trust in his name that pays LHH for the care it provides him. His brother, Gedda, is the trustee.

From the time of his accident until approximately mid-September 2021, State Farm paid for SG’s medical expenses under the no-fault act, MCL 500.3101 et seq. Gedda paid for SG’s care from SG’s trust, then sought reimbursement from State Farm on the trust’s behalf. State Farm reimbursed SG’s trust at a rate of $29.50 an hour for high-tech care and $72.50 an hour for nursing care, and the trust directly paid those amounts to LHH for its services.

In 2019, the Michigan Legislature amended the no-fault act. As part of the amendments, the Legislature imposed new fee schedules and other rules about the amounts service providers could charge. This new fee schedule took effect in early July 2021 and required reimbursement caps on various categories of healthcare expenses, including, relevant here, in-home care. See MCL 500.3157, as amended by 2019 PA 21. Between July 2021 and mid-September 2021, State Farm continued paying for all of SG’s care. But in mid-September 2021, it stopped making payments.

Gedda negotiated with State Farm for several months to restart payments for SG’s care, without progress. Gedda therefore sued State Farm in early February 2022, raising a single breach- of-contract claim against State Farm. He alleged that State Farm’s reduced reimbursement rates constituted a breach of contract and a breach of its statutory obligations under the no-fault act. He also alleged that, at the time he filed the complaint, State Farm owed over $200,000 for SG’s care. Gedda sought back and future payment of LHH’s invoices, 12% penalty interest as provided by MCL 500.3142, prejudgment interest as provided by MCL 600.6013, and attorney fees. He also requested injunctive relief requiring State Farm to fully and timely pay SG’s in-home care at its pre-amendment rates while the case proceeded through litigation.

After answering Gedda’s complaint and largely denying the allegations against it, State Farm issued a letter in mid-March 2022 indicating its reduction to the hourly rate of reimbursement for SG’s care. For high-tech care, it reduced the rate from $29.50 an hour to $16.89 an hour; for nursing care, it reduced the rate from $72.50 an hour to $41.51 an hour.

In mid-March 2022, Gedda moved for a preliminary injunction compelling State Farm to pay for SG’s care at the pre-amendment rates of $29.50 per hour for the high-tech care and $72.50 per hour for the nursing care. Between the time Gedda filed the complaint and the time he moved for a preliminary injunction, the amount he alleged State Farm owed had risen from over $200,000 to over $425,000. According to Gedda, SG’s trust advanced payment for his care but had been “depleted[]to the point where [it] will be unable to continue to pay for [his] care much longer.” Gedda argued that the four factors relevant for determining whether to issue an injunction favored SG. He asserted that SG faced irreparable harm to his life if the court did not issue the preliminary injunction, and contended this harm far outweighed any financial harm State Farm faced from entry of an injunction. Gedda also argued that his underlying claim was likely to succeed, asserting that State Farm violated the no-fault act by failing to pay SG benefits for approximately six months and the new fee schedule did not apply retroactively to individuals like SG injured before the effective date of the amendment. And he argued that the public had an interest in ensuring that insurers pay benefits they contracted to pay.

-2- In mid-April 2022, State Farm responded to Gedda’s motion for a preliminary injunction. It argued that the four factors did not support entry of an injunction. State Farm asserted that Gedda had failed to show irreparable harm because this case only involved a rate dispute and, at best, SG faced speculative economic injury. It noted that the amendment to MCL 500.3157 did not eliminate SG’s care but instead placed a limitation on the rate for allowable expenses. State Farm further argued that the underlying claim was likely to fail on the merits because the amendments to the no-fault act were retroactive. It also argued that the harm it faced outweighed that of SG because State Farm likely would not recover any excess payment if it was ultimately found improper. State Farm finally argued that injunctive relief was improper because SG had an adequate remedy at law (money damages) and an injunction would grant complete relief before a hearing on the merits.

In late April 2022, the trial court dispensed with oral argument on Gedda’s motion under MCR 2.119(E)(3), granted the motion, and issued a preliminary injunction. The court concluded that “all [four] factors” for granting an injunction were “supported through [Gedda’s] argument.” The trial court found that the irreparable harm was “not economic,” but to SG’s “health and life” and agreed there was “no injury more irreparable than lasting illness or death.” It also found that SG’s “physical and mental safety outweigh[ed] [State Farm’s] possible economic loss.” The trial court therefore found that “factors 1 and 2” (irreparable harm and harm to the applicant outweighs harm to adverse party) weighed “heavily” in Gedda’s favor. The court also found that MCL 500.3157 did not apply retroactively to an injury that occurred in 2011, noting that the Legislature’s “silence as to retroactivity speaks loudly . . . .”2 In the context of this motion, it further found that the “new fee schedule found [in the] no fault reform [was] unconstitutional.” The trial court therefore granted Gedda’s motion for a preliminary injunction and ordered State Farm to “process and pay” all of SG’s “home-care bills from July 2, 2021, until further order of the Court, at a rate of $29.50/hour for [SG’s] high-tech care and $72.50/hour for nursing care.”

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Pontiac Fire Fighters Union Local 376 v. City of Pontiac
753 N.W.2d 595 (Michigan Supreme Court, 2008)
Fancy v. Egrin
442 N.W.2d 765 (Michigan Court of Appeals, 1989)
Thermatool Corp. v. Borzym
575 N.W.2d 334 (Michigan Court of Appeals, 1998)
Al-Maliki v. LaGrant
781 N.W.2d 853 (Michigan Court of Appeals, 2009)
Bratton v. Detroit Automobile Inter-Insurance Exchange
327 N.W.2d 396 (Michigan Court of Appeals, 1982)
Moskalik v. Dunn
221 N.W.2d 313 (Michigan Supreme Court, 1974)
Kern v. Blethen-Coluni
612 N.W.2d 838 (Michigan Court of Appeals, 2000)
Sherman v. Sea Ray Boats, Inc
649 N.W.2d 783 (Michigan Court of Appeals, 2002)
Cudnik v. William Beaumont Hospital
525 N.W.2d 891 (Michigan Court of Appeals, 1994)
Boulton v. Fenton Township
726 N.W.2d 733 (Michigan Court of Appeals, 2007)
Campau v. McMath
463 N.W.2d 186 (Michigan Court of Appeals, 1990)
Elba Township v. Gratiot County Drain Commissioner
831 N.W.2d 204 (Michigan Supreme Court, 2013)
Demski v. Petlick
873 N.W.2d 596 (Michigan Court of Appeals, 2015)
Jawad a Shah Md Pc v. State Farm Mutual Automobile Insurance Co
920 N.W.2d 148 (Michigan Court of Appeals, 2018)
The Epworth Assembly v. Ludington & Northern Railway
194 N.W. 562 (Michigan Supreme Court, 1923)
Michigan AFSCME Council 25 v. Woodhaven-Brownstown School District
809 N.W.2d 444 (Michigan Court of Appeals, 2011)
In re Indiana Michigan Power Co.
297 Mich. App. 332 (Michigan Court of Appeals, 2012)
Hammel v. Speaker of the House of Representatives
825 N.W.2d 616 (Michigan Court of Appeals, 2012)
Barrow v. City of Detroit Election Commission
305 Mich. App. 649 (Michigan Court of Appeals, 2014)

Cite This Page — Counsel Stack

Bluebook (online)
20231207_C361693_51_361693.Opn.Pdf, Counsel Stack Legal Research, https://law.counselstack.com/opinion/20231207_c361693_51_361693opnpdf-michctapp-2023.