Burris v. Allstate Insurance Co.

745 N.W.2d 101, 480 Mich. 1081, 2008 Mich. LEXIS 453
CourtMichigan Supreme Court
DecidedMarch 7, 2008
Docket132949
StatusPublished
Cited by15 cases

This text of 745 N.W.2d 101 (Burris v. Allstate Insurance Co.) is published on Counsel Stack Legal Research, covering Michigan Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Burris v. Allstate Insurance Co., 745 N.W.2d 101, 480 Mich. 1081, 2008 Mich. LEXIS 453 (Mich. 2008).

Opinion

745 N.W.2d 101 (2008)

Randy C. BURRIS, Plaintiff-Appellee,
v.
ALLSTATE INSURANCE CO., Defendant-Appellant.

Docket No. 132949. COA No. 261505.

Supreme Court of Michigan.

March 7, 2008.

On January 9, 2008, the Court heard oral argument on the application for leave to appeal the September 21, 2006 judgment of the Court of Appeals. On order of the Court, the application is again considered. MCR 7.302(G)(1). In lieu of granting leave to appeal, we REVERSE the judgment of the Court of Appeals and REINSTATE the Wayne Circuit Court's September 10, 2004 Order Granting Judgment Notwithstanding the Verdict in Part and the February 23, 2005 Order for Final Judgment and for Sanctions, because the plaintiff did not present sufficient evidence at, trial that he incurred attendant care expenses. The evidence failed to establish that the attendant care providers expected compensation for their services. Therefore, the evidence failed to establish that the plaintiff "incurred" attendant care expenses. Proudfoot v. State Farm Mut. Ins. Co., 469 Mich. 476, 484, 673 N.W.2d 739 (2003).

*102 CORRIGAN, J., concurs and states as follows:

I concur with the order reversing the judgment of the Court of Appeals and reinstating the trial court's order partially granting judgment notwithstanding the verdict (JNOV) and the order for final judgment and sanctions. I write separately to complete the picture plaintiff presented in this record and to respond to the dissents' legal arguments.

I. Facts and Procedural History

In 1978, plaintiff, who was then six years old, sustained severe and permanent injuries when he was struck by a drunken driver. After the accident, plaintiff underwent extensive medical treatment, including multiple surgeries, all of which defendant covered under its no-fault policy. Despite plaintiff's physical limitations, he attended college, obtained employment, married, fathered a child, and performed routine activities, including driving. After plaintiff had an unsuccessful surgery in 2000, however, one of plaintiff's three treating physicians prescribed 24-hour attendant care. Defendant paid plaintiffs then-wife, Diane Vermette, for round-the-clock attendant-care services at the rate of $1,428 weekly. Vermette stopped furnishing attendant-care services just one month after plaintiffs surgery. Nevertheless, plaintiff continued to claim attendant-care services Vermette purportedly provided. He went to great lengths to hide his fraud from defendant. He instructed defendant to make the benefit checks payable to Vermette in her maiden name because plaintiff did not want defendant to know that it was paying his spouse to care for him. Plaintiff directed defendant to send the checks to his post office box. Plaintiff then cashed the checks, using Vermette's identification, and deposited the money into his bank account.

Plaintiff abused defendant's trust in other ways. Plaintiff submitted claims for several thousands of dollars for gym equipment and a special bed, neither of which plaintiff had actually purchased. Defendant paid these claims. Plaintiff also stole prescription pads from one of his treating physicians. He forged his name for the purpose of illegally obtaining prescription medication for which defendant paid. Plaintiff also forged a legitimate $50 receipt from a health-care provider to claim $1,200. Because of questions related to the forged receipt and a private investigator's observations during surveillance of plaintiff, defendant notified plaintiff to appear for an examination under oath, as the insurance policy provided. Plaintiff failed to appear for that examination. Defendant suspended the payment of all personal protection insurance benefits because of plaintiffs fraud, his violation of the terms of the insurance policy by failing to appear for the examination under oath, and a letter from one of plaintiffs doctors stating that he did not require 24-hour care.

Plaintiff and Vermette separated in November 2001 and later divorced. Plaintiff moved back to his parents' home. Three people cared for plaintiff while he was living at his parents' home: Richard Burris (plaintiffs father), Ryan Burris (plaintiffs brother), and Christopher Marcott (plaintiffs friend). All three acknowledged that they had no record of the dates and times they allegedly cared for plaintiff and never submitted a claim to defendant for payment of those services. Further, none of them ever asked plaintiff for any payment for their services, and plaintiff never promised them payment. Ryan and Christopher further testified that they did not expect to be paid for their services. Ryan testified that he just wanted to help his brother ("This is my brother, it's not about money"), and Christopher testified that he just wanted to "hang out" with his *103 best friend ("[It's] not a job, he's my friend").

In 2002, plaintiff filed this first-party nofault action, seeking payment of attendant care benefits and unpaid medical expenses. Plaintiff sought an award of $156,376 in attendant-care expenses (approximately $8.50 an hour, 24 hours a day for 761 days). The primary issue at the jury trial was whether defendant was obligated to pay for attendant-care services allegedly provided by Richard, Ryan, and Christopher after plaintiff moved back into his parents' home in December 2001. The jury awarded plaintiff $7,610.98 in medical expenses and $78,438 in attendant-care expenses ($26,146 for Richard, $6,536.50 for Ryan, and $45,755.50 for Christopher).[1] The verdict was about half the amount plaintiff sought. The jury thus rejected plaintiffs exaggerated claims.

The trial court thereafter granted defendant's motion for JNOV and vacated the jury's award of attendant-care expenses. The court ruled that plaintiff had failed to provide sufficient evidence that he had incurred such expenses:

With regard to the attendant care circumstances, I understand that there are some cases that say that there is some leeway with regard to family members. But in this case, they [Richard, Ryan, and Christopher] couldn't say what they did. They couldn't specify the number of hours. They couldn't even manage to say that they expected reimbursement. They went so far as to say they didn't expect to get anything. And with regard to Mr. Marcott, it's all the worse because he's not a family member.
The motion is granted with regard to the attendant care expenses awarded with regard to Richard Burris, Ryan Burris and Christopher Marcott. These didn't come close to being reimbursable. And the verdict is affirmed in all other regards.[[2]]

The Court of Appeals reversed and reinstated the jury verdict in an unpublished opinion per curiam.

II. Response to the Dissents

MCL 500.3107(1) provides, in pertinent part:

Except as provided in subsection (2), personal protection insurance benefits are payable for the following:
(a) Allowable expenses consisting of all reasonable charges incurred for reasonably necessary products, services and accommodations for an injured person's care, recovery, or rehabilitation. [Emphasis added.]

MCL 500.3110(4) provides that "[p]ersonal protection insurance benefits payable for accidental bodily injury accrue not when the injury occurs but as the allowable expense, work loss or survivors' loss is incurred." (Emphasis added.) In Nasser v. Auto Club ins. Ass'n, 435 Mich.

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745 N.W.2d 101, 480 Mich. 1081, 2008 Mich. LEXIS 453, Counsel Stack Legal Research, https://law.counselstack.com/opinion/burris-v-allstate-insurance-co-mich-2008.