Claudia Moore v. Memberselect Insurance Company

CourtMichigan Court of Appeals
DecidedMay 23, 2025
Docket365330
StatusUnpublished

This text of Claudia Moore v. Memberselect Insurance Company (Claudia Moore v. Memberselect Insurance Company) 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
Claudia Moore v. Memberselect Insurance Company, (Mich. Ct. App. 2025).

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

CLAUDIA MOORE, UNPUBLISHED May 23, 2025 Plaintiff-Appellant, 10:43 AM

v No. 365330 Oakland Circuit Court MEMBERSELECT INSURANCE COMPANY, LC No. 2021-188692-CZ

Defendant-Appellee.

Before: GADOLA, C.J., and MURRAY and REDFORD, JJ.

PER CURIAM.

Plaintiff, Claudia Moore, appeals as of right from a judgment of no cause of action entered following a jury trial involving plaintiff’s claim of breach of contract against defendant, Memberselect Insurance Company (“AAA”). Plaintiff also appeals the trial court’s denial of her motions for summary disposition, directed verdict, judgment notwithstanding the verdict (JNOV), and new trial. We affirm.

I. FACTUAL BACKGROUND

This case arises out of damage to plaintiff’s home and contents caused by water originating from a second-floor bathroom in December 2020. AAA insured plaintiff’s home and contents under a replacement cost policy. The policy stated:

GENERAL DUTIES

A person claiming, or who may claim, any coverage under this policy must:

1. cooperate with and assist us in any matter concerning a claim or suit;

2. send any legal papers received relating to any claim or suit to us promptly;

3. provide any written proofs of claim or loss we require. Submit to examinations by us, under oath, while not in the presence of any other insured person or witness. This must be done as often as we may reasonably require.

-1- DUTIES UNDER PART I AND PART III

In the event of property loss, you must:

1. give us immediate notice. In case of theft, also notify the police. In case of credit card, electronic fund transfer card or access device or check forgery loss, also notify the bank or the issuer of the card or device. If loss is caused by or results from the peril of hail, loss must be reported to us within 12 months of the loss;

2. protect the property from further damage, making necessary and reasonable repairs to protect the property, and keeping records of the costs of repairs;

3. separate damaged from undamaged personal property. Give us a detailed list of the damaged, destroyed or stolen property, showing the quantity, cost, Actual Cash Value in the amount of loss claimed;

4. send to us within 60 days after loss, a proof loss signed and sworn to by the insured person, including:

a. the time and cause of loss;

b. the interest of insured persons and all others in the property;

c. Actual Cash Value and amount of loss to the property;

d. all encumbrances on the property;

e other policies covering the loss;

f. changes in title, use, occupancy or possession of the property; and

g. if required, any plans and specifications of the damaged buildings or fixtures;

5. show us the damaged property. We have a right to reasonable and safe opportunities to view and inspect the loss as often as necessary unimpeded by actions of you or others that prevent us from viewing and inspecting the loss. We may require you to accompany us when we conduct these activities;

6. submit to examinations under oath by any person named by us and sign the transcript of the examinations;

7. produce for examination, with permission to copy, all books of account, bills, invoices, receipts and other vouchers as we may reasonably require; and

8. produce receipts for any Additional Expenses to maintain your standard of living while you reside elsewhere, and records pertaining to any loss of rental income.

-2- We have no duty to provide coverage under Parts I and III of this policy if you, an insured person, or a representative of either fail to comply with items 1. through 8. above.

The policy further provided that AAA “may not be sued unless there is full compliance with all the terms of this policy.”

Following the loss, plaintiff hired Raymond Fair, an independent claims adjuster, to assist her in organizing her claim under the policy. AAA advised plaintiff of the steps she must take to comply with its investigation of the loss and sent her a blank “Sworn Statement in Proof of Loss” to return within 60 days of the loss. During its investigation it requested that plaintiff submit documentation of the claimed loss and her finances. AAA also requested that plaintiff submit to examinations under oath (EUO) and permit inspection of her contents.

On June 25, 2021, plaintiff filed a complaint for breach of contract against AAA because it had not paid for the water loss claim. AAA defended on the basis that plaintiff had not complied with the conditions precedent in the policy such that AAA’s obligation to pay had not been triggered. AAA alleged it was still investigating the claim when plaintiff filed her complaint, making her lawsuit premature. AAA also defended on the basis that plaintiff had made material misrepresentations in her claim by exaggerating the extent of damage to both the structure and contents.

At trial, a jury agreed with AAA that plaintiff did not meet her burden of proof to establish that she substantially complied with the conditions precedent. Consequently, she was not entitled to payment under the policy. The jury did not reach the issue of material misrepresentation in light of its finding that plaintiff did not comply with the conditions precedent. The trial court entered a judgment of no cause of action.

In this appeal, plaintiff claims error arising out of the trial court’s failure to grant motions for summary disposition, directed verdict, JNOV, and new trial. In her motion for summary disposition, plaintiff argued she complied with each condition precedent as a matter of law and AAA waived the defense of noncompliance. The trial court held there was an issue of fact regarding the conditions precedent and that AAA sufficiently pleaded the defense of noncompliance. In her motions for directed verdict, JNOV, and new trial, plaintiff argued no reasonable juror could conclude that she did not comply with the conditions precedent. The trial court rejected these arguments on the basis that sufficient evidence supported the jury verdict.

Plaintiff also claims evidentiary error arising from admission of evidence of plaintiff’s noncompliance with the conditions precedent. She asserts these issues were questions of law for the trial court to decide rather than the jury. Additionally, she claims evidentiary error arising from the admission of Fair’s previous fraudulent conduct at trial because it was irrelevant, unfairly prejudicial, and inadmissible under MRE 404 and 608. Plaintiff claims instructional error arising from the trial court’s instruction to the jury that plaintiff bore the burden of establishing her compliance with the conditions precedent. Finally, plaintiff contends AAA’s interpretation of the policy was unreasonable. We conclude that none of these arguments entitle plaintiff to reversal.

-3- II. LEGAL BACKGROUND

This appeal involves the effect of a written insurance policy. An insurance policy is construed in the same manner as any other contract. DeFrain v State Farm Mut Auto Ins, Co, 491 Mich 359, 367; 817 NW2d 504 (2012). This Court reviews de novo, as a question of law, the proper interpretation of a contract. Innovation Ventures v Liquid Mfg, 499 Mich 491, 507; 885 NW2d 861 (2016). Policy language is given its plain and ordinary meaning. Wells Fargo Bank, NA v Null, 304 Mich App 508, 519; 847 NW2d 657 (2014). An unambiguous contract must be enforced as written, without judicial construction, because it reflects the parties’ intent as a matter of law. Hastings Mut Ins Co v Safety King, Inc, 286 Mich App 287, 292; 778 NW2d 275 (2009).

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Claudia Moore v. Memberselect Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/claudia-moore-v-memberselect-insurance-company-michctapp-2025.