Dell v. Citizens Insurance Company of America

880 N.W.2d 280, 312 Mich. App. 734
CourtMichigan Court of Appeals
DecidedOctober 20, 2015
DocketDocket 322654
StatusPublished
Cited by98 cases

This text of 880 N.W.2d 280 (Dell v. Citizens Insurance Company of America) 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
Dell v. Citizens Insurance Company of America, 880 N.W.2d 280, 312 Mich. App. 734 (Mich. Ct. App. 2015).

Opinion

TALBOT, C.J.

Plaintiff, Tina Marie Dell, appeals as of right the trial court’s order granting the motion of defendants, Citizens Insurance Company of America and Citizens Insurance Company of the Midwest (collectively, Citizens), for judgment notwithstanding the verdict (JNOV). Citizens cross-appeals from an order of the trial court denying its motion for summary disposition under MCE 2.116(C)(8). We affirm the trial court’s order denying Citizens’ motion for summary disposition, reverse the trial court’s order granting JNOV, and remand for further proceedings.

*737 i. facts and procedural history

This case arises out of an accident that occurred in 1984. Dell, a pedestrian, was struck by a motor vehicle. She suffered a closed head injury and injuries to her left leg. These injuries significantly impair her ability to walk. Since the accident, Dell has received no-fault benefits from Citizens under a policy issued to her parents, Paula and Larry Chambers. To date, Citizens has paid approximately $1M in benefits to Dell.

The dispute in this matter centers on Citizens’ failure to pay attendant care benefits to Dell from the time of her accident through 2011. Dell has been under the care of Dr. Brian Visser since her accident. At trial, Dr. Visser testified that he believed Dell has always needed attendant care. According to Paula Chambers, she contacted Citizens in 1987 to request reimbursement for attendant care she provided to Dell. Citizens denied the request, informing her that no such benefits were available. In April 2011, through her attorney, Dell submitted a written claim for attendant care benefits, attaching to the claim a prescription for attendant care written by Dr. Visser. At that point, Citizens began paying attendant care benefits, including reimbursement for attendant care provided in the year before the 2011 claim was filed.

Dell filed suit on July 28, 2011, seeking unpaid no-fault benefits. On one of Citizens’ motions for summary disposition, the trial court ruled that under MCL 500.3145(1), Dell’s claim was limited to benefits incurred no more than a year before she filed her complaint. Dell subsequently sought leave to amend her complaint to add a claim under the Michigan Consumer Protection Act (MCPA). 1 Citizens contested *738 the amendment, arguing that it was time-barred by MCL 445.911(7). The trial court granted leave to amend the complaint after concluding that there was a question of fact regarding whether Dell’s MCPA claim was barred by MCL 445.911(7).

After Dell filed her amended complaint, Citizens failed to timely file an answer, and a default judgment was entered. Citizens’ motion to set aside the default was denied by the trial court. Citizens filed a motion for reconsideration. Citizens subsequently filed a motion for summary disposition, arguing that under MCL 500.3145(1) and this Court’s opinion in Grant v AAA Mich/Wisconsin, Inc (On Remand), 2 Dell’s MCPA claim must be limited to expenses incurred no more than one year before Dell filed her complaint.

The trial court first granted reconsideration and set aside the default. The trial court denied Citizens’ motion for summary disposition, finding that MCL 500.3145(1) did not apply to Dell’s MCPA claim. Citizens then filed a motion under MCR 2.116(C)(8). The motion argued that Dell’s amended complaint failed to state a claim under the MCPA because the MCPA did not apply to misconduct that occurs in the claims-handling and adjustment process. The trial court denied the motion, concluding that Dell’s complaint stated a claim under the MCPA.

The matter proceeded to trial. With regard to Dell’s claim for no-fault benefits, the jury found that Dell had not incurred any allowable expenses under the no-fault act during the period between July 28, 2010 (one year before filing her complaint) and the time of trial. With regard to Dell’s MCPA claim, the jury concluded that Citizens had violated the MCPA. The jury awarded *739 Dell $1.7 million in unpaid benefits and $300,000 in damages for mental anguish resulting from the violation. After trial, Dell filed a motion seeking attorney-fees and costs. Citizens moved for JNOV, arguing that the jury’s verdict with respect to the first count established that Dell’s MCPA claim was time-barred under MCL 445.911(7). The trial court agreed and granted the motion. Having granted JNOV, the trial court did not consider Dell’s request for costs and attorney fees.

On appeal, Dell raises several issues, many of which contest the trial court’s decision to grant JNOV. Citizens cross-appeals, arguing that the trial court erred when it concluded that the MCPA applies to misconduct that occurs in the claims-handling and adjustment process. We begin with Citizens’ cross-appeal.

II. CROSS-APPEAL

Citizens argues that the trial court erred when it denied Citizens’ second motion for summary disposition. We disagree.

A. STANDARD OF REVIEW

Issues of statutory interpretation are reviewed de novo. 3 This Court also reviews de novo a trial court’s decision on a motion for summary disposition. 4

A motion under MCR 2.116(C)(8) tests the legal sufficiency of the complaint. All well-pleaded factual allegations are accepted as true and construed in a light most favorable to the nonmovant. A motion under MCR 2.116(C)(8) may be granted only where the claims alleged are so clearly unenforceable as a matter of law that no factual development could possibly justify recovery. When *740 deciding a motion brought under this section, a court considers only the pleadings. [5]

B. DISCUSSION

The question, before this Court is whether the conduct alleged in Dell’s amended complaint, all of which occurred in the claims-handling and adjustment process, is actionable under the MCPA. In her amended complaint, Dell alleged the following:

25. [Citizens has] engaged in unfair, unconscionable or deceptive conduct in violation of Chapter 20 of the Michigan Insurance Code in its dealings with [Dell] and her family, agents or representatives.
26. In particular, [Citizens has] violated [its] duties to act honestly and to explain benefits under MCL 500.2006(3)_
27. [Citizens] also violated [its] obligations under MCL 500.2026, including but not limited to, the duty not to misrepresent facts or coverages, the duty to communicate promptly, the duty to affirm or deny coverage timely, the duty to promptly investigate claims, the duty to effectuate prompt, fair and equitable settlements of claims, the duty not to compel insureds to institute litigation by underpaying, the duty to identify payments and coverage, and/or the duty to explain [the] basis for denial or offer of compromise.

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Bluebook (online)
880 N.W.2d 280, 312 Mich. App. 734, Counsel Stack Legal Research, https://law.counselstack.com/opinion/dell-v-citizens-insurance-company-of-america-michctapp-2015.