DeLuca v. Amica Mutual Insurance

119 F. Supp. 3d 611, 2015 U.S. Dist. LEXIS 104313, 2015 WL 4724801
CourtDistrict Court, E.D. Michigan
DecidedAugust 10, 2015
DocketCase No. 14-12175
StatusPublished

This text of 119 F. Supp. 3d 611 (DeLuca v. Amica Mutual Insurance) is published on Counsel Stack Legal Research, covering District Court, E.D. Michigan primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
DeLuca v. Amica Mutual Insurance, 119 F. Supp. 3d 611, 2015 U.S. Dist. LEXIS 104313, 2015 WL 4724801 (E.D. Mich. 2015).

Opinion

MEMORANDUM AND ORDER DENYING PLAINTIFFS’ MOTION FOR SUMMARY JUDGMENT ON DEFENDANT’S COUNTERCLAIM (Doc. 19)

AVERN COHN, District Judge. '

I.Introduction ..............................•......¡.......................614

II. Background................................................ 614

A. The Accident............................ 614

B. The 2007 Lawsuit...:...........................................•.....614

C. The 2010 Lawsuit.................................................. 615

D. DeLuca Appointed Guardian..........................................615

E. Basis for EDS’s Complaint............................................615

F. Proceedings in this Court........................................'.....615

III. Summary Judgment.......................................................615

IV. An Overview of Michigan’s No-Fault Act...................................616

V. Analysis................................................................617

A EDS’s Arguments ...................................................617

B. Standing....................................... 618

C. Real Party in Interest.........................;......................618

D/ Res Judicata arid Collateral Estoppel...........;.......................620

1. In' General.......-................................................620

2. The May 2008 Settlement _..........................................620

3. The October 2011 Arbitration......................................621

VII. Conclusion.........................................................•.....623

[614]*614I. Introduction

This is an insurance casé in which plaintiffs seek payment of insurance benefits under Michigan’s No-Fault Act from defendant. The defendant insurance company denies liability. The dispute arises out of an automobile accident on December 26, 2002 in which Stephanie Rudd (Rudd) suffered what was later determined to be a traumatic brain injury. Plaintiffs/Counter-defendants Elizabeth DeLuca (DeLuca) and EDS Care Management, LLC, (EDS) (collectively, where appropriate, EDS) sued defendant/counter-plaintiff Arnica Mutual Insurance Company (Arnica)' in state court seeking to recover guardianship, conservatory, and trustee expenses, as well as expenses associated with residential and attendant care services supplied to Rudd from May 12, 2013 and beyond. DeLuca otos EDS, an attendant care provider facility.

Arnica removed the case to federal court based on diversity jurisdiction and filed a counterclaim seeking to recoup the funds that it says have been erroneously paid to EDS. In seeking recoupment, Arnica maintains that Rudd did not in fact suffer a traumatic brain injury or that her injuries are not related to the accident. The counterclaim asserts the following claims: Payment Under Mistake of Fact (Count I), Unjust Enrichment (Count II), and Breach of Fiduciary Duty (Count III). In Counts I and II of the counterclaim, Arnica seeks a money judgment in the amount of benefits it says it mistakenly paid to EDS on behalf of Rudd. In Count III, EDS also 'seeks a money judgment on the grounds that DeLuca engaged in a prohibited transaction under Michigan’s Estates and Protected Individuals Code when DeLuca, as guardian for Rudd, removed her from her previous live-in care facility to DeLu-ca’s facility, EDS.

Before the Court is EDS’s motion for summary judgment on Arnica’s counterclaims, contending that (1) Arnica does not have standing and/or is not the real party in interest to pursue these claims since it has been reimbursed for any payments exceeding $300,000.00 by the Michigan Catastrophic Claims Association, (2) Arni-ca’s claims, are barred by either res judica-ta and/or collateral estoppel because of prior litigation between Rudd and Arnica. As will be explained, none of these arguments have merit. For the reasons that follow, the motion will be denied.

II. Background

The material facts as gleaned from the parties’ papers follow.

A. The Accident

On December 27, 2002, Rudd was riding in an automobile driven by her father when it was involved in an accident. Rudd injured her head when the airbag deployed and smashed- into her face and skull. Rudd was insured under an automobile policy her father had with Arnica.

Sometime after the accident, Rudd was diagnosed by Dr. Owen Z. Perlman to have suffered a traumatic brain injury from the blow to the head by the airbag. Dr. Perl-man also noted that Rudd suffered from an “organic mood disorder with some depression.”

Subsequently, Rudd was found to be legally incompetent. In’ 2006, Rudd’s mother, Robin Massey-Rudd, was appointed her legal guardian.

B. The 2007 Lawsuit

In 2007, Rudd’s mother sued Arnica on behalf of Rudd in state court, seeking PIP benefits. The case settled in case evaluation procéedings. Rudd’s mother signed, individually and as conservator of Rudd, a Release of Claims for Benefits Under [615]*615Michigan’s No Fault Law on May 1, 2008. The case settled for $200,000 for claims made through April 18,2008; a Stipulation and Order for Dismissal was entered thereafter.

C.The 2010 Lawsuit

A few years later, Rudd’s mother filed a second lawsuit in state court against Arnica for benefits that expenses that occurred after April 18, 2008. The parties agreed to submit the claim to binding arbitration. The agreement between the parties stated that

[t]he arbitrators shall' hear and determine the issues of liability and allowable damages under MCL 500.8105. The arbitrators ... will decide: What allowable expenses, if any, are owed by Arni-ca, after April 18, 2008, as a result of the December 27, 2002 motor vehicle accident?

The arbitrators awarded Rudd $178,593.96. The award covered the period from April 18, 2008 to the date of the award, October 26, 2011 and was broken down among specific medical providers.

D. DeLuca Appointed Guardian

In 2012, the Washtenaw County Probate Court appointed DeLuca as Rudd’s new legal guardian. DeLuca is a licensed attorney and owner of EDS, an attendant care provider company. DeLuca, with Rudd’s mother’s agreement, transferred Rudd from her prior live-in care facility, Eisenhower Center, to EDS’s facility sometime after May of 2013.

E. Basis for EDS’s Complaint

EDS says that it has incurred reasonable and necessary expenses in caring for Rudd as well assisting her in her recover and rehabilitation from the injury she suffered in the accident. EDS sought payment for these expenses from Arnica. After questioning whether there was a conflict of interest with DeLuca being Rudd’s personal representative and her company providing care for Rudd, Arnica agreed to pay EDS’s claims at a rate negotiated, by DeLuca and a claims representative for Arnica..

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Bluebook (online)
119 F. Supp. 3d 611, 2015 U.S. Dist. LEXIS 104313, 2015 WL 4724801, Counsel Stack Legal Research, https://law.counselstack.com/opinion/deluca-v-amica-mutual-insurance-mied-2015.