Gentris v. State Farm Mutual Automobile Insurance

297 Mich. App. 354, 2012 WL 1758733
CourtMichigan Court of Appeals
DecidedMay 17, 2012
DocketDocket No. 300288
StatusPublished
Cited by30 cases

This text of 297 Mich. App. 354 (Gentris v. State Farm Mutual Automobile Insurance) 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
Gentris v. State Farm Mutual Automobile Insurance, 297 Mich. App. 354, 2012 WL 1758733 (Mich. Ct. App. 2012).

Opinion

Per Curiam.

Defendant, State Farm Mutual Automobile Insurance Company, appeals as of right the trial court’s order denying its postjudgment motion for attorney fees and taxable costs. This case involved a five-day jury trial in which the jury found no cause of action with respect to plaintiffs lawsuit that sought payment for no-fault attendant-care services under MCL 500.3107(l)(a). We affirm in part and vacate in part the trial court’s order and remand for further proceedings consistent with this opinion.

The attendant-care services were allegedly provided to plaintiff, John Raymond Gentris (hereafter referred to as “plaintiff” or “John”), by his mother, Ramona Thomas, his stepfather, Kelvin Thomas, and other family members, most notably Gourmia Gentris. In 1997, at the age of 16, John was struck by a motor vehicle and severely injured. Ramona Thomas pursued the instant litigation as next friend on John’s behalf. The lawsuit, which was commenced in April 2004, concerned the alleged underpayment, and at times nonpayment, of attendant-care benefits from April 2004 until trial in 2010. There is no dispute that State Farm paid attendant-care benefits from April 2004 to July 22, 2008, at a rate of approximately $9 an hour for 24 hours a day, 7 days a week. No attendant-care benefits were paid from July 23, 2008, to November 30, 2008, as State Farm accused the Thomases of misrepresentations in paperwork submitted to State Farm in regard to services supposedly provided. Benefits were resumed per court order on December 1, 2008, and paid through July 31, 2009, at the same hourly rate of about $9, but for 16 and not 24 hours a day, 7 days a week. Thereafter, no attendant-care benefits were paid by State Farm. At trial, plaintiff sought an award of nearly [357]*357$800,000, which included a calculation for interest, pursuant to MCL 500.3107.1 The amount of attendant-care benefits requested by plaintiff was predicated on reviews and surveys showing the average local rates for home healthcare services, which substantially surpassed the hourly rate paid by State Farm. The jury answered the following verdict-form question in the negative: “Were allowable expenses incurred by or on behalf of the Plaintiff arising out of the accidental bodily injury?” Having answered no to this first question on the verdict form, the jury’s deliberations were complete.

Following trial, State Farm sought $101,415 in attorney fees pursuant to MCL 500.3148(2), which is part of the no-fault act and provides that “[a]n insurer may be allowed by a court an award of a reasonable sum against a claimant as an attorney’s fee for the insurer’s attorney in defense against a claim that was in some respect fraudulent or so excessive as to have no reasonable [358]*358foundation.” The trial court denied the request for attorney fees on the basis that there was no dispute that John was injured and in need of attendant-care services and that the only trial issues concerned whether the caregivers actually performed the services and what hourly rate should have been paid. Additionally, State Farm sought $50,143 in taxable costs pursuant to MCR 2.625(A), which provides that “[c]osts will be allowed to the prevailing party in an action, unless prohibited by statute or by these rules or unless the court directs otherwise, for reasons stated in writing and filed in the action.” The trial court denied the request for taxable costs on the basis that State Farm did not comply with the technical requirements of MCR 2.625(G) with respect to the submitted bill of costs and supporting affidavit.

State Farm indicates in its appellate brief that it “never disputed that Mr. Gentris sustained a traumatic brain injury and [has] physical limitations as a result of the subject accident,” and State Farm notes that it agreed that John “needed external structure and supervision with activities as the result of his injuries.” There is no dispute regarding the accuracy of the diagnosis of traumatic brain injury with cognitive disorder, seizure disorder, left-sided hemiparesis with contracture of the left upper extremity, left foot drop, antalgic gait, and associated depression. There is also no dispute regarding the nature of John’s physical problems and limitations with respect to the left side of his body, especially his left hand and arm, which, for all practical purposes, have been rendered nonfunctional, leaving him to tackle tasks using only his right hand and arm. John has various orthotic devices. He has a splint for his left wrist in order to prevent his hand from curling up, a splint for his left elbow, a brace for his left leg, and an ankle-foot orthotic (AFO) for his left ankle and foot, [359]*359occasionally referred to as his “boot.” On occasion, John also uses a cane for walking. Additionally, there is no dispute that John’s primary doctor prescribed attendant-care services for him covering 24 hours a day, 7 days a week. The focus of the litigation was not on whether John had serious injuries necessitating attendant-care services, but on whether Mr. and Mrs. Thomas were actually providing services as claimed, whether the care and services that were provided were adequate, and whether the rate of pay for services was appropriate.

On appeal, State Farm first argues that the trial court erred when it failed to award State Farm attorney fees under MCL 500.3148(2). State Farm contends that the claim for attendant-care benefits was fraudulent and baseless, consisting of blatant misrepresentations and untruths concerning the care allegedly provided to John. According to State Farm, the jury’s verdict of no cause of action clearly supports State Farm’s description of plaintiffs case as fraudulent and having no reasonable foundation. State Farm notes the claims for benefits relative to February 21, 2009, on which date the Thomases were incarcerated and not watching John; August 13, 2009, on which date the Thomases attended a funeral without John; and August 11, 2009, on which date John was not at home part of the day, yet the Thomases sought benefits for that period and reported that he was at home.2 With respect to plain[360]*360tiffs argument that Gourmia Gentris provided substitute care, State Farms maintains that even Gourmia testified that she allowed John to leave the house unaccompanied at times. Aside from State Farm’s claims of fraud, it also posits that plaintiffs request for hundreds of thousands of dollars in benefits constituted a claim that was so excessive as to have no reasonable foundation. Citing unpublished opinions issued by this Court, State Farm argues that the excessiveness of plaintiffs claim was established and demonstrated by the fact that the jury awarded plaintiff nothing in the face of a request amounting to nearly $800,000. In further support of the argument on excessiveness and the absence of a reasonable foundation, State Farm notes that the Thomases sought benefits for times when John was not actually with them or relatives despite indicating otherwise in the daily reports, that the Thomases failed to adequately supervise John, resulting in John leaving the house by himself and smoking marijuana, and that the Thomases failed to ensure that substitute care providers supplied the necessary supervision.3

[361]*361As already indicated, MCL 500.3148(2) provides that “[a]n insurer may be allowed

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Cite This Page — Counsel Stack

Bluebook (online)
297 Mich. App. 354, 2012 WL 1758733, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gentris-v-state-farm-mutual-automobile-insurance-michctapp-2012.