IDS Property Casualty Insurance Co. v. Kasneci

222 F. Supp. 3d 545, 2016 U.S. Dist. LEXIS 167255, 2016 WL 7048809
CourtDistrict Court, E.D. Michigan
DecidedDecember 5, 2016
DocketCase No. 13-11233
StatusPublished

This text of 222 F. Supp. 3d 545 (IDS Property Casualty Insurance Co. v. Kasneci) 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
IDS Property Casualty Insurance Co. v. Kasneci, 222 F. Supp. 3d 545, 2016 U.S. Dist. LEXIS 167255, 2016 WL 7048809 (E.D. Mich. 2016).

Opinion

OPINION AND ORDER REGARDING CROSS-MOTIONS FOR SUMMARY JUDGMENT

PRESENT: Honorable Gerald E. Rosen, United States District Judge

I. INTRODUCTION

After Defendant Frano Kasneci sustained injuries in a 2007 automobile accident, he reached a settlement with his automobile insurer, Plaintiff IDS Property Casualty Insurance Company, that called for Plaintiff to provide various benefits to Defendant for a two-year period concluding in April of 2014. Upon conducting surveillance of Defendant in September of 2012, however, the Plaintiff insurer determined that Defendant was no longer entitled to the benefits awarded to him under the parties’ settlement agreement. Accordingly, Plaintiff evidently ceased to pay these benefits in March of 2013, and it also commenced the present action in this Court, seeking (i) a declaration that it has no further obligation to provide benefits to Defendant under the parties’ settlement agreement, and (ii) recovery of all past payments made to Defendant under the settlement agreement. Defendant, in turn, has filed a counterclaim against the Plaintiff insurer, alleging that it has breached the parties’ settlement agreement by improperly ceasing payment of the benefits granted to Defendant under the agreement.

Through the present cross-motions, Defendant seeks an award of summary judgment in his favor as to each of the claims asserted in Plaintiffs complaint, and Plaintiff requests that summary judgment be awarded in its favor on the counterclaims asserted by Defendant, These motions have been fully briefed by the parties.1 Having reviewed the parties’ briefs and accompanying exhibits, as well as the remainder of the record, the Court finds that the relevant allegations, facts, and legal arguments are adequately presented in these written submissions, and that oral argument would not aid the decisional process. Accordingly, the Court will decide the parties’ cross-motions “on the briefs.” See Local Rule 7.1(f)(2), U.S. District Court, Eastern District of Michigan. This opinion sets forth the Court’s rulings on these motions.

II. FACTUAL BACKGROUND

On March 20, 2007, Defendant Frano Kasneci sustained various injuries in an automobile accident. Following this accident, Defendant sought benefits from his automobile insurer, Plaintiff IDS Property Casualty Insurance Company. Although Plaintiff allegedly “commenced the payment of benefits to [Defendant] from the date of the accident” through the date the present suit was filed, (Complaint at ¶ 7), Defendant evidently was dissatisfied with [548]*548these payments and brought a state court suit against Plaintiff in April of 2009.

In May of 2012, the parties entered into a settlement agreement calling for Plaintiff to pay certain benefits to Defendant for the period from April 20, 2012 to April 19, 2014. (See Complaint, Ex. 1, Settlement Agreement.) Specifically, this agreement provided that Plaintiff would pay Defendant (i) $1,568.00 per week for 128 hours of home attendant health care services, (ii) $400 per month for transportation services, and (iii) the cost of a health club membership in lieu of physical therapy. (Id. at 1-2.)2 In addition, Plaintiff promised to pay the “reasonable medical expenses incurred for [Defendant’s] care, treatment, rehabilitation and accommodation ... arising as a result of’ his auto accident, as well as the cost of “all medications prescribed by physicians! ]” for Defendant’s care and treatment arising from this accident. (Id. at 2-3.) The parties agreed, however, that if there was “a substantial change in [Defendant’s] medical circumstance,” Plaintiff would be relieved of its obligation to pay benefits “for that period of time that said change [in] circumstance shall continue.” (Id. at 3.)

Both before and during the two-year term of the settlement agreement, a private investigator retained by the Plaintiff insurer conducted surveillance of Defendant’s activities. (See Defendant’s Motion, Ex. 7, Adamczyk Dep. at 10-11, 20, 33-36.) Although Defendant’s health care providers opined that he could not drive due to his medical condition,3 Defendant was observed driving a car in November of 2011 and September of 2012. (See id. at 15-19, 25-31; see also Plaintiffs Motion, Ex. 9, 9/30/2012 Surveillance Report at 2.) Moreover, Defendant suffered from occasional seizures and episodes of aggressive behavior and loss of control, concerns that presumably led to the provision in the settlement agreement calling for over 18 hours a day of attendant care. Yet, Plaintiffs surveillance disclosed that Defendant engaged in various activities—e.g., a convenience store transaction, (see 9/30/2012 Surveillance Report at 25), numerous interactions with a contractor at his home over the course of several hours, (see Plaintiffs Motion, Ex. 10, 1/28/2013 Surveillance Report at 19-37), and helping a man confined to a wheelchair gain entrance to an office building, (see Plaintiffs Motion, Ex. 11, 3/19/2013 Surveillance Report at 22-23)— without any attendant care provider on hand to intervene and assist Defendant if that proved necessary.

In light of this surveillance, the Plaintiff insurer ceased making payments to Defendant under the settlement agreement. In addition, Plaintiff commenced the present action in this Court on March 20, 2013, seeking (i) a declaration that the parties’ settlement agreement is no longer enforceable, whether due to a mistaken understanding of Defendant’s condition at the time the parties entered into this agreement or a subsequent improvement in Defendant’s condition, and (ii) reimbursement of the payments made by Plaintiff to Defendant under the agreement. Defendant, in turn, filed a counterclaim against Plaintiff, seeking (i) a declaration that Plaintiff is responsible for paying the entirety of [549]*549the benefits called for under the settlement agreement, and (ii) an award of all benefits withheld by Plaintiff over the two-year term of this agreement.

III. ANALYSIS

A. The Standards Governing the Parties’ Cross-Motions

Through the present cross-motions, both Plaintiff and Defendant seek an award of summary judgment in their favor as to each of the claims asserted against them by the opposing party. Under the pertinent Federal Rule governing these motions, summary judgment is proper “if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.” Fed. R. Civ. P. 56(a). As the Supreme Court has explained, “the plain language of Rule 56[ ] mandates the entry of summary judgment, after adequate time for discovery and upon motion, against a party who fails to make a showing sufficient to establish the existence of an element essential to that party’s case, and on which that party will bear the burden of proof at trial.” Celotex Corp. v. Catrett, 477 U.S. 317, 322, 106 S.Ct. 2548, 2552, 91 L.Ed.2d 265 (1986).

In deciding a motion brought under Rule 56, the Court must view the evidence “in a light most favorable to the party opposing the motion, giving that party the benefit of all reasonable inferences.” Smith Wholesale Co. v. R.J. Reynolds Tobacco Co., 477 F.3d 854, 861 (6th Cir. 2007).

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Bluebook (online)
222 F. Supp. 3d 545, 2016 U.S. Dist. LEXIS 167255, 2016 WL 7048809, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ids-property-casualty-insurance-co-v-kasneci-mied-2016.