Luzviminda Lanurias v. Progressive Insurance Company

CourtMichigan Court of Appeals
DecidedOctober 18, 2016
Docket327435
StatusUnpublished

This text of Luzviminda Lanurias v. Progressive Insurance Company (Luzviminda Lanurias v. Progressive 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
Luzviminda Lanurias v. Progressive Insurance Company, (Mich. Ct. App. 2016).

Opinion

STATE OF MICHIGAN

COURT OF APPEALS

LUZVIMINDA LANURIAS, BROOKS UNPUBLISHED NEUROLOGICAL PRACTICES, TIMELY October 18, 2016 TRANSPORTATION, LLC,

Plaintiffs-Appellants,

and

LEVEL ONE HOME CARE, INC.,

Plaintiff/Counter-defendant- Appellant,

SAUNDERS DORSEY,

Plaintiff/Counter-defendant,

v No. 327435 Wayne Circuit Court PROGRESSIVE INSURANCE COMPANY, LC No. 12-011562-CZ

Defendant/Counter-plaintiff- Appellee.

Before: MURRAY, P.J., and CAVANAGH and WILDER, JJ.

PER CURIAM.

Plaintiffs, Luzviminda Lanurias, Brooks Neurological Practices (“BNP”), Timely Transportation, LLC (“Timely Transportation”), and Level One Home Care, Inc. (“Level One”) appeal as of right an order granting sanctions under MCL 500.3148(2) to defendant, Progressive Insurance Company.1 We affirm.

1 We note that the order appealed from separately lists Progressive Insurance Company and Progressive Michigan Insurance Company as defendants. However, the appearance filed with

-1- I. FACTS

This case arises out of Lanurias’s2 alleged injuries and claim for no fault benefits stemming from a car accident that occurred on July 27, 2011. Lanurias was involved in a car accident when she was driving her car and another driver failed to stop at a stop sign. As a result of the accident, Lanurias was taken to the hospital.

According to Lanurias, she was in pain after the accident and did not have medical insurance (and did not know no-fault benefits under her husband’s no-fault policy with defendant would pay for medical care arising out of her car accident), so she asked her friend Ana Lou Brooks (“Ana Lou”) for help. Ana Lou, a case manager for a case management company, Brooks Neurological Practices (“BNP”), which was owned by her husband Harvey Brooks (“Harvey”), discussed the car accident and possible treatment options with Lanurias. Thereafter, BNP began providing case management services to Lanurias.

As part of the case management services, BNP referred Lanurias to Level One, a company that provides home healthcare to patients injured in automobile accidents, which is owned by Harvey’s longtime friend Saunders Dorsey. BNP also recommended that Lanurias use Carla Aikens, Dorsey’s daughter, as an attorney. Aikens is also the owner of Timely Transportation, a business that provides transportation for medical appointments.

Level One and Timely Transportation began providing services to Lanurias. In fact, Level One agreed with Abdullah Haqq to pay him $1,085 per month3 for providing six to eight hours of attendant care services for Lanurias per day and $20 a day for performing replacement household services. It was explained to Haqq that in order for him to get paid for performing the services, he was required to keep a log of the services he performed for Lanurias.

On August 5, 2011, BNP requested that defendant pay for case management, attendant care, and transportation services. In response to the request, defendant sent an investigation letter, because (1) defendant had not yet received Lanurias’s medical records and (2) Lanurias indicated she did not plan on getting these services in earlier communications with defendant.

Over the next few months, Haqq received preprinted forms from Level One that indicated he performed various services for Lanurias, even though he did not perform them. Haqq even received preprinted forms indicating he performed various services when he was actually in Japan. In addition, Haqq received preprinted forms for periods of the time that were in the future. Haqq acknowledged that the services performed and the time expended on services indicated on the attendant care logs were inaccurate, but signed the forms because Level One

this Court by defendant’s attorney only lists Progressive Insurance Company as defendant, and no other pleadings, filings, or briefs indicate that Progressive Michigan Insurance Company is a separate defendant in the instant action. 2 Lanurias was born in the Phillipines and moved to Michigan in 2001, and her first language is Tagalog. 3 $35 a day.

-2- told him to.4 Moreover, the preprinted forms indicated that Haqq was a supervised caregiver and that Nikki Ford, an employee of Level One, was the nurse supervisor.

After Haqq signed the forms, he would send them to Level One and Ford would review the service logs. Ford never verified that the services indicated on the forms were actually provided, nor did she supervise Haqq when he performed the services. Nevertheless, Ford would sign the forms and send them to Dorsey. Dorsey in turn submitted bills to defendant for payment. Initially, Level One billed defendant $28,182, or $462 a day, for the attendant care services incurred in the first billing cycle.

Adam Rybicki, a claims representative for defendant, thought the charge of $462 a day was unreasonable, so he negotiated with Dorsey to a rate of $195 a day. In total, defendant paid Level One $21,450. Rybicki testified that he would not have paid that amount if he knew Haqq only spent 75 minutes performing services a day or if he knew that Ford was not supervising Haqq.

For the month of August, 2011, BNP billed defendant $2,250 (25 hours at $90 an hour) for case management services rendered on behalf of Lanurias. Defendant refused to pay BNP for case management services because (1) Lanurias’s reason for needing case management services (getting faster service) was unreasonable and (2) a case manager was not necessary to help translate for Lanurias as Karen Barney, Lanurias’s case manager, did not speak Tagalog, and defendant would have simply paid for Lanurias to have a translator if one was needed.

As a part of defendant’s investigation,5 Rybicki set up an independent medical examination as he was suspicious of the nature and seriousness of Lanurias’s claimed injuries. Defendant received the independent medical examination report created by Dr. Vikram Narula, and according to the report, attendant care and household services were not required for Lanurias. As a result, defendant sent a letter to Lanurias terminating her attendant care and household services.6

Plaintiffs filed a complaint on March 9, 2012, alleging that defendant failed to pay for attendant care, transportation, case management, and household replacement services rendered by Level One, BNP and Timely Transportation. Plaintiffs subsequently amended their complaint to add a cause of action for unpaid underinsured motorist benefits.7

4 The preprinted forms indicated he spent 7 hours and 45 minutes each day providing services for Lanurias, while he really only spent about an hour and fifteen minutes. 5 Rybicki investigated Lanurias’s case more thoroughly because he thought it was odd Lanurias was claiming case management, attendant care, and transportation services when she only suffered soft tissue injuries. 6 Transportation services were not terminated until January 24, 2012. Despite the fact that benefits were terminated, Timely Transportation continued to submit bills to defendant because Lanurias was still using transportation services. 7 The parties agreed to settle this claim.

-3- In response, defendant filed a counterclaim against Level One and Dorsey for (1) fraud, (2) innocent misrepresentation, (3) unjust enrichment, and (4) “payment under mistake of fact.” Specifically, defendant alleged that Level One knew it was billing Progressive for services that were either not rendered or not supervised, as indicated on the attendant care logs. Defendant subsequently amended its counterclaim and sought to pierce Level One’s corporate veil and hold Dorsey personally liable for Level One’s obligations.

After several discovery issues, Level One and Dorsey filed a motion for summary disposition brought under MCR 2.116(C)(8) and (C)(10) on defendant’s counterclaims.

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