Malick Gueye v. State Farm Mutual Automobile Insurance Company

CourtMichigan Court of Appeals
DecidedSeptember 22, 2022
Docket358992
StatusPublished

This text of Malick Gueye v. State Farm Mutual Automobile Insurance Company (Malick Gueye v. State Farm Mutual Automobile 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
Malick Gueye v. State Farm Mutual Automobile Insurance Company, (Mich. Ct. App. 2022).

Opinion

If this opinion indicates that it is “FOR PUBLICATION,” it is subject to revision until final publication in the Michigan Appeals Reports.

STATE OF MICHIGAN

COURT OF APPEALS

MALICK GUEYE, FOR PUBLICATION September 22, 2022 Plaintiff-Appellant, 9:30 a.m.

v No. 358992 Oakland Circuit Court STATE FARM MUTUAL AUTOMOBILE LC No. 2021-186759-NI INSURANCE COMPANY and SHANNON LEE HOOD,

Defendants-Appellees.

Before: CAVANAGH, P.J., and GARRETT and YATES, JJ.

GARRETT, J.

Plaintiff Malick Gueye appeals as of right the trial court’s order dismissing Gueye’s claims against defendant State Farm for both uninsured/underinsured motorist (UM/UIM) benefits and no-fault personal protection insurance (PIP) benefits. We affirm the portion of the order dismissing Gueye’s UM/UIM claim but remand for the trial court to determine whether dismissal is with or without prejudice. We vacate the portion of the order dismissing Gueye’s no-fault claim and remand for further proceedings.

I. FACTUAL BACKGROUND

This case arises out of an automobile accident involving Gueye and defendant, Shannon Lee Hood,1 that occurred on March 8, 2020. After the accident, Gueye filed a claim with State Farm, his automobile insurer. State Farm requested that Gueye appear for an insurance medical examination (IME)2 on September 16, 2020; Gueye did not attend. State Farm also requested that

1 Claims against Hood are not a subject of this appeal. 2 Although the trial court and the parties refer to this examination as an “independent medical examination,” this opinion instead refers to the examination as an insurance medical examination. As we observed in Micheli v Mich Auto Ins Placement Facility, ___ Mich App ___, ___; ___

-1- Gueye appear for an examination under oath (EUO) on October 6, 2020 and scheduled another IME on October 28, 2020. Gueye’s counsel responded to the request on September 24, 2020, sharing that Gueye would soon be out of the country but expressing willingness to schedule an EUO over Zoom. On October 1, 2020, State Farm denied Gueye’s claim for no-fault benefits for failure to appear at the September 16, 2020 IME. State Farm also followed up with Gueye’s counsel about scheduling an EUO on November 10, 2020, but Gueye’s counsel explained that a lawsuit would be filed shortly, making the EUO duplicative of a deposition that would likely occur during litigation.

Gueye filed a complaint on March 8, 2021, alleging that State Farm had unreasonably refused to pay him both UM/UIM benefits and no-fault PIP benefits under the Michigan no-fault act, MCL 500.3101 et seq.3 State Farm moved the trial court for summary disposition, arguing that Gueye’s failure to attend the EUO and the IME—prerequisites to recovery under the applicable policy—precluded him from collecting UM/UIM benefits. State Farm also contended that Gueye’s failure to appear for an IME justified dismissal of the claim for PIP coverage under the statutory provisions of the no-fault act.

In an order, the trial court concluded:

Defendant correctly states that the Michigan No-Fault Act does not require insurers to provide [UM or UIM] protection. When this coverage is elected the provisions of the contract, rather than statute, govern all disputes.

The contract between the parties clearly states that Plaintiff’s submission to both an independent medical examination (IME) and an examination under oath (EUO) are required as conditions precedent to the Plaintiff’s ability to file suit. Plaintiff failed to submit to either an IME or an EUO prior to filing the Complaint in this matter. When Defendant learned that a Complaint was forthcoming, it stated that the examinations were unnecessary, as they would be duplicative of discovery in the matter.[4] Plaintiff claims that this amounts to waiver by Defendant. This

NW2d ___ (2022) (Docket No. 356559); slip op at 2 n 3, the commonly used phrase “independent medical examination” is a “euphemistic term of art.” In the insurance context, “an IME involves obtaining a second opinion from a doctor who is entirely selected and paid for by an insurance company, rendering the ‘independence’ of the examination somewhat questionable.” Id. 3 Our Legislature recently amended the no-fault act, effective June 11, 2019. 2019 PA 21. 4 This sentence in the trial court’s order is factually mistaken; it was Gueye’s attorney, not State Farm, who expressed that an EUO was unnecessary because it would be duplicative of discovery conducted during a lawsuit.

-2- argument fails, as the lawsuit was already in motion.[5] Accordingly, the Plaintiff’s claims for UM/UIM [benefits] are denied.

Conversely, PIP benefits are statutorily required. Plaintiff’s failure to submit to an IME or to an EUO as required by MCL 500.3151 and MCL 500.3153 respectively, preclude Plaintiff from receiving benefits. Each section requires the Plaintiff to submit to examinations to be entitled to PIP benefits. The Plaintiff has submitted to neither the IME nor the EUO.

For these reasons, Defendant’s Motion for Summary Disposition and Dismissal of PIP and UM/UIM benefits is granted, and the case is hereby dismissed.

Gueye moved the trial court for reconsideration, arguing in part that the severe sanction of dismissal for missed IMEs was not a “just” order under MCL 500.3153. The trial court denied the motion for reconsideration, and this appeal followed.

II. UM/UIM BENEFITS

Gueye argues that the trial court erred by granting summary disposition to State Farm and dismissing his claim for UM/UIM benefits.

A. STANDARD OF REVIEW

We review de novo a trial court’s decision on a motion for summary disposition under MCR 2.116(C)(10).6 Dressel v Ameribank, 468 Mich 557, 561; 664 NW2d 151 (2003). “De novo review means that we review the legal issue independently” and without deference to the trial court. Wright v Genesee Co, 504 Mich 410, 417; 934 NW2d 805 (2019).

Under MCR 2.116(C)(10), the party moving for summary disposition is entitled to judgment as a matter of law when, “[e]xcept as to the amount of damages, there is no genuine issue as to any material fact.” The reviewing court “considers affidavits, pleadings, depositions, admissions, and documentary evidence filed in the action or submitted by the parties, MCR

5 At the time Gueye’s attorney communicated that an EUO was unnecessary, the attorney represented that a lawsuit was forthcoming. But as previously discussed, Gueye did not file his complaint until March 8, 2021. 6 The trial court did not specify which court rule it relied on when granting State Farm’s motion for summary disposition, nor did State Farm file its motion under a particular section of MCR 2.116. Because State Farm submitted evidence beyond the pleadings in support of its motion, we construe the trial court as having granted summary disposition under MCR 2.116(C)(10). See Krass v Tri-County Security, Inc, 233 Mich App 661, 664-665; 593 NW2d 578 (1999) (“Where the record is unclear with regard to which section of MCR 2.116 the trial court based its ruling, and both the defendant and the trial court relied on documentary evidence beyond the pleadings in support of the defendant’s motion for summary disposition, this Court must construe the defendant’s motion as being granted pursuant to MCR 2.116(C)(10).”).

-3- 2.116(G)(5), in the light most favorable to the party opposing the motion.” Quinto v Cross & Peters Co, 451 Mich 358, 362; 547 NW2d 314 (1996). The moving party has the initial burden to support its position; once met, the burden shifts to the nonmoving party to establish that a genuine issue of material fact exists. Id.

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Bluebook (online)
Malick Gueye v. State Farm Mutual Automobile Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/malick-gueye-v-state-farm-mutual-automobile-insurance-company-michctapp-2022.