Maple Manor Rehabilitation Center LLC v. Evanston Insurance Co

CourtMichigan Court of Appeals
DecidedApril 27, 2023
Docket359147
StatusUnpublished

This text of Maple Manor Rehabilitation Center LLC v. Evanston Insurance Co (Maple Manor Rehabilitation Center LLC v. Evanston Insurance Co) 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
Maple Manor Rehabilitation Center LLC v. Evanston Insurance Co, (Mich. Ct. App. 2023).

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

MAPLE MANOR REHABILITATION CENTER, UNPUBLISHED LLC, April 27, 2023

Plaintiff-Appellant/Cross-Appellee,

v No. 359147 Wayne Circuit Court EVANSTON INSURANCE COMPANY, LC No. 20-000301-CB

Defendant-Appellee/Cross-Appellant.

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

PER CURIAM.

Plaintiff appeals as of right the trial court order granting summary disposition in defendant’s favor under MCR 2.116(C)(10) (no genuine issue of material fact) and the trial court order granting in part and denying in part defendant’s motion for costs and attorney fees. Defendant cross appeals the trial court order granting in part and denying in part its motion for costs and attorney fees. We affirm the grant of summary disposition in defendant’s favor, reverse the trial court’s order awarding only part of defendant’s requested attorney fees, and remand for entry of an order awarding defendant all of its requested attorney fees.

I. FACTS

The underlying facts in this matter are largely undisputed. Dorothy Irvine, 88 years old, was admitted to plaintiff, Maple Manor Rehabilitation Center (“Maple Manor”), on November 25, 2014, after a hospital stay. Irvine had a significant health history that included COPD,1 nephrolithiasis, osteoarthritis, abdominal aortic aneurysm, diverticulosis, peripheral neuropathy, vertigo, hypothyroidism, esophageal varices, dementia, and thrombocytopenia. On or about December 11, 2014, she was found lying on the floor at the rehabilitation center. She appeared injured and was taken to the emergency room at Annapolis Hospital after the unwitnessed fall. A

1 Chronic obstructive pulmonary disease.

-1- computed tomography (CT) scan performed there revealed an “acute on chronic subdural hematoma”2 and she was transferred to Garden City Hospital (“the Hospital”) for further work up and management.

Upon admission to the Hospital, Irvine was noted to have a left head hematoma, left wrist fracture, and right rib fracture. A repeat CT scan performed at Garden City Hospital on December 12, 2014, revealed no significant interval change from a scan previously conducted on November 6, 2014. While in the hospital, however, Irvine was found to have a urinary tract infection, worsening mental state, difficulty swallowing, and metabolic abnormalities. She passed away at the Hospital on December 16, 2014. Irvine’s death certificate, issued December 17, 2014, indicated that the cause of her death was atherosclerotic cardiovascular disease and the manner of her death was natural.

On August 18, 2015, Irvine’s son called the Wayne County Medical Examiner’s Office and reported that Irvine’s death was related to a fall at Maple Manor and that the manner of her death was thus accidental. The medical examiner’s office thereafter obtained some, but not all, of Irvine’s information and medical records from the Hospital, which led it to believe that while at Maple Manor on December 11, 2014, Irvine fell from her wheelchair and hit her head on the floor. Thus, the medical examiner issued an amendment to change the cause of death to subdural hematoma and the manner of death to accident. An amended death certificate was issued to reflect those changes.

On July 20, 2017, Irvine’s son, as personal representative of Irvine’s estate, filed a wrongful death lawsuit against Maple Manor, asserting negligence (“the Irvine lawsuit”). At the time the Irvine lawsuit was filed, Maple Manor had a professional insurance policy in place with Evanston Insurance Company (“defendant”). However, Maple Manor did not notify defendant of the Irvine lawsuit when it was filed. Rather, Maple Manor defended the Irvine lawsuit itself. As the Irvine lawsuit proceeded through discovery, Maple Manor subpoenaed the medical examiner’s office for all medical records and documents relating to Irvine and the medical examiner forwarded the request to the Hospital. After obtaining all of the requested medical records, the medical examiner issued an October 30, 2018 post mortem report stating that “the December 11, 2014 fall did not produce any intracranial injuries that caused or contributed to death.” Irvine’s death certificate was then amended back to its original form.

The Irvine lawsuit nonetheless proceeded and Maple Manor continued to defend itself through discovery, various motions, and through case evaluation in November 2018. On June 7, 2019, Maple Manor reported the Irvine lawsuit to Risk Placement Services, Inc., an insurance broker through which Maple Manor had obtained its insurance policy with defendant, and Risk Placement Services then filed a first notice of loss with defendant. On June 12, 2019, defendant denied the request, stating it was not notified of the claim in a timely manner as required by the insurance policy, and that because Maple Manor had cancelled coverage with defendant prior to having notified defendant of the Irvine lawsuit, there was no coverage available to Maple Manor.

2 A second episode of acute hemorrhage into a pre-existing chronic subdural hematoma.

-2- In the meantime, Maple Manor and Irvine’s estate reached an agreement to participate in arbitration with a further agreement that the arbitration award would have a set low/high amount of $10,000/$100,000. On or about June 13, 2019, an order was entered dismissing the Irvine lawsuit with prejudice. The Irvine lawsuit was closed in the trial court in October 2019.

In January 2020, Maple Manor filed a complaint against defendant for breach of contract. Maple Manor asserted that it made numerous demands for insurance coverage and legal defense to defendant for the Irvine lawsuit and defendant wrongfully denied coverage. Maple Manor sought declarations that defendant must provide insurance coverage, legal defense, and indemnification to it, must reimburse plaintiff for all attorney fees and costs of litigation so far expended in the Irvine lawsuit, and an order that defendant participate in the currently scheduled arbitration with Irvine’s estate. Alternatively, Maple Manor requested that the trial court order defendant to refund all insurance premiums Maple Manor had paid to it for failure to provide insurance coverage.

Defendant moved for summary disposition under MCR 2.116(C)(10), asserting the policy issued to Maple Manor contained language requiring that claims be made during the policy period, and reported to defendant “as soon as practicable,” including “immediately” forwarding to Evanston any legal process in order to qualify for coverage. Defendant claimed there was no question of fact that Maple Manor did not comply with these policy terms. Maple Manor responded because there were still four months of discovery left and several key discovery items (such as depositions and requests for the insurance claims file) outstanding, summary disposition would be premature. Maple Manor also claimed that whether it notified defendant of the lawsuit “as soon as practicable” was a question of fact, because defendant initially misrepresented to Maple Manor that it had no insurance coverage with defendant and that Maple Manor therefore undertook to defend against the lawsuit on its own. It was only when Maple Manor re-investigated its insurance coverage that it discovered its policy with defendant was, in fact, in effect when the lawsuit was filed. The trial court denied defendant’s motion.

After the close of discovery, defendant again moved for summary disposition under MCR 2.116(C)(10).

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Maple Manor Rehabilitation Center LLC v. Evanston Insurance Co, Counsel Stack Legal Research, https://law.counselstack.com/opinion/maple-manor-rehabilitation-center-llc-v-evanston-insurance-co-michctapp-2023.