Meemic Insurance Company v. Louise M Fortson

CourtMichigan Supreme Court
DecidedJuly 29, 2020
Docket158302
StatusPublished

This text of Meemic Insurance Company v. Louise M Fortson (Meemic Insurance Company v. Louise M Fortson) is published on Counsel Stack Legal Research, covering Michigan Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Meemic Insurance Company v. Louise M Fortson, (Mich. 2020).

Opinion

Michigan Supreme Court Lansing, Michigan

Syllabus Chief Justice: Justices: Bridget M. McCormack Stephen J. Markman Brian K. Zahra Chief Justice Pro Tem: Richard H. Bernstein David F. Viviano Elizabeth T. Clement Megan K. Cavanagh

This syllabus constitutes no part of the opinion of the Court but has been Reporter of Decisions: prepared by the Reporter of Decisions for the convenience of the reader. Kathryn L. Loomis

MEEMIC INSURANCE COMPANY v FORTSON

Docket No. 158302. Argued November 6, 2019 (Calendar No. 2). Decided July 29, 2020.

Meemic Insurance Company brought an action in the Berrien Circuit Court against Louise M. Fortson and Richard A. Fortson, individually and as conservator of their son, Justin Fortson, alleging that Richard and Louise had fraudulently obtained payment for attendant-care services they did not provide to Justin. Richard and Louise were named insureds on a no-fault insurance policy issued by Meemic. Justin was considered an insured person under the policy because he was a “resident relative” as defined by the policy and because under MCL 500.3114(1) of the no- fault act, MCL 500.3101 et seq., he was a relative domiciled in the same house as a named insured. The policy contained an antifraud provision stating that the policy was void if any insured person intentionally concealed or misrepresented any material fact or circumstance relating to the insurance, the application for it, or any claim made under it. In 2009, Justin was injured when he fell from the hood of a motor vehicle, necessitating constant supervision and long-term care. Richard and Louise opted to provide attendant care to Justin in their home on a full-time basis. Justin received benefits under his parents’ no-fault policy with Meemic, and from 2009 until 2014, Louise submitted payment requests to Meemic for the attendant-care services she and her husband provided, asserting that they provided full-time supervision; Meemic routinely paid the benefits. In 2013, Meemic investigated Richard and Louise’s supervision of Justin and discovered that they had not provided him with daily direct supervision; in fact, Justin had been periodically jailed for traffic and drug offenses and had spent time at an inpatient substance-abuse rehabilitation facility at times when Richard and Louise stated they were providing full-time supervision. Meemic terminated Justin’s no-fault benefits and filed suit, asserting claims of breach of contract, fraud, common-law statutory conversion, and unjust enrichment. Meemic alleged that Louise and Richard had fraudulently represented the attendant-care services they claimed to have provided and sought to void the policy under its contractual antifraud provision, terminate any future liability for benefits, and require Louise and Richard to reimburse Meemic for the fraudulent attendant-care statements. Louise and Richard counterclaimed, arguing that Meemic breached the insurance contract by terminating Justin’s benefits and refusing to pay for attendant-care services. Meemic moved for summary disposition, and the court, John M. Donahue, J., initially denied the motion, reasoning that under the innocent-third-party rule, Meemic could not rescind the policy on the basis of fraud to avoid liability for benefits owed to Justin, an innocent third party. Meemic moved for reconsideration of that decision after the Court of Appeals later concluded in Bazzi v Sentinel Ins Co, 315 Mich App 763 (2016),1 that the innocent-third-party rule was no longer good law. On reconsideration, the trial court granted summary disposition in favor of Meemic. Louise and Richard appealed. The Court of Appeals, MARKEY, P.J., and M. J. KELLY, J. (CAMERON, J., dissenting), reversed, first reasoning that Bazzi did not apply because the fraud in this case did not occur in the procurement of the policy and did not affect the validity of the contract. The Court concluded, however, that the policy’s antifraud provision was invalid because it would enable Meemic to avoid the payment of personal protection insurance (PIP) benefits mandated by MCL 500.3105. Judge CAMERON, dissenting, would have affirmed the trial court’s grant of summary disposition to Meemic because the policy permitted rescission on the basis of fraud and fraud had occurred. 324 Mich App 467 (2018). The Supreme Court granted Meemic’s application for leave to appeal. 503 Mich 1031 (2019).

In an opinion by Justice VIVIANO, joined by Chief Justice MCCORMACK, and Justices MARKMAN, BERNSTEIN, and CAVANAGH, the Supreme Court held:

A no-fault insurance policy may contain contractual defenses to benefits mandated by the no-fault act if the defense is provided by the act or the contractual defense is based on a common- law defense that has not been abrogated by the act; a policy provision may not go beyond either statutory or common-law defenses to limit mandatory coverages to a greater extent than either the act or the common law. Meemic did not assert one of the statutory defenses allowed by the no- fault act, and the contract-based fraud defense was not the type of common-law fraud defense that would allow for rescission, the remedy most analogous to that sought under the antifraud provision. Accordingly, the antifraud provision was unenforceable.

1. With regard to motor vehicle insurance policies, the no-fault act governs the coverages that are mandated by the act. Because MCL 500.3105 provides that PIP benefits are mandatory, the act controls any questions regarding the award of those benefits. In contrast, coverages that are not required by the no-fault act (that is, optional coverages) are controlled by the language of the insurance policy. With regard to optional coverage, a court must construe and apply unambiguous contract provisions as written unless the provision violates a law or one of the traditional defenses to the enforceability of a contract applies; that is, unambiguous insurance policies are not open to judicial construction and must be enforced according to their unambiguous terms unless doing so would violate law or public policy. Common-law defenses that have not been abrogated by the no-fault act are available against claims for coverage mandated by the act. Accordingly, a contractual defense to mandatory benefits under the no-fault act is valid and enforceable when the defense is provided by the act itself or when the contractual defense is based on a common-law defense that has not been abrogated by the act; thus, an insurer may include common-law defenses that have not been abrogated by the act in an insurance policy. However, an insurance policy may not go beyond either statutory or common-law defenses to limit mandatory coverage to a greater extent than either the act or the common law; to hold otherwise would improperly reduce the scope of mandatory coverage required by the no-fault act. Therefore, a provision in an insurance policy that purports to set forth a defense to a claim for mandatory coverage is valid and enforceable only to the extent it contains a defense available under the no- fault act or a common-law defense that has not been abrogated.

1 Aff’d in part and rev’d in part 502 Mich 390 (2018). 2. If a contract is obtained as a result of fraud or misrepresentation, a party may be entitled to a legal or equitable remedy. At common law, the defrauded party could only seek to rescind the contract, that is, avoid the transaction, if the fraud related to the inducement or inception of the contract. While a contractual provision that rescinds a contract because of postprocurement fraud is not invalid in all circumstances—specifically, the clause would be valid as applied to a party’s failure to perform a substantial part of the contract or one of its essential terms—in general, the mere breach of a contract would not entitle the injured party to avoid the contract at common law.

3.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Langley v. Federal Deposit Insurance
484 U.S. 86 (Supreme Court, 1987)
Titan Insurance Company v. Hyten
491 Mich. 547 (Michigan Supreme Court, 2012)
DeFRAIN v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY
817 N.W.2d 504 (Michigan Supreme Court, 2012)
People v. Moreno
814 N.W.2d 624 (Michigan Supreme Court, 2012)
Rory v. Continental Insurance
703 N.W.2d 23 (Michigan Supreme Court, 2005)
Twichel v. MIC General Insurance Corporation
676 N.W.2d 616 (Michigan Supreme Court, 2004)
Quality Products and Concepts Co. v. Nagel Precision, Inc.
666 N.W.2d 251 (Michigan Supreme Court, 2003)
Cruz v. State Farm Mutual Automobile Insurance
648 N.W.2d 591 (Michigan Supreme Court, 2002)
Cohen v. Auto Club Ins. Ass'n
620 N.W.2d 840 (Michigan Supreme Court, 2001)
Great American Reserve Insurance Co. of Dallas v. Strain
1962 OK 241 (Supreme Court of Oklahoma, 1962)
Husted v. Auto-Owners Insurance
591 N.W.2d 642 (Michigan Supreme Court, 1999)
Citizens Insurance Co. of America v. Federated Mutual Insurance
531 N.W.2d 138 (Michigan Supreme Court, 1995)
Cardinal Mooney High School v. Michigan High School Athletic Ass'n
467 N.W.2d 21 (Michigan Supreme Court, 1991)
Stine v. Continental Casualty Co.
349 N.W.2d 127 (Michigan Supreme Court, 1984)
Rohlman v. Hawkeye-Security Insurance
502 N.W.2d 310 (Michigan Supreme Court, 1993)
Marquis v. Hartford Accident & Indemnity
513 N.W.2d 799 (Michigan Supreme Court, 1994)
Millross v. Plum Hollow Golf Club
413 N.W.2d 17 (Michigan Supreme Court, 1987)
Farm Bureau Mutual Insurance v. Nikkel
596 N.W.2d 915 (Michigan Supreme Court, 1999)
Advisory Opinion Re Constitutionality of 1972 PA 294
1972 PA 294 (Michigan Supreme Court, 1973)
Shavers v. Attorney General
267 N.W.2d 72 (Michigan Supreme Court, 1978)

Cite This Page — Counsel Stack

Bluebook (online)
Meemic Insurance Company v. Louise M Fortson, Counsel Stack Legal Research, https://law.counselstack.com/opinion/meemic-insurance-company-v-louise-m-fortson-mich-2020.