Roberts v. Farmers Insurance Exchange

737 N.W.2d 332, 275 Mich. App. 58
CourtMichigan Court of Appeals
DecidedAugust 15, 2007
DocketDocket 270406
StatusPublished
Cited by53 cases

This text of 737 N.W.2d 332 (Roberts v. Farmers Insurance Exchange) 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
Roberts v. Farmers Insurance Exchange, 737 N.W.2d 332, 275 Mich. App. 58 (Mich. Ct. App. 2007).

Opinion

PER CURIAM.

Defendant/third-party plaintiff-appellant/cross-appellee Farmers Insurance Exchange (Farmers) appeals as of right an order granting summary disposition in this action and awarding attorney fees for unreasonable denial of first-party no-fault insurance benefits. Third-party defendant-cross-appellant Regina Roberts, individually, cross-appeals the same order. On appeal, Farmers argues that the circuit court erred in determining that it unreasonably denied benefits and therefore owed attorney fees. On cross-appeal, Roberts argues that the trial court erred in requiring her to pay a cancellation fee because she was hospitalized at the time of the missed doctor’s appointment. We reverse the trial court’s award of sanctions against Farmers, and on the cross-appeal, affirm the trial court’s determination of Roberts’s liability for the $1,000 cancellation fee.

i

On December 11, 2002, when Brittany Underwood was 12 years old, she and her mother, Roberts, were involved in an automobile accident. Roberts alleged that Underwood’s “injuries resulted in a closed head injury and other physically debilitating injuries.” Farm *60 ers acknowledges that “[a]t the time of the automobile accident, [Underwood] was an insured under a no-fault automobile policy issued to her mother, Regina Roberts.”

In April 2003, Underwood was examined by Dr. Jacobus Donders of Mary Free Bed Hospital. Dr. Donders noted that Underwood reported “[r]ight frontal headaches that radiate to the neck and shoulders; apparently pressure-tension type.” In December 2003, Underwood twice failed to appear at Mary Free Bed Hospital for counseling.

In 2004, Underwood repeatedly failed to attend the physical and neuropsychological independent medical examinations (IMEs) Farmers sought and scheduled. On January 8, 2004, a physical IME of Underwood was scheduled for January 26, 2004. On January 19, 2004, Farmers scheduled a neuropsychological IME for January 28, 2004, in Grand Rapids. According to Farmers, Roberts cancelled the neuropsychological IME on January 22, 2004. On January 22, 2004, the psychological IME was rescheduled for February 27, 2004, with Robert Fabiano, Ph.D., in Grand Rapids.

On January 26, 2004, Roberts called to cancel Underwood’s physical IME and rescheduled it for February 9, 2004. Roberts then cancelled the February 9, 2004, appointment.

On February 9, 2004, the psychological examination was rescheduled for March 17, 2004. Also on February 9, 2004, the physical IME was rescheduled for February 19, 2004, with Dr. Olejniczak in Grand Rapids. Roberts and Underwood attended the February 19, 2004, physical IME.

Underwood failed to appear for either the February 27, 2004, neuropsychological examination or the March 17, 2004, neuropsychological examination. On *61 March 25, 2004, the neuropsychological examination was rescheduled for April 23, 2004, with Dr. Fabiano. On April 22, 2004, the day before the neuropsycho-logical examination, Roberts cancelled the appointment. Farmers was assessed a $250 late cancellation fee.

On April 27, 2004, Farmers rescheduled Dr. Fabi-ano’s examination for May 21, 2004. Dr. Fabiano indicated that if the patient again failed to appear or cancelled after May 14, 2004, he would assess a no-show/cancellation charge of $1,000. Accordingly, Farmers sent Underwood a letter in care of Roberts indicating: “If you fail to attend this appointment, or you cancel this appointment after 5/14/04, you will be responsible for any and all no-show/cancellation fees incurred by you at a rate of $1,000.00.” Underwood broke the May 21, 2004, appointment, so Dr. Fabiano charged Farmers the $1,000 fee.

As a result of the foregoing events, effective May 21, 2004, Farmers cancelled Underwood’s first-party no-fault benefits. In a letter dated July 13, 2004, plaintiffs counsel requested that Farmers reinstate benefits. In a letter dated July 21, 2004, Farmers responded that it would reschedule the IME on receipt of the $1,000 for the no-show/cancellation fee incurred as a result of Underwood’s failure to attend the IME, stating, “[u]ntil such time, our discontinuation of benefits, effective May 21, 2004, stands firm.”

On August 20, 2004, Roberts, as next friend of Underwood, filed a complaint asserting that Farmers “has refused or is expected to refuse to pay Plaintiff all personal protection benefits in accordance with the applicable no-fault and contract provisions.” Plaintiff further alleged that Farmers “has unreasonably refused to pay or has *62 unreasonably delayed making proper payments to Plaintiff contrary to MCL 500.3142 and MCLA 500.3148____" 1

*63 On August 25, 2004, 2 Farmers reaffirmed its discontinuation of benefits for Underwood, stating: “To date, we have not received payment for the no-show/cancellation fee. At this time we are closing our file. If we receive the requested payment in the future, we will reschedule the Independent Medical Evaluation and reconsider the claim at that time.”

On October 19, 2004, Farmers filed a third-party complaint against Roberts individually, asserting one count for breach of contract. Farmers alleged that under the terms of the automobile insurance policy and the no-fault act, MCL 500.3151, 3 Roberts “became obligated to submit minor plaintiff Brittany Underwood to mental or physical examinations by physicians,” and that as a result of Roberts’s failure to produce Underwood for an IME, Farmers “has incurred $1,000 in no show fees.”

On January 26, 2005, Roberts filed a motion for declaratory relief, summary disposition, and sanctions, arguing that Farmers wrongfully suspended no-fault benefits under MCL 500.3142 and MCL 500.3148. Roberts sought summary disposition under MCR 2.116(0(10) and an order relieving her of any responsibility to pay the $1,000 cancellation fee because she was “legally excused . . . because of her medical emergency.” Roberts argued that there was an implied good-faith covenant between insurer and insured, and *64 that Farmers failed to act in good faith and its actions demonstrated a disdain for fair dealing. Roberts argued that it was impossible for Underwood to attend the medical evaluation, and that “impossibility of performance relieves the promisor of any duty.” Roberts further argued that: (1) Farmers had an obligation to continue benefits for Underwood; (2) Farmers could have hired a case manager or made transportation arrangements for Underwood; (3) there was no noncooperation by Underwood to justify termination of benefits; and (4) sanctions should be awarded because benefits were unreasonably refused.

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Bluebook (online)
737 N.W.2d 332, 275 Mich. App. 58, Counsel Stack Legal Research, https://law.counselstack.com/opinion/roberts-v-farmers-insurance-exchange-michctapp-2007.