Sharp v. Preferred Risk Mutual Insurance

370 N.W.2d 619, 142 Mich. App. 499
CourtMichigan Court of Appeals
DecidedMay 7, 1985
DocketDocket 79575
StatusPublished
Cited by15 cases

This text of 370 N.W.2d 619 (Sharp v. Preferred Risk Mutual Insurance) 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
Sharp v. Preferred Risk Mutual Insurance, 370 N.W.2d 619, 142 Mich. App. 499 (Mich. Ct. App. 1985).

Opinion

Allen, P.J.

In this action to enforce a no-fault automobile insurance contract, defendant appeals as of right from a July 16, 1984, judgment awarding plaintiff reimbursement for nursing services, rental expenses, and replacement services performed by plaintiff in connection with injuries sustained by her son. Plaintiff cross-appeals from the failure to order reimbursement of the full amount of rental expenses and contests the amounts awarded for nursing and replacement services. Defendant does not contest liability, the only issue being the amounts due plaintiff as "allowable expenses” under MCL 500.3107(a); MSA 24.13107(a). Whether apartment rental falls within this provision is an issue of first impression.

On October 27, 1979, 20-year-old Scott Sharp was involved in a single-car automobile accident. He was immediately taken to McPherson Hospital *502 in Howell, Michigan. After approximately eight hours, when he had stabilized, he was taken to St. Joseph’s Hospital in Ann Arbor. Scott suffered no broken bones or internal injuries other than a gross closed head injury which resulted in a coma. Thomas Szymke, M.D., a specialist in physical medicine and rehabilitation, described Scott’s injuries as severe damage to the motor cortex of the brain. Duane E. Powers, D.O., an osteopathic physician, described the injuries as a spastic paralysis due to brain damage.

Scott remained at St. Joseph Hosptial until January 2, 1980, when he was transferred to McLaren Hospital in Flint, where he was confined until May, 1980, when he was transferred to Kith-Haven, an extended care facility in Flint. While Scott was at McLaren Hospital, plaintiff spent 12 to 14 hours a day with him and learned to monitor intravenous tubes for infiltration and gastric feeding tubes for rate of flow and continued to assist in Scott’s care by doing percussion on his lungs, rubbing his back and assisting the nurses in turning him in bed. As a precondition for Scott’s being admitted to Kith-Haven, plaintiff had to provide 24-hour nursing care. Therefore, plaintiff hired Kelly Health Care, a temporary employment service providing nurses and nurse’s aides. Plaintiff spent five to six hours per day with Scott.

On July 11, 1980, Scott was transferred to Flint Osteopathic Hospital where surgery was performed to correct problems with his gastric feeding tube where, except for a six-week period at Mayo Clinic, he remained until early November, 1980, when he was moved to an apartment which plaintiff had rented in Flint. Dr. Laronas of Flint Osteopathic Hospital wanted Scott returned to Kith-Haven, but plaintiff thought it would be bet *503 ter for her son and less expensive to try home care.

At the apartment 24-hour nursing care was required and was provided by Kelly Health nurses. In August 1981, plaintiff moved Scott into a larger apartment that was wheelchair-accessible. At the second apartment she had a whirlpool installed for therapy. A Hoyer Lift was installed to move Scott to the whirlpool and to a La-Z-Boy chair. In February 1982, the plaintiff began employing nurses from Medical Personnel Pool. While Scott was living at the second apartment, the plaintiff also had an $88,000 addition built on the home she and her husband owned. She hired designers and builders of handicapper-accessible buildings to design a self-contained home environment, complete with kitchen and bathroom facilities. She sought to make it private, yet accessible to the rest of the house so that she could supervise the nurses. Scott lived at the second apartment until August or September 1983, when he moved into the new addition.

In October 1983, the plaintiff replaced the Medical Personnel Pool nurses with Samaritan nurses. In November 1983, she decided that the nursing companies were "too much of a hassle”, and began to hire her own nurses and phase out the Samaritan nurses. By December she was solely responsible for hiring and paying Scott’s nurses. She testified that she handled all of the insurance claims sent to the defendant, Preferred Risk Mutual Insurance Company, including the nursing bills. From this she knew that Medical Personnel Pool charged the insurance company $13.50, $11.50 and $7.00 per hour, plus mileage and time and a half for overtime, for registered nurses (RNs), licensed practical nurses (LPNs), and nurse’s aides, respectively.

*504 Medical Personnel Pool only paid their nurses $7.00 to $8.00 an hour for RNs, $6.00 to $6.75 for LPNs, and $4.00 for nurse’s aides. The plaintiff charged the insurance company $13.00 per hour for RNs, $11.00 per hour for LPNs, and $7.00 per hour for nurse’s aides. She paid RNs $9.00 per hour, LPNs $8.00 to $9.00 per hour, and nurse’s aides $4.00 per hour.

Mrs. Sharp testified that she performs numerous services for Scott. She cleans his apartment, picks up his medications and equipment, does his banking, grocery shopping and personal shopping, and fills out insurance forms. She coordinated a National Academy for Child Development program, involving 70 volunteers who worked with Scott. Mrs. Sharp also testified concerning times when she had to work nurse’s shifts because the nursing companies failed to provide a nurse. After much persuasion from the trial court, counsel for the defendant and the plaintiff were able to stipulate how often she substituted for nurses.

Defendant paid all of the hospital and nursing expenses incurred while Scott was at the several named hospitals and paid Kith-Haven and Kelly Health Care for their services. Likewise, defendant paid in full for the addition built on plaintiff and her husband’s home. However, defendant declined to pay any rental incurred when plaintiff rented the two apartments and further declined to pay plaintiff for the nursing services performed by her when she assisted the hospital, Kelly Health Care, and home care services. It was for the services and costs for which defendant declined to pay .that plaintiff filed suit. At trial defendant contended that plaintiff’s claim for reimbursement for nursing services was barred by the statute of limitations and that defendant was entitled to a setoff of $9,400 for social security benefits for which Scott *505 became eligible and received during the first three years of his disability. Following a bench trial in July, 1984, the trial court entered judgment in relevant part as follows:

(1) Defendant is entitled to a setoff or credit of $9,400 for social security benefits received by Scott during the first three years following his injury; defendant is allowed no credit or setoff thereafter.

(2) Defendant waived its defense of the statute of limitations, since the court finds that the defense was not raised at trial.

(3) Plaintiff is entitled to recover $8,541 rental expenses.

(4) Plaintiff is entitled to $5,000 in nurses’ aide and replacement services and is qualified and capable of providing, administering and supervising nursing care; to the extent that she provides Such services she may charge the insurer $13 per hour for RNs, $11 per hour for LPNs, and $4 per hour for nurses’ aids.

(5) Plaintiff is not due penalty interest or attorney fees under MCL 500.3148; MSA 24.13148.

From the judgment of the trial court as so entered, both parties appeal.

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Bluebook (online)
370 N.W.2d 619, 142 Mich. App. 499, Counsel Stack Legal Research, https://law.counselstack.com/opinion/sharp-v-preferred-risk-mutual-insurance-michctapp-1985.