Shaun Bonkowski v. Allstate Insurance Company

544 F. App'x 597
CourtCourt of Appeals for the Sixth Circuit
DecidedAugust 23, 2013
Docket12-2038
StatusUnpublished
Cited by4 cases

This text of 544 F. App'x 597 (Shaun Bonkowski v. Allstate Insurance Company) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Shaun Bonkowski v. Allstate Insurance Company, 544 F. App'x 597 (6th Cir. 2013).

Opinion

OPINION

SARGUS, District Judge.

This case arose from Plaintiff-Appellant Shaun Bonkowski’s claim for insurance benefits under Michigan’s No-Fault Insurance Act, Mich. Comp. Laws § 500.3101 et seq., which entitles him to, inter alia, the cost of attendant care provided to him by his father, Andrew Bonkowski. From 2001 through the filing of this action in 2008, Defendant-Appellee Allstate Insurance Company (“Allstate”) compensated Appellant’s father at $166,440.00 per year *599 for the attendant care of Appellant, who was rendered a quadriplegic in 2001. In this action, Appellant seeks additional attendant care benefits. The district court denied Appellant’s motion for summary judgment and the case proceeded to trial to determine the reasonable pay due to Mr. Bonkowski. The jury returned a verdict in favor of Allstate, finding that no additional amount was due Mr. Bonkowski. After the trial, the district court denied Appellant’s renewed motion for judgment as a matter of law, in which he argued that there was insufficient evidence to support the jury verdict. In the same post-trial motion, Appellant moved for a new trial based on the district court’s denial of his request to present a certain jury instruction proposed by Appellant and a particular evidentiary ruling made by the district court. Appellant now appeals the district court’s denials of these motions. For the reasons that follow, we AFFIRM the district court’s decisions.

I.

A. Facts

On June 3, 2001, while walking home, Appellant was struck by a motor vehicle whose unknown driver fled the scene. Appellant was found in the early morning hours of June 4, 2001, in the ditch of his front lawn after having remained outside, unconscious, in forty to fifty degree weather. He was life-flighted to the hospital, where he remained for more than two months, undergoing multiple surgeries to his legs and cervical spine. He was eighteen years old at the time of the accident.

On August 14, 2001, Appellant was transferred to Craig Hospital in Denver, Colorado, a premier center for specialty rehabilitation and research for spinal cord and traumatic brain injuries. On August 8, 2001, Dr. Mark P. Cilo of Craig Hospital described Appellant’s remaining medical issues to include a spinal cord injury with quadriplegia; traumatic brain injury complicated by prolonged hypothermia and probably hypoxia with retrograde amnesia of less than twenty-four hours; loss of consciousness of approximately two days and posttraumatic amnesia of several weeks; a history of subdural he-matoma; respiratory failure requiring ventilator support; prolonged hypothermia requiring cardiopulmonary bypass for rewarming; bilateral tibial fractures requiring post intramedullary nailing; a neurogenic bladder requiring an urethral catheter; a neurogenic bowel; a percuta-neous gastrostomy tube in place for feedings; malnutrition due to poor intake and poór tolerance of tube feedings; recurrent fevers and pneumonias, with multiple antibiotics provided; contractures in both upper extremities; anxiety and depression; and severe pain due to his multiple problems, particularly contractures.

Craig Hospital educated and trained Mr. Bonkowski- to provide for his son’s care. Examples include providing daily manual bowel evacuation (an invasive treatment requiring knowledge of body handling and positioning), bladder care, medication assistance, and transfer assistance. Since Appellant’s discharge from Craig Hospital on December 1, 2001, he maintains that his father has cared for him twenty-four hours a day, seven days a week, in accordance with the training and the prescriptions of his physicians. Allstate compensated Mr. Bonkowski at $166,440.00 per year for the attendant care, which is equivalent to an hourly rate of $19.00, for twenty-four hours a day, seven days a week.

B. Michigan’s No-Fault Insurance Act

Allstate is the first party no-fault insurer of Appellant. Michigan’s No-Fault Insurance Act, Mich. Comp. Laws *600 § 500.3101 et seq., abolished third party tort liability for certain economic damages arising out of a motor vehicle accident and provided a substitute via private insurance. These economic damages include wage loss below the statutory limit, medical costs, and other allowable expenses, including “reasonable charges incurred for reasonably necessary products, services and accommodations for an injured person’s care, recovery, or rehabilitation,” collectively known as Personal Injury Protection benefits. See Mich. Comp. Laws §§ 500.3107-.3110; In re Felski, 277 B.R. 732, 733-34 (E.D.Mich.2002). The Michigan state courts have also approved no-fault compensation for care provided by family members of the injured individual. Booth v. Auto-Owners Ins. Co., 224 Mich.App. 724, 727-29 (1997) (citations omitted).

Three requirements must be satisfied to hold a no-fault insurer responsible for benefits for care provided by a family member: (1) the expense must have been incurred, (2) the expense must have been reasonably necessary for the injured person’s care, recovery, or rehabilitation, and (3) the amount of the expense must be reasonable. Nasser v. Auto Club Ins. Ass’n, 435 Mich. 33, 50, 457 N.W.2d 637 (1990). The burden is on a plaintiff to prove that the expenses were reasonable under the circumstances. Id. at 49, 457 N.W.2d 637.

C. State Court Litigation

Litigation between Allstate and the Bon-kowskis began in state court on October 4, 2001 (“Bonkowski I”), and addressed Appellant’s expenses incurred from the time he was at Craig Hospital. That case was heard by a jury, which rendered its verdict on July 7, 2006. On the question of the value of the attendant care provided by Mr. Bonkowski the jury was asked: “What is the amount of allowable expenses owed to the plaintiff (include only expenses not already paid by the defendant)?” The jury responded: $1,381,114.00.

Allstate filed an appeal, in which it argued that the there was insufficient evidence upon which a jury could have based its verdict. The Michigan Court of Appeals disagreed, explaining:

The only legally relevant question presented to the jury was whether the compensation [Allstate] paid to Andrew was reasonable. The record contains sufficient evidence to conclude that the jury rejected [Allstate’s] position. Substantial evidence was introduced chronicling Andrew’s everyday care of [the] plaintiff. Not only did Andrew provide care consistent with that of a licensed health care professional, but ample evidence was presented to support the conclusion that Andrew’s care was more conducive to [the] plaintiffs care, recovery, or rehabilitation than care that could have been provided by a licensed health care professional. The evidence established that Andrew provided plaintiff care that nurses ordinarily do not provide, including treatment specific to paraplegic patients.
“[T]he trier of fact will ultimately determine whether a charge is reasonable.” Advocacy Organization for Patients & Providers v. Auto Club Ins. Ass’n, 257 Mich.App. 365, 379 [670 N.W.2d 569] (2003), citing Nasser v. Auto Club Ins. Ass’n, 435 Mich.

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

Related

Cite This Page — Counsel Stack

Bluebook (online)
544 F. App'x 597, Counsel Stack Legal Research, https://law.counselstack.com/opinion/shaun-bonkowski-v-allstate-insurance-company-ca6-2013.