State Farm Mutual Automobile Insurance v. Accident Victims Home Health Care Services, Inc.

467 F. App'x 368
CourtCourt of Appeals for the Sixth Circuit
DecidedJanuary 10, 2012
Docket09-2452, 09-2509
StatusUnpublished
Cited by4 cases

This text of 467 F. App'x 368 (State Farm Mutual Automobile Insurance v. Accident Victims Home Health Care Services, Inc.) 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
State Farm Mutual Automobile Insurance v. Accident Victims Home Health Care Services, Inc., 467 F. App'x 368 (6th Cir. 2012).

Opinion

OPINION

JANE B. STRANCH, Circuit Judge.

Accident Victims Home Health Care Services, Inc. (AVHHC) and George Paige appeal the judgment entered in favor of State Farm Mutual Automobile Insurance Company following a jury trial. Because the district court erred in admitting propensity evidence under Federal Rule of Evidence 404(a), we REVERSE the judgment and REMAND the case for a new trial.

I. FACTS

AVHHC provides home attendant care supervision services for individuals who are injured in automobile accidents. Pursuant to Michigan’s no-fault law, State Farm paid AVHHC personal injury protection insurance benefits for all necessary and reasonable services for two AVHHC clients, Wendell Jackson and Luella Neal. AVHHC also claimed benefits for a third client, June Ely, but State Farm refused to pay benefits for her care.

AVHHC employees used a “Daily Observation Report” to record their time and activities while providing attendant care supervision to clients. As AVHHC’s president, Paige reviewed the accuracy of these reports and corrected any errors before forwarding the reports to the insurance company with a request for payment.

State Farm conducted twenty-four days of undercover surveillance, which yielded minutes of video showing Jackson unsupervised on two occasions and Neal unsupervised playing a casino slot machine. In February 2007, State Farm filed this diversity suit against AVHHC and Paige to recover all of the benefits it had paid for Jackson and Neal in the amount of $916,754.00. State Farm alleged that the services AVHHC provided to these two clients were unnecessary or unreasonable or, alternatively, AVHHC submitted fraudulent claims. AVHHC counterclaimed against State Farm seeking reimbursement for services provided to Ely. In February 2009, the district court entered summary judgment in favor of Paige and dismissed him from the suit. The case proceeded to jury trial.

AVHHC filed a pretrial motion in limine to preclude State Farm from introducing evidence about AVHHC’s billings to State Farm concerning another client, Kathy Owens. The district court denied the motion and admitted the challenged evidence during State Farm’s questioning of Paige and Rammell Sanders, Owens’s caregiver. At the close of State Farm’s proof, the district court allowed State Farm to conform the pleadings to the proof and again added Paige as a defendant in the suit.

At the conclusion of the seven-day trial, the jury returned a verdict in favor of State Farm on all claims and awarded $528,566.24. The district court granted State Farm’s motion for prejudgment interest on that amount and also granted State Farm’s motion for attorney fees in the amount of $297,386.86. AVHHC and Paige sought a new trial under Federal Rule of Civil Procedure 59(a) and relief from judgment under Federal Rule of Civil Procedure 60(b). The district court denied the motion, and this appeal followed. 1

*371 II. ANALYSIS

A. Standard of Review

This Court reviews for an abuse of discretion the district court’s evidentiary rulings, the denial of a motion for new trial, and the denial of a motion for relief from judgment. See United States v. Talley, 194 F.3d 758, 765 (6th Cir.1999) (evidentiary rulings); Morgan v. New York Life Ins. Co., 559 F.3d 425, 434 (6th Cir.2009) (new trial motion); ACLU v. McCreary Cnty., 607 F.3d 439, 450 (6th Cir.2010) (Rule 60(b) motion). An abuse of discretion occurs when the district court relies on clearly erroneous factual findings, applies the law improperly, or employs an erroneous legal standard. CareToLive v. FDA, 631 F.3d 336, 344 (6th Cir.2011). Reversal is warranted if this Court is left with a “definite and firm conviction that the trial court committed a clear error of judgment.” Nolan v. Memphis City Schs., 589 F.3d 257, 264 (6th Cir.2009) (internal quotation marks omitted).

B. Rule 404 Evidence

AVHHC’s motion in limine sought to exclude evidence concerning a Michigan state court proceeding, Owens v. State Farm. That case involved Kathy Owens, an AVHHC client who sued State Farm to recover first-party no-fault benefits. State Farm settled with Owens. AVHHC intervened in the suit as a plaintiff to pursue a reimbursement claim against State Farm for services it provided to Owens. During trial, the state court judge found that Paige had tampered with documentary evidence shortly before trial by fraudulently altering certain AVHHC daily observation reports. As a sanction for Paige’s conduct, the court dismissed AVHHC’s case against State Farm. In dismissing, the state court stated on the record:

This goes to the very essence, the heart of our system in terms of altering evidence that has been tampered with, in essence. For someone to intentionally tamper with the evidence and make a misrepresentation and actually ask an employee to get involved in something like this I think is a bad thing; in fact, it is awful, and I am sorry to be a witness to something like this.

In support of the motion in limine, AVHHC argued under the Federal Rules of Evidence that any evidence from or mention of Owens was not relevant under Rule 401 and therefore inadmissible under Rule 402 because the case on trial concerned billings for Jackson, Neal, and Ely, while Owens involved a different client, different billings, and different issues. AVHHC also argued under Rule 403 that evidence from Owens would confuse the jury and result in unfair prejudice to AVHHC because State Farm wanted the jury to draw the conclusion that Paige must have committed fraud in the case before it because Paige had committed fraud in Owens. AVHHC further argued that evidence from Owens would be inadmissible under Rule 608 because evidence of untruthful character may be attacked only in the form of opinion or reputation testimony, and not by evidence of specific instances of conduct.

State Farm responded that Michigan law permits introduction of circumstantial evidence to establish fraud. In a diversity case like this one, however, the Federal Rules of Evidence govern the admission of evidence, while state law governs the substantive issues. See Gass v.

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Cite This Page — Counsel Stack

Bluebook (online)
467 F. App'x 368, Counsel Stack Legal Research, https://law.counselstack.com/opinion/state-farm-mutual-automobile-insurance-v-accident-victims-home-health-care-ca6-2012.