ZCD Transportation, Inc. v. State Farm Mutual Automobile Insurance

830 N.W.2d 428, 299 Mich. App. 336, 2012 Mich. App. LEXIS 2807
CourtMichigan Court of Appeals
DecidedNovember 27, 2012
DocketDocket No. 304719
StatusPublished
Cited by32 cases

This text of 830 N.W.2d 428 (ZCD Transportation, Inc. v. State Farm Mutual Automobile 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
ZCD Transportation, Inc. v. State Farm Mutual Automobile Insurance, 830 N.W.2d 428, 299 Mich. App. 336, 2012 Mich. App. LEXIS 2807 (Mich. Ct. App. 2012).

Opinion

PER CURIAM.

Plaintiff, ZCD Transportation, Inc., appeals as of right a circuit court order granting the motion for summary disposition of defendant, State Farm Mutual Automobile Insurance Company, pursuant to MCR 2.116(C)(10) in this action to recover first-party no-fault benefits. We affirm in part, reverse in part, and remand for further proceedings.

Arnold Grinblatt was injured in an automobile accident in 2001. Before the accident, Grinblatt was unable to walk and got around using a personal mobility [339]*339scooter. He was able to drive using a van fitted with a lift and hand controls. After the accident, Grinblatt was too weak to move himself from the scooter to the driver’s seat of the van and vice versa. He therefore hired plaintiff to provide transportation services, both for medical appointments and for personal trips unrelated to medical treatment. Plaintiffs fee for the service consisted of three components: (1) a pick-up fee of $35 to come and get the client, (2) a wait fee of $30 an hour, billed in 15-minute increments if the driver had to wait for the client, and (3) mileage. Plaintiff charged $3 a mile, but every client was charged for a minimum of 10 miles for a one-way trip and 20 miles for a round trip, regardless of the number of miles actually driven. Plaintiff acknowledged that a majority of Grinblatt’s trips involved distances less than the mileage minimum.

Defendant objected to paying for plaintiffs personal trips and for medical transportation costs to the extent that plaintiff sought compensation for times when Grinblatt was not actually in the vehicle being transported. The trial court granted defendant’s motion for summary disposition under MCR 2.116(C)(10).

The trial court’s ruling on a motion for summary disposition is reviewed de novo on appeal. Moser v Detroit, 284 Mich App 536, 538; 772 NW2d 823 (2009). A motion under MCR 2.116(C)(10) “tests the factual support of a plaintiffs claim.” Spiek u Dep’t of Transp, 456 Mich 331, 337; 572 NW2d 201 (1998). Summary disposition is appropriate if “there is no genuine issue as to any material fact, and the moving party is entitled to judgment or partial judgment as a matter of law.” MCR 2.116(C)(10). “The court considers the affidavits, pleadings, depositions, admissions, and other documentary evidence submitted or filed in the action to deter[340]*340mine whether a genuine issue of any material fact exists to warrant a trial.” Spiek, 456 Mich at 337. The determination of what constitutes an allowable expense under the no-fault act is a question of law that is also reviewed de novo. In re Geror, 286 Mich App 132, 134; 779 NW2d 316 (2009).

Under the no-fault act, an insurance company is “required to provide first-party insurance benefits . .. for certain expenses and losses.” Johnson v Recca, 492 Mich 169, 173; 821 NW2d 520 (2012). Specifically, an insurer must pay personal protection benefits “for accidental bodily injury arising out of the ownership, operation, maintenance or use of a motor vehicle as a motor vehicle .. . .” MCL 500.3105(1). Those benefits include:

(a) Allowable expenses consisting of all reasonable charges incurred for reasonably necessary products, services and accommodations for an injured person’s care, recovery, or rehabilitation[, and]
(c) Expenses not exceeding $20.00 per day, reasonably incurred in obtaining ordinary and necessary services in lieu of those that, if he or she had not been injured, an injured person would have performed during the first 3 years after the date of the accident, not for income but for the benefit of himself or herself or of his or her dependent. [MCL 500.3107(1)].

Because benefits are only payable for accidental injury arising out of the ownership, operation, maintenance, or use of a vehicle and benefits include allowable expenses, the allowable expenses must be “causally connected to the accidental bodily injury arising out of an automobile accident.” Griffith v State Farm Mut Auto Ins Co, 472 Mich 521, 531; 697 NW2d 895 (2005). [341]*341Therefore, the product, service, or accommodation claimed as an allowable expense must be related to the insured’s injuries. Id. An expense is an “allowable expense” if (1) the expense is for an injured person’s care, recovery, or rehabilitation, (2) the expense is reasonably necessary, (3) the expense is incurred, and (4) the charge is reasonable. Douglas v Allstate Ins Co, 492 Mich 241, 259; 821 NW2d 472 (2012).

The terms “care,” “recovery,” and “rehabilitation” are to be given their ordinary meanings. Hamilton v AAA Mich, 248 Mich App 535, 546; 639 NW2d 837 (2001). Both recovery and rehabilitation “refer to restoring an injured person to the condition he was in before sustaining his injuries.” Griffith, 472 Mich at 534-535. Thus, expenses for recovery and rehabilitation “are costs expended in order to bring an insured to a condition of health or ability sufficient to resume his preinjury life.” Id. at 535. The scope of the term “care” is limited “to expenses for those products, services, or accommodations whose provision is necessitated by the injury sustained in the motor vehicle accident.” Id. “Care” “may encompass expenses for products, services, and accommodations that are necessary because of the accident but that may not restore a person to his preinjury state.” Id. The Supreme Court recently reaffirmed Griffith’s definition of “care,” stating that “although services for an insured’s care need not restore a person to his preinjury state, the services must be related to the insured’s injuries to be considered allowable expenses.” Douglas, 492 Mich at 260.

Allowable expenses and replacement services are two “separate and distinct categories” of benefits. Johnson, 492 Mich at 180; accord Douglas, 492 Mich at 262. “Services that were required both before and after the injury, but after the injury can no longer be provided by [342]*342the injured person himself or herself because of the injury, are ‘replacement services,’ not ‘allowable expenses.’ ” Johnson, 492 Mich at 180. That is because while the services “might be necessitated by the injury if the injured person otherwise would have performed them himself, they are not for his care . . . .” Douglas, 492 Mich at 263.

An expense is “reasonably necessary” if (1) it is objectively reasonable and (2) it is necessary for the insured’s care, recovery, or rehabilitation. Krohn v Home-Owners Ins Co, 490 Mich 145, 163; 802 NW2d 281 (2011). An expense is incurred when the insured becomes liable to pay. Proudfoot v State Farm Mut Ins Co, 469 Mich 476, 484; 673 NW2d 739 (2003). There must at least be evidence that the service provider expected compensation for its services. Burris v Allstate Ins Co, 480 Mich 1081 (2008). The insurer “is not obliged to pay any amount except upon submission of evidence that services were actually rendered and of the actual cost expended.” Moghis v Citizens Ins Co of America, 187 Mich App 245, 247; 466 NW2d 290 (1991).

We agree with defendant that transportation expenses unrelated to medical treatment are not recoverable even if prescribed by a doctor as being necessary for the patient’s care, recovery, and rehabilitation.1

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Bluebook (online)
830 N.W.2d 428, 299 Mich. App. 336, 2012 Mich. App. LEXIS 2807, Counsel Stack Legal Research, https://law.counselstack.com/opinion/zcd-transportation-inc-v-state-farm-mutual-automobile-insurance-michctapp-2012.