LEGAL DECISIONS AND SETTLEMENTS
MILLION DOLLAR SETTLEMENT ON A MOTORCYCLE
VERSUS AUTO CLAIM
Wayne Miller obtained a settlement of $1,050,000 in an automobile negligence claim. Our client was lawfully riding a motorcycle when the Defendant driver suddenly and without warning turned left in front of our client. Our client suffered severe orthopedic injuries, but fortunately no brain or spinal injury. The Defendant admitted that he did not see our client, even though he was in plain sight on a clear summer's morning.
TRIAL VICTORY: HOME MODIFICATIONS AND THE
ADMIRE DECISION
In what is believed to be the only Home Accommodation case tried to a jury since the Admire v Auto Owners decision, Maureen Kinsella defeated the Insurance Company when an Oakland County jury said that an accessible apartment, with no special modifications, IS a covered benefit.
Our client was a 65 year-old woman who was an above-the-knee amputee, and primarily wheelchair bound as a result of her injuries from a motorcycle/motor vehicle accident. She owned a home at the time of the accident that could not be modified and made accessible. The Insurance Company agreed that the home she owned pre-accident could not be modified. Our client leased an apartment that was, WITHOUT MODIFICATION, barrier free by virtue of its bigger size and open floor plan. The Insurance Company had been paying $1,400 of the $2800/month rent. However, the Insurance Company argued at trial that it didn't owe anything, per the Admire decision, because the apartment had not been modified in any way and it was an "ordinary expense." In other words, the Insurance Company interpreted Admire as requiring some sort of "modification" to an otherwise "normal" accommodation.
Maureen argued to the jury that the "as-is" apartment was a reasonable accommodation for our client and that our client's need for housing was of a wholly different character than it existed before the accident (i.e., before the accident our client's house was clearly not barrier free; the apartment clearly was barrier free).
After three days in trial, the jury agreed that the apartment was a covered expense and awarded payment for past rent at the rate of $2000/month (as opposed to the entire $2800/month). The jury said the payment was overdue and awarded interest as well. As we continue to try and understand how Admire affects home accommodation cases, Maureen's victory is an important step along the way: the jury did not accept the insurer's argument that a "reasonable accommodation" requires a modification.
MICHIGAN COVERAGE OBTAINED FOR OUT-OF-STATE ACCIDENT
Injured in a car accident in Hawaii. The No-Fault insurer denies benefits. What do you do?
We chose to fight, conducting extensive discovery first with claims and then with underwriting, and ultimately convincing the trial court to reform the policy so as to find coverage.
Our clients, husband and wife, travelled to Hawaii for vacation. A high-speed collision caused injuries to both including catastrophic injuries to the wife. The No-Fault insurer denied their claim for benefits.
Are you entitled to benefits if injured in an out-of-state accident? The No Fault Act says "yes" but only if you are the (1) "named insured" under a Michigan No-Fault policy, his/her spouse, or a resident relative, or (2) an occupant of a vehicle whose owner or registrant was insured under a Michigan No-Fault policy. So, if you arrive out-of-state by plane, you must be, married to, or live with a relative who is, the named insured - the person or entity in the upper left of the first page of the policy dec sheet.
As our clients learned initially, the likelihood of coverage is particularly remote if you are insured under a commercial policy. A corporation cannot sustain injury in a motor vehicle accident (and thus its named insured status is meaningless), has no spouse, and has no resident relatives. Our clients were listed as drivers on a commercial policy that their son's corporation secured. Their vehicle was listed on the same policy. The corporation was the only named insured. Neither listed drivers nor listed drivers who own listed vehicles are entitled to No-Fault benefits when injured in an out-of-state accident if not the named insured. Our clients were not the named insured on any policy - and neither was their son.
We challenged the insurer's denial of benefits. We asserted that under the No-Fault Act's priority rules our clients would not receive No-Fault benefits from the insurer which issued the policy listing them as drivers, listed their vehicle, and collected a premium - even if they were injured in their own vehicle while in Michigan. Instead, they would collect benefits through the Assigned Claims Plan. We argued that a policy that never would pay benefits contravenes the No-Fault Act which favors the payment of benefits by the household or employer's insurer. The trial court agreed and denied the insurer's motion for summary disposition and granted our clients' request for reformation.
What are the lessons? First, before leaving on an airplane to another state, check to make sure that you, your spouse, or a resident relative is the named insured on a policy. If not, ask the insurer to amend the policy to add you as the named insured or to add a broadened form coverage endorsement. Second, think twice before insuring personal vehicles on a commercial policy. Third, if a basis exists to challenge a coverage denial, don't accept the insurer's contention that the coverage issue is purely a legal question that does not require discovery.
