Michigan Court of Appeals Finds for Plaintiff in PIP Causation Case

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Michigan Court of Appeals Finds for Plaintiff in No-Fault PIP Causation Case

Michigan No-Fault Lawyers

The Michigan Court of Appeals made an important ruling this week on a Michigan car accident case involving Michigan no-fault PIP benefits and whether enough evidence was brought by the plaintiff to allow the case to go before a jury.

In Randall v. State Farm Mutual Auto Ins. Co., docket no. 327292 (unpublished, 6/21/16), a woman was rear-ended while traveling on I-96 in Livingston County. She felt pain at the accident scene and drove herself to the emergency room. While there, she complained of numbness on the right side of her head and neck, headaches and swelling in her shoulder.

After a period of treatment, which included visits to a pain doctor, neurologist and dentist, her treating physicians diagnosed her with a mild traumatic brain injury (TBI), post-concussive syndrome, headaches, back spasms and a temporomandibular disorder – all related to the Livingston County car accident.

The Plaintiff turned to her no-fault carrier, State Farm Insurance, for the payment of PIP no-fault benefits. These benefits included the payment of her medical expenses from the car accident, replacement services, wage loss and attendant care.

State Farm denied the claim and filed a motion with the trial judge to dismiss the case, arguing the plaintiff could not establish that her injuries were related to the car accident. Despite the fact the plaintiff’s own treating physicians related her medical treatment to the accident, and the fact her medical records outlined the disabilities and injuries she sustained, the trial judge dismissed the case, holding that her injuries were pre-existing and not car accident related.

The plaintiff appealed the ruling. In reversing the trial court’s ruling, the Court of Appeals held that under Michigan law, the plaintiff did establish enough of a casual connection between her injuries and the car accident that a jury should be able to hear the case and make a determination as to whether or not State Farm Insurance is obligated to pay the plaintiff’s no-fault PIP benefits.

In making this ruling, the Court of Appeals noted a number of things. First, the trial judge was incorrect in holding that a Michigan car accident victim must show objective findings to establish the casual connection between her injuries and the car accident. Although many of the plaintiff’s objective tests – such as MRIs and x-rays – were negative, this evidence is not enough to warrant dismissal of a first-party no-fault claim.

Second, the plaintiff’s subjective complaints of pain as well as the doctors’ objective observations supported a finding that the accident may have caused her injuries.

Third, the plaintiff’s own treating doctors testified her injuries were from the accident. For example, her pain management doctor specifically testified she believed that the plaintiff’s traumatic brain injury was auto accident related. Another doctor believed her concussion syndrome stemmed from the accident.  Her neurologist reported muscle spasms and tissue abnormalities in her neck and right shoulder a year following the accident.

Although this is just one case, it is an important one. Michigan car insurance companies have become more and more aggressive in denying claims and using any avenue to get out of paying valid claims. State Farm Insurance in particular is egregious in its scorch-earth tactics in denying no-fault benefits.

In making its ruling, the Court of Appeals is placing a limit on these games and restoring some order to Michigan car accident law. This case should not have been dismissed by the trial judge. Dismissal of a lawsuit is a drastic measure. Under the law, an insurance company can only dismiss a lawsuit when viewing the evidence in a light most favorable to the plaintiff, there is no genuine issue of material fact for a jury to decide the case in favor of the injured party.

As previously described, there were genuine issues of material fact all over this case. Yet, State Farm Insurance took a gamble and filed a motion to dismiss anyway, hoping to find a sympathetic judge. In this situation, State Farm found one such judge. Thankfully, the Court of Appeals reversed the trial judge and reinstated the case.

Although the result was correct, this decision is a cautionary tale. We can expect more aggressive maneuvering by car insurance carriers moving forward on Michigan no-fault cases.