“Fraudulent insurance act” under MCL 500.3173a; Distinguishing Candler v Farm Bureau Mut Ins Co of MI & Bakeman v Citizens Ins Co of the Midwest; Intent; Knowledge that a statement contained false information; Materiality; Personal representative (PR)
On remand from the Supreme Court, the court concluded that there was a genuine issue of material fact as to whether one of plaintiff-Estate’s PRs (Lateshea) knew that the answers to defendant-insurer’s (AAA) interrogatories contained false information. Thus, it again reversed summary disposition for AAA and remanded. The Supreme Court reversed the court’s prior decision in the case (Willaimson I) and remanded for the court to address the Estate’s alternative arguments not addressed there, including whether AAA satisfied “the intent and materiality prongs of the” Candler test. The fourth prong “states that, in order to commit a fraudulent insurance act under MCL 500.3173a, ‘the person must have known that the statement contained false information.’” In this case, Lateshea signed the answers to AAA’s interrogatories on the Estate’s behalf. The court found “that, at a minimum, there exists a genuine issue of material fact regarding whether Lateshea knew that her answers to AAA’s interrogatories contained false information.” It noted that the statements at issue “in determining whether the Estate committed a fraudulent insurance act under MCL 500.3173a were the interrogatory answers, which twice stated that Williamson died on [10/24/19]. In addition, although the answers referenced the replacement-services and attendant-care forms,” another individual (B), “rather than Lateshea, signed those forms.” Thus, this case was distinguishable from Candler, where “the plaintiff forged his brother’s signature on replacement-services calendars submitted to the” insurer and from Bakeman, where “the plaintiff signed the attendant-care forms that were submitted to the assigned insurer. In this case, [B] signed the forms indicating the days on which he provided services for Williamson. Considering that Lateshea twice stated in her interrogatory answers that Williamson died on [10/24/19], and that she did not sign the replacement-services and attendant-care forms, there exists a genuine issue of material fact regarding whether she knew that her answers contained false information.” As to the fifth prong, the court rejected the Estate’s assertion that the statements were not material. They “concerned the dates on which [B] rendered attendant-care and replacement services to Williamson, an issue directly relevant to the amount that the Estate claimed was due.”
Full PDF Opinion