e-Journal Summary

e-Journal Number : 83488
Opinion Date : 04/10/2025
e-Journal Date : 04/22/2025
Court : Michigan Court of Appeals
Case Name : Pattee v. Farm Bureau Gen. Ins. Co. of MI
Practice Area(s) : Contracts Insurance
Judge(s) : Per Curiam - Murray and Sawyer; Concurrence - K.F. Kelly
Full PDF Opinion
Issues:

Coverage dispute regarding personal protection insurance (PIP) benefits; Exclusion of nonresidents who don’t own a vehicle that was registered & insured in Michigan at the time of the accident; MCL 500.3113(c); Whether an individual is covered under an insurance policy; MCL 500.3114(1); Andary v USAA Cas Ins Co; Intended beneficiary; MCL 600.1405; Schmalfeldt v North Pointe Ins Co; Notice to named insureds; Casey v Auto Owners Ins Co; Filing of policy forms with the Department of Insurance & Financial Services (DIFS) before altering PIP benefits; MCL 500.2106(2); MCL 500.2108(6) & (7)

Summary

The court held that the trial court did not err by granting summary disposition for defendant-insurer and dismissing plaintiff’s complaint in this coverage dispute over PIP benefits. SDW, a Florida resident, was deemed a protected person after suffering serious injuries in a car accident in Michigan. Plaintiff, as guardian, sued defendant when it stopped paying SDW’s PIP benefits. The trial court agreed with defendant that plaintiff did not have a valid claim for PIP benefits under the No-Fault Act (NFA) or the insurance policy at issue. On appeal, the court rejected plaintiff’s argument that the trial court erred by dismissing the complaint because defendant and the named insureds agreed to an auto insurance policy that provided broader PIP benefit coverage than required by statute, and SDW was an insured under the policy. “SDW was not a family member of the named insureds because, although she was related to them by blood, she was not a member of their household. And, although SDW was occupying a covered vehicle, she was not ‘entitled under the Code to recover’ PIP benefits as a nonresident under the amended version of MCL 500.3113(c).” Further, under MCL 500.3114(1), she “was not (1) named in the policy, (2) a spouse, nor (3) a ‘relative of either domiciled in the same household[.]’” The court also rejected plaintiff’s claim that the trial court erred by dismissing the complaint because SDW was a third-party beneficiary under the policy, which was issued before the NFA was amended. “Contrary to plaintiff’s argument, SDW did not have preexisting contractual or statutory rights to receive unlimited PIP benefits under the” policy. And even “assuming the class of individuals under the insurance policy was not too broad, it did not recognize SDW as an intended third-party beneficiary of PIP benefits.” The court further rejected plaintiff’s contention that the trial court erred by dismissing the complaint because PIP benefit coverage could not be reduced unless defendant notified the named insureds of the change. “Plaintiff broadly contends that defendant violated the insurance policy by not notifying the named insureds of a reduction in coverage, but has not identified which section of the policy mandated this requirement.” Finally, the court rejected plaintiff’s argument that the trial court erred because defendant was required to file policy forms with the DIFS for approval before altering the available PIP benefits. It noted the Legislature amended the NFA “and those amendments were automatically incorporated into the insurance policy, as asserted by the parties.” Affirmed.

Full PDF Opinion