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An 18 year old moved out of his family home and into a friend’s home to attend school in another town.  The son, however, kept his family home address on his driver’s license and provided his school and a part-time employer with it as opposed to the friend’s.  His checking account also kept his home address.  He maintained possessions in a bedroom at his family’s home.  Often, he would return home during breaks, catch up with his family, sleep in his bedroom, eat with his family and clean his laundry before going back to school.  He was allowed to drive the family cars and he was listed as a driver on the family auto policy.  His parents provided clothing, food, a cell phone and other maintenance items including cash.  He was maintained on his mother’s health insurance through her employer because she represented he still lived with the family. Finally, the son intended to return to the family home after school concluded.

While away at school, the son borrowed his friend’s car and was involved in a motor vehicle accident and suffered bodily injuries requiring medical care.  The family auto insurance and the friend’s auto insurance each denied liability to pay the injured son’s medical bills pointing the liability finger at each other instead.  Under the no-fault law, one is covered by family auto insurance provide s/he is considered “domiciled” in the family household.  MCL 500.3114(1).  The Court of Appeals held that the son was domiciled in the family home, thus holding the family auto insurer liable to pay his medical bills.  The court reasoned that while young adults who transition from parental homes to independent living arrangements pose special problems in determining domicile, children studying abroad who clearly have not severed ties to the family household such as this case, remain legally domiciled in the family home.

What this means for injured persons:

Frankly, the outcome really does not matter for the injured person because either way, s/he is going to be covered by no-fault insurance.  If the facts were tilted in the opposite where a return to home or fewer ties existed, then the injured son would have been covered by the friend’s auto insurance.  MCL 500.3114(4).  What this case importantly illustrates, however, is the correct decision by the injured person to timely file a lawsuit against both insurance companies to protect his rights under the no-fault law.  Failure to file suit within one year [MLC 500.3145] and/or to name both insurers could have been fatal to his claim.   Has he not done either, the medical bills could have become his legal responsibility.

Thus, always submit your claims to all potential auto no-fault insurers in the chain of priority under MCL 500.3114 and/or MCL 500.3115.  The general rule is that one of the insurers will accept responsibility and then settle its dispute with the other; regrettably, more often than not, no-fault insurers do not follow the law hoping instead that the injured person will not learn that if s/he does nothing about it within one year, the claim is lost.  MCL 500.3145.

Another recommendation to follow is that when two or more auto insurers are disputing liability, the injured person should file a claim with the Michigan Assigned Claims Facility [MCL 500.3172].  The MACF, by law, will literally randomly assign the claim to a third auto insurer which must pay the benefits and seek recoupment from the other insurers who are later determined to be legally liable.  Failure to timely submit a claim to the MACF within the one-year rule [MCL 500.3145] is likewise fatal to that claim, too.

What this means for medical service providers:

This case illustrates is that medical providers must continue to be diligent on intake and discover the identity of all potential auto insurers within the chain of priority [MCL500.3114 and MCL 500.3115] and then submit the claim to them all.  And where the potential insurers refuse responsibility, the provider must file its own claim with the MACF, too.  Finally, the one-year time limitation [MCL 500.3145] applies to medical providers too and therefore, they must be equally cognoscente of this fact and keep watch.  Medical providers cannot rely on patients to take action on his/her own; often they do not and ignore repeated efforts at collection.  Therefore, providers must be pro-active and pursue their claim directly against the auto insurers.

Injured people and medical providers can obtain an application to file a claim with the MACF here.

And, you can read the Opinion that provided the back-drop for this discussion here.

Authored by L. Page Graves

Facts & Ruling by Court:

An adult was placing personal items into her motor vehicle which was parked.  She had reached into the passenger side of the vehicle with its door open.  In one fluid motion, she stood back up to regain her upright balance and stepped away from the car while also shutting the door with her hand.  It was at this point that she slipped and fell on a patch of ice beneath her feet and suffered bodily injury requiring medical care.  The no-fault law provides coverage when a person is “entering” or “alighting” from a parked motor vehicle [MCL 500.3106(1)(c)].  The Michigan Supreme Court ruled that the injured person was not “alighting” from her motor vehicle because, it reasoned, she was in no way reliant upon the vehicle itself to maintain her balance.  The Court said she had already alighted and that closing a car door is not part of the alighting process.

 

What this means for injured persons:

 

This is new law created by the Court.  Closing the door used to be considered a part of the alighting process since the no-fault act was enacted in 1973.  Now it is not.  Therefore, in fact patterns identical to this case, injured persons are no longer covered by their auto no-fault insurance which they must purchase as mandated by law.  Instead, coverage for their medical care falls to any other accident or health coverage applicable (e.g., BC/BSM, Medicare, Medicaid, etc.) or private pay.

 

What this means for Medical Service Providers:

 

In fact patterns identical to this case, medical providers can no longer pursue auto no-fault coverage in cases just like this.  Instead, they must submit their claims to the patient’s applicable health coverage.

 

You can read this Opinion here.

 Authored by L. Page Graves


Facts & Ruling by Court:

 

A minor riding a school bus suffered bodily injuries when the school bus swiped a temporarily stopped city garbage truck that pulled back into the travel lane while the school bus was passing.  The Michigan Court of Appeals held that even if the garbage truck was temporarily stopped, that fact did not shield the city from liability for the minor’s injuries under governmental immunity.  The truck was still in “operation” as contemplated by the law [MCL 691.1405] because temporarily stopping is carrying out the garbage truck’s designed and intended function and purpose.

 

What this means for accident victims:

 

This is good because the court followed existing law which holds governmental bodies liable for personal injury caused by the negligent operation of governmentally owned vehicles.

 

What this means for Medical Service Providers:

 

This case does not change or affect a medical provider’s independent claim for no-fault insurance to cover the injured person’s incurred charges for medical care.  The child was in the bus which was operating.  The bus could have hit any standing object and no-fault coverage would apply.  The no-fault rules of priority apply [MCL 500.3114]: submit claim to the child’s household family auto coverage; if there is no family auto coverage in the household, then submit claim to the city’s auto coverage.

 

You can read the Opinion here.

Authored by L. Page Graves