|
|
Thursday, June 29, 2023
By Michael Nichols
Categories: Personal Injury
Your life is changed forever in a car crash in which you are left a quadriplegic. You wake up the next day – the night before was your first night since the unexpected catastrophe that means that you will never wake up the same ever again. You cannot walk on your own, you cannot move your arms … and it will never be the same … ever.
You need attendant care forever. You will not be able to care for yourself. The bills will pile up. The anxiety starts to creep up. The last thing is certainly not for the insurance company on which you rely to pay your claims to go belly up – but that is exactly what happened to Justin Childers. The saga of the insurance companies who were supposed to be there for him but fought to slough the financial responsibility on to each other ended up in a published (i.e. binding) opinion from the Michigan Court of Appeals last fall (September 15, 2022). The case is “Childers and the Michigan Property and Casualty Guaranty Association v Progressive Marathon Insurance.”
You need a Venn diagram to understand who was arguing about what but an important concept to understand is priority of insurance providers. Mr. Childers was a passenger in a vehicle that was involved in an accident. The driver of the vehicle was uninsured. Because of the status of the driver as uninsured, the Michigan Property and Casualty Guaranty Association (MPCGA) was left to pay benefits for Mr. Childers. The MPCGA, as the insurance provider of “last resort” had the responsibility to help find insurance coverage for Mr. Childers medical bills and bills for his daily care – the term for the day-to-day needs of a person who cannot take complete care of himself is attendant care. MPCGA is created by statute to provide benefits coverage for situations just like this one until and unless another “priority provider” can be found. What we are talking about are Personal Injury Protection (PIP) benefits, which are specifically defined under Michigan law as the type of benefits offered in an auto accident situation to basically take care of the “life” needs of the injured party or parties as well as their medical care.
An insurance company that was next in line went insolvent. It was declared insolvent by the State of Michigan … and yes that is a thing. Therefore, that insurance company, that was connected to the parties because it provided a homeowners policy to Mr. Childers’ mother, was off the hook. Then, here comes the Progressive Marathon Insurance Company – which provided a policy for auto insurance coverage for the brother of the driver of the vehicle in which Mr. Childers was riding. Now the “games” really begin.
When Progressive was put on notice they gave a big fat “nuh uh” to the MPCGA. Progressive claimed that there was an exclusion that applied so that the driver of the vehicle could not turn to them for coverage. Progressive also claimed that the legal claim was made too late – we call this the “statute of limitations” defense.
Because of the extent of Mr. Childers’ injuries, he was declared mentally incompetent and his mom was declared his guardian. Mr. Childers’ mother sued under a term that we call “Next Friend of” in conjunction with the MPCGA to force Progressive to pay the claim. By the way, this lawsuit was brought in 2013 and it took 9 years for this particular legal issue to finally reach its resolution by the Court of Appeals.
Judge Christopher Yates wrote the opinion for the court. The court spent significant time analyzing the statute of limitations issue, siding ultimately with the plaintiffs, Mr. Childers and the MPCGA. However, the meat of the dispute seemed to be whether the defendant, Progressive, was considered a priority insurer, despite arguing 3 policy exclusions with the contract that it had to insure the driver’s brother. An important point that Judge Yates made is that the policy behind the no-fault insurance scheme and requirement that people purchase insurance for vehicles, is to insure people not automobiles. Here, the court found that the driver was the relative (sister) of the policy holder, that she lived with him prior to the accident and that she also suffered injuries. Even though her injuries did not require hospitalization or much by way of treatment, there was no “qualification” for the seriousness of the injury.
When we are confronted with people who suffer tragedies and it seems as if an unfair outcome is about to result, it becomes a Gordian knot. The problem of ancient heritage that seems so complicated that the only solution is to slice the knot off rather than untie it. Sometimes, we have to just untie it. Either way, the point is to achieve justice despite the efforts of the insurance companies.