Michigan Court of Appeals Reaffirms that a Plaintiff’s Injuries Must Be More Than “Incidental” to Recover No-Fault Benefits

Michigan Court of Appeals Reaffirms that a Plaintiff’s Injuries Must Be More Than “Incidental” to Recover No-Fault Benefits

03/29/2021

Michigan’s no-fault act doesn’t allow an injured person to claim benefits for a limitless chain of injuries or conditions. Benefits are payable for injuries “arising out of the ownership, operation, maintenance or use of a motor vehicle as a motor vehicle.” MCL 500.3105(1). They’re not recoverable for injuries that are only incidentally or fortuitously related to an accident. The Court of Appeals reaffirmed this principle in AdvisaCare v Auto-Owners Ins Co (Docket Nos. 349756 and 350221), providing a helpful example of where insurers and courts must draw the line.

Background on AdvisaCare

Vivian Mazade sustained multiple injuries in a one-car accident, including an open and deep traumatic wound on her lower left leg. After the accident, while visiting family, Mazade fell several times and suffered more injuries to her left leg, which resulted in an infection and, ultimately, an amputation. Mazade’s treating physicians attributed the amputation to the accident. They reasoned, “[B]ecause the accident caused Mazade to suffer instability, it was that instability that led to her falls, with one of those falls resulting in the contraction of the infection.” AdvisaCare, unpub op at 4.

AdvisaCare Healthcare Solutions, Inc., provided attendant care services for Mazade after the amputation. It then claimed no-fault benefits from Mazade’s no-fault insurer, Auto-Owners Insurance Company, for those services. Auto-Owners denied the claim under MCL 500.3105(1) and McPherson v McPherson, 493 Mich 294; 831 NW2d 219 (2013), concluding that the infection and amputation didn’t arise out of the accident.

In McPherson, the plaintiff sustained a neurological injury in a 2007 motor vehicle accident. In 2008, the plaintiff suffered a seizure consistent with the disorder. As a result, he lost control of his motorcycle, crashed, and sustained a severe spinal cord injury. He claimed no-fault benefits for the spinal cord injury, arguing that it arose out of the 2007 accident (not the 2008 accident). The Michigan Supreme Court held that “[t]he facts alleged by [the] plaintiff [were] insufficient to support a finding that the first injury caused the second injury in any direct way.” McPherson, 493 Mich at 298. In other words, the plaintiff’s second injury was “too attenuated from the first accident to permit a finding that the second injury was directly caused by the first accident.” Id. at 299. So the plaintiff wasn’t entitled to no-fault benefits under MCL 500.3105(1).

In AdvisaCare, the provider eventually sued Auto-Owners for unpaid no-fault benefits. In the trial court, Auto-Owners filed motions for summary disposition, arguing that Mazade’s need for post-amputation attendant care didn’t arise from injuries sustained in the accident. The trial court disagreed. The case went on to trial, where Auto-Owners moved for directed verdict on the same basis. The trial court denied that motion too. Ultimately, the jury rendered a verdict for AdvisaCare, and Auto-Owners appealed.

Court of Appeals’ Ruling and Reasoning

On appeal, AdvisaCare argued that the trial court erred when it denied its motions for summary disposition and motion for directed verdict. Unlike the trial court, the Court of Appeals sided with AdvisaCare.

The Court explained, “[T]he trial court should have applied McPherson and granted either defendant’s motion for summary disposition or motion for directed verdict.” AdvisaCare, unpub op at 3. The panel acknowledged that there was evidence that Mazade sustained a serious left-leg injury in the accident, and it was that leg that was later infected and amputated. “However, there was no evidence to suggest that the injuries that Mazade sustained to her left leg from the car accident caused the infection and subsequent amputation.” Id. “Similar to McPherson, the record reflect[ed] that ‘the first injury directly caused the second accident, which in turn caused the second injury.’ ” Id., quoting McPherson, 493 Mich at 298-299 (emphasis in original)). Consequently, “the infection and subsequent amputation did not ‘arise out of’ the injuries sustained” in the accident. AdvisaCare, unpub op at 3.

AdvisaCare wasn’t required to prove proximate causation, but it was required to show “that the causal connection between the injury and the use of the motor vehicle was” more than “merely incidental, fortuitous, or ‘but for.’ ” Id. (quotation marks and citations omitted). Because AdvisaCare didn’t present any evidence that “‘the first injury caused the second injury in a direct way,’” Auto-Owners was entitled to judgment. Id. at 4, quoting McPherson, 493 Mich at 298.

What’s Next?

In November 2020, AdvisaCare filed an application for leave to appeal in the Michigan Supreme Court. Time will tell whether the Court will grant leave and, if so, whether it will agree with the Court of Appeals.

 


 

If you have questions about the application of MCL 500.3105(1), please feel free to contact the author, Lauren A. Frederick. More information about Collins Einhorn’s General and Automotive Liability Practice Group is available here.


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