Searching over 5,500,000 cases.


searching
Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.

Batts v. Titan Insurance Co.

Court of Appeals of Michigan

December 12, 2017

WILLIAM JOSEPH BATTS, Plaintiff-Appellee,
v.
TITAN INSURANCE COMPANY, Defendant-Appellant.

         Wayne Circuit Court LC No. 14-013559-NF

          Before: Jansen, P.J., and Cavanagh and Cameron, JJ.

          Cavanagh, J.

Defendant appeals as of right from a stipulated judgment entered following the trial court's order denying defendant's motion for summary disposition in this no-fault insurance dispute. We affirm and remand for entry of an order granting summary disposition in plaintiff's favor.

         Plaintiff, a military veteran, was riding a motor scooter and was injured when he struck a vehicle that failed to stop at an intersection stop sign. The vehicle could not be identified. Plaintiff received various medical treatments through the Veteran Administration (VA) for his injuries, but also received medical care from non-VA medical providers, including Serenity Personal Care, an assisted-living facility. Plaintiff did not have a policy of no-fault insurance available to him in his household. Therefore, plaintiff filed a claim for no-fault personal injury protection (PIP) benefits through the assigned claims plan, which assigned the claim to defendant. Defendant refused to pay any of the requested PIP benefits on the ground that plaintiff was entitled to health care benefits through the VA, and thus, the VA was the primary insurer responsible for plaintiff's medical care and expenses.

         Plaintiff then filed his complaint seeking payment of PIP benefits from defendant. Plaintiff alleged that defendant had refused to pay any PIP benefits, including medical, attendant care, replacement service, and transportation benefits.

         Defendant filed a motion for summary disposition under MCR 2.116(C)(10), arguing that as a military veteran plaintiff had health "insurance" coverage through the VA which, like an HMO, required plaintiff to receive medical treatment within the VA system. Consequently, under the coordination of benefits provision of MCL 500.3109a, defendant was not liable for the cost of any medical treatment received by plaintiff outside of the VA system. Similarly, because benefits through the assigned claims carrier are coordinated under MCL 500.3172(2) and plaintiff had health care coverage through the VA, defendant was not liable for any of plaintiff's medical expenses. Further, under the set-off provision of MCL 500.3109(1), defendant was entitled to a set-off against federal benefits to which plaintiff was entitled. And, in this case, the VA health system could provide the same treatments and services plaintiff received from non-VA providers after his motor vehicle accident; thus, defendant was not liable for those expenses. That is, although plaintiff's case manager, Monica Gay, testified that a VA social worker contacted her to locate 24-hour care for plaintiff following a surgical procedure, Gay did not seek that care from a VA facility before having him placed at Serenity Personal Care. Further, a social worker at the VA, Pamela Mackey, testified that although the VA does not provide 24hour care, a veteran can apply to a VA-run medical foster care program which requires a veteran to privately pay to receive care by individuals who are reviewed by VA staff. Therefore, defendant argued, plaintiff's complaint seeking PIP benefits should be summarily dismissed.

         Plaintiff responded to defendant's motion for summary disposition and requested summary disposition in his favor under MCR 2.116(I)(2). First, plaintiff argued, the VA is not a health insurance company; it is a medical provider of last resort for veterans unless they have a service-connected injury. Federal law-specifically 38 USC § 1729-establishes that the VA is not an "insurer" because it grants the federal government the right to be reimbursed for the cost of medical care provided to veterans for non-service related injuries. More specifically, 38 USC § 1729 states that when a veteran receives medical care for non-service connected injuries incurred in a motor vehicle accident, no law of any state and no contract provision shall prevent recovery by the Unites States for the care or services furnished to the veteran. See also United States v State Farm Ins Co, 599 F.Supp 441 (ED Mich, 1984). Accordingly, this federal law preempts the state law provisions that defendant is relying on and defendant's argument is without merit.

         Second, plaintiff argued, the no-fault provisions and cases relied upon by defendant in support of its legal position are inapposite. In this case, plaintiff did not choose to purchase a coordinated automobile insurance policy that offered reduced health care benefits. Moreover, again, the VA is not a health insurance company. That is why the VA actually sought payment from defendant through its numerous billings for medical services provided to plaintiff as a consequence of the motor vehicle accident. Further, defendant was sent a letter written by a staff attorney at the VA General Counsel Office which set forth the legal authority, including 38 USC § 1729, supporting its efforts to seek reimbursement for medical services provided to plaintiff as a result of the motor vehicle accident. In summary, plaintiff argued, he was wrongfully denied PIP benefits and was entitled to summary disposition in his favor.

         Following oral arguments, the trial court denied defendant's motion for summary disposition. The trial court held that because the VA did not offer the services that plaintiff needed, defendant was liable for those expenses incurred outside the VA. Subsequently, the trial court granted defendant's motion to stay proceedings pending this Court's decision on defendant's application for leave to appeal. After this Court issued an order denying defendant's application, the parties agreed to a contingent award of damages pending appeal and the trial court entered a stipulated judgment that closed the case. This appeal of right followed.

         Defendant argues that plaintiff had health insurance coverage through the VA and was required under provisions of the no-fault act to seek and receive all medical treatment within the VA system. Therefore, defendant was not liable for any outstanding PIP benefits and the trial court erred in denying its motion for summary disposition. We disagree.

         We review de novo a trial court's decision to grant a motion for summary disposition. Lakeview Commons v Empower Yourself, LLC, 290 Mich.App. 503, 506; 802 N.W.2d 712 (2010). A motion brought under MCR 2.116(C)(10) tests the factual support of a plaintiff's claim and should be granted if, after consideration of the evidence submitted by the parties in the light most favorable to the nonmoving party, no genuine issue regarding any material fact exists. Id.

         We also review de novo questions of statutory interpretation. Dextrom v Wexford Co, 287 Mich.App. 406, 416; 789 N.W.2d 211 (2010). It is well-established that the goal of statutory interpretation is to give effect to the intent of the Legislature. Atchison v Atchison, 256 Mich.App. 531, 535; 664 N.W.2d 249 (2003). "If the language of a statute is clear and unambiguous, the statute must be enforced as written and no further judicial construction is permitted." Whitman v City of Burton, 493 Mich. 303, 311; 831 N.W.2d 223 (2013).

         Under the assigned claims statutory scheme, including MCL 500.3172(3)(b) and 500.3175(1), defendant was required to make prompt payment for plaintiff's losses suffered as a consequence of the motor vehicle accident in accordance with the no-fault act. Defendant has asserted three untenable excuses for failing to do so. First, defendant claims that under the coordination of benefits provision of MCL 500.3109a, it ...


Buy This Entire Record For $7.95

Download the entire decision to receive the complete text, official citation,
docket number, dissents and concurrences, and footnotes for this case.

Learn more about what you receive with purchase of this case.