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Farley v. Integon National Insurance Co.

United States District Court, E.D. Michigan, Southern Division

July 3, 2018

ASIA KENOSHA-CHARI FARLEY, Plaintiff,
v.
INTEGON NATIONAL INSURANCE COMPANY, Defendant.

          DAVID R. GRAND MAGISTRATE JUDGE

          OPINION AND ORDER GRANTING IN PART AND DENYING IN PART DEFENDANT'S MOTION FOR SUMMARY JUDGMENT [27]

          LAURIE J. MICHELSON U.S. DISTRICT JUDGE

         Asia Kenosha-Chari Farley was in a car accident in April 2016 that resulted in back injuries. Farley brought suit against the driver who hit her as well as her insurance company, Integon National Insurance Company, for refusing to fully reimburse her for related medical expenses. Farley has since settled with the driver. (R. 29.) Integon now seeks summary judgment, contending that the remaining benefits being sought are not reimbursable chiropractic services. The matter is fully briefed, (R. 34; 35), and the Court heard argument on June 21, 2018. For the following reasons, the Court grants in part and denies in part Integon's motion.

         I.

         On April 22, 2016 Farley was driving on Interstate Highway 75 when another driver drifted into her lane, striking the rear passenger side of Farley's car. (PageID.11.) Farley sustained injuries to her back, for which she received a variety of chiropractic services. (PageID.451.)

         Farley sued both the driver and her insurance company, Integon, seeking to recover personal injury protection (PIP) benefits. Against Integon, she seeks compensation for her medical expenses, lost income, travel expenses for medical care, attendant care, and expenses to cover services she would have performed for herself or her dependents. (PageID.14.) Integon paid over $15, 000 for medical expenses, (R. 27-2), but refused to pay for three chiropractic services: mechanical traction, the application of hot and cold packs, and extraspinal manipulation. (PageID.366.)

         Integon now moves for summary judgment asserting that the three contested medical expenses are not reimbursable as a matter of law. It also asks the Court to deem her requests to admit admitted (thereby eliminating Farley's remaining damages claims) and to rescind her policy because of material misrepresentations. (R. 27.)

         II.

         Summary judgment is proper “if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law.” Fed.R.Civ.P. 56(a). The moving party may discharge its initial summary judgment burden by “pointing out to the district court . . . that there is an absence of evidence to support the nonmoving party's case.” Celotex Corp. v. Catrett, 477 U.S. 317, 325 (1986). If the moving party does so, the party opposing the motion “must come forward with specific facts showing that there is a genuine issue for trial.” Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587 (1986). A fact is material only if it might affect the outcome of the case under the governing law. See Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 249 (1986). On a motion for summary judgment, the court must view the evidence, and any reasonable inferences drawn from the evidence, in the light most favorable to Farley. See Matsushita, 475 U.S. at 587 (citations omitted); Redding v. St. Edward, 241 F.3d 530, 531 (6th Cir. 2001).

         III.

         Integon argues that Michigan PIP law does not require reimbursement for Farley's mechanical traction, hot- and cold-pack application, or extraspinal manipulation treatments.

         To decide whether Integon is correct, the Court must determine the permissible scope of PIP coverage. Generally, PIP covers “reasonable charges incurred for reasonably necessary products, services and accommodations for an injured person's care, recovery, or rehabilitation.” Mich. Comp. Laws. § 500.3107 (2013). But in Michigan Compiled Laws § 500.3107b, the legislature created a separate section of excludable expenses. One of those excluded expenses is for chiropractic services, “unless the service was included in the definition of practice of chiropractic under . . . MCL 333.16401, as of January 1, 2009.” Id.; see also Measel v. Auto Club Grp. Ins. Co., 886 N.W.2d 193, 197 (Mich. Ct. App. 2016). The definition of the “practice of chiropractic” as of January 1, 2009 was the version of Michigan Compiled Laws § 333.16401 last amended in 2002. That definition is as follows:

‘Practice of chiropractic' means that discipline within the healing arts which deals with the human nervous system and its relationship to the spinal column and its interrelationship with other body systems. Practice of chiropractic includes the following:
(i) Diagnosis, including spinal analysis, to determine the existence of spinal subluxations or misalignments that produce nerve interference, indicating the ...

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