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Perrin v. State Farm Mutual Automobile Insurance Co.

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

June 25, 2019

NYLA PERRIN, as PERSONAL REPRESENTATIVE OF THE ESTATE OF YOLANDA THOMAS, Plaintiff,
v.
STATE FARM MUTUAL AUTOMOBILE INSURANCE CO., Defendant.

         HON. MARK A. GOLDSMITH

          OPINION & ORDER DENYING DEFENDANT STATE FARM'S SECOND MOTION FOR SUMMARY JUDGMENT (DKT. 74)

          MARK A. GOLDSMITH, UNITED STATES DISTRICT JUDGE

         This matter is before the Court on Defendant State Farm's second motion for summary judgment (Dkt. 74). The issues have been fully briefed. Because oral argument will not aid the decisional process, the motion will be decided based on the parties' briefing. See E.D. Mich. LR 7.1(f)(2); Fed.R.Civ.P. 78(b). For the reasons that follow, the Court denies State Farm's motion.

         I. BACKGROUND

         The Court previously explained the facts of the case as follows:

Plaintiff Yolanda Thomas was involved in two distinct motor vehicle accidents in 2014: one in January and one in November. Statement of Mat. Facts ¶ 2 (Dkt. 35). Thomas now seeks payment of no-fault benefits from Defendant State Farm. Id. ¶ 3. According to Thomas's doctor, she sustained a traumatic brain injury and suffers from memory loss. See Bleiberg Dep., Ex. 3 to Pl. Resp, at 18, 104 (Dkt. 45-6). Due to her injuries, Thomas received in-home attendant care through One Life Care Services. Statement of Mat. Facts ¶ 5. Plaintiff's counsel submitted attendant care calendars, signed by Plaintiff, as part of her claim for PIP (personal injury protection) benefits. Counter-Statement of Mat. Facts ¶ 10 (Dkt. 45). These calendars noted that Thomas was receiving in-home care every day between September 2015 and November 2017, though it does not appear calendars for June 2016, June 2017, or July 2017 were submitted. See Attendant Care Calendars, Ex. C to Def. Mot (Dkt. 35). However, Thomas was attending an in-patient physical therapy program from November 2016 through January 11, 2017, Statement of Mat. Facts ¶ 5, and was in a coma in the hospital between May 21, 2017 and June 3, 2017, id. ¶ 8. State Farm - whose policy provides that “[t]here is no coverage under this policy if you or any other person insured under this policy has made false statements with the intent to conceal or misrepresent any material fact or circumstance in connection with any claim under this policy” - cut off payment of PIP benefits due to this allegedly fraudulent behavior. Insurance Policy, Ex. D to Def. Mot., § 11 (Dkt. 35). Thomas brought this suit seeking payment of benefits.

See 11/1/2018 Op. & Order Denying Def. Mot. for Summ. J. (Dkt. 51) (internal footnote omitted).

         Following the Court's denial of its prior motion, State Farm acquired additional attendant care calendars from Plaintiff's counsel. These calendars show that Thomas was receiving 24-hour care from September 22, 2017 through December 22, 2017. See New Attendant Care Calendars, Ex. B. to Def. 2d Mot. (Dkt. 74-3). At his deposition, Johnny Hunter - the owner of One Life Ca re Services (“One Life”) - testified that his company provided the following services: “assisting, hygiene, grooming, bathing, toileting, positioning, physical therapy oversight. . . . Eating, preparing meals, safety services, make sure she's taking her medicine, medication management, making sure she's taking her medicine on time when she's supposed to.” Hunter Dep., Ex. A to Def. 2d Mot., at 15-16 (Dkt. 74-2).

         State Farm filed a motion for leave to file a second summary judgment motion, which this Court granted. See 5/6/2019 Order (Dkt. 73). In its second motion for summary judgment, State Farm argues that One Life operated as unlicensed adult foster care facility, and thus Plaintiff is barred from recovery.

         II. STANDARD OF REVIEW

         A motion for summary judgment under Federal Rule of Civil Procedure 56 shall be granted “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). A genuine dispute of material fact exists when there are “disputes over facts that might affect the outcome of the suit under the governing law.” Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986). “[F]acts must be viewed in the light most favorable to the nonmoving party only if there is a ‘genuine' dispute as to those facts.” Scott v. Harris, 550 U.S. 372, 380 (2007). “Where the record taken as a whole could not lead a rational trier of fact to find for the nonmoving party, there is no genuine issue for trial.” Matsushita Elec. Indus. Co. v. Zenith Radio Corp., 475 U.S. 574, 587 (1986).

         III. ANALYSIS

         State Farm argues that recovery for benefits is barred because One Life operates as an adult foster care facility, but is not properly licensed as such. Michigan law requires that any person or entity who runs an adult foster care facility be licensed by the state. See Mich. Comp. Laws § 400.713(1). An “adult foster care facility” is “a home or facility that provides foster care to adults, ” Mich. Comp. Laws § 400.703(4), with “foster care” defined as “the provision of supervision, personal care, and protection in addition to room and board, for 24 hours a day, 5 or more days a week, ...


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