Dell v. Citizens Insurance Company of America
312 Mich. App. 734
| Mich. Ct. App. | 2015Background
- 1984: Tina Dell, a pedestrian, suffered catastrophic injuries and received ~ $1M in no-fault benefits paid by Citizens (policy issued to her parents).
- Dell sought attendant-care benefits dating to the accident; Citizens denied reimbursement requests in the 1980s and paid attendant-care only after a written claim and physician prescription were submitted in 2011.
- Dell sued in July 2011 for unpaid no-fault benefits and later amended to add an MCPA claim alleging Citizens’ misconduct in claims handling and violations of Chapter 20 of the Insurance Code.
- At trial, the jury found no allowable no-fault expenses within the one-year pre-suit window but found Citizens violated the MCPA and awarded Dell $2.0M total (benefits plus mental anguish).
- The trial court granted Citizens’ JNOV, holding Dell’s MCPA claim was time-barred under MCL 445.911(7); trial court had earlier denied Citizens’ MCR 2.116(C)(8) motion that challenged MCPA applicability to claims handling.
- On appeal the Court of Appeals: affirmed denial of Citizens’ summary-disposition motion, reversed the JNOV, held Citizens waived the MCPA statute-of-limitations defense by failing to plead it, and remanded to reinstate the jury verdict and address attorney-fee requests.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether MCPA covers misconduct in insurance claims handling/adjustment | Dell: MCPA reaches claims-handling misconduct that causes confusion about legal rights and obligations | Citizens: MCPA does not reach claims-handling/adjustment conduct; only sale/marketing conduct | Court: MCPA can apply to claims handling (pre-3/28/2001 conduct); Dell pleaded actionable MCPA violations (e.g., §445.903(1)(n)) so C(8) denial affirmed |
| Whether violations of Chapter 20 alone create an MCPA claim | Dell: Violations of Chapter 20 can be pursued under MCPA where not exempted | Citizens: Chapter 20 violations alone do not create MCPA causes of action | Court: Chapter 20 violations do not automatically create MCPA claims; plaintiff must allege statutory MCPA violations, but Dell did so |
| Effect of changes to MCL 445.904 and timing of conduct | Dell: Her alleged misconduct occurred before March 28, 2001 and suit was timely filed (before cutoff) | Citizens: Legislative amendments limit MCPA coverage for insurance-related conduct | Court: Because alleged acts occurred before 3/28/2001 and suit was filed before June 5, 2014, MCL 445.904(3) carve-out does not bar Dell’s claim |
| Whether Citizens preserved statute-of-limitations defense under MCL 445.911(7) | Dell: Statute-of-limitations defense waived because Citizens failed to plead it in the responsive pleading | Citizens: Their pleadings and early motions sufficiently asserted timing limits | Court: Citizens waived MCL 445.911(7) defense (it was not pleaded or raised in an MCR 2.116 motion before answer); JNOV based on that defense was reversed |
Key Cases Cited
- Smith v. Globe Life Ins. Co., 460 Mich 446 (Michigan Supreme Court) (interpreting MCL 445.904 exemptions and MCPA applicability to insurance-related claims)
- Converse v. Auto Club Group Ins. Co., 493 Mich 877 (Michigan Supreme Court) (timing and scope of MCPA claims tied to 3/28/2001 amendment of MCL 445.904)
- Jesperson v. Auto Club Ins. Ass'n, 306 Mich App 632 (Court of Appeals) (discussion of pleading statute-of-limitations defenses and amendment leave)
- Zine v. Chrysler Corp., 236 Mich App 261 (Court of Appeals) (construing §445.903(1)(n) to include pre- and post-transaction representations)