Kevin Sampson Jr v. Gregory Jefferson
326561
| Mich. Ct. App. | Jul 14, 2016Background
- On Dec. 20, 2012, Sampson was injured in a car accident and later required surgery for cervical/lumbar herniations and a shoulder injury. He lived with the insureds (the Crofts), so the insurer (Home-Owners) handled his claim.
- Sampson claimed replacement household services (driving, errands) provided by caregiver Ciara Beard; Beard submitted a monthly household-services form for March 2013 that listed services for every calendar square but contained no date numbers and was signed by Beard (not Sampson).
- Home-Owners obtained surveillance video showing Sampson driving, carrying items, and running errands on March 6 and March 9, 2013, and moved for summary disposition under MCR 2.116(C)(10), arguing fraud under the policy’s fraud clause.
- Home-Owners argued the videotape proved the March household-services statement was false and material, barring coverage; Sampson countered the tapes showed only limited activity and did not disprove that replacement services were provided at other times due to fluctuating pain and medication.
- The trial court denied summary disposition, finding a genuine issue of material fact whether the videotape disproved Beard’s monthly statement or established intentional misrepresentation; the Court of Appeals affirmed.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether videotape evidence established fraud so insurer may void benefits under the policy fraud clause | Sampson: tapes show limited activity compatible with his testimony about intermittent ability to perform tasks while medicated; tapes don’t disprove services provided on other times/dates | Home-Owners: tapes show Sampson driving/performing errands on days for which replacement services were claimed, proving falsity and material misrepresentation | Denied summary disposition — genuine factual dispute exists whether the household-services statement was false or made with intent to defraud |
| Whether the household-services form itself established falsity (dates/entries) | Sampson: form lacks dated squares and claimant signature; entries don’t identify specific dates, so form alone doesn’t prove fraud | Home-Owners: the filled grid demonstrates claimed services for March and supports inference of falsity when combined with surveillance | Held: form alone insufficient; absence of date markings and corroborating testimony/affidavits creates a factual issue |
| Whether plaintiff’s testimony is inconsistent with surveillance | Sampson: testified he sometimes could perform tasks when medicated or not in pain; surveillance shows activity only at some times | Home-Owners: surveillance contradicts claimed need for replacement services on days in question | Held: Surveillance consistent with plaintiff’s testimony and does not categorically contradict claimed limitations; credibility/factual inferences for jury |
| Whether Bahri (308 Mich App 420) compels judgment for insurer | Sampson: Bahri is distinguishable because that plaintiff was observed doing extensive inconsistent activities and claimed services for pre-accident days | Home-Owners: relies on Bahri to argue surveillance showing inconsistent activity is dispositive | Held: Bahri distinguishable on facts; does not mandate summary disposition here |
Key Cases Cited
- Bahri v. IDS Prop. Cas. Ins. Co., 308 Mich. App. 420 (court applies elements for insurer to void policy for willful misrepresentation)
- The Reserve at Heritage Village Ass’n v. Warren Fin. Acquisition, LLC, 308 Mich. App. 92 (procedural preservation rules for appellate review)