BRONSON HEALTH CARE GROUP, INC., Plaintiff-Appellant, v STATE AUTO PROPERTY AND CASUALTY INSURANCE COMPANY and STATE AUTOMOBILE MUTUAL INSURANCE COMPANY, Defendants-Appellees.
No. 345332
STATE OF MICHIGAN COURT OF APPEALS
November 7, 2019
FOR PUBLICATION. 9:00 a.m. Kalamazoo Circuit Court. LC No. 2017-000582-NF
Before: MARKEY, P.J., and BORRELLO and BOONSTRA, JJ.
Plaintiff appeals by right the trial court‘s order granting summary disposition in favor of defendants under
I. PERTINENT FACTS AND PROCEDURAL HISTORY
Victor Caballero (Victor) was involved in an automobile accident while driving a motor vehicle insured under a Personal Auto Policy (the Policy) issued by State Auto1 to Maria Caballero (Maria), Victor‘s wife. Victor sustained injuries and was treated by plaintiff; he assigned to plaintiff his right to seek payment of personal injury protection (PIP) benefits under
the Michigan no-fault insurance act (the no-fault act);2 plaintiff in turn sought to recover them from State Auto. State Auto denied coverage on the ground that Victor was an excluded operator under the Policy. Plaintiff brought suit, asserting that Victor had a statutory right to receive PIP benefits and that plaintiff, by assignment, had a right to recover those benefits for the services it provided to Victor. State Auto moved for summary disposition under
II. STANDARD OF REVIEW
This Court reviews de novo a trial court‘s ruling on a motion for summary disposition. Zaher v Miotke, 300 Mich App 132, 139; 832 NW2d 266 (2013).
A motion under
MCR 2.116(C)(10) tests the factual support of a plaintiff‘s claim. Summary disposition is appropriate underMCR 2.116(C)(10) if there is no genuine issue regarding any material fact and the moving party is entitled to judgment as a matter of law. In reviewing a motion underMCR 2.116(C)(10) , this Court considers the pleadings, admissions, affidavits, and other relevant documentary evidence of record in the light most favorable to the nonmoving party to determine whether any genuine issue of material fact exists to warrant a trial. A genuine issue of material fact exists when the record, giving the benefit of reasonable doubt to the opposing party, leaves open an issue upon which reasonable minds might differ. [Id. at 139-140 (quotation marks and citations omitted).]
We review de novo as a question of law the interpretation of statutes. McCormick v Carrier, 487 Mich 180, 233; 795 NW2d 517 (2010). We also review de novo the construction and interpretation of an insurance contract. Lewis v Farmers Ins Exch, 315 Mich App 202, 209; 888 NW2d 916 (2016).
III. ANALYSIS
Plaintiff argues that the trial court erred by granting summary disposition in favor of State Auto because, based on the plain and unambiguous language of the Endorsement, it did not apply to PIP benefits. However, we disagree with plaintiff‘s framing of the issue. Moreover, we conclude, after appropriately framing the issue, that the trial court properly granted summary disposition in favor of State Auto, although our reasoning differs somewhat from that of the trial court.3
Although plaintiff argues that the issue before us is purely one of contract interpretation, we conclude that where, as here, the benefits in question are mandated by statute, the issue is actually one of statutory interpretation. “The no-fault act mandates certain minimal coverage,” although “a policy of insurance may provide broader coverage than that mandated under the statute or may provide supplemental coverage for benefits not required by the no-fault act.” See Rednour v Hasting Mut Ins Co, 245 Mich App 419, 422; 628 NW2d 116 (2001), rev‘d on other grounds 468 Mich 241 (2003). For non-mandated coverage, ” it is the insurance policy as a contractual agreement between the parties that governs the coverage, rather than the statutory provisions of the no-fault act.” Id. However, for mandated coverage, it is the no-fault act itself that governs the coverage. Id. See also, Cruz v State Farm Mut Auto Ins Co, 241 Mich App 159, 164-167; 614 NW2d 689 (2000).
PIP benefits are mandated by the no-fault act, and a claimant‘s entitlement to PIP benefits is therefore based in statute, not in contract. See, e.g.,
Because of the statutorily-mandated nature of PIP benefits, the no-fault act requires an insurer, in order to issue a policy consistent with the no-fault act, to provide PIP benefits to a “named insured” and to his or her spouse and household relatives. See
If authorized by the insured, automobile liability or motor vehicle liability coverage may be excluded when a vehicle is operated by a named person. An exclusion under this subsection is not valid unless the following notice is on the face of the policy or the declaration page or certificate of the policy and on the certificate of insurance:
Warning—when a named excluded person operates a vehicle all liability coverage is void—no one is insured. Owners of the vehicle and others legally responsible for the acts of the named excluded person remain fully personally liable.
The no-fault act thus provides a mechanism by which a person may be statutorily excluded from entitlement to PIP benefits notwithstanding that he or she may otherwise have been entitled to them. Therefore, the issue before us is whether Victor was properly named as an excluded operator under
When Maria purchased the policy from State Auto, she signed 4 endorsements, each entitled Named Driver Exclusion Endorsement, one for each of four persons who were identified on those endorsements as a “Person Excluded.”6 One of
The Endorsement thus clearly identifies “Victor Caballero” as a “Person Excluded.” In addition, the declarations page of the Policy7 contains the full language of the warning required by
the time of an accident, and also contains the warning language of
Plaintiff nonetheless contends that Victor was entitled to PIP benefits. Plaintiff‘s argument is premised on the fact that the Endorsement did not specifically list PIP benefits as among the benefits that would not apply when an otherwise covered motor vehicle was operated by an excluded operator; rather, it only identified “Liability, Uninsured Motorists, and Physical Damage” as benefits that would not apply when the vehicle was operated by an excluded operator. In other words, plaintiff‘s position at bottom is that State Auto is liable for PIP benefits because it failed to exclude them in the Endorsement. But this position runs afoul of the fact that PIP benefits are not contract-based, but are instead statutorily mandated.
Because PIP benefits are not a creature of contract but instead are statutorily mandated, Rednour, 245 Mich App at 422, they are not subject to contractual exclusion. See e.g., Citizens Ins Co of America v Federated Mut Ins Co, 448 Mich 225, 229-231, 238; 531 NW2d 138 (1995). Therefore, a contractual exclusion of PIP benefits would have been unenforceable, as it would have resulted in a policy that provided more restrictive coverage than is mandated by the no-fault act, and thus would have been contrary to the mandates of the act. Id. at 238 (holding that “the policy [excluding mandated benefits] is invalid as violative of the no-fault act“). See also Rohlman, 442 Mich at 530 n 10, quoting 12A Couch, Insurance, 2d (rev ed), § 45.697, p 334 n 3 (“A compulsory insurance statute in effect declares a minimum standard which must be observed, and a policy cannot be written with a more restrictive coverage. The statute is manifestly superior to and controls the policy, and its provisions supersede any conflicting provisions of the policy.) (emphasis added); see also Farmers Ins Exch v Kurzmann, 257 Mich App 412, 418; 668 NW2d 199 (2003) (noting that “[a]n insurer is free to define or limit the scope of coverage as long as the policy language . . . is not in contravention of public policy” and that the exclusion of benefits mandated by the no-fault act renders such an exclusion void).
Indeed, and directly contrary to plaintiff‘s position that a contractual exclusion of PIP benefits was required (in order for State Auto to avoid liability for PIP benefits), a contractual exclusion of PIP benefits would instead have been improper, as it would have been in derogation of the mandates of the no-fault act. Simply put, PIP benefits are statutory and thus not subject to a contractual exclusion. As relates to PIP benefits, therefore, the import of the Endorsement was not in the
As we have previously observed, a validly-excluded-driver‘s “act of driving the insured vehicle at the time of the accident render[s] the vehicle uninsured;” no further reference to the Policy is required because at the time of the accident “there was no personal liability or property damage ‘security’ required by
For all of these reasons, we conclude that Victor was properly named as an excluded operator and that he was therefore statutorily barred from receiving PIP benefits. Accordingly, the trial court properly granted State Auto‘s motion for summary disposition because, when viewed in the light most favorable to plaintiff, no genuine issue of material fact existed regarding Victor‘s entitlement to PIP benefits. See Miotke, 300 Mich App at 139-140;
Affirmed.
/s/ Mark T. Boonstra
/s/ Jane E. Markey
/s/ Stephen L. Borrello
