DRAGEN PERKOVIC v ZURICH AMERICAN INSURANCE COMPANY
No. 152484
Michigan Supreme Court
April 14, 2017
499 Mich. 935
Argued on application for leave to appeal December 7, 2016. Decided April 14, 2017.
Syllabus
Chief Justice: Stephen J. Markman
Justices: Robert P. Young, Jr., Brian K. Zahra, Bridget M. McCormack, David F. Viviano, Richard H. Bernstein, Joan L. Larsen
This syllabus constitutes no part of the opinion of the Court but has been prepared by the Reporter of Decisions for the convenience of the reader.
Reporter of Decisions: Kathryn L. Loomis
Dragen Perkovic filed an amended complaint in the Wayne Circuit Court naming Zurich American Insurance Company as a defendant in an action seeking to recover no-fault personal protection insurance (PIP) benefits for injuries he sustained in a motor vehicle accident on February 28, 2009. At the time of the accident, Perkovic was operating a semitruck. Perkovic was treated for his injuries at The Nebraska Medical Center. On April 30, 2009, The Nebraska Medical Center sent Perkovic‘s medical records and associated bills to Zurich American, Perkovic‘s employer‘s insurance company. Zurich asserted that it had no injury report for Perkovic and on May 19, 2009, denied payment for Perkovic‘s medical treatment at The Nebraska Medical Center. Perkovic filed his initial complaint on August 11, 2009, seeking unpaid PIP benefits and naming his own automobile insurance company, Citizens Insurance Company of the Midwest, as a defendant. He later amended the complaint to add his bobtail insurer, Hudson Insurance Company, as a defendant. Perkovic did not add Zurich American as a defendant until March 25, 2010, about 13 months after the accident. Perkovic‘s claims against Citizens and Hudson were dismissed after the Court of Appeals, STEPHENS, P.J., and OWENS and MURRAY, JJ., ruled that Zurich American was the highest-priority insurer. Perkovic v Hudson Ins Co, unpublished per curiam opinion of the Court of Appeals, issued December 20, 2012 (Docket No. 302868). When the case returned to the trial court, Zurich American moved for summary disposition under MCR 2.116(C)(7), contending that Perkovic‘s claim was barred by the one-year limitations period in
In an opinion by Justice BERNSTEIN, joined by Chief Justice MARKMAN and Justices ZAHRA, MCCORMACK, VIVIANO, and LARSEN, the Supreme Court held:
The statutory notice period for seeking no-fault benefits is satisfied when documentation containing all the information required by
Reversed and remanded. Trial court‘s summary disposition order vacated.
Justice YOUNG, dissenting, largely agreed with the reasoning of the majority opinion but disagreed with its outcome. Although Zurich American received notice that Perkovic had received medical treatment from The Nebraska Medical Center, the notice was not sent in behalf of an insured who was, at that time, claiming that he was еntitled to no-fault benefits. The notice Zurich American received did not clearly communicate that Perkovic was making a claim for PIP benefits; instead, the notice could have been interpreted as seeking other benefits under the insurance policy. The notice in this case was not given by either someone claiming to be entitled to no-fault benefits or someone acting in his behalf. Justice YOUNG would have affirmed the result reached by the Court of Appeals because summary disposition was properly granted in Zurich American‘s favor.
DRAGEN PERKOVIC, Plaintiff-Appellant, v ZURICH AMERICAN INSURANCE COMPANY, Defendant-Appellee.
No. 152484
STATE OF MICHIGAN SUPREME COURT
FILED April 14, 2017
OPINION
BEFORE THE ENTIRE BENCH
This case concerns the notice requirements of the no-fault act,
I. FACTS AND PROCEDURAL HISTORY
On February 28, 2009, plaintiff Dragen Perkovic was operating a semitruck in Nebraska when he swerved to avoid hitting a car that had spun out in front of him. Plaintiff‘s truck then crashed into a wall. Plaintiff‘s resulting injuries were treated at The Nebraska Medical Center. At the time of the accident, plaintiff maintained personal automobile insurance with Citizens Insurance Company of the Midwest (Citizens) and a bobtail insurance policy1 with Hudson Insurance Company (Hudson). Plaintiff‘s employer was insured by defendant Zurich American Insurance Company.
On April 30, 2009, staff at The Nebraska Medical Center mailed a bill for the services it had provided, as well as plaintiff‘s medical records, to defendant. A custodian of records and billing for The Nebraska Medical Center explained by affidavit that the bills and records were sent to defendant on plaintiff‘s behalf in order to obtain payment for the services provided in relation to plaintiff‘s accident-related injuries. The medical bills and records both contained plaintiff‘s name and address. The medical records also provided the following summary:
46 yo male semi truck driver c/o R upper back pain after MVC. States that he was driving down interstate when car in front of him began to spin[;] he swerved to avoid the car since in semi and ran into a wall hitting front[]driver side.
The records further stated that plaintiff may have suffered a “back sprain, cervical sprain or fracture, chest wall contusion, contusion, head injury, liver injury, myocardial contusion, pneumothorax, splenic injury, sprained or fractured extremity.”
On May 19, 2009, defendant denied payment for the services, returning the bill and records to the sender stamped with the following statement: “No injury report on file for this person.”
On August 11, 2009, plaintiff filed suit under the no-fault act, seeking unpaid personal protection insurance (PIP) benefits arising out of the February 28 accident. The initial complaint filed in the trial court only named Citizens, plaintiff‘s personal insurer, as a defendant. Plaintiff later amended the complaint to add Hudson, the bobtail insurer, as a defendant. Plaintiff did not amend his complaint to add defendant as a party until March 25, 2010, approximately thirteen months after the accident.
When the case returned to the trial court, defendant filed a motion for summary disposition under MCR 2.116(C)(7), arguing that plaintiff‘s claims were barred by the one-year statute of limitations in
II. STANDARD OF REVIEW
We review de novo questions of statutory interpretation. Jesperson v Auto Club Ins Ass‘n, 499 Mich 29, 34; 878 NW2d 799 (2016). When interpreting a statute, the primary rule of construction is to discern and give effect to the Legislature‘s intent, the most reliable indicator of which is the clear and unambiguous language of the statute. Id. We enforce such language as written, giving effect to every word, phrase, and clause. Id. We also review de novo the grant or denial of a motion for summary disposition. Id.
III. ANALYSIS
The no-fault act allows a person injured in an automobile accident to recover PIP benefits for certain reasonably necessary expenses incurred for the care, recovery, and rehabilitation of the injured person.
An action for recovery of personal protection insurance benefits payable under this chapter for accidental bodily injury may not be commenced later than 1 year after the date of the accident causing the injury unless written notice of injury as provided herein has been given to the insurer within 1 year after the accident or unless the insurer has previously made a payment of personal protection insurance benefits for the injury. If the notice has been given or a payment has been made, the action may be commenced at any time within 1 year after the most recent allowable expense, work loss or survivor‘s loss has been incurred. However, the claimant may not recover benefits for any portion of the loss incurred more than 1 year before the date on which the action was commenced. The notice of injury required by this subsection may be given to the insurer or any of its authorized agents by a person claiming to be entitled to benefits therefor, or by someone in his behalf. The notice shall give the name and address of the claimant and indicate in ordinary language the name of the person injured and the time, place and nature of his injury.
Therefore, under
The Court of Appeals considered the first exception in a string of cases published in the 1980s. In Dozier v State Farm Mut Auto Ins Co, 95 Mich App 121, 128; 290 NW2d 408 (1980), the Court of Appeals held that substantial compliance with the written-notice provision can preserve a claim under
The Court of Appeals in this case concluded that the medical bills and records sent to defendant did not constitute notice for the purposes of
We disagree with the Court of Appeals’ reliance on the perceived purpose of the notice requirement of
As stated in note 3 of this opinion, the plain language of the statute lists what information the written notice must include in the final sentence: “The notice shall give the name and address of the claimant and indicate in ordinary language the name of the person injured and the time, place and nature of his injury.”
While
The fact that plaintiff might have been unaware of The Nebraska Medical Center‘s transmission of notice to defendant is not detrimental to his claim. The penultimate sentence of
That the “in his behalf” language of
Therefore, we conclude that the notice given in this case satisfied the first exception of
IV. CONCLUSION
We hold that, under the circumstances of this case, plaintiff satisfied the notice requirements of
Richard H. Bernstein
Stephen J. Markman
Brian K. Zahra
Bridget M. McCormack
David F. Viviano
Joan L. Larsen
DRAGEN PERKOVIC, Plaintiff-Appellant, v ZURICH AMERICAN INSURANCE COMPANY, Defendant-Appellee.
No. 152484
STATE OF MICHIGAN SUPREME COURT
YOUNG, J. (dissenting).
Although I largely agree with the reasoning of the majority opinion, I respectfully dissent from the result. I would hold that defendant is entitled to summary disposition, affirming on alternative grounds the judgment of the Court of Appeals. I disagree with the majority that the alleged notice sent to defendant by The Nebraska Medical Center was given to an insurer by or in behalf of “a person claiming to be entitled to” personal protection insurance benefits under the no-fault act for accidental bodily injury, as required by
I. FACTS AND PROCEDURAL HISTORY
Plaintiff, a Michigan resident, was in an automobile accident on February 28, 2009, while operating a semitruck in Nebraska. He was taken by ambulance to The Nebraska Medical Center (NMC), where he received emergency medical treatment. At the time of the accident, the company for which plaintiff worked had an insurance policy with defendant. On April 30, 2009, NMC sent defendant a bill for the medical services it provided to plaintiff, along with plaintiff‘s medical records. Defendant denied payment for these services, stating that there was “[n]o injury report on file for this person.”
Plaintiff filed suit on August 11, 2009, seeking unpaid personal protection insurance (PIP) benefits. Plaintiff named оnly his personal insurer in the original complaint. Plaintiff did not amend his complaint to add defendant until March 25, 2010. After being adjudicated the highest-priority insurer, defendant moved for summary disposition under MCR 2.116(C)(7). Defendant argued that plaintiff‘s claims were barred by the one-year statute of limitations in
II. ANALYSIS
I would affirm the grant of summary disposition to dеfendant, but, like the majority, I disagree with the reasoning of the Court of Appeals. The critical holding of the Court of Appeals was that “the medical bill and medical records, although sufficient in content, did not fulfill the purposes
Instead, as the majority holds, what is required is actual compliance with the statute.6
An action for recovery of personal protection insurance benefits payable under this chapter for accidental bodily injury may not be commenced later than 1 year after the date of the accident causing the injury unless written notice of injury as provided herein has been given to the insurer within 1 year after the accident or unless the insurer has previously made a payment of personal protection insurance benefits for the injury. If the notice has been given or a payment has been made, the action may be commenced at any time within 1 year after the most recent allowable expense, work loss or survivor‘s loss has been incurred. However, the claimant may not recover benefits for any portion of the loss incurred more than 1 year before the date on which the action was commenced. The notice of injury required by this subsection may be given to the insurer or any of its authorized agents by a person claiming to be entitled to benefits therefor, or by someone in his behalf. The notice shall give the name and address of the claimant and indicate in ordinary language the name of the person injured and the time, place and nature of his injury.7
To toll the statute of limitations,
Under the last antecedent rule, the descriptive clause, “claiming to be entitled to benefits,” modifies the noun “person.”8 The present participle “claiming” does not immediately connote the exact time at which the statutory “person” must be claiming entitlement to no-fault benefits. The ordinary meaning of the verb “claim” is “to ask for [especially] as a right.”9 Again, this definition could lend itself to either interpretation: a person can assert a right to no-fault benefits at the time the action is initiated or the time the notice is given. A person could “claim” to be entitled to no-fault benefits either by filing a no-fault аction or by asserting that “right” in a letter to an insurer.10
The statutory context more clearly shows that the most reasonable reading of this provision is that the person must be claiming “personal protection insurance benefits . . . for accidental bodily injury” at the time the notice is given.
Plaintiff argues that because thе disputed sentence states that notice “may be given to the insurer . . . by a person claiming to be entitled to benefits therefor,”13 this clause cannot define a requirement for the statutory notice of injury. “May” generally denotes something that is permissive rather than mandatory, in contrast to the word “shall,” which is used in the second sentence.14 However, in the context of the sentence and this statutory provision, “may” is more reasonably read as stating that notice may be given either “by
NMC sent defendant a bill for the services NMC had rendered to plaintiff along with plaintiff‘s medical records. The parties agree on appeal that these are the only documents that could possibly constitute notice under
Plaintiff argues that because the insurance policy covered no-fault benefits, defendant was notified that this claim for benefits under the policy could lead to a no-fault claim. However, the insurance policy that defendant issued to plaintiff‘s emplоyer did not solely cover no-fault PIP benefits; conceivably, the documents sent to defendant by NMC could have been claiming other benefits due under the policy.
III. CONCLUSION
The medical bill was not given to defendant “by a person claiming to be entitled to benefits therefor, or by someone in his behalf.” Therefore, the medical bill and records were insufficient to avoid operation of the statute of limitations in
Robert P. Young, Jr.
