Lead Opinion
In this no-fault insurance action, a jury found defendant Auto Club Insurance Association (ACIA) hable to plaintiff William Hardrick for family-provided attendant-care services at a rate of $28 an hour. The jury reached this judgment after a trial at which ACIA was barred from presenting any evidence.
The parties vigorously contest the parameters of the evidence relevant on retrial to prove the reasonable rate for family-provided attendant-care services. ACIA contends that agency rates are irrelevant to establish the cost of family-provided care. We conclude that evidence
I. BACKGROUND FACTS AND PROCEEDINGS
In May 2007, a car struck Hardrick, then aged 19, as he walked home from work. Hardrick suffered a traumatic brain injury resulting in cognitive deficits and emotional instability. Extensive hospital-based rehabilitation yielded only minimal therapeutic gains. In 2008, Hardrick’s psychiatrist recommended around-the-clock attendant care “for supervision and safety.” Hardrick’s parents provide the prescribed attendant care.
ACIA admitted responsibility for paying Hardrick’s personal protection insurance (PIP) benefits, “consisting of all reasonable charges incurred for reasonably necessary products, services and accommodations for an injured person’s care, recovery, or rehabilitation.” MCL 500.3107(l)(a). ACIA classified Hardrick’s parents as “home health aides,” and paid them a rate of $10.25 to $10.50 an hour for the attendant care they provided. Hardrick filed this lawsuit seeking a determination that his parents qualified as “behavioral technicians,” entitling them to charge a higher hourly rate. Throughout the litigation, the parties disputed only the “reasonable charge” for Hardrick’s parents’ services. ACIA never contested the number of hours Hardrick’s parents worked providing attendant care or its responsibility to pay PIP benefits.
At the trial, Hardrick presented the testimony of Robert Ancell, Ph.D., a vocational rehabilitation counselor and case manager. Ancell opined that Hardrick’s psychiatrist ordered attendant-care services at a level consistent with the care provided by behavioral technicians. Ancell explained that within the attendant-care rubric, a “companion, like a baby sitter,” fulfills the lowest level of responsibility. At the next level, nurse’s aides, also known as home health aides, attend to “basic care needs” such as “[b]athing, feeding, dressing” and spending time with the brain-injured patient. Licensed practical nurses occupy the next rung of the responsibility ladder. “Somewhere comparable” to the licensed practical nurses, behavioral therapists “understandG how to deal with behavior issues” by “cuing” and “structuring” behavior. According to Ancell, Hardrick’s psychiatrist ordered supervision “by someone with [the] experience of a behavioral technician or life skills trainer, or someone who is very familiar to the patient who knows how to distract him, structure him, and set limits on him in a way that won’t escalate his behaviors.”
The trial court limited the jury’s reasonable-charge calculation to a range of $25 to $45 an hour, and the jury ultimately concluded that $28 an hour represented a reasonable charge for Hardrick’s parents’ attendant-care services. The trial court then ordered ACIA to pay Hardrick’s attorney fees, pursuant to MCL 500.3148(1) of the no-fault act, at a rate of $500 an hour, finding that ACIA “unreasonably delayed in making proper payment.”
II. DISCOVERY VIOLATION
ACIA concedes “that it did not timely respond to Plaintiffs . . . interrogatories and requests for discovery” and that the trial court was justified in imposing a sanction. ACIA challenges only the court’s choice of a sanction.
Following the court’s imposition of the sanction, the court twice adjourned the trial to accommodate the needs of Hardrick’s counsel. As the date for the rescheduled trial approached, ACIA filed a motion for reconsideration, expressing its desire to introduce “expert witnesses regarding rate and level of care.” By then, ACIA had supplied Hardrick with complete discovery and Hardrick had had a sufficient opportunity to review the information, thereby eliminating any possible prejudice. In the interim, however, the case had been reassigned to a visiting judge who declined to overrule the original judge’s penalty imposed for ACIA’s past conduct.
We review a trial court’s imposition of discovery sanctions for an abuse of discretion. Dorman v Clinton Twp,
MCR 2.313(B)(2) provides for the imposition of discovery sanctions as follows:
If a party or an officer, director, or managing agent of a party, or a person designated... to testify on behalf of a party, fails to obey an order to provide or permit discovery,... the court in which the action is pending may order such sanctions as are just, including, but not limited to the following:
(a) an order that the matters regarding which the order was entered or other designated facts may be taken to be established for the purposes of the action in accordance with the claim of the party obtaining the order;
(b) an order refusing to allow the disobedient party to support or oppose designated claims or defenses, or prohibiting the party from introducing designated matters into evidence;
(c) an order striking pleadings or parts of pleadings, staying further proceedings until the order is obeyed, dismissing the action or proceeding or a part of it, or rendering a judgment by default against the disobedient party;
*661 In lieu of or in addition to the foregoing orders, the court shall require the party failing to obey the order or the attorney advising the party, or both, to pay the reasonable expenses, including attorney fees, caused by the failure, unless the court finds that the failure was substantially justified or that other circumstances make an award of expenses unjust.
It is readily apparent that the trial court abused its discretion by selecting the sanction imposed. The court specifically concluded that ACIA’s conduct did not merit the drastic sanction of a default judgment. Even though the court labeled its order as “a lesser sanction,” the court actually imposed a sanction more severe and limiting than a default judgment would have been. Had the court granted Hardrick’s request for a default judgment, ACIA would have been permitted to present evidence to prove the extent of Hardrick’s damages. Wood v Detroit Auto Inter-Ins Exch,
A court may impose the severe sanction of a default judgment “only when a party flagrantly and wantonly refuses to facilitate discovery, not when the failure to comply with a discovery request is accidental or involuntary.” Bass v Combs,
Before imposing the sanction of a default judgment, a trial court should consider whether the failure to respond to discovery requests extends over a substantial period of time, whether an existing discovery order was violated, the amount of time that has elapsed between the violation and the motion for a default judgment, the prejudice to defendant, and whether wilfulness has been shown. [Thorne v Bell,206 Mich App 625 , 632-633;522 NW2d 711 (1994).]
Ultimately, the court’s chosen discovery sanction must “be proportionate and just. . ..” Kalamazoo Oil Co v Boerman,
The trial court correctly determined that ACIA had violated the court’s discovery order by providing belated and incomplete discovery. ACIA’s failure to adequately respond to discovery requests extended over several months, even after an order to compel was entered. The court also correctly concluded that ACIA’s discovery violation was not flagrant and wanton, but more likely negligent. Given the lack of flagrant and wanton conduct on ACIA’s part, the court properly determined that a default judgment would be too severe a sanction.
Yet, as noted, the trial court found that Hardrick had suffered severe prejudice. At that point, the date originally set for trial was drawing nigh and the court was concerned that ACIA’s delay amounted to a “trial by ambush.” The court expressed further concern over the effect of ACIA’s delay on the court’s docket: “The alternative would be for this Court to basically re-start and re-gear up the scheduling order which would include significantly expanding the time that the Court
The trial court clearly erred by concluding that ACIA’s discovery violations severely prejudiced Hardrick. Hardrick controlled the necessary information regarding his treatment, progress, and the attendant-care services provided by his parents. Hardrick bore the burden of proof on the reasonable value of the attendant-care services and could investigate the issue without assistance from ACIA. Hardrick was also fully aware of ACIA’s defense theory given that ACIA had compensated his parents at “health aide” rates. He easily could have accessed the United States Department of Labor’s statistics on which ACIA based its payment schedule. Moreover, at the time of the discovery-violation hearing, the parties had agreed to proceed with witness depositions despite the expiration of the discovery period. Thus, the court and Hardrick were aware that Hardrick would discover additional information regarding ACIA’s defense before trial. The court could have allayed its concern that ACIA was attempting to conduct a trial by ambush by precluding ACIA’s presentation of any undisclosed witnesses or evidence. And the proper remedy for the inconvenience caused to the court’s docket would be to hold ACIA in contempt of court. MCR 2.313(B)(2)(d); Johnson,
III. FAMILY-PROVIDED ATTENDANT CARE
By remanding this case for a new trial, we have reopened the parties’ debate regarding the valuation of family-provided attendant-care services. MCL 500.3107(1)(a) provides for the payment of “[allowable expenses,” “consisting of all reasonable charges incurred for reasonably necessary products, services and accommodations for an injured person’s care, recovery, or rehabilitation.” ACIA contends that the rates charged by health-care agencies for attendant-care services are irrelevant to establish the reasonable rate for unlicensed, family-provided services. ACIA argues that the rate for family-provided attendant care must be based on what a similarly skilled care provider doing the same work could earn if employed performing that work for an unrelated employer. According to ACIA, the pertinent rate for determining the value of the family-
A. RELEVANCY
ACIA relies extensively on Bonkowski v Allstate Ins Co,
This case touches on an interesting question of law and statutory interpretation: whether, when determining reasonable compensation payable under MCL 500.3107(l)(a) to lay providers of attendant care services, a jury may rely on the rates charged by health care agencies that employ licensed health care professionals who provide attendant care services. We use the words “touches on” intentionally, as this issue is not squarely before us in this appeal.
This Court has previously embraced the notion that “comparison to rates charged by institutions provides a valid method for determining whether the amount of an expense was reasonable and for placing a value on comparable services performed [by family members].” Manley v Detroit Automobile Inter-Ins Exch,127 Mich App 444 , 455;339 NW2d 205 (1983). We question the conclusion reached in Manley.
*666 Notwithstanding our questioning of Manley, defendant did not argue in the trial court or on appeal in this Court that Manley was wrongly decided. Rather, the lower court record reflects that defendant only argued before the trial court that, under MCL 500.3107, Andrew’s expenses had not been “incurred.” The question whether attendant care services were “incurred” is distinct from the question whether the amount paid for attendant care services was reasonable. [Bonkowski,281 Mich App at 164-165 (citation omitted).]
We are, therefore, in no way bound to follow Bonkowski. Allison v AEW Capital Mgt, LLP,
In any event, we disagree with Bonkowski’s suggestion that agency rates are irrelevant to establish family-care rates, to wit:
In determining reasonable compensation for an unlicensed person who provides health care services, a fact-finder may consider the compensation paid to licensed health care professionals who provide similar services.. .. For this reason, consideration of the compensation paid by health care agencies to their licensed health care employees for rendering services similar to the services provided by unlicensed family members is appropriate when determining reasonable compensation for those family members. However, the actual charges assessed by health care agencies in the business of providing such services is not relevant and provides no assistance in determining reasonable compensation for the actual provider of such services. The focus should be on the compensation provided to the person providing the services, not the charge assessed by an agency that hires health care professionals to provide such services. [Bonkowski,281 Mich App at 164-165 .]
We agree that the rates charged by an agency to provide attendant-care services are not dispositive of the reasonable rate chargeable by a relative caregiver. However, this does not detract from the relevance of such evidence.
“Under our system, molded by the tradition of jury trial and predominantly oral proof, a party offers his evidence not en masse, but item by item. An item of evidence, being but a single link in the chain of proof, need not prove conclusively the proposition for which it is offered. It need not ever make that proposition appear more probable than not. Whether the entire body of one party’s evidence is sufficient to go to the jury is one question. Whether a particular item of evidence is relevant to his case is quite another. It is enough if the item could reasonably show that a fact is slightly more probable than it would appear*669 without that evidence. Even after the probative force of the evidence is spent, the proposition for which it is offered still can seem quite improbable. Thus, the common objection that the inference for which the fact is offered ‘does not necessarily follow’ is untenable. It poses a standard of conclusiveness that very few single items of circumstantial evidence ever could meet. A brick is not a wall.” [Brooks,453 Mich at 519 , quoting 1 McCormick, Evidence (4th ed), § 185, p 776.]
Here, the question presented is not whether an agency rate is reasonable per se under the circumstances, but whether evidence of an agency rate may assist a jury in determining a reasonable charge for family-provided attendant-care services. The fact that an agency charges a certain rate for precisely the same services that Hardrick’s parents provide does not prove that the rate should apply to the parents’ services. However, an agency rate for attendant-care services, routinely paid by a no-fault carrier, is a piece of evidence that throws some light, however faint, on the reasonableness of a charge for attendant-care services. See Beaubien v Cicotte,
The dissent argues that “market rates” should dictate a “ ‘reasonable charge’ for no-fault services . . . Post at 692. According to the dissent, “a reasonable charge for attendant-care services provided by a family member is determined by what the family member could receive in the open market for providing similar services.” Post at 692. The dissent reasons that the “relevant market” includes “what an individual care provider would be paid” or “what a health-care agency might pay an ‘independent contractor’ to provide similar services.” Post at 692. After confining a “reasonable charge” to the wage that might be earned by a family member “in the open market,” the dissent contends that agency rates lack relevance to market rates. Post at 692 (emphasis added).
Neither the no-fault act nor this state’s vast body of no-fault caselaw mentions the term “relevant market.” It commonly appears, however, in antitrust cases. A claimant seeking to prove the existence of a monopoly must establish the relevant market. Attorney General, ex rel State Banking Comm’r v Michigan Nat’l Bank,
A relevant market includes a cluster of services or products rather than a lone offering. “Relevant markets are generally not limited to a single manufacturer’s products, but are composed of products that have reasonable interchangeability-i.e., gasoline rather than ExxonMobil-branded gasoline.” Partner & Partner, Inc v ExxonMobil Oil Corp,
[DJefining a relevant product market is a process of describing those groups of producers which, because of the similarity of their products, have the ability — actual or potential - to take significant amounts of business away from each other. A market definition must look at all relevant sources of supply, either actual rivals or eager potential entrants to the market. [SmithKline Corp v Eli Lilly & Co, 575 F2d 1056, 1063 (CA 3, 1978).]
Under federal law, determining the parameters of the relevant market presents questions of fact. White & White, 723 F2d at 499-500.
The Legislature selected “reasonableness” as the operative criterion for determining the amount of a charge for services. MCL 500.3107(l)(a). To the extent that the market for a particular service bears on its
Further, the dissent’s wage-based approach to defining a “reasonable charge” cannot be reconciled with the language of the no-fault act. According to the dissent, “a reasonable charge for any attendant-care services plaintiffs parents provide is the equivalent of what compensation they could command on the open market for providing similar services to unrelated persons. This, in turn, would depend on their qualifications, training, experience, and what persons providing similar services could earn.” Post at 692. Thus, the dissent limits a “reasonable charge” for attendant-care services supplied by family members to “what the family member could receive in the open market for providing similar services.” Post at 692. This definition conflates an employee’s wage with a provider’s reasonable charge.
The governing statutory language provides that a no-fault insurer must pay “[allowable expenses consisting of all reasonable charges incurred for reasonably necessary products, services and accommodations for an injured person’s care, recovery, or rehabilitation.” MCL 500.3107(l)(a) (emphasis added). To charge is “ ‘[t]o demand a fee; to bill.’ ” Holland v Trinity Health Care Corp,
Another legal analogy illustrates the fundamental distinction between wages and reasonable charges. Attorney fee statutes such as 42 USC 1988 authorize courts to award a “reasonable attorney’s fee” to prevailing litigants. Reasonable fees, equivalent to reasonable charges, are generally “calculated according to the prevailing market rates in the relevant community, regardless of whether plaintiff is represented by private or non-profit counsel.” Blum v Stenson,
In seeking some basis for a standard, courts properly have required prevailing attorneys to justify the reasonableness of the requested rate or rates. To inform and assist the court in the exercise of its discretion, the burden is on the fee applicant to produce satisfactory evidence — in addition to the attorney’s own affidavits — that the requested rates are in line with those prevailing in the community for similar services by lawyers of reasonably comparable skill, experience, and reputation. A rate determined in this way is normally deemed to be reasonable, and is referred to — for convenience — as the prevailing market rate. [Id. at 895 n 11.]
only permits an award of a reasonable fee, i.e., a fee similar to that customarily charged in the locality for similar legal services, which, of course, may differ from the actual fee charged or the highest rate the attorney might otherwise command. As Coulter v Tennessee, 805 F2d 146, 148 (CA 6, 1986), explains, reasonable fees “are different from the prices charged to well-to-do clients by the most noted lawyers and renowned firms in a region.” [Smith,481 Mich at 528 (opinion by Taylor, C.J.) (emphasis omitted).]
Instead, several factors determine a reasonable attorney fee, including “ ‘the fee customarily charged in the locality for similar legal services’ ” and the number of attorney hours expended in the litigation. Id. at 530 (citation omitted). The “relevant market” for this inquiry encompasses the locality in which the case was litigated. Id. The Supreme Court took pains to emphasize that “[t]he fees customarily charged in the locality for similar legal services” should be the measure, rather than the fee charged by an area’s top lawyers. Id. at 531.
In the no-fault realm, this Court has repeatedly rebuffed efforts by both providers and insurers to circumscribe a fact-finder’s reasonable-charge determination. In Hofmann v Auto Club Ins Ass’n,
*675 ACIA’s reasoning is premised on the principle that BCB-SM’s “payments” to plaintiffs for x-rays, as opposed to plaintiffs’ “charges” to BCBSM for those x-rays, are the proper criteria to be used in determining the plaintiffs’ “customary charge” for x-rays. This position is untenable, however, in light of the clear statutory language of [MCL 500.3157], which states that a “charge” in a no-fault case “shall not exceed the amount [a] person or institution customarily charges for like products, services and accommodations in cases not involving insurance” (emphasis added). Thus, ACIA’s reliance on the amount that was “paid” by BCBSM, as opposed to the amount that plaintiffs “charged,” is unwarranted.
In Mercy Mt Clemens Corp v Auto Club Ins Ass’n,
C. OTHER RELEVANT EVIDENCE
Given that many factors influence the determination of a “reasonable charge” for attendant-care services, a jury may consider a provider’s wage as one piece of evidence relevant to this calculation. We view the reasonableness inquiry as encompassing any evidence bearing on fair compensation for the particular services rendered. The principles supporting the relevancy of agency rates equally support the relevancy of other evidence. For example, Ancell testified that an agency would pay its employees less than the $25 to $45 hourly rate charged to the patient. Evidence of the employee’s
Similarly, evidence of the “overhead” incurred (or not incurred) by Hardrick’s parents would be relevant to calculating a reasonable charge. In this regard, we find instructive Sharp v Preferred Risk Mut Ins Co,
A parent who personally provides attendant-care services also certainly bears an “opportunity cost.” “The term ‘opportunity cost,’ which is borrowed from the field of economics, refers to the amount that is sacrificed when choosing one activity over the next best alternative.” Mira v Nuclear Measurements Corp, 107 F3d 466, 472 (CA 7, 1997) (citation and some quotation marks omitted). “[T]he opportunity one gives up by engaging in some activity is the cost of that activity....” Chronister Oil Co v Unocal Refining & Mktg,
The defendant argues that there is no reason why the plaintiffs wife should receive the extra money that an agency charges to address administrative costs. Although we agree that this argument is logically compelling, we hold that what level of compensation is reasonable is a factual determination for the magistrate to decide.
[T]he magistrate is in a better position than an appellate court to make this determination. The record before us on appeal is limited, and it is difficult for us to know whether it would be appropriate to award at least part of the extra expense required to hire a home companion from a nursing agency. Many considerations may be necessary to make such a determination.
For example, the cost of minimal benefits and social security contributions may be included in the higher hourly rate paid to a nursing agency, and it may be necessary to provide similar benefits to an independent companion, over and above a standard salary. Nursing agencies may also pay to provide training to their employees above and beyond the abilities of an independent companion, training that may be necessary to care for the plaintiff. In short, this is a multifaceted factual issue, involving the various types of in-home care available, the duties performed by them, their customary billing and*678 payment practices, and the type of services being performed by the plaintiff’s wife. [Id. at 145-146 (emphasis added).]
None of the evidence proffered by ACIA or Hardrick, or even mentioned by this Court, is dispositive of the reasonable-charge issue. Rather, the evidence provides a collage of factors affecting the reasonable rate that may be charged by Hardrick’s parents for the services they provide.
D. RELEVANCY PRINCIPLES APPLIED
The no-fault act entitles providers of attendant care to impose a “reasonable charge” for their services. The reasonable-charge provision applies to family members, agencies, and independent contractors. In a recent case construing MCL 500.3107(l)(a), our Supreme Court set forth several definitions of the term “reasonable,” including “that which is ‘agreeable to or in accord with reason; logical,’ or ‘not exceeding the limit prescribed by reason; not excessive,’ ” and “ ‘fair, proper, or moderate under the circumstances’ and ‘[f]it and appropriate to the end in view.’ ” Krohn v Home-Owners Ins Co,
“[T]he question whether expenses are reasonable and reasonably necessary is generally one of fact for the
E. JURY INSTRUCTIONS
As noted, ACIA requested special jury instructions designed to limit or direct the jury’s consideration of the factors relevant to establishing a “reasonable charge” for services. We review de novo the trial court’s rejection of ACIA’s requested special jury instructions. Heaton v Benton Constr Co,
ACIA presented two alternative jury instructions to guide the jury’s consideration. Proposed Alternative A instructed the jury that “[a]mounts charged by health care agencies cannot be considered in determining reasonable compensation.” The trial court properly rejected that instruction because it would have precluded the jury’s consideration of relevant evidence.
ACIA’s proposed Alternative B, on the other hand, recognizes the multifaceted nature of the required calculation:
Plaintiff can recover benefits for care provided by member[s] of Plaintiffs family at its reasonable market value. In determining the reasonable market value of such care, you are to consider:
(1) the type and amount of care Plaintiff reasonably needed;
(2) the various types of in-home care available from outside care providers;
(3) the duties performed by outside care providers;
(4) the customary billing and payment practices of outside care providers; and
(5) the type and amount of services being performed by the member[s] of Plaintiffs family.
There is evidence that rates charged by home care agencies are higher than the amounts paid to the employees who actually render care. The difference between the rates charged by agencies and the amounts paid to its employees include agency overhead, such as social security contributions, malpractice insurance, health insurance, disability insurance, office clerical staff, rent, legal fees, accounting costs and office supplies, in addition to profit for the agency. In determining the amount owed for care*681 rendered by member[s] of Plaintiffs family, you are to consider whether any additional amounts charged by home care agencies are also necessary for the family member to provide care to Plaintiff.
Alternative B accurately reflects that many factors are relevant to the reasonable-rate issue. Alternative B is consistent with Sokolek’s analysis of a reasonable rate for home-provided care in the workers’ compensation realm. See Sokolek,
Whether the charge sought by Hardrick’s parents qualifies as “ ‘fair, proper, or moderate under the circumstances’ ” and “ ‘[f]it and appropriate to the end in view,’ ” Krohn,
Accordingly, we vacate the judgment against ACIA and remand for a new trial consistent with this opinion.
Notes
These three appeals all arise out of the same lower-court action for no-fault benefits and have been consolidated to advance the efficient administration of the appellate process.
ACIA’s counsel conceded in a pretrial motion that “The only issue for [t]rial is the amount of compensation for Plaintiffs family members who provide Plaintiff the needed 24 hour a day attendant care.” At the hearing on Hardrick’s motion for a default judgment, ACIA’s counsel further conceded: “The only issue in this case is whether or not the attendant care rate being paid to the parents of this injured individual is
The trial court granted a partial directed verdict in Hardrick’s favor, requiring the jury to determine a value for attendant-care services between $25 and $45 an hour. The court’s decision was based on the lack of evidence contradicting Hardrick’s expert witness’s valuation of such services. Because ACIA will be able to present evidence regarding damages on remand, including the reasonableness of the rate, we need not consider the propriety of the court’s order granting a partial directed verdict.
In People v VanderVliet,
*668 “This is the normal test for materiality: Does the item of evidence even slightly increase or decrease the probability of the existence of any material fact in issue? Standing alone, the item of evidence need not have sufficient probative value to support a finding that the fact exists. So long as the item of evidence affects the balance of probabilities to any degree, the item is logically relevant.” [Citation omitted.]
The relevancy of agency rates in determining a reasonable rate for home care has long been implied in Michigan jurisprudence. See Reed v Citizens Ins Co of America,
Michigan’s antitrust laws are patterned after federal statutes. ETT Ambulance Serv Corp v Rockford Ambulance, Inc,
We respectfully disagree with the dissent’s contention that evidence establishing only the “outer boundaries” of an issue “is not helpful to prove the fact at issue.” Post at 695. Usually, no single piece of evidence proves a case. Individual pieces of evidence, like bricks, join together to form a wall of proof. An agency rate may represent the “outer boundary” of a reasonable charge for attendant-care services, but along with other evidence including rates charged by independent contractors, a litigant may elect to incorporate evidence of agency rates in a wall of proof supporting the reasonableness of the rate claimed.
ACIA also challenges the court’s award of no-fault penalty interest for unreasonably delaying payment after proof of loss was presented. Because this issue may be eliminated on retrial, we decline to comment on the propriety of the award.
Concurrence in Part
(concurring in part and dissenting in part). I agree with the majority that the trial court abused its discretion by imposing an unjust and disproportionate discovery sanction and that, therefore, the judgment for attendant care and attorney fees must be vacated and this case remanded for a new trial. I respectfully disagree, however, that agency rates are relevant to determining a reasonable charge for attendant care provided by family members under the no-fault insurance act. MCL 500.3107(1)(a). I find persuasive the discussion on this issue in Bonkowski v Allstate Ins Co,
In Docket No. 294875, defendant Auto Club Insurance Association (defendant or ACIA), appeals by right the judgment entered in plaintiffs favor for attendant care as an allowable expense under the no-fault act, MCL 500.3107(1)(a). In Docket Nos. 298661 and 299070, defendant appeals the trial court’s order for attorney fees under MCL 500.3148(1).
Flaintiff suffered a traumatic brain injury after being struck by an automobile while walking home from his job. Flaintiff asserted that although his parents were
In Docket Nos. 298661 and 299070, defendant appeals the trial court’s order for attorney fees under MCL 500.3148(1), asserting bona fide factual issues existed regarding the reasonable level of attendant care plaintiff required and the reasonable rate that plaintiffs parents could charge for it. Alternatively, defendant argues that the trial court assessed an unreasonably high attorney fee.
I. FAMILY-PROVIDED ATTENDANT CARE
Before trial, defendant filed with the court requests for jury instructions based on Sokolek v Gen Motors
Defendant also filed a motion in limine seeking to preclude plaintiff from introducing evidence of amounts health-care agencies charge for providing home attendant care. On the basis of Sokolek and Bonkowski, defendant argued that rates health-care agencies charge are irrelevant in determining compensation for unlicensed family members who provide attendant care. Defendant argued that the only relevant evidence is evidence regarding what such agencies would pay to their health-care employees to provide services similar to what the family member provided. Plaintiff argued that the discussion in Bonkowski on this issue is nonbinding dicta, and that Manley v Detroit Auto Inter-Ins Exch,
A. STANDARD OF REVIEW
A trial court’s decision to admit or exclude evidence is reviewed on appeal for an abuse of discretion. Craig v Oakwood Hosp,
Allegations of instructional error are reviewed de novo. Heaton v Benton Constr Co,
B. ANALYSIS
The questions presented are what evidence is relevant and what courts should instruct jurors in deciding what constitutes a “reasonable charge” for reasonably necessary attendant-care services, under MCL 500.3107(1)(a), provided by a family member to another
Additionally, the issue presented in Manley concerned whether the parents of the injured plaintiff could claim as an allowable expense charges for room and board and nurse’s aides for their son. See Manley,
Despite its lack of precedential value, subsequent panels of this Court have cited the Manley dicta. In Sharp v Preferred Risk Mut Ins Co,
In Reed v Citizens Ins Co of America,
Nevertheless, even though it lacks precedential authority, I find that the Manley Court correctly opined that “ ‘allowable expenses’ . . . are implicitly purchased
The Bonkowski Court discussed these market principles in a case very similar to the present case in that it involved family-provided attendant care, and many of the same experts testified. The plaintiff in Bonkowski was severely injured, suffering not only traumatic brain injury but also spinal injuries that rendered him a quadriplegic. Bonkowski,
On appeal, the issue of using agency rates as a basis for determining the reasonableness of charges for family-provided attendant care was not squarely presented because Allstate had not argued in the trial court that Manley was wrongly decided. Nevertheless, the Bonkowski Court questioned the Manley dicta and opined:
Under MCL 500.3107, family members are entitled to reasonable compensation for the services they provide at home to an injured person in need of care. In determining reasonable compensation for an unlicensed person who provides health care services, a fact-finder may consider the compensation paid to licensed health care professionals who provide similar services. For this reason, consideration of the compensation paid by health care agencies to their licensed health care employees for rendering services similar to the services provided by unlicensed family members is appropriate when determining reasonable compensation for those family members. However, the actual charges assessed by health care agencies in the business of providing such services is not relevant and provides no assistance in determining reasonable compensation for the actual provider of such services. The focus should be on the compensation provided to the person providing the services, not the charge assessed by an agency that hires health care professionals to provide such services. [Bonkowski,281 Mich App at 164-165 .]
In dicta, the Bonkowski Court opined that the market rate or reasonable charge that a family member providing attendant care may charge can be determined from evidence of what persons providing similar care would be paid, not by what an agency would be paid to provide a care worker to perform similar services. But,
The Bonkowski Court also addressed the issue of agency rates when it held that the trial court had erred by awarding attorney fees under MCL 500.3148(1) because Allstate had a bona fide factual basis to challenge the plaintiffs claim. On this point, the Court opined:
Neither the medical community nor the legal community has established a hard and fast rule for determining the reasonable rate of compensation due unlicensed individuals who provide necessary health care services to family members. While consideration of rates paid to licensed and trained health care providers is appropriate, the law does not require that unlicensed individuals who have not earned a degree in a pertinent health care profession be paid the same compensation paid to licensed health care professionals. It can hardly be disputed that the greater the time a health care professional invests in his or her education and training, the greater the compensation would be for that professional. Andrew received specialized training to allow him to provide professional quality care to his son in an array of disciplines. However, Andrew’s training was provided over the course of four months. Andrew did not invest years to obtain an education and specialized training to become a medical professional. Quality care made possible by the dedication and love of family members is often preferable to institutional care. Yet, this Court has recognized that family-provided accommodations are generally less costly than institutional care. Under these circumstances we cannot conclude that defendant acted unreasonably when it offered to compensate Andrew at the lower end of the range of what a licensed and formally educated health care professional might ex*692 pect to command in the open market. [Bonkowski,281 Mich App at 172-173 (citation omitted).]
I would combine the reasoning of Manley that market rates control what is a “reasonable charge” for no-fault services with the reasoning of Bonkowski regarding the relevant market: what an individual care provider would be paid. I would hold that a reasonable charge for attendant-care services provided by a family member is determined by what the family member could receive in the open market for providing similar services. So, under § 3107 a reasonable charge for any attendant-care services plaintiffs parents provide is the equivalent of what compensation they could command on the open market for providing similar services to unrelated persons. This, in turn, would depend on their qualifications, training, experience, and what persons providing similar services could earn. Perhaps the closest market equivalent is what a health-care agency might pay an “independent contractor” to provide similar services.
The companion case of Mullins v Frank H Wilson Co, decided with Sokolek,
Another question presented here is whether a reasonable charge for family-provided attendant care would include shift premiums, overtime, and benefits that a health-care worker might earn if employed by an agency. The Bonkowski Court suggested that a reasonable charge by a family member for attendant care would not include shift premiums and overtime. Bonkowski,
Finally, while I generally agree with the majority’s discussion of relevance under MRE 401, I respectfully disagree with the majority’s application of the “any tendency” standard in this circumstance where agency rates can only be said to be relevant because they encompass evidence at the heart of the issue: what individual caregivers are paid to provide the services at issue. The analogy of “[a] brick is not a wall” the majority discusses, see People v Brooks,
This point is illustrated in People v Coy,
In the present case, evidence of agency rates is only relevant to determine a reasonable rate to compensate family members providing attendant care if there is also evidence separating the component of an agency’s hourly fee that represents that which is necessary to compensate an individual caregiver providing similar services. Bonkowski,
II. MOTIONS FOR A DIRECTED VERDICT
Defendant argues that because plaintiffs parents did not testify at trial, there was no evidence that they actually provided the high level of care that plaintiff sought as an allowable expense. As a result, defendant argues, plaintiff failed to prove the care his parents provided was entitled to compensation at a rate higher than that of a health aide, which defendant had already paid. Consequently, defendant argues, the trial court erred by not granting it a directed verdict. Alternatively, defendant argues that the trial court erred by granting plaintiff a directed verdict on the issue that the higher level of attendant care had been “incurred.” Defendant notes that while some level of care was incurred, the lack of evidence plaintiff presented entitled defendant, on plaintiffs motion for a directed verdict, to the reasonable inference that the care provided was at the
A. PRESERVATION
Defendant opposed granting plaintiffs motions for a directed verdict that attendant care had been “incurred” and limiting the jury’s consideration of a “reasonable” rate to charge for the care to between $25 and $45 an hour. Defendant also moved for a directed verdict on the issue that plaintiff had not presented proof that plaintiffs parents actually proved a higher level of care than that for which defendant had already paid. Thus, these issues are properly preserved because they were raised, addressed, and decided by the trial court.
B. STANDARD OP REVIEW
A trial court’s decision on a motion for a directed verdict is reviewed de novo. Sniecinski v Blue Cross & Blue Shield of Mich,
On review of the record, I conclude that the trial court properly denied defendant’s motion for a directed verdict on the basis of the lack of proof that the claimed attendant-care hours had been “incurred.” The jury could reasonably infer the attendant-care hours were incurred from calendar time records submitted to defendant, the medical prescriptions for attendant care, Dr. Gerald Shiener’s testimony that plaintiffs parents provided the prescribed attendant care, and defendant’s payment of the attendant-care hours claimed. Indeed, there was no evidence from which the jury could conclude that the claimed attendant-care hours were not “incurred.” Therefore, the trial court properly granted plaintiffs motion for a directed verdict on this issue.
On the other hand, under the no-fault act, “allowable expenses” must be “reasonable charges,” MCL 500.3107(1)(a), and a person providing an injured person services “may charge a reasonable amount for . . . services,” MCL 500.3157. “When read in harmony, §§ 3107 and 3157 clearly indicate that an insurance carrier need pay no more than a reasonable charge and that a health care provider can charge no more than that.” McGill,
Additionally, the trial court erred by limiting the jury’s determination of a reasonable rate of compensation because it is the jury’s responsibility to weigh the evidence and judge the credibility of witnesses. King,
For these reasons, I conclude that the trial court erred by limiting the jury’s determination regarding a reasonable charge for the attendant-care services that plaintiffs parents provided and that this error also warrants reversal and remand for a new trial.
III. CONCLUSION
I agree with the majority that the tried court abused its discretion by imposing a sanction for a discovery violation that was not just or proportionate to the violation. The disproportionate discovery sanction that precluded defendant from presenting any witnesses or
I also conclude that the trial court erred by not granting defendant’s motion in limine regarding evidence of agency rates, by refusing to give supplemental jury instructions as requested, and by limiting the jury’s fact-finding ability when determining a reasonable charge for the attendant care at issue. These errors also warrant reversal and remand for a new trial.
Because of the resolution of the issues raised in Docket No. 294875, the issues in Docket Nos. 298661 and 299070 are moot.
Defendant’s proposed “Alternative A” jury instruction provides:
Family members are entitled to reasonable compensation for care provided to an injured person. In determining reasonable compensation for a family member who provides health care services, you may consider the compensation paid to licensed health care professionals who provide similar services. Amounts charged by health care agencies cannot be considered in determining reasonable compensation.
In determining the amount owed for care rendered by [a] member [s] of Plaintiffs family, you are to consider:
(1) the type and amount of care Plaintiff reasonably needed;
(2) the type and amount of services actually performed by [a] member[s] of Plaintiffs family;
(3) whether the family member was a licensed health care provider;
*687 (4) the types of in-home care available from outside care providers; and
(5) the amounts outside care providers would have been paid to provide the type and amount of services Plaintiff received from [a] member[s] of [his/her] family.
All activities in life have “opportunity costs” and I read nothing in the no-fault act or MCL 500.3107(l)(a) in particular that permits anyone— whether or not a family member — to recover as part of a “reasonable charge” for an “allowable expense” the cost of opportunities foregone.
