Perkovic v. Zurich Am. Ins. Co.

• Decision Date: 14 April 2017
• Docket Number: No. 152484,152484
• Citation: 893 N.W.2d 322
• Parties: Dragen PERKOVIC, Plaintiff–Appellant, v. ZURICH AMERICAN INSURANCE COMPANY, Defendant–Appellee.
• Court: Michigan Supreme Court

893 N.W.2d 322

Dragen PERKOVIC, Plaintiff–Appellant,

v.ZURICH AMERICAN INSURANCE COMPANY, Defendant–Appellee.

No. 152484

Supreme Court of Michigan.

Argued December 7, 2016

Decided April 14, 2017

OPINION

Bernstein, J.

This case concerns the notice requirements of the no-fault act, MCL 500.3101 et seq. , specifically those set forth in MCL 500.3145(1). The question before us is whether a nonparty medical provider's provision of medical records and associated bills to an injured person's no-fault insurer within one year of the accident causing injury constitutes proper written notice under MCL 500.3145(1), so as to prevent the one-year statute of limitations in MCL 500.3145(1) from barring the injured person's subsequent no-fault claim. We hold that when, as in this case, the documentation provided by the medical provider contains all of the information required by MCL 500.3145(1) and is provided to the insurer within one year of the accident, the statutory notice requirement is satisfied and the injured person's claim is not barred by the statute of limitations. Therefore, we reverse the judgment of the Court of Appeals, vacate the trial court's order granting summary disposition in favor of defendant Zurich American Insurance Company, and remand to the trial court for further proceedings consistent with this opinion.

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.

Some confusion arose as to which of the insurers was highest in priority, but ultimately the Court of Appeals concluded that defendant was the highest-priority insurer. See Perkovic v. Hudson Ins. Co. , unpublished per curiam opinion of the Court of Appeals, issued December 20, 2012 (Docket No. 302868), 2012 WL 6633991. The claims against the other insurers were then dismissed.

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 MCL 500.3145(1) because defendant had not received written notice of the claim or paid any benefits before the limitations period expired. Plaintiff contended that the medical bills and records from The Nebraska Medical Center satisfied the notice requirements of MCL 500.3145(1), but the trial court disagreed and granted defendant's motion for summary disposition in an opinion and order dated February 20, 2014. The Court of Appeals affirmed the trial court's ruling in a published opinion. Perkovic v. Zurich American Ins. Co. , 312 Mich.App. 244, 876 N.W.2d 839 (2015).

II. STANDARD OF REVIEW

We review de novo questions of statutory interpretation. Jesperson v. Auto Club Ins. Ass'n , 499 Mich. 29, 34, 878 N.W.2d 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. MCL 500.3107(1)(a). This recovery is limited by, among other provisions, MCL 500.3145(1), which provides:

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 MCL 500.3145(1), a claim for PIP benefits must be filed within one year after the accident causing the injury unless either of two exceptions applies: (1) the insurer was properly notified of the injury, or (2) the insurer had previously paid PIP benefits for the same injury. Jesperson , 499 Mich. at 39, 878 N.W.2d 799. Here, defendant was not added to the complaint until thirteen months after plaintiff's accident. It is undisputed that the second exception does not apply in this case. The issue is whether the first exception applies in this case—that is, whether defendant was properly notified of plaintiff's injuries by the medical bills and records provided to defendant by The Nebraska Medical Center.

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 N.W.2d 408 (1980), the Court of Appeals held that substantial compliance with the written-notice provision can preserve a claim under MCL 500.3145(1).² In reaching this conclusion, the Dozier panel relied on the need to construe notice provisions in favor of the insured. Id . at 129, 290 N.W.2d 408. The panel stated that the purpose of the notice provision was " 'to provide time to investigate and to appropriate funds for settlement purposes.' " Id . at 128, 290 N.W.2d 408, quoting Davis v. Farmers Ins. Group , 86 Mich.App. 45, 47, 272 N.W.2d 334 (1978). A subsequent Court of Appeals panel relied on Dozier in holding that an "Auto Accident Notice" that did not indicate the nature of the plaintiff's injury nonetheless constituted notice under MCL 500.3145(1) because it substantially complied with the notice provision. Walden v. Auto Owners Ins. Co. , 105 Mich.App. 528, 534, 307 N.W.2d 367 (1981). Similarly, in Lansing Gen. Hosp., Osteopathic v. Gomez , 114 Mich.App. 814, 825, 319 N.W.2d 683 (1982), the Court of Appeals held that written notification provided by an insurance agent to the defendant insurance company was sufficient to preserve the plaintiff medical provider's claim under MCL 500.3145(1). Although the notice did not name one of the injured parties, it "was sufficient to provide time for defendant Auto–Owners to investigate the accident." Id . By contrast, in Heikkinen v. Aetna Cas. & Surety Co. , 124 Mich.App. 459, 463–464, 335 N.W.2d 3 (1981), the Court of Appeals held that a death certificate transmitted by the plaintiff to her insurance agent for the purpose of filing a tax return did not create sufficient notice under MCL 500.3145(1) that a claim might be filed. Even though the certificate contained all of the information required by MCL 500.3145(1), it was not presented under circumstances suggesting the existence of a claim for PIP benefits—rather, it was presented explicitly for the purpose of a tax return. Id . Therefore, under this line of cases, a claim for PIP benefits may be preserved if a plaintiff substantially complies with the purpose of the statute, even if all of the statutory requirements are not met. However, as seen in Heikkinen , fulfilling all of the stated...