From Casetext: Smarter Legal Research

Mousa v. State Auto Insurance Companies

Michigan Court of Appeals
Aug 23, 1990
185 Mich. App. 293 (Mich. Ct. App. 1990)

Summary

holding that MCR 2.116(C) is the proper court rule for a claim involving MCL 500.3145

Summary of this case from Green v. Home-Owners Ins. Co.

Opinion

Docket No. 117578.

Decided August 23, 1990.

Stuart Stuart (by Mark F. Stuart), for plaintiff.

Best, Schmucker, Heyns Klaeren, P.C. (by Chad C. Schmucker), for defendant.

Before: MARILYN KELLY, P.J., and HOOD and DOCTOROFF, JJ.


This is an action for no-fault personal injury protection benefits. Plaintiff appeals as of right from a grant of partial summary disposition to defendant, holding plaintiff's claim is barred by the "one-year-back" limitation period of MCL 500.3145(1); MSA 24.13145(1). The trial court found that the limitation prevented recovery for wage loss and medical expenses incurred before April 8, 1987.

Defendant moved for summary disposition under MCR 2.116(C)(7) and (10). Being that a statute of limitations issue was raised, we have reviewed the motion under MCR 2.116(C)(7) and MCR 2.116(G) (3)(a).

Plaintiff admitted that defendant gave him notice in 1986 that it was denying him further work-loss benefits. Therefore, we find no error in the trial court's ruling that the one-year-back limitation barred plaintiff's claim for work-loss benefits. MCR 2.116(I)(1). In reaching this conclusion, we reject plaintiff's assertion that defendant was obliged to deny benefits in writing. What is required is a formal denial of liability, not a writing. Lewis v DAIIE, 426 Mich. 93; 393 N.W.2d 167 (1986). Although the best formal notice is a writing, notice may be sufficiently direct to qualify as formal without being put in writing.

As for medical benefits, we vacate the trial court's decision and remand for further proceedings under MCR 2.116(I)(3). We are not persuaded that the lower court record failed to demonstrate a genuine issue of material fact concerning whether the limitation period was tolled. It is not clear either whether plaintiff exercised the requisite due diligence in taking advantage of the tolling. Although he admitted at deposition that he was told in 1986 that benefits were being terminated, one could reasonably infer that the admission applied only to wage-loss benefits. Summary disposition is not appropriate if the facts can support conflicting inferences even when there is no material factual dispute. DiFranco v Pickard, 427 Mich. 32, 54; 398 N.W.2d 896 (1986); Lewis, supra; MCR 2.116(I)(1).

On remand, the trial court should consider whether the one-year-back limitation period is tolled for medical expenses plaintiff incurred as a result of the accident, applying the test in Johnson v State Farm Mutual Automobile Ins Co, 183 Mich. App. 752; 455 N.W.2d 420 (1990). The requirement in Johnson that the insured give notice of a loss should not be construed too broadly. The notice must be specific enough to inform the insurer of the nature of the loss. It must give sufficient information that the insurer knows or has reason to know that there has been a compensable loss.

Affirmed in part, vacated in part, and remanded for further proceedings. This Court does not retain jurisdiction.


Summaries of

Mousa v. State Auto Insurance Companies

Michigan Court of Appeals
Aug 23, 1990
185 Mich. App. 293 (Mich. Ct. App. 1990)

holding that MCR 2.116(C) is the proper court rule for a claim involving MCL 500.3145

Summary of this case from Green v. Home-Owners Ins. Co.

finding a formal denial of benefits when the plaintiff admitted that the insurer had orally denied the claim

Summary of this case from Devillers v. Auto Club Ins Ass'n

In Mousa, 185 Mich.App. 293, applying the pre-Devillers tolling exception to former MCL 500.3145, this Court explained that while a formal denial need not be in writing, it must be "sufficiently direct."

Summary of this case from Encompass Healthcare, PLLC v. Citizens Ins. Co.
Case details for

Mousa v. State Auto Insurance Companies

Case Details

Full title:MOUSA v STATE AUTO INSURANCE COMPANIES

Court:Michigan Court of Appeals

Date published: Aug 23, 1990

Citations

185 Mich. App. 293 (Mich. Ct. App. 1990)
460 N.W.2d 310

Citing Cases

Mt. Carmel Mercy Hospital v. Allstate Insurance

What is required for denial of a PIP claim is a "formal" denial of liability. Mousa v State Auto Ins Cos, 185…

Encompass Healthcare, PLLC v. Citizens Ins. Co.

Id. at 101-103. See also Johnson v State Farm Mut Auto Ins Co, 183 Mich.App. 752; 455 N.W.2d 420 (1990)…