e-Journal Summary

e-Journal Number : 78886
Opinion Date : 01/26/2023
e-Journal Date : 02/10/2023
Court : Michigan Court of Appeals
Case Name : Rodriguez v. Farmers Ins. Exch.
Practice Area(s) : Insurance
Judge(s) : Per Curiam – Cavanagh, O’Brien, and Rick
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Issues:

Action seeking PIP benefits under the No-Fault Act; Entitlement to benefits through the Michigan Automobile Insurance Placement Facility; MCL 500.3173a; Fraudulent insurance act; MCL 500.3173a(2); Candler v Farm Bureau Mut Ins Co of MI; Materiality; Bahri v IDS Prop Cas Ins Co; Eligibility; MCL 500.3107(1)(a); Griffith v State Farm Mut Auto Ins Co; Michigan Assigned Claims Plan (MACP)

Summary

The court held that the trial court properly found there was “no genuine issue of material fact regarding plaintiff’s commission of a fraudulent insurance act and that plaintiff was ineligible for benefits under MCL 500.3173a(2).” Plaintiff was walking when he was hit and injured by a vehicle that was never identified. The MACP assigned his PIP claim to defendant, which denied it on the basis that he made materially false statements in his application regarding his medical history, including his involvement in several accidents prior to the accident at issue, his preexisting conditions, and the severity of his injuries. The trial court granted summary disposition for defendant, rejecting plaintiff’s “defense of somebody helped him fill out the application, the plaintiff would be responsible. He signed it.” It also found that there was no genuine issue of fact that he “made a false statement in his affidavit in response to defendant’s motion for summary disposition when he stated that the person depicted in the photographs and videos submitted by defendant was his twin brother.” On appeal, the court rejected plaintiff’s argument that the trial court erred by making credibility determinations as to the photos and videos defendant submitted, and by improperly weighing the statements he made in his affidavit when deciding defendant’s summary disposition motion. It held that the trial court “properly found that there was no genuine issue that plaintiff committed a fraudulent insurance act under MCL 500.3173a(2) when he knowingly made false statements in his application for benefits with respect to his medical history and preexisting conditions and that plaintiff was not entitled to PIP benefits.” A review of plaintiff’s “extensive omissions leaves no question that [he] was dishonest in his application for no-fault benefits. A reasonable juror could not conclude [he] was unaware that he was submitting false information.” And the false statements were material to his claim. Affirmed.

Full PDF Opinion