Action seeking PIP benefits for replacement services & attendant care; MCL 500.3105(1); MCL 500.3107(1)(a) & (c); Johnson v Recca; Fraud; Bahri v IDS Prop Cas Ins Co; Meemic Ins Co v. Fortson; Materiality; Mina v General Star Indem Co

The court held that the trial court erred by denying defendant-insurer’s motion for summary disposition on the basis of insurance fraud. Plaintiff filed this action when defendant denied her claim for PIP benefits after a car accident. On appeal, the court agreed with defendant that the trial court erred by denying its summary disposition motion “because no genuine dispute of fact existed as to whether plaintiff made material misrepresentations with respect to her claim for replacement services and attendant care.” It noted that she “clearly submitted affidavits for attendant care and replacement services that were, in [her] own words, inaccurate.” She failed to identify “any evidence that anyone actually did anything for her at her home during” her four-day trip out of state. In addition, it was a “logical stretch for plaintiff to claim she required 12 hours of attendant care at her home while she was not there.” Further, not only was her “claim for replacement services while she was out of town false, the misrepresentations were material.” Thus, there was “no genuine issue of material fact regarding whether plaintiff materially misrepresented her need for replacement services during the time she was out of town. Plaintiff submitted fraudulent claims for replacement services under the terms of the insurance contract, which entitled defendant to void the contract. Defendant was entitled to summary disposition on this basis alone.” Reversed and remanded for entry of summary disposition for defendant.