News 10.10.23

Segal McCambridge Secures Victory in Coverage Dispute

Segal McCambridge Associate Olivia Martin recently secured a partial summary judgement win for our client in the State of Michigan Macomb County Circuit Court.

In the case, the carrier, represented by Olivia, filed a Motion for Partial Summary Disposition. The dispute centered around whether the plaintiff was eligible to seek personal protection benefits for allowable medical expenses and excess attendant care expenses. The carrier argued that the plaintiff had opted out of coverage for these benefits, while the plaintiff contended that their policy explicitly provided coverage for them.

One week before the date of loss, the plaintiff amended their insurance contract, opting out of excess medical and attendant care benefits. During oral arguments, the plaintiff contended that they hadn’t made these changes and there were clerical discrepancies in the certified copies of insurance on the date of loss. However, the carrier urged the court to apply strict contract interpretation, pointing to the clear and unambiguous language within the amended insurance contract indicating that the plaintiff was excluded from allowable medical expenses and excess attendant care coverage. The court, in its analysis, agreed with the carrier and considered the language of the insurance contract and relevant Michigan statutes. The court found that the amended insurance policy clearly excluded the plaintiff from seeking such benefits.

As a result, the court granted the carrier’s Motion for Partial Summary Disposition, concluding that the plaintiff was not eligible to claim these benefits. This dismissed over $51,000.00 in coverage liability for the carrier. The case remains open, as this decision does not resolve the last pending claim.

Olivia Martin is an associate in our Detroit office and is licensed in Michigan.