Spectrum Health Hosps. v. Esurance Prop. & Cas. Ins. Co.

UNPUBLISHED

Ingham Circuit Court LC Nos. 17-000785-NF, 17-000376-NF

Before: Rick, P.J., and O'Brien and Cameron, JJ.

Per Curiam

In these consolidated appeals involving claims for no-fault personal protection insurance (PIP) benefits, defendant Esurance Property and Casualty Insurance Company appeals the trial

court's January 8, 2020 judgment in favor of plaintiffs Spectrum Health Hospitals and Spectrum Health Continuing Care Center, Inc., doing business as Spectrum Health Rehab and Nursing Center-Kalamazoo Avenue, and Chelsea Loughin, as personal representative of the Estate of Kevin Shea Lindsey and as next friend of Constance Lindsey, Shealyn Lindsey, and Kevin E. Lindsey. Defendant also challenges the trial court's decisions to grant summary disposition in favor of plaintiffs and to deny defendant's motion for summary disposition. We reverse in part, affirm in part, vacate in part, and remand for further proceedings consistent with this opinion.

I. BACKGROUND

On November 26, 2016, the decedent and Loughin, who were in a relationship at the time, were arguing in a motor vehicle that was being driven by Loughin. The decedent either fell or jumped out of the vehicle. The decedent suffered head injuries and died in September 2017. Defendant denied claims for PIP benefits on the ground that the decedent's injuries did not qualify as an "accidental bodily injury" under MCL 500.3105(1) because the decedent had intentionally caused his injuries.

Plaintiffs filed suits seeking PIP benefits under Michigan's No-Fault Automobile Insurance Act, MCL 500.3101, et seq. Defendant and Loughin filed cross-motions for summary disposition, and Spectrum Health Hospitals and Spectrum Health Continuing Care Center moved for summary disposition in their favor under MCR 2.116(I)(2). The trial court denied defendant's motion and granted plaintiffs' motions. The trial court concluded that the undisputed evidence established that the decedent's injuries were accidental and that defendant was liable for PIP benefits under MCL 500.3105(1). Thereafter, on January 8, 2020, the trial court entered a final judgment in favor of plaintiffs, which included interest and attorney fees. These appeals followed.

II. SUMMARY DISPOSITION IN FAVOR OF PLAINTIFFS

Defendant argues that the trial court erred by granting summary disposition in favor of plaintiffs on their claims for no-fault benefits. We agree.

A. STANDARDS OF REVIEW

"We review de novo issues of statutory . . . interpretation." Vanalstine v. Land O'Lakes Purina Feeds, LLC, 326 Mich.App. 641, 648; 929 N.W.2d 789 (2018). Generally, this Court "review[s] de novo a trial court's decision on a motion for summary disposition." El-Khalil v. Oakwood Healthcare, Inc, 504 Mich. 152, 159; 934 N.W.2d 665 (2019).

A motion under MCR 2.116(C)(10) . . . tests the factual sufficiency of a claim. When considering such a motion, a trial court must consider all evidence submitted by the parties in the light most favorable to the party opposing the motion. A motion under MCR 2.116(C)(10) may only be granted when there is no genuine issue of material fact [Id. at 160 (quotation marks, citations, and emphasis omitted).]

"Courts are liberal in finding a factual dispute sufficient to withstand summary disposition." Innovative Adult Foster Care, Inc v. Ragin, 285 Mich.App. 466, 476; 776 N.W.2d 398 (2009). Courts may not resolve factual disputes or determine matters of credibility when deciding

a motion for summary disposition. White v. Taylor Distrib Co, Inc, 275 Mich.App. 615, 625; 739 N.W.2d 132 (2007). "Because questions of credibility and intent are properly resolved by the trier of fact," Triple E Produce Corp v. Mastronardi Produce, Ltd, 209 Mich.App. 165, 174; 530 N.W.2d 772 (1995), "[s]ummary disposition is suspect where motive and intent are at issue or where the credibility of a witness is crucial," Foreman v. Foreman, 266 Mich.App. 132, 135; 701 N.W.2d 167 (2005). Ultimately, "[a] genuine issue of material fact exists when the record, drawing all reasonable inferences in favor of the nonmoving party, leaves open an issue upon which reasonable minds might differ." Myers v. City of Portage, 304 Mich.App. 637, 641; 848 N.W.2d 200 (2014) (quotation marks and citation omitted).

Summary disposition under MCR 2.116(I)(2) is proper "[i]f it appears to the court that the opposing party, rather than the moving party, is entitled to judgment" as a matter of law.

B. ANALYSIS

"[A]n insurer is liable to pay benefits for accidental bodily injury arising out of the ownership, operation, maintenance or use of a motor vehicle as a motor vehicle[.]" MCL 500.3105(1). "Bodily injury is accidental as to a person claiming [PIP] benefits unless suffered intentionally by the injured person or caused intentionally by the claimant." MCL 500.3105(4). Thus, recovery of PIP benefits is barred "by people who intended to injure themselves or commit suicide."^[1] Frechen v. Detroit Auto Inter-Ins Exch, 119 Mich.App. 578, 580; 326 N.W.2d 566 (1982). The insurer bears the burden to establish an exclusion from coverage. Hunt v. Drielick, 496 Mich. 366, 373; 852 N.W.2d 562 (2014).

"One acts intentionally if he [or she] intended both the act and the injury." Miller v. Farm Bureau Mut Ins Co, 218 Mich.App. 221, 226; 553 N.W.2d 371 (1996). "The subjective intent of an actor is the focus of determining whether the actor acted intentionally." Id. Intent may be inferred from the facts, Schultz v. Auto-Owners Ins Co, 212 Mich.App. 199, 202; 536 N.W.2d 784 (1995), and "need not be proven by direct evidence," Cipri v. Bellingham Frozen Foods, Inc, 235 Mich.App. 1, 12; 596 N.W.2d 620 (1999) (quotation marks and citation omitted). In other words, "questions concerning the state of one's mind, including intent, motivation, or knowledge can be proven by circumstantial evidence." Bergen v. Baker, 264 Mich.App. 376, 387; 691 N.W.2d 770 (2004). Circumstantial evidence is evidence that would "facilitate reasonable inferences of causation, not mere speculation." Skinner v. Square D Co, 445 Mich. 153, 164; 516 N.W.2d 475 (1994). To be circumstantial evidence of causation, the facts or conditions require "a reasonable likelihood of probability rather than a possibility," and "such evidence must exclude other reasonable hypotheses with a fair amount of certainty." Id. at 166 (quotation marks omitted). "[W]hen the matter remains one of pure speculation or conjecture, or the probabilities are at best evenly balanced, it becomes the duty of the court to" grant judgment as matter of law. Id. at 165 (quotation marks and citation omitted).

"Frequently, the most probative evidence of intent will be objective evidence of what actually happened rather than evidence describing the subjective state of mind of the actor." Cipri, 235 Mich.App. at 12 (quotation marks and citations omitted). While an actor's intent to injure himself cannot be judged merely by what is a foreseeable result of his conduct, Frechen, 119 Mich.App. at 581-582, it is nonetheless true that an actor's intent may be reflected in "the natural consequences of his deeds," Cipri, 235 Mich.App. at 12 (quotation marks and citations omitted). See also Foreman, 266 Mich.App. at 143 ("Intent is a mental condition and is determined not so much by what one says as it is by what one does.") (Quotation marks and citation omitted.) Stated differently, "where the injury or resulting death is the natural, anticipated and expected result of an intentional act, courts may presume that both act and result are intended." Mattson v. Farmers Ins Exch, 181 Mich.App. 419, 424; 450 N.W.2d 54 (1989) (alteration, quotation marks, and citation omitted).

When evaluating whether an individual intended to cause injury to himself or herself,...