MICHAEL J CHARTIER V AUTOMOBILE CLUB INS ASSN
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STATE OF MICHIGAN
COURT OF APPEALS
MICHAEL J. CHARTIER,
UNPUBLISHED
January 12, 2006
Plaintiff-Appellee,
v
No. 257301
Bay County Circuit Court
LC No. 03-003069-NF
AUTOMOBILE CLUB INSURANCE
ASSOCIATION,
Defendant-Appellant.
Before: Hoekstra, P.J., and Neff and Davis, JJ.
PER CURIAM.
Defendant appeals as of right from the trial court’s judgment in favor of plaintiff in this
no-fault automobile insurance coverage dispute. We affirm in part, reverse in part, and remand.
I
As a result of injuries incurred in a motor vehicle accident in 1979, plaintiff is a
paraplegic. In spite of his disability, plaintiff is employed and his job requires some amount of
regular travel by motor vehicle in addition to his travel to and from his work place. In the years
since his accident, plaintiff has purchased a number of vehicles which defendant has paid to
modify for his use. In 2003, plaintiff’s physician gave an opinion that plaintiff required a
properly equipped, handicapped accessible van to address upper extremity problems and pain
and to avoid degenerative changes. Plaintiff requested that defendant purchase a suitable van for
him, but defendant refused. This lawsuit followed. The trial court entered a declaratory
judgment requiring defendant to provide plaintiff with a van modified for his use and to pay
plaintiff’s actual and reasonable attorney fees. Subsequently, the court entered a money
judgment in plaintiff’s favor in the amount of $46.575.50 to pay for the appropriate van, $10,830
in attorney fees, and $233 in fees.
Defendant first argues that the van was not an allowable expense and urges this Court to
either distinguish the current facts from those of Davis v Citizens Ins Co of America, 195 Mich
App 323; 489 NW2d 214 (1992), or declare its disagreement with the precedent pursuant to
MCR 7.215(J)(2). Additionally, defendant argues that an award of attorney fees was
inappropriate in this case.
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II
The first issue on appeal is whether summary disposition was appropriate. This Court
reviews a trial court’s grant of summary disposition, as well as statutory interpretation, de novo
on appeal. Williams v AAA Mich, 250 Mich App 249, 257; 646 NW2d 476 (2002); Hamilton v
AAA Mich, 248 Mich App 535, 541; 639 NW2d 837 (2001). A motion brought under MCR
2.116(C)(10) tests whether there is factual support for a claim and affidavits, pleadings,
depositions, admissions, and other evidence submitted by the parties are considered in the light
most favorable to the party opposing the motion. Spect Imaging, Inc v Allstate Ins Co, 246 Mich
App 568, 573-574; 633 NW2d 461 (2001).
The overall goal of the Michigan no-fault insurance system “is to provide accident
victims with assured, adequate, and prompt reparations at the lowest cost to both the individuals
and the no-fault system.” Williams, supra at 257. Under the no-fault act, personal protection
insurance benefits are payable for “[a]llowable expenses consisting of all reasonable charges
incurred for reasonably necessary products, services and accommodations for an injured person’s
care, recovery, or rehabilitation.” MCL 500.3107(1)(a); MSA 24.13107(a). In order for an item
to be considered an “allowable expense” under the statute, three factors must be met: “(1) the
charge must be reasonable; (2) the expense must be reasonably necessary; and (3) the expense
must be incurred.” Davis, supra at 326. The questions of whether charges are reasonable and
the expense reasonably necessary are generally for the jury, but in some instances, the trial court
may properly determine the issue as a matter of law if it can be said with certainty that the
expense was reasonable and necessary. Spect, supra at 575.
As to reasonableness, although plaintiff argued that the lowest price quote offered by
defendant reflected a lower quality purchase, neither plaintiff nor defendant argue on appeal that
the expense of the van is unreasonable. Therefore, we do not need to address the reasonableness
of the expense.
Whether the expense is reasonably necessary can be resolved by reference to Davis. The
facts in the present case are almost identical to the facts present in Davis. Both plaintiffs were
rendered paraplegics following an automobile accident, and both requested that the respective
defendants pay for a van modified for use by a person in a wheelchair. Id. at 325. In finding that
a modified van was reasonably necessary, the Davis Court stated:
Transportation is as necessary for an uninjured person as for an injured person.
However, the modified van is necessary in this case given the limited availability
of alternative means of transportation. . . . The van allows plaintiff to travel
outside the county for medical purposes and vacations. In addition, the van was
reasonably necessary according to plaintiff’s treating physician. . . . Under these
circumstances, we find that the modified van is an allowable expense. [ID at 327328.]
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Therefore, this Court must focus on the unique circumstances of the current facts to
determine whether a modified van is necessary. For almost a decade, plaintiff’s treating
physician has prescribed a modified van for plaintiff. Even the occupational therapist
recommended by defendant’s case manager stated that plaintiff requires an accessible van.
Therefore, it is clear that, based on the needs of his particular disability, plaintiff’s circumstances
require a modified van. Additionally, plaintiff’s treating physician believes plaintiff’s disability
is “partial, permanent and ongoing.” Thus, it does not appear that plaintiff’s need for a modified
van is likely to diminish anytime in the near future. Accordingly, plaintiff has unquestionably
demonstrated his need for a modified van due to his disability and we affirm the court’s finding
underlying its declaratory judgment that the expense was reasonably necessary.
Defendant argues that this Court should express its disagreement with the precedent
established in Davis. However, this Court’s finding that plaintiff’s unique circumstances require
a modified van, under the Davis requirement that a court look to the unique circumstances of the
case, is consistent with the goals of the no-fault act. “The overall goal of the no-fault insurance
system is to provide accident victims with assured, adequate, and prompt reparations at the
lowest cost to both the individuals and the no-fault system.” Williams, supra at 257. For over
two decades, plaintiff has accepted the modifications defendant has placed on the vans plaintiff
purchases. However, these modifications are inadequate for plaintiff’s unique disability and
have only served to further irritate plaintiff’s condition. Any reparation short of a modified van
is inadequate for this particular plaintiff, and therefore in conflict with the goal of the no-fault
system. We are in agreement with the holding of the Davis case and the result it compels in this
case with regard to reasonable necessity.
Finally, in order for an item to be considered an “allowable expense” under the statute,
the expense must be incurred. Davis, supra at 326. The Michigan Supreme Court discussed the
meaning of “incurred” in Proudfoot v State Farm Mut Ins Co, 469 Mich 476, 484; 673 NW2d
739 (2003). In Proudfoot, the plaintiff sustained serious injuries during an automobile accident
that resulted in the plaintiff’s need for a wheelchair. Id. at 478. The plaintiff paid an architect to
prepare plans for significant home modifications. Id. The defendant denied both the plaintiff’s
request for reimbursement of the architect’s bill as well as the plaintiff’s request for the home
modifications. Id. The Michigan Supreme Court affirmed this Court’s holding that the
modifications to the plaintiff’s home were reasonably necessary and the amount was reasonable;
however, the Court reversed the portion of this Court’s opinion requiring defendant to pay the
total amount of future home modifications because the expenses in question had not yet been
incurred. Id. at 483. In doing so, the Court stated:
To “incur” means “to become liable or subject to, [especially] because of
one’s own actions.” A trial court may enter “a declaratory judgment determining
that an expense is both necessary and allowable and the amount that will be
allowed[, but s]uch a declaration does not oblige a no-fault insurer to pay for an
expense until it is actually incurred. At the time of the judgment, plaintiff had not
yet taken action to become liable for the costs of the proposed home
modifications. Because the expenses in question were not yet “incurred,” the
Court of Appeals erred in ordering defendant to pay the total amount to the trial
court. [Proudfoot, supra at 484 (citations omitted).]
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In the instant case, plaintiff did not purchase the van and never became liable for
payments. Therefore, based on the reasoning in Proudfoot, plaintiff did not “incur” the expense
within the meaning of § 3107. Accordingly, the cost of the modified van is not an “allowable
expense” and the court’s grant of monetary relief based on the purchase price of the modified
van is reversed.
III
The next issue on appeal is whether the trial court erred in awarding plaintiff attorney
fees. This Court will not reverse a trial court’s finding regarding an unreasonable refusal or
delay in paying benefits in the absence of clear error which will only be found when we are left
with the definite and firm conviction on the entire record that a mistake was made Attard v
Citizens Ins Co of America, 237 Mich App 311, 316-317; 602 NW2d 633 (1999).
MCL 500.3148 provides, in relevant part:
An attorney is entitled to a reasonable fee for advising and representing a
claimant in an action for personal or property protection insurance benefits which
are overdue. The attorney’s fee shall be a charge against the insurer in addition to
the benefits recovered, if the court finds that the insurer unreasonably refused to
pay the claim or unreasonably delayed in making proper payment.
Therefore, in order for defendant to be liable for payment of attorney fees, the benefits
must be overdue. In this case, claims for the modified van are not overdue because they have not
yet been incurred. See Proudfoot, supra at 485. Accordingly, it was clear error for the court to
award plaintiff attorney fees and the award is reversed.
We affirm the trial court’s declaratory judgment that defendant is required to provide
plaintiff with a modified van, but reverse the trial court’s grant of a monetary judgment and its
award of attorney fees. We remand for proceedings consistent with this opinion. We do not
retain jurisdiction.
/s/ Janet T. Neff
/s/ Alton T. Davis
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