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April 17, 2017

To satisfy the no-fault act requirements, notice need not be in particular format or expressly identify a possible claim for benefits, says the MSC

In Perkovic v Zurich American Insurance, No. 152484, the Michigan Supreme Court held that the statutory notice period for seeking no-fault benefits is satisfied when documentation containing all the information required by Michigan’s No-Fault Act is provided to an insurance company by the medical provider that treated the insured.  The Court also held that notice does not need to inform an insurer of a potential claim, nor does a claim need to already have been filed for notice to be sufficient. 
 
Plaintiff Dragen Perkovic was injured in a motor vehicle accident while operating a semitruck for his employer.  He was treated for his injuries at The Nebraska Medical Center.  The Nebraska Medical Center subsequently sent Perkovic’s medical records to Zurich American Insurance Company, his employer’s insurer.  But because Zurich had no injury report for Perkovic, it denied payment for his medical treatment.  Perkovic filed his initial complaint seeking unpaid PIP benefits in August 2009, and named his own insurance company, Citizens Insurance Company.  He later amended the complaint to add his bobtail insurer, Hudson Insurance Company.  However, Perkovic did not add Zurich as a defendant until about 13 months after the accident. After Hudson and Citizens were dismissed from the case, Zurich moved for summary disposition, contending that Perkovic’s claim was barred by the one-year limitations period because Zurich had not received notice of his claim and had not paid any benefits on his behalf before the limitations period expired.  Perkovic argued that The Nebraska Medical Center’s correspondence with Zurich constituted sufficient notice.  The trial court granted summary disposition for Zurich, and the Court of Appeals affirmed.
 
The Michigan Supreme Court reversed, holding that the documentation Zurich received from The Nebraska Medical Center was sufficient to provide notice of Perkovic’s claim for no-fault benefits.  Under the No-Fault Act, a claim for PIP benefits must be filed within one year after an accident unless either of two exceptions applies: (1) the insurer was properly notified of the injury, or (2) the insurer had previously paid PIP benefits for the same injury.  Here, the documentation sent to Zurich provided sufficient notice pursuant to the requirements of the Act because it included the claimant’s name and address, the name of the person injured, and the time, place, and nature of the injuries.  Contrary to the Court of Appeals’ conclusion that notice must inform an insurer of a possible claim for no-fault benefits, the No-Fault Act does not include such a requirement.  Nor does it require that an insured already be pursuing a claim for no-fault benefits.  Since Zurich received the records from The Nebraska Medical Center within one year of the accident, Perkovic’s amended complaint was not barred by the statute of limitations. Accordingly, the Michigan Supreme Court reversed the Court of Appeals’ judgment, vacated the trial court’s order granting summary disposition, and remanded to the trial court.
 
Justice Young dissented, agreeing with the majority’s reasoning but disagreeing with the outcome.  Indeed, Justice Young would have affirmed on alternative grounds because the notice was not sent on behalf of an insured who was at the time claiming that he was entitled to no-fault benefits.  Because the notice Zurich received did not clearly communicate that Perkovic was making a claim for PIP benefits, it could have instead been interpreted as seeking other benefits under the insurance policy.
 

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