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A Better Partnership
December 11, 2014

COA affirms denial of PIP, uninsured motorist benefits

In Bahri v. IDS Property Casualty Company, No. 316869, the Michigan Court of Appeals held that an insured who submitted fraudulent receipts for replacement services was not entitled to first-party personal injury protection benefits or uninsured motorist benefits under the terms of her policy. The plaintiff was involved in a car accident in 2011. The police report stated that it was a two car accident, but the plaintiff testified that another unidentified vehicle caused her to hit the other car.
Plaintiff’s doctors intervened and appealed the trial court’s grant of summary disposition for the defendants. The Court of Appeals held that the plaintiff was not entitled to PIP benefits because she submitted receipts for replacement services for days when she had been seen on surveillance video performing the very tasks with which she claimed she needed help. This conduct fell within her insurance policy’s fraud exclusion, so she was disqualified from receiving benefits.

The plaintiff also submitted a claim for uninsured motorist benefits under her policy. The court held that even if she had not submitted fraudulent claims, she would not have been entitled to uninsured motorist benefits because the unidentified vehicle did not come into contact with her vehicle, her person, or a vehicle she occupied as required by her policy.
This opinion was issued as an unpublished opinion in October and approved for publication in December.

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