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138602 - Wilcox v State Farm

Catherine Wilcox, individually, and as Next Friend of Isaac Wilcox, a minor,
 
William W. Decker Jr.
April H. Sawhill
 
Plaintiffs-Appellants,
 
And
 
 
Sunrise Home Health Services, Inc.,
 
 
 
Intervening Plaintiff,
 
 
(Appeal from Ct of Appeals)
 
 
(Kent – Trusock, M.)
 
State Farm Mutual Automobile Insurance Company,
 
Daniel S. Saylor
 
Defendant-Appellee.
 

Summary

​In November 2004, Catherine Wilcox’s four-year-old son Isaac was injured in an automobile accident, leaving him a quadriplegic who cannot breathe on his own. State Farm Mutual Automobile Insurance Company was the Wilcox family’s no-fault automobile insurance carrier at the time of the accident. Under MCL 500.3105(1), a no-fault insurer must pay benefits for “accidental bodily injury” arising out of the ownership, operation, maintenance, or use of a motor vehicle. MCL 500.3107(1)(a) provides that no-fault 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.”

Four months after the accident, Isaac was discharged from a long-term pediatric ventilation facility at the University of Michigan. Upon his discharge, Isaac moved with his family into a partially barrier-free apartment in Howell. State Farm agreed to pay the full amount of rent in exchange for the family’s agreement to pay for the utilities, maintenance, and other similar costs.

Soon afterward, the Michigan Supreme Court released its opinion in Griffith v State Farm Mutual Automobile Ins Co, 472 Mich 521 (2005). Griffith concerned the insurance company’s obligation under the no-fault act to reimburse the plaintiff for food expenses. The Supreme Court held in Griffith that the insurance company was not obligated to cover the food expenses. The majority reasoned that that there was no evidence that the injured person’s diet was different than that of a non-injured person, and that the food expenses were not part of his “care, recovery, or rehabilitation.” To be covered, the plaintiff’s expenses would have to be “casually connected to” his injury, the majority stated.

In the wake of Griffith, State Farm took the position that it was liable only for the amount in excess of the family’s pre-accident rental cost; moreover, State Farm said, it was only required to pay that portion of the rent that was attributable to Isaac’s injuries. State Farm began paying two-fifths of the total monthly rent, which covered Isaac and a caregiver. State Farm attributed the remaining three-fifths of the monthly rent payment to the other three Wilcox family members.

Wilcox sued State Farm, seeking reimbursement of the family’s housing costs. After filing suit, the family moved to a $280,000 home with handicap-accessible features. In addition, the Wilcox family wanted modifications to the 4,000-square-foot home that would cost an estimated $260,000.

State Farm filed a motion for partial summary disposition, asking the trial judge to rule as a matter of law that State Farm was not liable for the full purchase price of the Wilcox family’s home, but was only responsible for the reasonable costs associated with reasonably necessary modifications for Isaac’s care, recovery, and rehabilitation. Wilcox filed a counter-motion for summary disposition. Among other things, she argued that State Farm was liable for $22,500.00 in past unpaid rental expenses, the full purchase price of the home, and the full cost of home modifications.

The trial judge ruled that State Farm was only liable for increased housing costs arising from Isaac’s injuries. The judge further held that it was a question of fact for a jury to determine those costs.

Wilcox filed an application for leave to appeal in the Court of Appeals. About six weeks later, and before the Court of Appeals had made any ruling on her case, she filed an application for leave to appeal in the Supreme Court, asking for leave to bypass the Court of Appeals. The Court of Appeals issued a peremptory order remanding this case to the trial court for further proceedings. The panel held that “[w]hether a cost constitutes an allowable expense is a question of law and so, it is to be determined by the court, not the jury.” The Court of Appeals directed the parties to submit evidence on each expense at issue to the trial court. After the Court of Appeals made this ruling, the Supreme Court granted Wilcox’s application for leave to appeal.