Background
Chimere Cheryl Cooks was injured while driving a vehicle owned by her sister, April Clay, with whom Cooks lived. Clay’s vehicle was insured by Progressive Insurance Company. Cooks sought personal protection insurance benefits as a resident relative, but Progressive requested additional information because the address on Clay’s policy was incorrect and later allegedly denied the claim for noncooperation, priority, and residency-related reasons.
Cooks then applied for benefits through the Michigan Assigned Claims Plan, which assigned her claim to Citizens Insurance Company of the Midwest. Citizens denied benefits on the ground that Progressive was the higher-priority insurer. Cooks sued Citizens, but the Wayne Circuit Court granted Citizens summary disposition under MCR 2.116(C)(10). Cooks appealed.
The Court’s Holding
The Court of Appeals affirmed. The undisputed evidence established that Cooks was domiciled with Clay, a named insured under a valid Progressive policy. Under MCL 500.3114(1), that policy applied to Cooks as a resident relative. Because applicable personal protection insurance existed, Cooks was not eligible for Assigned Claims Plan benefits under MCL 500.3172.
The court held that Citizens needed to establish only that another policy was applicable, not that Progressive had accepted Cooks’s claim or paid benefits. No evidence showed that Progressive had rescinded Clay’s policy or otherwise rendered it inapplicable. The unnotarized voicemail transcript offered by Cooks did not create a genuine issue of material fact, even if treated as legitimate, because a claim denial did not establish that the policy itself was inapplicable.
The court explained that any dispute arising from Progressive’s denial or the incorrect policy address had to be pursued against Progressive, not Citizens. Because its ruling disposed of the case, the court declined to address Cooks’s alternative argument concerning the timeliness or tolling of claims for chiropractic treatment under MCL 500.3145(3).
Key Takeaways
- A valid no-fault policy covering a person as a domiciled resident relative is “applicable” for priority purposes even if the insurer denies that person’s claim.
- A claimant cannot obtain Michigan Assigned Claims Plan benefits merely by showing that a higher-priority insurer refused to pay; the claimant must show that no applicable policy exists.
- A dispute over a higher-priority insurer’s denial must be pursued against that insurer when the underlying policy remains valid and has not been rescinded.
Why It Matters
The decision reinforces the Michigan Assigned Claims Plan’s role as an insurer of last resort. A claimant may not shift a coverage dispute to an assigned insurer when an existing policy applies under the statutory order of priority.
For practitioners, the opinion highlights the importance of joining or timely pursuing the allegedly responsible higher-priority insurer. Evidence of claim denial, without evidence that the policy was rescinded or legally inapplicable, will not establish eligibility for Assigned Claims Plan benefits.