Background
Chimere Cheryl Cooks was injured in a March 2022 motor-vehicle accident while driving a vehicle belonging to her sister, April Clay, with whom she 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 did not match Cooks’s address.
After Progressive allegedly denied the claim for noncooperation and other reasons, Cooks applied for benefits through the Michigan Assigned Claims Plan. Citizens Insurance Company of the Midwest was assigned the claim but denied benefits because Progressive was a higher-priority insurer. Cooks sued Citizens, and the circuit court granted Citizens summary disposition under MCR 2.116(C)(10).
The Court’s Holding
The Court of Appeals affirmed. The undisputed evidence established that Cooks was domiciled with her sister, a named insured under a valid Progressive policy. Under MCL 500.3114(1), that policy therefore applied to Cooks as a resident relative, making her ineligible for assigned-claims benefits under MCL 500.3172.
The court explained that Citizens needed to establish only that another no-fault policy was applicable, not that Progressive had accepted the claim or paid benefits. Cooks produced no evidence that Progressive had rescinded the policy or that the policy was otherwise inapplicable. Her unnotarized transcription of a voicemail describing a claim denial did not create a genuine issue of material fact, particularly because denial of a claim did not itself eliminate the policy’s statutory applicability.
Any dispute over Progressive’s handling of the claim or the incorrect policy address had to be pursued against Progressive, not Citizens. Because the applicability ruling disposed of the appeal, the court declined to address Cooks’s alternative argument concerning the one-year-back rule and tolling under MCL 500.3145(3).
Key Takeaways
- A valid no-fault policy covering a claimant as a domiciled resident relative is “applicable” for priority purposes even if the insurer denies the claimant’s request for benefits.
- The Michigan Assigned Claims Plan is an insurer-of-last-resort mechanism and is unavailable when applicable PIP coverage exists under an identifiable policy.
- A claimant opposing summary disposition must present admissible evidence creating a factual dispute; an unverified voicemail transcription did not establish that the higher-priority policy had been rescinded or was inapplicable.
Why It Matters
The decision distinguishes a policy’s legal applicability from an insurer’s willingness to pay a particular claim. A denial based on noncooperation, priority, or address-related concerns does not automatically shift liability to an assigned-claims insurer when the claimant remains within the coverage class established by MCL 500.3114(1).
Claimants facing a denial by an identifiable higher-priority insurer must timely pursue that insurer and develop evidence concerning rescission or nonapplicability. They cannot obtain assigned-claims benefits merely by showing that the higher-priority insurer declined to pay.