Background
Chimere Cheryl Cooks was injured while driving a vehicle belonging to her sister, April Clay, with whom she lived. The vehicle was insured by Progressive Insurance Company. Cooks sought personal protection insurance benefits as a resident relative, but Progressive requested additional information because the policy listed an incorrect address and later allegedly denied her claim for noncooperation, order of priority, and her failure to live at the policy address.
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 because Progressive was a higher-priority insurer. Cooks sued Citizens, but the circuit court granted Citizens summary disposition under MCR 2.116(C)(10). Cooks appealed the subsequent dismissal order.
The Court’s Holding
The Court of Appeals affirmed. The undisputed evidence established that Cooks was domiciled with her sister when the accident occurred and that her sister had a valid Progressive policy. Under MCL 500.3114(1), that policy applied to Cooks as a relative domiciled in the named insured’s household. Because applicable personal protection insurance existed, Cooks was ineligible for benefits through the assigned-claims system under MCL 500.3172.
The court held that Citizens did not have to prove Progressive had accepted Cooks’s claim or actually paid benefits. Cooks produced no evidence that Progressive had rescinded the policy or that the policy was otherwise inapplicable. Her unnotarized voicemail transcript, even if accepted as authentic, did not create a genuine issue of material fact. Any dispute arising from Progressive’s denial or the incorrect policy address had to be pursued against Progressive, not Citizens. Given this disposition, the court declined to address Cooks’s alternative argument concerning the timeliness or tolling of claims for chiropractic treatment.
Key Takeaways
- A valid no-fault policy covering a claimant as a domiciled resident relative is “applicable” insurance that precludes Michigan Assigned Claims Plan benefits.
- An insurer assigned through the plan need not show that the higher-priority insurer accepted the claim or paid benefits; it need only establish that the other policy applied.
- A denial based on noncooperation or an address dispute does not establish that a policy was inapplicable when the policy remained valid and was not rescinded.
Why It Matters
The decision reinforces the Michigan Assigned Claims Plan’s role as a source of last-resort benefits, not an alternative forum for resolving coverage disputes with an identifiable higher-priority insurer. A claimant cannot obtain assigned-claims benefits merely because the applicable insurer disputes or denies the claim.
Practitioners should promptly pursue the insurer whose policy applies and consider joining that insurer before statutory timing rules restrict recovery. Evidence of an actual rescission or other basis making the policy inapplicable may change the analysis, but proof of a claim denial alone is insufficient.