Background
Angerica L. Downer purchased a no-fault policy from USA Underwriters Insurance Company and selected a $50,000 personal protection insurance benefit limit available only to qualifying Medicaid enrollees. Downer was not enrolled in Medicaid when she applied. After she was injured in an automobile accident, Detroit Medical Center treated her and sought payment from USA.
In an earlier appeal, the Court of Appeals held that the rebuttable presumption in MCL 500.3107c(3) could apply even though Downer was statutorily ineligible to select the $50,000 limit. The court remanded because USA had not yet supplied an affidavit linking Downer’s premium payments to that coverage level. On remand, USA submitted an affidavit from underwriting specialist Takara Thompkins and supporting policy, payment, and premium-comparison records. The circuit court found that evidence sufficient, granted USA partial summary disposition on the policy-limit issue, and later denied DMC’s motion for reconsideration.
The Court’s Holding
The Court of Appeals affirmed. It held that the law-of-the-case doctrine foreclosed DMC’s renewed argument that MCL 500.3107c(3) did not apply when the insured’s $50,000 selection was ineffective because she lacked Medicaid eligibility. The prior appellate decision had already resolved that issue on materially unchanged facts. The court also concluded that its subsequent decision in Northland Radiology did not undermine the earlier ruling because that case concerned opting out of PIP benefits under a different statute that lacks MCL 500.3107c(3)’s rebuttable presumption.
The court further held that Thompkins’s affidavit satisfied the applicable evidentiary requirements and established the statutory presumption that Downer’s premium reflected $50,000 in PIP coverage. Although the affidavit did not expressly use the words “personal knowledge,” Thompkins identified herself as USA’s underwriting specialist assigned to review Downer’s application and payment history, affirmed the truth of her statements under penalty of perjury, and attached records connecting the premium paid to the $50,000 limit and comparing premiums for higher coverage levels.
Key Takeaways
- MCL 500.3107c(3)’s rebuttable presumption may apply when an insured ineffectively selects the Medicaid-restricted $50,000 PIP limit but pays the corresponding premium.
- A prior appellate ruling on the presumption’s applicability governed the later appeal under the law-of-the-case doctrine.
- An affidavit can demonstrate personal knowledge through the affiant’s position, assigned review, sworn assertions, and supporting business records even without expressly stating that it is based on “personal knowledge.”
Why It Matters
The decision reinforces that an ineffective PIP coverage selection does not automatically produce unlimited benefits under MCL 500.3107c(4). When the insurer presents competent evidence connecting the premium payment to a particular coverage level, Subsection (3)’s rebuttable presumption may determine the applicable limit.
For insurers and medical providers litigating Michigan no-fault claims, the opinion also illustrates the documentation needed to connect a paid premium to limited PIP coverage at summary disposition.