Northland Radiology, Inc. v. Allstate Fire and Casualty Insurance Company

Summary

The Michigan Court of Appeals held that an insured’s election to opt out of personal protection insurance medical coverage was ineffective because a resident relative did not have the required qualified health coverage and documentation was not provided for that relative. Under MCL 500.3107d(4), the policy was therefore considered to provide unlimited PIP medical coverage, absent other valid defenses. The court reversed summary disposition for Allstate and remanded for further proceedings, including possible consideration of fraud and rescission.

Holdings

1. All criteria in MCL 500.3107d must be satisfied for an election to opt out of PIP medical coverage to be effective. Because Turner's required coverage was absent and documentation of his qualified coverage was not provided, Springer did not make an effective election.
2. When the applicant or named insured has not made an effective election under MCL 500.3107d(1), the policy is considered to provide unlimited PIP medical coverage. That coverage applies to the whole policy rather than only to selected individuals.
3. The trial court erred by granting summary disposition to Allstate because the ineffective opt-out meant that, absent another valid defense, the policy provided unlimited PIP medical coverage.

Questions Presented

1. Whether Springer's election to opt out of PIP medical coverage was effective when her resident relative did not have the required qualified health coverage or other automobile-policy PIP coverage.
2. Whether an ineffective opt-out causes the policy to be deemed to provide unlimited PIP medical coverage under MCL 500.3107d(4) and MCL 500.3107c(1)(d).
3. Whether the trial court properly granted Allstate summary disposition based on its ability to rely on Springer's statements on the opt-out form.

Disposition

reversed_and_remanded