Willie Griffin was operating a motorcycle when he swerved to avoid a truck and crashed. There was no physical contact between the motorcycle and truck. The responding officer spoke to the truck driver but did not record the license plate number or VIN of the truck, the insurer of the truck, the owner of the truck, or any other identifying information regarding the truck, other than the driver’s name, who was listed as a witness. Trumbull Insurance was Griffin’s personal automobile insurer at the time of the accident, and the policy included PIP coverage. Trumbull unsuccessfully attempted to contact the truck driver and closed its investigation about eight months after the accident occurred, and it did not pay or deny Griffin’s PIP benefits claim. Griffin submitted PIP claims to the MAIPF, Esurance, and Allstate, which were all lower in priority that Trumbull and the truck driver’s unnamed insurer. Griffin’s attorney hired MEA Research Services in a final attempt to locate any additional insurance coverage that may apply but the MEA found no insurance policies for the truck driver. Later it was determined it was an employer owned vehicle.
After Griffin filed his lawsuit, the parties subpoenaed the truck driver, who appeared for his deposition. The truck driver had never contacted his insurer and did not own the truck he was driving. The truck was owned by Pavex, the driver’s former employer, and was fully insured with Harleysville Insurance. The truck driver had submitted an accident report to Pavex but Pavex never reported the accident or submitted a claim to Harleysville, and the driver never forwarded Griffin’s letter to Pavex.
Trumbull moved for summary disposition under MCR 2.116(C)(10), arguing that it was not liable to pay PIP benefits because Harleysville was the highest-priority insurer. MAIPF filed its Dispositive Motion arguing that Trumbull as Griffin’s insurer was higher in the order of priority. The trial court agreed that Trumbull was not the highest-priority insurer and that Griffin had not exercised reasonable diligence in attempting to timely locate Harleysville. Both Dispositive Motions were granted by the trial court. The Court of Appeals affirmed.
In the context of MCL 500.3114, a claim for benefits is simply a demand to an insurer by its insured or a third party for payments that are believed to be due after a motor vehicle accident. MCL 500.3114 puts the onus on a claim to claim PIP benefits from a specified list of insurers based on priority, as determined in the statute. One must put potential insurers on notice and submit insurance claims stating an entitlement to benefits and requesting payment. A claimant must be diligent in the pursuit of his or her claim for PIP benefits. Due diligence requires a good-faith effort to fulfill a legal obligation or requirement that could ordinarily be expected of a person under the factual circumstances. Requiring a claimant to identify potential insurers and pursue a PIP benefits claim with due diligence is consistent with the purpose of the No-Fault Act and its limitations period.
Although insurers who receive a claim for PIP benefits prior to expiration of the limitations period must act diligently when investigating, responding to, and resolving the claim, an insurer that is confident that it is not liable to pap PIP benefits can and should promptly deny the claim so that the claimant can seek assignment by the MAIPF to take other actions that might be necessary to preserve the right to PIP benefits. However, a lower-priority insurer is not statutorily obligated to pay PIP benefits merely because it received a timely claim for such benefits. Rather, such insurers have an obligation to act diligently in deciding how to resolve the claim and to inform the claimant of that decision timely. Diligent and timely action by all parties is required; gamesmanship should not be rewarded.
The Michigan Supreme Court concluded that Griffin acted diligently under the circumstances. The crash report contained contact information for the truck driver but omitted insurance and identifying information for the truck at issue. Griffin hired an attorney to assist him who promptly sent a letter of intent to the truck driver, which was ignored. Griffin’s attorney then filed a claim with Trumbull, who was Griffin’s general PIP provider. Trumbull did not make payment or deny Griffin’s claim, and it did not timely respond to inquiries from Griffin’s attorney. During this waiting period, Griffin also submitted notices and claims to the MAIPF, Esurance, and Allstate as lower-priority insurers. Griffin hired an independent, third-party company to try to identify the truck driver’s insurance provider, but the company was unsuccessful. It was only through deposition testimony in the case Griffin filed against Trumbull that the parties learned that the truck was a work vehicle insured by Harleysville, which was not notified of the accident earlier by either the driver or the insured business within a year of the date of the motor vehicle accident.
Griffin exercised due diligence by doing everything the law required of him, and the Michigan Supreme Court refused to reward Trumbull for its gamesmanship. Instead it reversed the judgments of the lower courts as to Trumbull and found that Trumbull was liable to pay Griffin’s claim for PIP benefits under MCL 500.3114(5).