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Case Summary: LEWIS v AETNA CASUALTY SURETY COMPANY, Docket No. 54644 (Mich. Ct. App. Sept. 8, 1981)

Factual and Procedural Background

Plaintiff was involved in an automobile accident in 1974 and applied for and received personal injury protection (PIP) benefits from defendant, her no-fault insurer. About six months later defendant discontinued payment of benefits, allegedly based on plaintiff's doctor's opinion that she was able to return to work. Plaintiff did not return to work and continued treatment. She sued defendant in the Common Pleas Court for the City of Detroit seeking reimbursement for medical expenses and wage losses; a jury awarded her $7,400.

Subsequently, plaintiff incurred additional medical expenses and wage losses. Defendant refused to honor those later claims, and plaintiff commenced a second lawsuit which was settled for $20,000. Plaintiff signed a release covering past, present, and future claims arising from the 1974 accident.

Plaintiff allegedly continued to incur expenses and commenced the present lawsuit. The trial court granted defendant's motion for accelerated judgment on the basis of the release(s). Plaintiff appealed, contending the release of future benefits was void under the no-fault statute and contrary to public policy.

Legal Issues Presented

  1. Whether a release of past, present, and future no-fault benefits is void under MCL 500.3143; MSA 24.13143 (which states, "An agreement for assignment of a right to benefits payable in the future is void").
  2. Whether such a release is void as contrary to public policy given the purpose of the no-fault insurance statute to provide assured, adequate, and prompt compensation.

Arguments of the Parties

Plaintiff's Arguments

  • The release of future benefits is void under MCL 500.3143; MSA 24.13143 because the statute prohibits agreements concerning future benefits.
  • The release is void as against public policy because the no-fault statute was designed to assure adequate and prompt reparation and insurers should not be adversaries that can extinguish future benefits by settlement.
  • Plaintiff contends she was effectively forced to settle the second lawsuit and sign the release under an "all or nothing" proposition, implying coercion to accept the settlement.

Defendant's Arguments

  • Defendant moved for accelerated judgment on the ground that the claims in the present suit are barred by the release executed in the prior settlement.
  • In the second lawsuit defendant contested parts of the claim, alleging plaintiff included expenses from an unrelated illness; thus defendant denies liability for those disputed items and defended against the broader claim.

Table of Precedents Cited

Precedent Rule or Principle Cited For Application by the Court
Shavers v Attorney General, 402 Mich. 554; 267 N.W.2d 72 (1978) Supports statement of the purpose of the no-fault act: to provide assured, adequate, and prompt compensation for losses. Used to acknowledge the remedial purpose of the statute while proceeding to analyze statutory text and contested-claims provisions.
Lewis v Detroit Automobile Inter-Ins Exchange, 90 Mich. App. 251; 282 N.W.2d 794 (1979) Authority indicating insurers may contest claims where a reasonable dispute exists. Cited to support the proposition that the no-fault act contemplates contested claims and allows insurers to challenge claims without penalty when reasonable dispute exists.
Wood v Detroit Automobile Inter-Ins Exchange, 99 Mich. App. 701; 299 N.W.2d 370 (1980) Authority regarding insurers' ability to contest claims under the no-fault act. Included with other cases to demonstrate consistent case law allowing reasonable dispute and contesting of claims by insurers.
Swanson v Citizens Ins Co, 99 Mich. App. 52; 298 N.W.2d 119 (1980) Authority concerning contested claims under the no-fault statutory scheme. Used to show legislative scheme contemplates contested claims and insurer challenges.
Skutt v City of Grand Rapids, 275 Mich. 258, 264; 266 N.W. 344 (1936) Authority on the public policy standard (conduct that is "cruel or shocking to the average man's conception of justice"). Applied to reject plaintiff's public policy challenge, finding the use of a release in settlement of a reasonably disputed claim is not "cruel or shocking."
Chapman v Ross, 47 Mich. App. 201; 209 N.W.2d 288 (1973) Rule that tender of settlement proceeds is a necessary step when seeking rescission of a release. Noted by the court to observe plaintiff apparently had not tendered the $20,000 settlement—an omission relevant to any claim for rescission of the release.

Court's Reasoning and Analysis

The court began by analyzing MCL 500.3143; MSA 24.13143, which provides "An agreement for assignment of a right to benefits payable in the future is void." The court emphasized the statute's plain language, concluding it addresses assignments rather than releases and that it would be improper to expand the statute's language to prohibit releases of future benefits. Accordingly, the statute was inapplicable to the release in this case.

The court next addressed the public policy argument. While recognizing the no-fault act's remedial purpose (citing Shavers), the court observed the act contains multiple provisions that contemplate contested claims (referencing §§ 3112, 3142, 3145, 3148, 3151 and citing appellate decisions). Reading the statute as a whole, the court concluded the Legislature did not intend that insurers must pay all submitted claims without review for coverage, excessiveness, or fraud; where a reasonable dispute exists regarding coverage or amount, an insurer may contest the claim under the act without penalty.

Regarding plaintiff's claim she was forced to settle under an "all or nothing" choice, the court noted defendant contested portions of the second suit on the ground some expenses arose from an unrelated illness. The court explained that if plaintiff were seeking excessive benefits the release served as the quid pro quo for defendant's payment. Conversely, had plaintiff prevailed she could have recovered interest and attorney fees under MCL 500.3142 and 500.3148 for unreasonable refusal to pay. The court treated plaintiff's decision to settle as a tactical choice not subject to appellate reexamination.

The court concluded that employing a release of future benefits to settle a reasonably disputed claim does not constitute conduct "cruel or shocking" to the average person's sense of justice, and thus is not void as against public policy. The court also noted plaintiff had apparently not tendered the $20,000 settlement payment back to defendant, a necessary step to seek rescission of the release under Chapman v Ross.

Holding and Implications

Holding: The Court of Appeals affirmed the trial court's grant of accelerated judgment to defendant; costs were awarded to defendant.

Implications: The direct effect is that plaintiff's present suit is barred by the prior release she signed in settlement of the second lawsuit, and the trial court's judgment in favor of defendant is affirmed. The opinion focuses on statutory construction (distinguishing assignments from releases) and on permitting insurers to contest reasonably disputed claims; it does not announce a broader change in legal doctrine beyond the court's application of those principles to these facts.

LEWIS v AETNA CASUALTY SURETY COMPANY

PER CURIAM.

Plaintiff appeals the trial court's order granting accelerated judgment to defendant on the ground the claim was barred by a release. GCR 1963, 116.1(5).

Plaintiff was involved in an automobile accident in 1974. She applied for and received personal injury protection benefits from defendant, her no-fault insurer. About six months later, defendant discontinued payment of the benefits, allegedly due to the opinion of plaintiff's doctor that she was able to return to work.

Plaintiff did not return to work, and she continued treatment with the physician. She commenced an action against defendant in the Common Pleas Court for the City of Detroit, seeking reimbursement for medical expenses and wage losses accrued at that time. The jury awarded plaintiff $7,400.

Subsequently, plaintiff continued to incur additional medical expenses and wage losses. Defendant refused to honor those claims. Another lawsuit was commenced against defendant. The suit was settled for $20,000. Plaintiff signed a release for past, present, and future claims arising out of the 1974 accident.

Plaintiff allegedly continued to incur expenses due to the accident. She commenced the present lawsuit. The trial court granted defendant's motion for accelerated judgment on the basis of the releases signed by the plaintiff.

Plaintiff raises one issue on appeal. She asserts that the release of future benefits is void as being contrary to the no-fault insurance statute, MCL 500.3143; MSA 24.13143, and as being contrary to public policy.

MCL 500.3143; MSA 24.13143 states:

"An agreement for assignment of a right to benefits payable in the future is void."

The clear language of the statute indicates that it applies to assignments. An assignment is not a release. We have no authority or desire to expand upon the plain language of the statute to include releases in the prohibition. Thus, the trial court correctly ruled that the statute is inapplicable to the case at bar.

Plaintiff also argues that the release is void as being against public policy. She argues that the no-fault statutory scheme was designed to provide insureds with adequate and prompt reparation for losses resulting from motor vehicle accidents. Consequently, insurers should not be adversaries of claimants, but rather mere distributors of benefits.

While it is true that the purpose of the no-fault act is to provide insureds with assured, adequate, and prompt compensation for losses, Shavers v Attorney General, 402 Mich. 554; 267 N.W.2d 72 (1978), the act is replete with references to contested claims. Cf. §§ 3112, 3142, 3145, 3148, 3151. Reading the act as a whole, it is clear that the Legislature did not intend for no-fault insurers to pay all claims submitted without reviewing the claims for lack of coverage, excessiveness, or fraud. Where a reasonable dispute exists as to coverage or the amount of benefits owing, the insurer is allowed to contest the claim under the act without penalty. See Lewis v Detroit Automobile Inter-Ins Exchange, 90 Mich. App. 251; 282 N.W.2d 794 (1979), Wood v Detroit Automobile Inter-Ins Exchange, 99 Mich. App. 701; 299 N.W.2d 370 (1980), Swanson v Citizens Ins Co, 99 Mich. App. 52; 298 N.W.2d 119 (1980).

Thus, plaintiff's argument that insurers are required to merely process and pay claims without reasonably challenging their validity lacks support in the act or under case law.

Plaintiff argues that she was forced to settle the second lawsuit and sign the release because it was an "all or nothing" proposition. In the second lawsuit, which resulted in the release at issue, defendant contested some of the claim because the plaintiff allegedly included expenses incurred from an unrelated illness. If, indeed, plaintiff was seeking excessive benefits, the release was the quid pro quo for defendant's payment of those benefits. On the other hand, if plaintiff had prevailed at trial in proving that she deserved reimbursement for all the claim as submitted, she could have received interest and attorney fees under the act for defendant's unreasonable refusal to pay. See MCL 500.3142, 500.3148; MSA 24.13142, 24.13148. It was plaintiff's choice to settle the dispute and sign the relase, a tactical judgment which this Court will not review.

We find the use of a release of future benefits in settlement of a reasonably disputed claim does not constitute a course of conduct which is cruel or shocking to the average man's conception of justice. Consequently, plaintiff's public policy argument is without merit. Skutt v City of Grand Rapids, 275 Mich. 258, 264; 266 N.W. 344 (1936).

Finally, we note that plaintiff apparently has not tendered the $20,000 settlement to defendant, a necessary step in seeking rescission of the release. See Chapman v Ross, 47 Mich. App. 201; 209 N.W.2d 288 (1973).

Affirmed. Costs to defendant.

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LEWIS v. AETNA CASUALTY CO
(Sep 8, 1981)