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No. 133466, 133468
| United States Fidelity Insurance & Guaranty |
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Jeffrey C. Gerish |
| Company, |
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Gregory Gromek |
Plaintiff-Appellee, |
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| v |
(Appeal from Ct of Appeals) |
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(Oakland - Andrews, S.) |
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| Michigan Catastrophic Claims Association, |
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Joseph K. Erhardt |
Defendant-Appellant, |
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| and |
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| Michael Migdal, Individually and as Conservator for |
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Milea M. Vislosky |
| the Estate of Daniel Migdal, a Protected Person, |
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Defendant. |
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| ------------------------------------------------------------ |
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| Hartford Insurance Company of the Midwest, |
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Janet Callahan Barnes |
Plaintiff-Appellee, |
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John H. Cowley, Jr. |
| v |
(Appeal from Ct of Appeals) |
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(Oakland - Nichols, R.) |
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| Michigan Catastrophic Claims Association, |
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Ava K. Ortner |
| Defendant-Appellant. |
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| __________________________________________ |
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Click link to view briefs in Adobe format:
Supreme Court Order Granting Rehearing: 03/27/09>>
Pleadings filed after grant of rehearing:
133466 - Defendant-Appellant's Motion for Recusal>>
133466 - Defendant-Appellant's Reply Brief in Support of Motion for Recusal>>
133466 - Defendant-Appellant's Supplemental Authority in Support of Motion for Recusal>>
133466 - Defendant-Appellant's Response to Amicus Curiae Coalition Protecting
Auto No-Fault's Reesponse to Motion for Recusal>>
133466 - Defendant-Appellant's Reply to Plaintiff-Appellee's Response to Motion for Recusal>>
133466 - Plaintiff-Appellee's Response to Motion for Recusal>>
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133468 - Defendant-Appellant's Motion for Recusal>>
133468 - Defendant-Appellant's Reply Brief in Support of Motion for Recusal>>
133468 - Defendant-Appellant's Supplemental Authority in Support of Motion for Recusal>>
133468 - Plaintiff-Appellee's Response to Motion for Recusal>>
133468 - Plaintiff-Appellee's Statement re Supplemental Authority>>
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133466/133468 - Coalition Protecting Auto No-Fault's
Amicus Response to Defendant-Appellant's Motion for Recusal>>
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Pleadings filed before grant of rehearing:
133466 - Plaintiff-Appellee's Brief on Appeal>>
133466 - Defendant-Appellant's Brief on Appeal>>
133466 - Defendant-Appellant's Reply Brief>>
133466 - Defendant's Brief on Appeal>>
133468 - Plaintiff-Appellee's Brief on Appeal>>
133468 - Defendant-Appellant's Brief on Appeal>>
133468 - Defendant-Appellant's Repy Brief>>
Coalition Protecting Auto No-Fault's ("CPAN") Amicus Curiae Brief>>
Commissioner of the Office of Financial and Insurance Regulation's Amicus Curiae Brief>>
Insurance Institute of Michigan's Amicus Curiae Brief>>
State Farm Mutual Automobile Insurance Company's Amicus Curiae Brief>>
Background
The Michigan Catastrophic Claims Association (MCCA) was created by the Legislature to serve as a “reinsurer” for insurance companies offering automobile insurance in Michigan. The MCCA reimburses insurers for amounts paid on no-fault personal injury protection claims (commonly known as PIP benefits) in excess of $250,000. In these two consolidated cases, the MCCA seeks review of claims made by two insurance companies. In the first case, the United States Fidelity Insurance & Guaranty Company (USF&G) entered into a consent judgment with an insured, agreeing to pay no-fault PIP benefits to cover the costs of attendant care provided to Daniel Migdal, who had been involved in an automobile accident that left him severely and permanently injured. USF&G agreed to pay $17.50 an hour for nursing care services, with yearly increases of 8.5 percent compounded annually, so long as Daniel resided in the family home. By July 2003, USF&G had paid over $7 million in PIP benefits on Daniel’s behalf, and was paying $54.84 an hour for Daniel’s nursing care services. USF&G submitted these claims to the MCCA for reimbursement. The MCCA reimbursed USF&G $22.05 an hour for nursing care services, which it considered a reasonable rate of reimbursement, instead of the hourly rate set forth in the consent judgment. USF&G sued the MCCA, seeking reimbursement of all the amounts that it paid under the consent judgment. The trial court ruled in USF&G’s favor, and the MCCA appealed. In the second case, Hartford Insurance Company of the Midwest agreed in a consent judgment to pay $30 an hour for attendant care for Robert Allen, who was severely and permanently injured in an automobile accident. The MCCA refused to reimburse Hartford for more than $20 an hour. Hartford sued the MCCA, but in this case, the trial court refused to rule that the insurance company’s position was correct as a matter of law. The court concluded that a question of material fact existed concerning the reasonableness of the amounts paid by Hartford on Allen’s behalf. Hartford appealed, and the Court of Appeals granted leave to appeal and consolidated the two cases. In a published opinion, the Court of Appeals ruled that the MCCA is required to reimburse insurers for the actual amount of PIP benefits paid in excess of the statutory threshold, regardless of the reasonableness of the payments. The appellate court affirmed the trial court’s ruling in the USF&G case and reversed the trial court’s ruling in the Hartford case. The MCCA appeals.
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