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February 18, 2021
In the unpublished decision of Sefcik v Home-Owners Insurance Company and Auto-Owners Insurance Company, (Docket No. 351137), the Michigan Court of Appeals considered the sufficiency of an automobile loss notice and police report for purposes of satisfying the statutorily required notice of a claim within one year. MCL 500.3145.
Plaintiff Saraphina Sefcik was involved in a motor vehicle accident as an occupant of a vehicle which was being driven by her boyfriend and was owned by his parents, Ross and Sheryl Leisman. The vehicle was insured with Home Owners Insurance Company. The police report-obtained by Home-Owners as part of its own investigation rather than being supplied by the Plaintiff-indicated that following the accident, the Plaintiff was transported to Munson Medical Center. The day after the accident, the Leismans’ insurance agent submitted an automobile loss notice form to Home-Owners, indicating that “Sara” was treated and released from the hospital after complaints of a headache. Home-Owners assigned an adjuster to investigate the claim. Home-Owners eventually learned that it was Plaintiff who was injured, not Ms. Leisman. Home-Owners’ adjuster spoke to Plaintiff’s mother at one point in the investigation to determine whether Co-Defendant GEICO, Plaintiff’s mother’s insurer, would be responsible for the payment of any claims. GEICO denied coverage asserting Plaintiff was not a resident relative of her mother.
Plaintiff filed suit, and Home-Owners moved for summary disposition on the basis that Plaintiff had not provided timely notice within one year of the accident as required under MCL 500.3145(1). The trial court granted Home-Owners’ motion finding that Home-Owners had notice of Plaintiff’s name, that she was involved in an accident, and that there was an injury but the notice did not substantially comply with MCL 500.3145(4) because Home-Owners’ first notice was oral, not written, and was not provided by Plaintiff or someone “in her behalf.” The trial court also noted that the notice was deficient in that it did not properly apprise Home-Owners of the full nature of Plaintiff’s claimed injuries.
The Court of Appeals reversed the trial court’s grant of summary disposition, relying on the Michigan Supreme Court’s decision in Perkovic v Zurich American Ins Co, 500 Mich 44; 893 NW2d 322 (2017). The Perkovic Court held that any documentation-including medical bills and other records-submitted to an insurer can fulfill the notice requirements of MCL 500.3145 as long as the documentation contains the name and address of the person injured, the time and place of the accident, and the nature of the injury. The Perkovic Court also noted that the purpose of the documentation need not be to explicitly apprise the insurer of a possible claim for benefits, since that requirement is nowhere found in the plain language of MCL 500.3145, and notice can be provided to an insurer without the knowledge or direction of the claimant.
The Perkovic Court provided a lengthy analysis on what it believed to be a subtle but important distinction between the phrases “in his behalf” vs. “on his behalf.” The Court believed the former, as used in MCL 500.3145(1), is much broader, as it means “in the interest, support or defense of” whereas the latter means “in the name of, on the part of, or as the agent or representative of.” “on his behalf” connotes the existence of an agency relationship between the person submitting the notice and the claimant, whereas “in his behalf” has no such connotation, and therefore the provision of notice need only have been in the claimant’s interest to satisfy MCL 500.3145(1).
Applying the Perkovic reasoning and holding, the Court of Appeals found the trial court erred in granting summary disposition; specifically, the trial court placed too much emphasis on who supplied the notice and did not properly consider whether the documents that Home-Owners received (the loss notice form submitted by the named insured and the police report), supplied the required notice. Without explicitly stating that these documents were sufficient, the Court of Appeals stated in a footnote that the police report clearly identified Plaintiff by name and address, indicated it was a personal injury accident, and that plaintiff had been transported by ambulance to the hospital. The Court of Appeals rejected Home-Owners argument that the police report should have been disregarded as part of the notice calculus because it was obtained by defendant rather than submitted by Plaintiff herself.
Finally, the Court of Appeals, relying on Dillon v State Farm Mut Auto Ins Co, 501 Mich 915; 902 NW2d 892 (2017), held that the Plaintiff’s initial complaint of a headache at the hospital as reflected on the Notice of Loss was sufficient to apprise Home-Owners of the nature of Plaintiff’s later-claimed concussion, migraines, and other injuries potentially consistent with a head injury. The Court reversed the trial court’s grant of summary disposition and remanded the case back down for further proceedings.