Report on Wilcox v. State Farm Oral Arguments

Recently, CPAN filed an amicus curiae (friend of the court) brief in the Michigan Supreme Court case of Wilcox v State Farm.  CPAN’s General Counsel, George T. Sinas, attended the oral arguments of the case on Nov. 4. Please take a few minutes to read this important report.

Thank you for your continued support.  Your membership enables CPAN to continue the fight to protect Michigan’s auto no-fault system — and your rights!

  - CPAN

Wilcox v State Farm Oral Arguments

On November 4, 2010, the Michigan Supreme Court heard oral argument in the case of Wilcox v State Farm. This is the case where the Court will revisit its earlier and very controversial decision in Griffith v State Farm, 472 Mich 521 (2005). In doing so, the Court will determine whether no-fault insurance companies can reduce their liability to pay no-fault PIP benefits by amounts representing what the injured person would have needed or consumed had he or she not been injured in the accident. This concept has been referred to as "incrementalism," signifying the notion that no-fault insurers are only liable to pay for the incremental increase in a victim’s pre- versus post-accident life.  Stated differently, products, services and accommodations that are just as necessary for an uninjured person as they are for an injured person would not be reimbursable under this theory. Obviously this issue has enormous consequences for all catastrophically injured patients, particularly those with severe brain injury and spinal cord injury. In addition, the decision will have very serious implications for all no-fault providers, particularly those involved with residential facilities, transportation services, home construction plan and design, and medical clinicians rendering treatment and rehabilitation for patients with preexisting conditions or dual diagnoses.

CPAN filed a very comprehensive brief in this case which was actually cited by Justice Alton Davis during oral argument. In this brief, CPAN urged the Court to hold that "an insurer is responsible to pay 100% of an allowable expense claim under Section 3107(1)(a) if the plaintiff establishes the following elements: (1) plaintiff’s injuries either materially affected his pre-accident need for the services at issue or the injuries were one of the reasons why plaintiff needs these services; (2) the services at issue are reasonably necessary for plaintiff’s care, recovery, and rehabilitation; and (3) the charge for the services is reasonable."

Several Justices, however, indicated, by their questioning, that "expenses related to a life unmarred by an auto accident injury" should not be compensable under no-fault.

It is not clear when the Wilcox decision will be issued. If the decision is not final by December 31, 2010 (issued and intact after the expiration of the rehearing period), it will be decided by the Court next year after Justice Davis has been replaced by newly elected Justice Mary Beth Kelly.

George T. Sinas, General Counsel