Appellate Court Upholds Dismissal of Vacationer’s PIP Claims for Fraud

"I was dreamin' when I wrote this
So sue me if I go 2 fast
But life is just a party, and parties weren't meant 2 last…"

Prince, “1999”

In Nelson v Geico Indem Co, No. 343639, 2019 WL 4894538 (Mich Ct App, October 3, 2019), the Michigan Court of Appeals upheld the trial court’s granting of motion for summary disposition in favor of the Personal Injury Protection (PIP) carrier based on the exclusionary policy language for fraudulent misrepresentations.

Nelson, a Michigan resident, was involved in a motor vehicle accident on Oct. 22, 2014. In her application for PIP benefits, she claimed back, neck and head injuries, but misrepresented whether she had previously experienced a “same or a similar condition.”

The plaintiff also submitted signed replacement services forms showing services that were performed every day beginning on the date of the accident, through October of 2017, with the exception of four days. The services were allegedly performed by her son, who testified that the forms were accurate.

It was discovered that the plaintiff took four vacations in 2016 to the following locations: New Orleans, Louisiana; Las Vegas, Nevada; Cancun, Mexico; and Minneapolis, Minnesota. The plaintiff testified that since the accident, she believes she also went to Melbourne, Florida with her daughter and perhaps on a cruise with her daughter as well.

While on these vacations, the plaintiff went on a helicopter ride, went dancing, and went on a boat ride. Among other things, the plaintiff also sang on stage, went to a Detroit Pistons game, went to a boxing gym to work out two to three times a week for 45 minutes to an hour, danced in a dance class once per week, appeared in dance performances, and attended a Prince tribute concert.

While the plaintiff was partaking in these in-and-out-of-state activities, her son remained in Michigan, where he reportedly performed replacement services.

The appellate court held that the misrepresentations regarding the plaintiff’s prior injuries and claims for replacement services, coupled with the policy’s exclusionary language for fraud, allowed the defendant carrier to void its policy because all elements necessary to establish fraud were present.

As the late Prince said, “A strong spirit transcends rules.” Here, the appellate court did not adopt Prince’s motto for the plaintiff.

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