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Spectrum Health Hosps, et al v Esurance Prop and Cas Ins Co, et al (COA – UNP 11/23/2021; RB #4351)

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Michigan Court of Appeals; Docket #352488, 352944; Unpublished
Judges Rick, O’Brien, and Cameron; Per Curiam
Official Michigan Reporter Citation: Not Applicable; Link to Opinion


STATUTORY INDEXING:
Disqualification for Intentionally Suffered Injury [§3105(4)]

TOPICAL INDEXING:
Not Applicable


SUMMARY:
In this unanimous unpublished per curiam decision, the Court of Appeals reversed the trial court’s summary disposition order in favor of Plaintiff Spectrum Health Hospitals (“Spectrum”), in Spectrum’s first-party action against Defendant Esurance Property and Casualty Insurance Company (“Esurance”). The Court of Appeals held that reasonable minds could differ as to whether Spectrum’s patient/Esurance’s insured, Kevin Shea Lindsey, intended to injure himself when he jumped from a moving vehicle at approximately 30-40 mph, such that he would be barred from no-fault PIP benefits under MCL 500.3105.

Chelsea Loughin and Kevin Shea Lindsey were traveling in a motor vehicle when an argument broke out between them. Loughin was driving the vehicle, and just after she slowed down upon reaching a roundabout, Lindsey somehow came to be ejected from the vehicle. Loughin testified that, immediately prior to Lindsey’s ejection from the vehicle, she told Lindsey she “wanted him out of my life,” and that Lindsey responded by saying “Fine, [f**k] it.” Loughin further testified that Lindsey “jumped out the door or he went out. I don’t know. It was like he was there and he was gone.” Due to Lindsey’s catastrophic injuries, he was unable to testify as to how he became ejected from the vehicle. After Lindsey received treatment for his injuries from Spectrum, Spectrum sought reimbursement from Lindsey’s no-fault insurer, Esurance. Esurance denied Spectrum’s claim and moved for summary disposition in Spectrum’s subsequent first-party action, arguing that Lindsey’s injuries were intentionally caused and therefore not “accidental bodily injuries.” Spectrum filed its own motion for summary disposition, in which it noted that, in order for an injured person to be precluded from no-fault PIP benefits for an intentionally caused accident, he or she must have intended both that the accident occur and that injury result. In this case, Spectrum argued, there was no evidence that Lindsey intended to injure himself—he never verbally expressed an intent to injure himself, he did not have a history of mental health issues or suicidal ideation, his death certificate listed his death as an accident, and one Dr. William J. Sanders opined in an affidavit that, although Lindsey jumped from the moving vehicle, he did not necessarily intend to injure himself. The trial court ultimately agreed with Spectrum, granting summary disposition in its favor.

The Court of Appeals reversed the trial court’s summary disposition order, holding that reasonable minds could differ as to whether Lindsey intended both to jump from the vehicle and to injure himself. The Court concluded that a reasonable juror could infer from the circumstances—i.e. Lindsey and Loughin’s argument, and the fact that “there [was] no indication that [Lindsey] made an effort to forestall the injuries attendant to falling or jumping from a moving vehicle by, for instance, tucking and rolling”—that Lindsey intended to jump from the vehicle in order to injure himself. In other words, the court reasoned that there was sufficient circumstantial evidence to preclude summary disposition, even though there was no direct evidence that Lindsey intended to injure himself.

“Although plaintiffs point out that Loughin was slowing the vehicle because she was approaching a roundabout at the time the decedent opened the door, the record evidence establishes that the decedent opened the door to the vehicle when it was traveling between 30 and 40 miles per hour. There is no evidence that the decedent asked Loughin to stop the vehicle before he opened the door, and the decedent never indicated whether he fell out of the vehicle or whether he jumped out of the vehicle. Additionally, there is no indication that the decedent made an effort to forestall the injuries attendant to falling or jumping from a moving vehicle by, for instance, tucking and rolling. Cf. Bronson Methodist Hosp, 198 Mich App at 630 (finding no intent to cause injury where the individual attempted to prevent the harm in question). Drawing all reasonable inferences in defendant’s favor, we conclude that reasonable minds could infer that, in the midst of a disagreement, the decedent became upset and leapt from a moving vehicle in order to cause himself injury. Consequently, material questions of fact remain.

We acknowledge that plaintiffs argue to the contrary on appeal. In doing so, however, they highlight evidence that is positive to their claims and invite this Court to impermissibly draw all inferences in their favor. See Myers, 304 Mich App at 641. For example, plaintiffs note that the decedent did not verbally express an intent to injure himself, that the decedent did not have a history of mental health issues or suicidal ideation, and that the decedent’s death certificate classified the decedent’s death as an accident. Plaintiffs also cite the affidavit of Dr. William J. Sanders, which supports that the decedent did not intend to injure himself. Instead, Dr. Sanders opined that, if the decedent opened the door to the vehicle, he did so ‘because of an impulsive act that was committed in the heat of a very passionate interaction with Ms. Loughin.’

Certainly, these are facts and circumstances bearing on the decedent’s intent which may be considered by the trier of fact when resolving the question of the decedent’s subjective intent.2 However, we cannot disregard defendant’s evidence or resolve factual disputes. See White, 275 Mich App at 625. Instead, considering all the evidence presented by the parties, MCR 2.116(G)(5), and viewing this evidence in a light most favorable to defendant, we conclude that material questions of fact remain regarding whether the decedent intentionally exited the moving vehicle and, if so, whether he did so with the intent to injure himself.”


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