Grimmett v. Encompass Indemnity Company et al
ORDER DENYING 70 WITHOUT PREJUDICE DEFENDANT'S AMENDED MOTION FOR SUMMARY JUDGMENT. Signed by District Judge Avern Cohn. (Attachments: # 1 Exhibit A) (MVer)
UNITED STATES DISTRICT COURT
EASTERN DISTRICT OF MICHIGAN
SOUTHEAST MICHIGAN SURGICAL
HOSPITAL, LLC, OAKLAND MRI, LLC, and
MICHIGAN AMBULATORY SURGICAL
Case No. 14-14646
ENCOMPASS INDEMNITY COMPANY,
HON. AVERN COHN
ORDER DENYING WITHOUT PREJUDICE DEFENDANT’S AMENDED MOTION FOR
SUMMARY JUDGMENT, (Doc. 70)
This is a no-fault benefits case. Plaintiffs include the driver—the insured—and
medical providers. The accident took place on March 4, 2013. The claim consists of:
medical services and expenses,
attendant care, and
Exhibit A reflects the chronology of the accident and medical services and
expenses. There is in the record no documentation of replacement services, work loss
or attendant care.
Defendant insurance company denies liability on several grounds including lack
of causation, lack of documentation and fraud.
On May 26, 2015, plaintiff was videod engaged in activities which may challenge
any claim she suffered from a physical condition that disabled her. A claim for benefits
that is legitimate at its inception may lose its legitimacy at some point. The evidence as
to fraudulent conduct vitiating the legitimacy of plaintiff’s claim is ambiguous. If there is
evidence of fraud, the date that the claim changed from a legitimate right to benefits to a
fraudulent claim of benefits is uncertain.
The record is long and complex, including contradictory medical opinions and
representations of the parties as to documentary support for the claims made by plaintiff
and third-party medical providers.
The Court cannot say there is no genuine issue of material fact over various
items of damages or the condition of plaintiff on various dates forward from the
accident. Accordingly, the record is not ripe for summary judgment in defendant’s favor
as to any particular item of insurable damages suffered by plaintiff or any third-party
UNITED STATES DISTRICT JUDGE
Dated: April 28, 2017
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