Chris Kallco v. Melissa Lynn Pugh ( 2024 )


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  •              If this opinion indicates that it is “FOR PUBLICATION,” it is subject to
    revision until final publication in the Michigan Appeals Reports.
    STATE OF MICHIGAN
    COURT OF APPEALS
    CHRIS KALLCO,                                                          UNPUBLISHED
    October 30, 2024
    Plaintiff-Appellant,                                    9:35 AM
    v                                                                      No. 368156
    Oakland Circuit Court
    MELISSA LYNN PUGH,                                                     LC No. 2022-192285-NI
    Defendant-Appellee.
    CHRIS KALLCO,
    Plaintiff-Appellant,
    and
    PRECISE MRI OF MICHIGAN, LLC,
    Intervening Plaintiff,
    v                                                                      No. 368157
    Oakland Circuit Court
    CITIZENS INSURANCE COMPANY OF THE                                      LC No. 2022-193406-NF
    MIDWEST and MELISSA LYNN PUGH,
    Defendants-Appellees.
    Before: MURRAY, P.J., and BORRELLO and MARIANI, JJ.
    PER CURIAM.
    In this consolidated first-party and third-party no-fault action, plaintiff appeals as of right
    from two orders granting summary disposition under MCR 2.116(C)(10) in favor of defendants.
    In Docket No. 368156, plaintiff appeals the trial court’s order granting summary disposition on
    plaintiff’s automobile negligence claim in favor of defendant Melissa Pugh. And in Docket No.
    -1-
    368157, plaintiff appeals the trial court’s order granting summary disposition on plaintiff’s
    personal protection insurance (PIP) benefits claim in favor of defendant Citizens Insurance
    Company of the Midwest (Citizens). We affirm.
    I. FACTUAL BACKGROUND
    This case arises out of a motor vehicle accident that occurred on March 9, 2020 involving
    plaintiff and Pugh. Plaintiff alleges that he sustained injuries from the accident. Plaintiff’s claim
    for PIP benefits was assigned to Citizens by the Michigan Automobile Insurance Placement
    Facility (MAIPF), pursuant to the Michigan Assigned Claims Plan (MACP). A year after the
    accident, plaintiff brought a negligence claim against Pugh, alleging that, because of Pugh’s
    negligence, plaintiff sustained “severe permanent and progressive personal injuries and serious
    impairment of a body function, including but not necessarily limited to: Head, Neck, Back,
    Shoulders . . . .” Plaintiff also brought a claim against Citizens for PIP benefits, including medical
    expenses, work loss, and replacement services.
    Pugh moved for summary disposition under MCR 2.116(C)(10), arguing that plaintiff
    could not meet his burden of showing that he sustained a threshold injury under the no-fault act,
    MCL 500.3101 et seq., and, therefore, he could not maintain his negligence claim against her.
    Pugh attached to her motion, in pertinent part, plaintiff’s deposition transcript, a selection of
    medical records, and a private detective’s surveillance report. In the relevant parts of his
    deposition, plaintiff testified that his last job was working as a mechanic at Ethan’s Auto Repair,
    but that he had been unemployed since December 2019. Plaintiff testified that he was physically
    unable to work as a mechanic after the accident because he was not able to grip power tools like
    he used to before the accident or apply the same level of force to them. He also testified about his
    recreational activities before and after the accident. According to plaintiff, both before and after
    the accident, he spent a lot of time playing with his kids and taking them to do activities, but since
    the accident, he has been unable to do things like carry his children or go with them to amusement
    parks because these kinds of activities would cause him pain, cramps, and muscle spasms. Plaintiff
    testified that he used to ride a bicycle before the accident but that he was unable to do so after the
    accident because it would give him cramps and because he was worried about maintaining his
    balance on the bike.
    The medical records that Pugh attached to her motion included the emergency room records
    from the date of the accident, which indicate that plaintiff complained of neck pain and underwent
    an x-ray of his cervical spine, which appeared normal. Pugh also attached medical records from a
    family practice where plaintiff was seen four times between June 2020 and August 2020, which
    indicate that plaintiff complained of neck pain from whiplash. Plaintiff returned to the same treater
    seven months later, in March 2021, to discuss a physical therapy referral. Pugh also included
    records from an independent medical examination (IME) conducted by Dr. James Bragman on
    December 27, 2021. Dr. Bragman observed that plaintiff was “very uncooperative with the entire
    exam” and at times “was totally non-compliant.” Dr. Bragman further observed that plaintiff had
    “near full range of motion” in his neck and that he was “eminently capable” of standing and
    touching his toes despite his refusal to do so. Dr. Bragman noted that plaintiff had “very little”
    medical treatment documented in his records and that he had been undergoing physical therapy for
    six months with no medical basis for doing so. He also noted that plaintiff had refused epidural
    injections which might have alleviated the alleged pain and that, as a result, he would be considered
    -2-
    at maximum medical improvement. Pugh also attached to her motion a private detective’s
    surveillance report. The report includes pictures of plaintiff walking, riding a child’s bicycle,
    squatting, bending over, lifting a bicycle out of a minivan unassisted, playing with a dog, driving
    a car, and twisting his neck.
    Shortly after Pugh filed her motion, Citizens filed its own motion for summary disposition
    under MCR 2.116(C)(10). Citizens argued that plaintiff made material misrepresentations to
    Citizens regarding the extent of his injuries, which rendered him ineligible for benefits under the
    MACP. Like Pugh, Citizens attached plaintiff’s deposition transcript, the surveillance
    investigation report, and medical records to its motion.
    Plaintiff failed to respond to either motion for summary disposition. The trial court waived
    oral argument and decided both motions in favor of defendants. In granting Pugh’s motion, the
    trial court found that, “while a factual dispute may exist concerning the nature and extent of
    Plaintiff’s injuries, the dispute is not material to the determination whether Plaintiff has suffered a
    serious impairment of body function” and thus the determination presented a question of law for
    the trial court to decide. The trial court found that, based upon the evidence presented, plaintiff
    failed to establish that he sustained a serious impairment of body function and therefore summary
    disposition in favor of Pugh was appropriate.
    With regard to Citizens’ motion, the trial court found “that absolutely no genuine issue of
    material fact exists as to whether Plaintiff knowingly made numerous materially false statements
    in his claims for [PIP] benefits relative to his alleged injuries and physical restrictions” arising out
    of the car accident. The trial court reasoned that, “by failing to respond to the subject dispositive
    motion, Plaintiff makes no attempt to deny and/or otherwise refute the evidence presented by
    Defendant Citizens regarding said material false statements,” thereby compelling summary
    disposition in favor of Citizens.
    Plaintiff moved for reconsideration of both orders. With regard to Pugh’s motion, plaintiff
    argued that his deposition testimony, which Pugh attached to her motion, was sufficient to create
    a genuine issue of material fact as to whether plaintiff suffered a serious impairment of body
    function. Regarding Citizens’ motion, plaintiff argued that Michigan law no longer recognized an
    insurer’s defense of fraud on the basis of statements made after claim denial, that surveillance
    observations could not prove insurance fraud as a matter of law, and that inconsistencies in the
    medical records could not prove fraud as a matter of law and could only create a question of fact.
    The trial court denied both motions for reconsideration. This appeal followed.
    II. STANDARD OF REVIEW
    We review de novo a trial court’s decision on a motion for summary disposition. Kandil-
    Elsayed v F & E Oil, Inc, 
    512 Mich 95
    , 109; 1 NW3d 44 (2023). Summary disposition under
    MCR 2.116(C)(10) is warranted when, “[e]xcept as to the amount of damages, there is no genuine
    issue as to any material fact, and the moving party is entitled to judgment or partial judgment as a
    matter of law.” MCR 2.116(C)(10). When moving under MCR 2.116(C)(10), the moving party
    has the initial burden to identify “the issues as to which the moving party believes there is no
    genuine issue as to any material fact.” MCR 2.116(G)(4); see also Lowrey v LMPS & LMPJ, Inc,
    
    500 Mich 1
    , 8-9; 
    890 NW2d 344
     (2016). If the moving party properly asserts and supports their
    -3-
    motion for summary disposition, the “burden then shifts to the opposing party to establish that a
    genuine issue of disputed fact exists,” and they cannot do this by relying on mere allegations or
    denials in their pleadings. Quinto v Cross & Peters Co, 
    451 Mich 358
    , 362; 
    547 NW2d 314
     (1996).
    If the party opposing summary disposition “fails to present any evidence, the motion is properly
    granted because no genuine issue of material fact exists.” Cleveland v Hath, ___ Mich App ___,
    ___; ___ NW3d ___ (2024) (Docket No. 363321); slip op at 5 (quotation marks and citation
    omitted). “Indeed, that must be the outcome unless the moving party’s motion fails to present a
    credible argument or itself presents evidence that creates a question of fact, such as inconsistent
    testimony about a central fact in the case.” 
    Id.
    In considering a motion for summary disposition, the court need only consider the evidence
    identified by the parties. See Barnard Mfg Co, Inc v Gates Performance Engineering, Inc, 
    285 Mich App 362
    , 377; 
    775 NW2d 618
     (2009). The court must consider the evidence submitted in
    the light most favorable to the nonmoving party, MCR 2.116(G)(5), and must draw all reasonable
    inferences in favor of the nonmoving party, Dextrom v Wexford Co, 
    287 Mich App 406
    , 415-416;
    
    789 NW2d 211
     (2010). The trial court may not make findings of fact or weigh credibility in
    deciding a motion for summary disposition. Patrick v Turkelson, 
    322 Mich App 595
    , 605; 
    913 NW2d 369
     (2018). “[I]f the evidence before it is conflicting, summary disposition is improper.”
    Lysogorski v Bridgeport Charter Twp, 
    256 Mich App 297
    , 299; 
    662 NW2d 108
     (2003). Appellate
    review of a summary disposition ruling is limited to the evidence presented to the trial court at the
    time the motion was decided. Innovative Adult Foster Care, Inc v Ragin, 
    285 Mich App 466
    , 475-
    476; 
    776 NW2d 398
     (2009).
    III. THRESHOLD INJURY
    Plaintiff argues that the trial court erred by granting summary disposition in favor of Pugh
    because genuine issues of material fact exist as to whether plaintiff suffered a serious impairment
    of body function. We disagree.
    Under MCL 500.3135, the threshold question of whether the person has suffered a serious
    impairment of body function should be determined by the court as a matter of law as long as there
    is no factual dispute regarding “the nature and extent of the person’s injuries” that is material to
    determining whether the threshold standards are met.1 McCormick v Carrier, 
    487 Mich 180
    , 193;
    1
    MCL 500.3135(2)(a) provides, in pertinent part:
    (a) The issues of whether the injured person has suffered serious impairment of
    body function or permanent serious disfigurement are questions of law for the
    court if the court finds either of the following:
    (i) There is no factual dispute concerning the nature and extent of the
    person’s injuries.
    -4-
    
    795 NW2d 517
     (2010), quoting MCL 500.3135(2)(a). If there is no factual dispute over the nature
    and extent of the plaintiff’s injuries, or if the dispute is not material to determining whether the
    plaintiff suffered a serious impairment of body function, the court should next determine whether
    the serious-impairment threshold has been crossed. 
    Id. at 215
    .
    Plaintiff argues that the trial court erred by finding that, under MCL 500.3135(2)(a)(ii), the
    court could decide as a matter of law whether plaintiff met the serious-impairment threshold
    because the factual dispute over the nature and extent of his injuries is “clearly” material to the
    determination of whether he met that threshold. But plaintiff fails to explain how the alleged
    dispute is material and, as set forth below, we see no error in the trial court’s assessment.
    Plaintiff also argues that the trial court erred by finding that there was no genuine issue of
    material fact regarding whether plaintiff met the serious-impairment threshold. But plaintiff’s
    failure to respond to the motion for summary disposition makes it difficult for him to support his
    argument. Summary disposition is properly granted where, like here, the nonmoving party fails to
    present any evidence that a genuine issue of material fact exists. Cleveland, ___ Mich App at ___;
    slip op at 5. Indeed, summary disposition in favor of Pugh “must be the outcome” unless Pugh’s
    motion failed to present a credible argument or itself presented evidence that creates a question of
    fact. 
    Id.
    Plaintiff argues that Pugh failed to present a credible argument in favor of summary
    disposition and therefore plaintiff had no duty to respond to the motion. We see no merit in this
    argument. Pugh’s motion made arguments explaining why there was no genuine factual dispute
    as to specific issues and the motion was supported by ample documentary evidence. Cf. Meyer v
    City of Center Line, 
    242 Mich App 560
    , 575; 
    619 NW2d 182
     (2000) (finding that the defendant
    did not properly present its motion for summary disposition under MCR 2.116(C)(10) where the
    defendant failed to identify specific issues for which no question of fact existed and failed to
    provide adequate documentary evidence). Accordingly, plaintiff was obligated to respond to
    Pugh’s motion in order to meet his burden of demonstrating that a fact question existed as to
    whether he suffered a serious impairment of body function.
    Plaintiff also argues that the evidence provided by Pugh in support of her motion itself
    demonstrates that a question of fact exists as to whether plaintiff suffered a serious impairment of
    body function. To establish a serious impairment of body function, there must be: “(1) an
    objectively manifested impairment (observable or perceivable from actual symptoms or
    conditions) (2) of an important body function (a body function of value, significance, or
    consequence to the injured person) that (3) affects the person’s general ability to lead his or her
    normal life (influences some of the plaintiff’s capacity to live in his or her normal manner of
    living).” McCormick, 
    487 Mich at 215
    . For each of these prongs, plaintiff points to his full
    (ii) There is a factual dispute concerning the nature and extent of the
    person’s injuries, but the dispute is not material to the determination
    whether the person has suffered a serious impairment of body function or
    permanent serious disfigurement. . . .
    -5-
    deposition testimony, attached to Pugh’s motion, and argues that it demonstrates the existence of
    a factual dispute.
    Plaintiff’s arguments, however, are compromised by his failure to respond to Pugh’s
    motion. The party opposing summary disposition has the burden of establishing that there is a
    genuine issue for trial. Barnard, 285 Mich App at 377. Thus, the court is not required to scour
    the record for evidence in support of a party’s argument, but instead need only consider the
    evidence specifically identified by the parties. Id. In determining whether the evidence attached
    to Pugh’s motion itself demonstrated a genuine issue of material fact, the trial court was only
    required to consider the parts of plaintiff’s deposition testimony specifically identified by Pugh,
    not the entire deposition transcript. This Court’s review is commensurate. See Bronson Methodist
    Hosp v AutoOwners Ins Co, 
    295 Mich App 431
    , 440; 
    814 NW2d 670
     (2012) (“We review de novo
    a trial court’s decision on a motion for summary disposition, reviewing the record in the same
    manner as must the trial court to determine whether the movant was entitled to judgment as a
    matter of law.”).
    The parts of plaintiff’s deposition identified by Pugh do not establish a genuine issue of
    material fact as to whether he suffered a serious impairment of body function. Under the first
    prong of the analysis, for instance, plaintiff must establish that he suffered an objectively
    manifested impairment of body function. McCormick, 
    487 Mich at 195
    . The “objectively
    manifested” requirement means that plaintiffs must “introduce evidence establishing that there is
    a physical basis for their subjective complaints of pain and suffering.” 
    Id. at 198
    . This generally
    requires medical testimony. 
    Id.
     Pugh presented objective medical records indicating that there
    was no physical basis for plaintiff’s subjective complaints of pain. The relevant portions of
    plaintiff’s deposition testimony fail to rebut this evidence and instead set forth, at best, mere
    subjective complaints of pain.
    Because, on the record that was properly presented to the trial court, plaintiff cannot show
    a factual dispute as to whether he suffered an objectively manifested impairment, he fails to satisfy
    the threshold serious-impairment requirement. Accordingly, the trial court did not err by granting
    summary disposition in favor of Pugh.
    IV. FRAUDULENT INSURANCE ACT
    Plaintiff also appeals the trial court’s grant of summary disposition in favor of Citizens on
    plaintiff’s claim for PIP benefits. Citizens moved for summary disposition under MCR
    2.116(C)(10) on the basis that plaintiff committed a fraudulent insurance act, which precluded him
    from recovering PIP benefits. MCL 500.3173a(4) states:
    A person who presents or causes to be presented an oral or written statement,
    including computer-generated information, as part of or in support of a claim to the
    [MAIPF], or to an insurer to which the claim is assigned under the [MACP], for
    payment or another benefit knowing that the statement contains false information
    concerning a fact or thing material to the claim commits a fraudulent insurance act
    under [MCL 500.4503] that is subject to the penalties imposed under [MCL
    500.4511]. A claim that contains or is supported by a fraudulent insurance act as
    -6-
    described in this subsection is ineligible for payment of [PIP] benefits under the
    [MACP].
    As this Court has explained, an individual commits a “fraudulent insurance act” under
    MCL 500.3173a when:
    (1) the person presents or causes to be presented an oral or written statement, (2)
    the statement is part of or in support of a claim for no-fault benefits, and (3) the
    claim for benefits was submitted to the MAIPF. Further, (4) the person must have
    known that the statement contained false information, and (5) the statement
    concerned a fact or thing material to the claim. [Candler v Farm Bureau Mut Ins
    Co of Mich, 
    321 Mich App 772
    , 779-780; 
    910 NW2d 666
     (2017).]
    Plaintiff’s arguments as to Citizens’ motion for summary disposition largely mirror his
    arguments as to Pugh’s motion. Our analysis on appeal is also similar. Because plaintiff failed to
    respond to Citizens’ motion, summary disposition in favor of Citizens was proper unless plaintiff
    can show that Citizens failed to present a credible argument or that the evidence relied on by
    Citizens itself demonstrates the existence of a genuine issue of material fact. Cleveland, ___ Mich
    App at ___; slip op at 5.
    We see no merit in plaintiff’s argument that Citizens failed to present a credible argument
    such that plaintiff was not required to respond to the motion for summary disposition in order to
    survive it. Like Pugh, Citizens made arguments in its motion explaining why there was no genuine
    factual dispute as to specific issues and the arguments were supported by ample documentary
    evidence. See Meyer, 
    242 Mich App at 575
    .
    Nor do we see any merit in plaintiff’s argument that the evidence submitted by Citizens in
    support of its motion itself demonstrates a genuine issue of material fact as to whether plaintiff
    committed a fraudulent insurance act. Plaintiff, again, points to his deposition testimony in full,
    arguing that it contradicts Citizens’ assertion that he misrepresented his injuries or impairment.
    But plaintiff’s arguments, again, are compromised by his failure to respond to Citizens’ motion,
    and the parts of plaintiff’s deposition specifically identified by Citizens do not demonstrate the
    existence of genuine dispute over any material fact. See Barnard, 
    285 Mich App at 377
    . In its
    motion, Citizens pointed to, in pertinent part, plaintiff’s testimony in which he described having
    difficulty playing with his children and needing assistance with cutting his hair and bathing his
    back, which Citizens argued was false based on plaintiff’s medical records and the surveillance
    reports Citizens procured. None of the evidence identified by Citizens contradicts its assertion
    that plaintiff’s testimony was false, and plaintiff fails to show how any evidence relied on by
    Citizens demonstrates a genuine factual dispute.
    Citing Shelton v Auto-Owners Ins Co, 
    318 Mich App 648
    , 660; 
    899 NW2d 744
     (2017),
    plaintiff also argues that the trial court erred by granting summary disposition in favor of Citizens
    because observations made during surveillance of an injured person engaging in physical activities
    that appear to contradict the person’s claim of physical injury, on their own, “are not sufficient to
    establish any of the elements of fraud beyond a question of fact.” Because, however, plaintiff
    failed to respond to Citizens’ motion for summary disposition and instead raised this argument for
    the first time in his motion for reconsideration, this argument is not preserved for appeal, and we
    -7-
    decline to overlook that waiver here. See AAA Life Ins Co v Dep’t of Treasury, ___ Mich App
    ___, ___; ___ NW3d ___ (2024) (Docket No. 365613); slip op at 9. The same holds true for
    plaintiff’s argument that statements made after litigation has ensued cannot constitute fraudulent
    insurance acts, which was likewise raised for the first time in his motion for reconsideration.2
    As to both motions for summary disposition, plaintiff failed to show that any genuine issue
    of material facts exists. Accordingly, the trial court did not err by granting summary disposition
    in favor of defendants.
    Affirmed.
    /s/ Christopher M. Murray
    /s/ Stephen L. Borrello
    /s/ Philip P. Mariani
    2
    It also bears noting that plaintiff, in making this argument, relies on caselaw which was recently
    overruled by our Supreme Court in Williamson v AAA of Mich, ___ Mich ___, ___; ___ NW3d
    ___ (2024) (Docket No. 165131).
    -8-
    

Document Info

Docket Number: 368156

Filed Date: 10/30/2024

Precedential Status: Non-Precedential

Modified Date: 10/31/2024