Mich. Panel Says Progressive’s Wording Expands PIP Benefits
Mich. Panel Says Progressive’s Wording Expands PIP Benefits
Written By: Emily Enfinger
Re-posted from Law360 (April 28, 2023, 7:53 PM EDT) — A Progressive no-fault policy that is the focus of a vehicle crash coverage dispute can provide broader personal injury protection benefits than required by state law because of its use of the word “residence” over “domicile,” a Michigan appeals court said.
In an opinion Thursday, the panel affirmed a trial court’s determination that a no-fault insurance policy may “by its terms” provide broader coverage than that required by the Michigan No-Fault Act, such as the one in this case. However, an issue of material fact remains on whether the woman who initiated the coverage fight is eligible for personal injury protection benefits under the policy.
“Progressive’s use of the word ‘residing’ in its policy, rather than the statutory term ‘domiciled,’ on its face provides broader coverage than does the statute,” the panel said.
The case was remanded to a trial court for further proceedings.
The coverage dispute stems from a vehicle accident that occurred in July 2019 involving a 2016 Impala co-owned by Delisa Mapp and her ex-husband, Michael Mapp.
According to the opinion, Delisa Mapp sought personal injury protection, or PIP, benefits under Michael Mapp’s Progressive Insurance Co. policy after the crash. The policy listed Delisa and Michael Mapp and their daughter, DeAndrea, as drivers and resident relatives, but it listed only Michael Mapp and DeAndrea as named insureds.
Although having divorced in 2009, Delisa and Michael Mapp continued to live together at a home in Detroit. DeAndrea also lived with them until 2017, when she married and moved into an apartment with her husband, but would still regularly stay at her parents’ home, considering it “a second place.”
Progressive denied coverage for Delisa Mapp, with the position that she was not a named insured or a resident relative of a named insured. She then applied for PIP benefits through the assigned claims plan, the panel said, which was assigned to Farm Bureau Mutual Insurance Co., eventually filing suit against Progressive and Farm Bureau.
The panel said the facts of the case show that the trial court was correct with its ruling that there is a genuine issue of material fact that Delisa Mapp and DeAndrea resided in the same household.
“If the facts bear that out to be the case, the policy provides coverage for the PIP benefits,” the panel said.
Farm Bureau has argued that coverage is triggered under the Progressive policy because Delisa is identified as a “resident relative” on the declarations page, among other reasons. The panel said Farm Bureau’s argument presents several challenges, one being that the trial court hadn’t addressed the argument.
“Even assuming that there may be merit to Farm Bureau’s argument, the trial court should be afforded the first opportunity to address it, including developing any additional facts or arguments that might support or oppose Farm Bureau’s theory of coverage,” the panel said.
Judges Kathleen A. Feeney, Michael J. Kelly and Brock A. Swartzle sat on the panel for the Michigan Court of Appeals.
Representatives for Progressive and Farm Bureau did not immediately respond to requests for comment. A representative for Delisa Mapp could not be reached for comment Friday.
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