Lansing General Hospital v. Gomez

Bronson, P.J.

(dissenting in part, concurring in part). I agree with the majority that this matter should be reversed and plaintiff’s cause of action reinstated. I also concur with the majority’s holding that Walden v Auto-Owners Ins Co, 105 Mich App 528; 307 NW2d 367 (1981), is applicable to this case. I disagree, however, with the majority’s resolution of the tolling issue.

There is currently a split of authority on this Court over the issue of whether the limitation period embodied in MCL 500.3145(1); MSA 24.13145(1) is tolled until the insurer formally denies benefits to the party seeking them. The two lead cases are Richards v American Fellowship Mutual Ins Co, 84 Mich App 629; 270 NW2d 670 (1978), lv den 406 Mich 862 (1979), holding that the limitations period is tolled, and Aldrich v Auto-Owners Ins Co, 106 Mich App 83; 307 NW2d 736 (1981), holding to the contrary.

While I am sympathetic to the majority’s desire to avoid a somewhat unpalatable result in this case, I agree with the Aldrich Court that the Richards decision undercuts the important policy of encouraging claimants to proceed on no-fault claims in a timely manner. I specifically rely on the following excerpt from Aldrich as expressing my opinion on this issue:

"The Richards panel held that the no-fault time bar is tolled from the date an insured gives notice of loss until the date of formal denial of liability by the insurance company. Under Richards, therefore, the permissible period of recovery runs, apparently, from one year prior to the commencement of the action only if there is no hiatus between the giving of notice of loss by the *829insured and the denial of liability by the insurance company. This seems to us contrary to the plain language of the statute and results in impermissible judicial legislation. We believe the statutory language is unambiguous and see no need for departing from the literal interpretation. See Becker v Detroit Savings Bank, 269 Mich 432, 436; 257 NW 853 (1934).
"In construing the statute to include a tolling provision the Richards Court stated:
" 'Thus, § 3145 must be construed in accordance with the Legislature’s purpose in enacting no-fault insurance, i.e., that persons injured in automobile accidents be promptly and adequately compensated for their losses arising out of the motor vehicle mishap. Shavers v Attorney General, 65 Mich App 355, 370; 237 NW2d 325 (1975), aff'd in part 402 Mich 554 (1977). See also MCL 500.3142(2); MSA 24.13142(2).
" 'If we were to accept defendant’s interpretation of the statutory provision, we would in effect be penalizing the insured for the time the insurance company used to assess its liability. To bar the claimant from judicial enforcement of his insurance contract rights because the insurance company has unduly delayed in denying its liability would run counter to the Legislature’s intent to provide the insured with prompt and adequate compensation.’ 84 Mich App 629, 634.
"If one of the purposes behind the quoted provision of the act is to encourage claimants to commence their actions in a timely fashion, cf. Davis v Farmers Ins Group Cos, 86 Mich App 45; 272 NW2d 334 (1978), it should not encourage procrastination by either party by undercutting such policy. The insured is not barred from seeking judicial enforcement of his claim and we have heard no argument in favor of a declaration of public policy to the effect that resort to the courts is an unacceptable or undesirable alternative.” Id., 86-87.

This is the second time I’ve been directly confronted with the question of whether Richards or Aldrich represents the more persuasive statutory construction, and I continue to adhere to the posi*830tion I took in English v Home Ins Co, 112 Mich App 468; 316 NW2d 463 (1982).1

Despite the foregoing, I would allow plaintiff to attempt to establish its claim of equitable estoppel against defendant insurance company (hereinafter defendant). To establish an equitable estoppel, plaintiff must show that defendant, by words, conduct or inaction, induced plaintiff to believe a certain factual situation existed and that plaintiff justifiably relied on defendant’s words, conduct or inaction to its detriment. Starboard Tack Corp v Meister, 103 Mich App 557, 564; 303 NW2d 38 (1981), and cases cited therein. Plaintiff asserts that its agents were led to believe by defendant that it would pay plaintiff’s claim if a request for payment was submitted by John Backus and Eugene Gomez, the injured persons. Plaintiff further contends that it justifiably relied on numerous representations made by defendant that the claim would be paid if a proper application for benefits was filed. Plaintiff finálly states that it reasonably relied upon defendant’s representations and accordingly refrained from instituting legal proceedings. Although defendant’s scenario of events is somewhat different, accelerated judgment should not have been granted in defendant’s favor since a material factual dispute remains to be resolved.2

Plaintiff also asserts that defendant waived the *831statute of limitations defense, relying on Better Valu Homes, Inc v Preferred Mutual Ins Co, 60 Mich App 315, 318; 230 NW2d 412 (1975). There, this Court held that, where an insurer engages in negotiations or dilatory tactics to induce the insured to forego suit until after the limitations period has expired, the limitations defense will be deemed waived. Upon review of the facts of Better Valu Homes and the authorities cited therein, I am convinced that a question of fact remains relative to this issue as well.3

Defendant argues that allowing either an estoppel or waiver claim to be presented in this case constitutes the essential destruction of the no-fault act’s limitations period. This is a view with which I cannot agree. An insurer can virtually eliminate any waiver or estoppel argument on facts such as are presented here simply by providing oral or written notice to the party claiming benefits that it intends to assert the statute of limitations defense if it becomes legally viable and that any requests for further information, negotiations, or investigation is not to be deemed a waiver of the right to assert the statute of limitations defense.4

*832I concur in reversal in this case, but not on the grounds advanced by the majority.

In Walden, supra, the majority opinion, in which I concurred, cites Richards. This citation, however, was not for the proposition that Richards correctly resolved the statute of limitations issue posed here. In Wolar v State Farm Mutual Automobile Ins Co, 111 Mich App 152; 314 NW2d 460 (1981), I concurred in an opinion which, although applying Aldrich, left open the possibility that, in cases with "factual patterns akin to Richards”, I might decline to follow the rule of Aldrich. I now expressly disavow any intention of following the rationale of Richards in any case. I do believe, however, that the result reached in Richards may well have been possible on grounds which I personally would find persuasive.

The lower court’s reason for rejecting the equitable estoppel argument is that plaintiff still had five months within which to file suit after defendant denied liability and to be in compliance with *831MCL 500.3145(1); MSA 24.13145(1). The circuit court’s decision, however, is premised on the applicability of Richards and no effective notice of claim being provided by plaintiff to the insurer until December 31, 1977. I reject both premises of the lower court’s syllogism. As such, I also reject the circuit court’s conclusion. I would allow defendant to argue to the jury, however, that the five-month delay from the denial of the claim to the commencement of suit was unreasonable so that the real cause of plaintiff’s detriment was its own procrastination.

In this case, there is little difference between the estoppel and waiver arguments. Both theories are supported by plaintiff’s agent’s declarations that defendant’s agents continually represented that the claim would be paid if Gomez and Backus filed appropriate applications.

Obviously written notice would provide an insurer with more protection than oral notice. Where the declaration is not reduced to writing, faulty memory, neglect in actually stating that the statute of limitations defense will be asserted if possible, and outright prevarica*832tion enter the picture and leave open the continuing possibility of genuine issues of material fact not being eliminated.