posted on June 05, 2020 by Willingham & Cote
by Dave Nelson, Insurance Law
You finally step out of the house and get into your car for a short trip to the grocery store. You have done your best to stay inside to avoid coming into contact with anyone infected by COVID-19, but you need groceries to make it through the week. As you are heading through the intersection, out of the corner of your eye you catch a glimpse of a black truck barreling at you. You try to avoid the collision but the truck catches you on the driver side and your vehicle spins through the intersection coming to rest at the curb. Glass is littering your lap like unwanted confetti. You realize you can’t move. It’s a blur. You are whisked away in an ambulance.
You awake in a hospital bed and are told you have a left femur fracture which will require surgery and you will likely be in the hospital for a few days. You undergo surgery and three days later you are finally being discharged. As the doctor is getting the discharge paperwork ready you start to feel fatigued. You ask for more blankets because you suddenly feel an immense chill come over your body. A nurse comes to check on you and asks if you are alright and you tell her that you feel tired and have chills. A concerned look washes over her face. She takes your temperature and you have a fever of 102 degrees. You are tested and are ultimately diagnosed with COVID-19. You remain hospitalized to treat the COVID-19 and after a lengthy hospital stay, you are discharged.
As a result of your hospital stay, you receive a hefty bill for your COVID-19 related treatment, which had you been discharged earlier would have been significantly less. Do you have any recourse? Can you have your auto carrier pay for this additional expense? After all you were only in the hospital because of the accident and if you had not been in the hospital you likely would not have contracted this virus.
The Michigan no-fault insurance act, MCL 500.3101 et seq., allows individuals to submit a claim for personal protection insurance benefits (also known as PIP benefits) when injured in a car accident. There are several types of no-fault benefits available provided that all of the legal requirements are met. No-fault benefits include payment of accident related medical expenses, replacement services (reimbursement for household chores needed as a result of the car accident) and attendant care (reimbursement for extraordinary care necessary because of the car accident, such as nursing care or wound care, etc).
In order to recover no-fault benefits the medical treatment must be reasonably necessary “for” the injured person’s care, recovery or rehabilitation and the injury or condition must have arisen from the use of a motor vehicle as a motor vehicle, i.e. for transportation.
The Michigan Supreme Court has determined injuries which are only “but for” related to the car accident do not meet this requirement. There must be more than a coincidental relationship to the car accident. The Supreme Court has also concluded that an event that occurs after the car accident, but which is unrelated to the use of a motor vehicle, breaks the “arising out of chain” and is not sufficient to give rise to a claim for no-fault benefits.
Prior case law is useful to shed light on this issue. For instance the Court of Appeals determined a claimant who underwent chiropractic treatment as a result of a car accident but then suffered a vertebral artery tear because of inappropriate chiropractic treatment was not entitled to no-fault benefits from his or her auto insurance company for the expenses arising from the vertebral tear.
Similarly, the court in another case determined a claimant who suffered a complication from a contaminated epidural steroid injection in the lower back while seeking treatment as a result of a car accident, also was not entitled to no-fault benefits from his auto carrier for the complications relating to the contaminated injection.
Likewise, in a different case, the court held a claimant who suffered an injury after a fall, even though a prior car accident caused a gait disturbance, was not entitled to seek reimbursement from his auto carrier for the fall related injuries.
The courts have been clear that all of those injuries were too remote in time and had too much of a tenuous relationship to the original injuries suffered in the car accident to be compensable under the no-fault act. Based on those cases it is likely that the courts will follow precedent and will hold that contracting COVID-19 because of a hospital stay following an automobile accident would be too remote, incidental and fortuitous to be considered automobile related treatment.
The moral of the story is that just because you suffer an injury or complication after a motor vehicle accident does not mean that injury or complication is related to the accident such that you have a claim against your insurance company. You should consult with your medical professionals to help you understand your injuries and if they are related to the car accident before making any claims against your no-fault carrier.
David Nelson is an attorney and shareholder at Willingham & Cote’, P.C. in East Lansing, Michigan. He specializes in the areas of no-fault litigation, insurance defense and defending third party litigation. Mr. Nelson may be reached at 517-324-1066 or email@example.com.