### IN THE CO URT OF APPEALS OF TE NNE SS EE AT NASHVILL E Sep te m be r 10 , 20 07 Ses si on

DANIEL LEON FRAI RE E T A L 

### . v. TI TAN INSURANCE COMPANY E T A L


### .

Appeal f rom the Circ uit Court for Hickman County No. 04-5003C Je ff

rey Bivins, Jud ge

No. M2006- 02515-COA-R 3-CV - F iled Jun e 29, 2009

T h e i ssue on appea l is whether Titan I nsuranc e Company
, which issued a “no-f ault” automob i l e insurance policy to a Michig an resident, is entitle d to be reimburse d for “per sonal protec tion insurance benef

its” paid to its insureds for injuries sustained in a vehicular acc ident in Tenne ssee. After the i nsureds entered into a subst antial s ettlement agr eeme n t with the t ortfea sors in this civil action, which compensa ted them in addition to the benef its paid by Titan under the no-fa ult policy
, Titan intervene d seeking reimburse ment of the benef its it paid. Titan contende d that it was entitled, pursuant to Michig an’s No -F au lt I nsuranc e Act to reimburse ment of the benef its remitted. The insureds, relying on the “made whole doctrine,” contended they had not been made whole by the settlement with the tortfea sor; there fore
, Titan was not entitled to reimburse ment. The trial court held that the made whole doctrine applied and that the i n s u re d s h ad not been made whole by the settlement; theref

ore, Titan w as not entitled to reimburse ment in any amount. Under Michig an’s No-F ault I nsuranc e Act, specific ally Mich. Comp. L aws § 500.3116(2), (4), the rig ht of the no-fa ult insurer to reimburse ment of “ec onomic” benef its paid for the benef

it of its insureds is not depende nt upon whethe r its insureds have been made whole by a settlement with the tortfea sor. There fore
, Titan’s rig ht to reimburse ment of economic benef its pa id is not de pendent on whether its insureds

wer e “made whole.” According ly , the judg ment of the trial c ourt is reve rsed, a nd we r emand with instructions for the trial c ourt to determine the extent to which Titan is entitl ed to be r eimbursed.

Tenn. R. App . P . 3 Appeal as of Right; Judgme nt of th e Circ uit Court Reve rsed and Rem anded

F R A N K G. C L E M E N T , J R ., J ., delivere d the opinion of the court, in which P A T R I C I A J

. C O T T R E L L , P.J ., 1 M.S., and T O M E. G R A Y , S P

. J ., joined.

Marianna Wil liams, Dy ersbur g , Tenne ssee, f or the a ppellant, Titan I nsuranc e Company

.

Br ian Dunig an, Goodlettsville, Tenne ssee, for the appellee s, Daniel L eon Fr aire
, L uis Gabr iel L eon Fr aire and James M. Rios

.

T h i s c a s e c a m e o n f

o r o r a l a r g u m e n t o n S e p t e m b e r 1 0
, 2 0 0 7

. T h e r e s p o n s i b i l i t y t o a u t h o r t h e m a j o r i t y o p i n i o n 1

w a s r e

- a s s i g n e d t o t h e a u t h o r o f t h i s o p i n i o n o n J u n e 1
, 2 0 0 9

.OP INION

The plaintiffs, J ames Rios and Daniel Fr aire
, who are Michig an residents, wer e involved in

a serious vehicular acc ident that occur red in Hickma n C o unty , Tenne ssee on J uly 16, 2003. The

acc ident occur

red when a trac tor trailer truck owned and opera ted by MCH Transpor tation Company struck the plaintiffs’ vehicle. The plaintiffs sustained sever e injuries and perma nent impairment as
a re sult of the acc ident. 2

The vehicle in which the plaintiffs wer e riding was owned by plaintiff J ames Rios. Mr. Rios

was insured pursuant to an automobile insurance policy is s ued by the Titan I nsuranc e Company (“Titan” ). The Titan policy was issued in compliance with Michig an’s “no-f ault” insurance law beca use of Mr. Rios’ Michig an residenc y

. Pursuant to the no-fa ult insurance policy and Michig an’s No-F ault I nsuranc e Act, Mich. Comp. L aws § 500.3101 et seq., Titan paid benef its of approximately $328,000 to cover

the plaintiffs’ medic al expenses and r elated e x penses a ffor ded by the policy

. 3

On J uly 24, 2004, the pl aintiffs filed this action in the C ircu i t C o u rt fo r Hickman County
, Tenne ssee ag ainst MCH Transpor tation Company
, the owner an d o p era tor of the vehicle, and its employ ee who was driving the truck (her einaf ter collectively “MCH”)

. I n 2006, the plaintiffs settled their persona l injury claims ag ainst MCH for a total of $968,283.22, of which $484,141.61 was paid to Daniel L eon F raire and $484,141.61 wa s paid to J ames Rios. 4

As part of the settlement, the plaintiffs signe d full rele ases of all of their claims ag ainst MCH and its insurer. One of the provisions in the settlement ag ree ment was a provision that the plaintiffs

wer e solely responsi ble for satisfy ing any and all claims Titan may asser t for reimburse ment of medical e x penses a

nd other be nefits paid by Titan to or for the plaintiffs’ bene fit as a r esult of the

acc ident.

I mmediately following the execution of the settlement ag ree ment with the plaintiffs, MCH filed a Motion for I nterplea der in the circ uit court ac t ion in order to interplea d Titan, deposit the settlement proce ed s wi t h t h e cler k of the court, and enjoin Titan, medical providers and other possible claimants from prosec uting any action ag ainst MCH, and to dismiss MCH from the action. There afte r, Titan made a formal appea ranc e throug h its counsel and stated that it did not oppose the Motion for I nterplea der. The trial court then g rante d MCH’s motion in all respects. 5

A t h i r d i n d i v i d u a l
, L u i s G a b r i e l F r a i r e , w a s a l s o i n t h e v e h i c l e

. H e , t o o , w a s i n j u r e d b u t i s n o t a p a r t y i n t h i s 2

a p p e a l

. H e r e c e i v e d $ 2 4
, 8 2 7

. 7 8 i n s e t t l e m e n t o f h i s p e r s o n a l i n j u r y c l a i m

.

T i t a n r e m i t t e d b e n e f

i t s o f $ 1 5 5 , 9 6 3

. 4 7 o n b e h a l f o f M r

. R i o s a n d $ 1 6 2
, 4 9 6

. 0 5 o n b e h a l f o f M r

. F r a i r e

. 3

T h e t o t a l s e t t l e m e n t w a s f o r p o l i c y l i m i t s o f $ 1
, 0 0 0
, 0 0 0
, o f w h i c h $ 6
, 8 9 0 w a s p a i d t o J a m e s R i o s f o r p r o p e r t y 4

d a m a g e t o h i s v e h i c l e , $ 2 4
, 8 2 7

. 7 8 w a s p a i d t o L u i s G a b r i e l F r a i r e f o r h i s i n j u r i e s , a n d t h e b a l a n c e o f $ 9 6 8
, 2 8 3

. 2 2 w a s p a i d i n e q u a l a m o u n t s o f $ 4 8 4
, 1 4 1

. 6 1 t o t h e p l a i n t i f f s , D a n i e l F r a i r e a n d J a m e s R i o s

.

A s a c o n s e q u e n c e , M C H w a s d i s m i s s e d ; l e a v i n g o n l y t h e p l a i n t i f f s a n d T i t a n a s t h e p a r t i e s t o t h i s a c t i o n

. 5

-2-After Titan beca me a party to this action, the plaintiffs filed a Motion to deter mine the extent of Titan’s claim. The motion was ac co m panied by a memorandum of law in which the plaintiffs

asser ted th at T i tan was not entitled to reimburse ment beca use the plaintiffs had not been “made whole” by the settlement with MCH. Titan responde d to the motion insisting that the made whole doctrine did not apply under Michiga n law. The parties agr eed that Michig an law was applicable

as the automobile insurance policy was subject to Michig an law and the benef its wer e paid pursuant to Michiga

n’s no-fa ult insurance sta tute.

The t ri al court conducte d a hear ing on the motion to deter mine two issues: whether the insureds wer e fully compensa ted b y the settlement proce eds, and whether the “made whole” rule applies to Titan’s rig ht of reimburse ment under the Michig an No-F ault I nsuranc e Act. On October 26, 2006, the trial court issued its order finding that the “made whole” doctrine did apply under Michig an law, that the statutory rig ht to reimburse ment did not abrog ate this doctrine, and that the reimburse ment statute of Michig an must be rea d in conjunction with the made whole doctrine. The trial court then deter

mined, based upon the testimony of medical experts, medical rec ords, and

ex hibits reg arding the Appellee s’ injuries, that the amount of the settlement was not sufficie n t t o fully compensa te the plaintiffs for their serious injuries, and, therefor e, that Tit an wa s not entitled to reimburse ment. Titan then filed this appea l from the order g ranting the plaintiffs summary judgme nt on the issue of re imbursement.

S U M M A R Y J U D G M E N T
- Q U E S T I O N O F L A W
Summary judgme nts do not enjoy a presumption of corr ectne ss on appea l. BellSouth Adve r. & Publ’g Co. v. Johnson
, 100 S.W .3d 202, 205 (Tenn

. 2 003). This court must make a fre sh deter mination that the require ments of Tenn. R. Civ. P. 56 have been satisfied. Hunter v. Brown , 955 S.W .2d 49, 50-51 (Te nn. 1997).

No g enuine materia l fac tual disputes are prese nted. The issue prese nted hinge s on the proper interpre tation of a statute and the application of the law to the undisputed fac ts of this case

. I ssues involving the co n struction of statutes and their application to fac ts involve questions of law. Mem phis Publ’

g Co. v. Cheroke e Children & Family Servs., Inc ., 87 S.W .3d 67, 74 (Tenn. 2002); Gleave s v. Check

er Cab Transit Corp., Inc ., 15 S.W .3d 799, 802 (Tenn. 2000); W aller v. Bryan , 16 S.W .3d 770, 773 (Tenn. Ct. App. 1999). The standard of revie w for questions of law is the de novo st an d ar d

. Gl ea ves v. Check er Cab Transit Corp., Inc ., 15 S.W .3d 799, 802 (Tenn. 2000). The primary rule of statutory construction is “to asce rtain and g ive eff ect to the intention and purpose of the l eg islature.” Carson Creek V acation Resorts, Inc. v. Departme nt of Rev enue , 865 S.W .2d 1, 2 (Tenn. 1993); McG ee v. B es t , 106 S.W .3d 48, 64 (Tenn. Ct. App. 2002). Our duty is to seek a
rea sonable construction “in light of the purposes, objectives, and spirit of the statute based on g ood sound rea soning.” Scott v. Ashland Healthcare Center, I nc., 49 S.W .3d 281, 286 (Tenn. 2001), citing State v. Turner , 913 S.W .2d 158, 160 (Tenn. 1995). To deter mine leg islative intent, we must look to the natura l and ordinary meaning of the lang uag e in the stat u t e. W e m u s t als o examine any provision within the context of the entire statute and in light of its over- arc hing purpose and the g oals it serve s. State v. Flemming
, 19 S.W .3d 195, 197 (Tenn. 2000); T.R. Mills Contractors, Inc. v. W RH

-3-Enterprises, LLC
, 93 S.W .3d 861, 867 (Tenn. Ct. App. 2002). The statute should be rea d “without

any fo rc ed o r s u btle construction which would extend or limit its meaning .” National Gas Distributor

s, Inc. v . State , 804 S.W .2d 66, 67 (Tenn. 1991)

.

A N A L Y S I S

The dispositi ve issues in this appea l are controlled by Michig an law. The principal issue on 6
appea l is whether
, under Michig an law, the “made whole doctrine” bars the claim of reimburse ment by Titan I nsuranc e Company

.
The materia l and undisputed fac ts are that Mr. Rios was a Michig an resident when the Titan policy was issued, the policy was issued subject to Michig an’s No-F ault I nsuranc e Act, Mich. Comp. L aws § 500.3101 et seq., both plaintiffs wer e insureds under the Titan policy as they wer e occupa nts of the insured vehi cl e, T i t an paid persona l protec tion insurance benef its for the benef

it of both plaintiffs pursuant to the no-fa ult insurance policy
, benef its paid b y T i t an total approximately $328,000, and the plaintiffs rea ched a settlement with the t ortfea sor responsible for the plaintiffs’ injuries wher eby the plaintiffs are to be paid a t o t al of $968,283.22 in compensa tion for their persona l injuries and expenses.

M I C H I G A N ’ S N O -F A U L T I N S U R A N C E A C T

The Michig an No-F ault I nsuranc e Act, which beca me law on October 1, 1973, was “an innovative social and leg al response to the long pay ment delay s, inequitable pay ment structure , and high leg al costs inhere nt in the tort (or “fa ult”) liability sy stem.” Shavers v. Attorney Gene ral
, 267 N.W.2d 72, 77 (Mich. 1978). “The g oal o f M i chig an’s no-fa ult insurance sy stem was to provide victims of m otor vehicle acc idents assure d, adequa te, and prompt repar ation for certa in economic losses.” Id

. I n order to attain its g oal, the Michigan L eg islature cre ated a compulsory insurance sy stem, wher eby

ever y Michig an motorist was require d to pur chase no-fa ult insura nce; otherwise, t h e m o t orist was not permitted to opera te a motor vehicle in the state. Id

. Under this “no-fau l t ” sy stem, “the victims of motor vehicle acc idents would rec eive insura nce be nefits for the ir injuries

as a substitut e for their common- law remedy in tort .” Id . (empha sis added).

The leg islative intent of Michig an’s statutory scheme was clea r: to abolish the common law tort li ab i l i t y wi t h limit ed exceptions and repla ce it with the no-fa ult sy stem. See Shavers
, 267 N. W

. 2 d 77; see also Kreiner v. Fischer
, 683 N.W.2d 611(Mich. 2004); Michigan Educ. Emples. Mu t. Ins. Co. v. Morris , 596 N.W.2d 142 (Mich. 1999). Under Michig an’s no-fa ult sy stem, th e

A l l p a r t i e s a g r e e t h a t M i c h i g a n l a w a p p l i e s a s t h e i n s u r a n c e c o n t r a c t w a s e x e c u t e d i n t h e s t a t e o f M i c h i g a n , 6

M r

. R i o s i s a M i c h i g a n r e s i d e n t , a n d T i t a n i s a M i c h i g a n i n s u r a n c e c o m p a n y

. U n d e r T e n n e s s e e ’ s c o n f l i c t s o f l a w

a n a l y s i s , “ [ i ] n t h e a b s e n c e o f a n e n f o r c e a b l e c h o i c e o f l a w c l a u s e , T e n n e s s e e c o u r t s a p p l y t h e s u b s t a n t i v e l a w o f t h e s t a t e i n w h i c h t h e p o l i c y w a s i s s u e d a n d d e l i v e r e d

. ” S t a n d a r d F i r e I n s

. C o

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. C h e s t e r O ’ D o n l e y & A s s o c

. , 9 7 2 S

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.
-4-insured would promptly rec eive pay ments to cover t h e insured’s “ec onomic” expenses, which included medical expenses and lost wag es, with no reg ard to fault. See Mich. C o m p

. L aws § 500.3107.

Sect i o n 5 00.3116 of the Michig an Compil ed L aws sets forth the rig ht of the insurance company to reimburse ment of benef its paid to or for an insured following a rec overy by the insured:

(2) A subtraction from or reimburseme nt for personal protection insurance benefits paid or pay able under this chapte r shall be made only if re cove ry is re alized upon a tort claim arising from an accide nt occurring outside this state , a tort claim broug ht within this state ag ainst the owner or opera tor of a motor vehicle wi t h re s p ect to which the secur ity require d by section 3101(3) and (4) was not in eff ect , o r a tort claim broug ht within this state based on intentiona l l y cause d harm to persons or proper ty , a n d s h al l b e made only to the exte nt that the recov ery realized by the claimant is for damages for which the claimant has rece ived or would otherwise be enti t l ed to rece ive personal protection insurance benefits

. A subtraction shall be made only to the extent of the rec overy , exclusive of rea sonable attorney s’ fee s and other rea sonable expenses incurre d in effe cting the re cover y . I f per sonal protec tion insurance benef

its have alre ady been rec eived, the claimant shall repa y to the insurers out of the rec overy a sum equal to the benef i t s re ceived, but not more than the

rec overy exclusive of rea sonable attorney s’ fee s and ot h er re asonable expenses incurre d in eff

ecting the rec overy

. The insurer shall have a lien on the rec overy to this extent. A recover

y by an i n j ured person or his or her estate for l oss suffe red by the person shall not be subtracte d in calc ulating benef its due a depende nt afte r the death and a rec overy by a depende nt for loss suffe red by the depende nt afte r the death shall not be subtrac ted in calc ulating be nefits due the injure d person.

. . . . (4) A s u b t ra ct i o n or reimburseme nt shall not be due the claimant’s insurer from that portion of any recov ery to the exte nt that recov ery is realized for noneconom ic loss as provided in section 3135(1) and (2)( b) or for allowable expenses, work loss, and survivor’s loss as define d in sections 3107 to 3110 in excess of the amount

rec overe d by

the claimant f

rom his or her insure r.
Mich. Comp. L aws § 500.3116(2) , (4) ( emphasis adde d).

Prior to 1978, the Michig an courts found the initial ver sion of the Act “ambig uous.” Great Lakes American Life Insurance Co. v

. Citi zens Insurance Co.
, 479 N.W.2d 20, 23 (Mich. Ct. App. 1991) (stating the reimburse ment provision “wa s arg uably ambig uous reg arding the extent to which

an insurance car

rier could seek reimburse ment for pe rsonal prote ction insurance benef it pay ments from an insured’s third-par ty tort rec overy .”) The ambig uity “wa s unequivoca lly resolved by a 1978 amendment of

§ 3116.” Id . at 23. As the c ourt explained:

-5-I t is now clea r that an insurance carrier responsible for no-fault benefits may realize reimburseme nt from an insured’s third-par t y tort claim only in the follow ing situati ons: (

1) accide nts occurring outside the state , (2) actions against uninsured

owner s or opera tors, or (3) intentional torts. Auto Club Ins As s ’n

. v. Henley
, 130 Mich App 767, 770; 344 NW2d 363 (1983). Furthermore, reimburseme nt from the insured’s third-party tort action is prohibited for damages realized

for noneconom ic loss or [personal protection insurance] benefits in exc ess of the amounts defined in §§ 3107 to 3110.

Id . at 23-24 (e mphasis added)

.

Ba sed on the fore g oing explanation of the now unambig uous rig ht of reimburse ment under a Mi chig an no-fault ins u ra n ce policy
, we have concluded that the right to be reimbursed does not depend upon a deter

mination that the insured was “made whole.” Acc ording ly
, we reve rse the trial 7 court’s holding that the “made whole doctr ine” ba rs Titan’s c laim for re imbursement.

The fore g oing n o t wi t h s t anding, under Michig an law Titan is only entitled to rec over that portion of the plaintiffs’ rec overy that was for their economic loss, as distinguished from their noneconomic losses. See Great Lakes American Life Ins. Co.
, 479 N.W.2d at 23–24; see also Dunn v. Detroit Auto Inter-I

ns. Exc h.
, 657 N.W.2d 153, 158 (Mich. Ct. App. 2002). Be cause the plaintiffs’ settlement ag ree m en t with MCH did not cate g orize the plaintiffs’ losses as economic or noneconomic, under the Michig an statutory scheme
, the burden of proof is on Titan to prove the portion of the plaintiffs’ rec overy that was for economic loss. See Allstate I ns. Co. v

. Jewe ll
, 452 N.W.2d 8 896, 899 (Mich. Ct. App. 1990).

I n m a k i n g t h e i r a r g u m e n t t h a t t h e “ m a d e w h o l e ” d o c t r i n e a p p l i e s , t h e p l a i n t i f f s p r i n c i p a l l y r e l i e d o n t w o c a s e s : 7

W a s h t e n a w M u t u a l F i r e I n s u r a n c e C o

. v

. B u d d
, 1 7 5 N

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. 2 3 1 ( M i c h

. 1 9 1 9 )
, a n d U n i o n I n s

. S o c ’ y o f C a n t o n v

. C o n s o l

. I c e C o

. , 2 4 5 N

. W

. 5 6 3
, 5 6 4 ( M i c h

. 1 9 3 2 )

. W e h a v e d e t e r m i n e d t h a t t h e p l a i n t i f f s ’ r e l i a n c e o n t h e s e o p i n i o n s i s m i s p l a c e d b e c a u s e M i c h i g a n ’ s n o

- f a u l t s t a t u t o r y s c h e m e w a s a d o p t e d i n p e r t i n e n t p a r t a f t e r t h e s e c a s e s w e r e f

i l e d

. A c c o r d i n g l y , w e f i n d t h e c a s e s i n a p p l i c a b l e t o t h e i s s u e a t h a n d

. W e a l s o f i n d n o m e r i t t o t h e p l a i n t i f f s ’ a r g u m e n t t h a t t h e m a d e w h o l e d o c t r i n e w a s a p p l i e d “ a s r e c e n t l y ” a s 1 9 8 0 i n t h e c a s e o f M i c h i g a n M u t u a l I n s

. C o

. v

. S h a h e e n , 3 0 0 N

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. 2 d 5 9 9 ( M i c h

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. W h i l e t h e i n s u r e d i n S h a h e e n a r g u e d t h a t p u b l i c p o l i c y w o u l d r e q u i r e t h e “ t r u s t a g r e e m e n t b e i n t e r p r e t e d
t o e n t i t l e t h e i n s u r e r t o b e s u b r o g a t e d t o t h e p r o c e e d s o f a n y s e t t l e m e n t o n l y i f t h e i n j u r e d p a r t y h a s b e e n f u l l y

c o m p e n s a t e d f

o r h i s l o s s e s , ” t h e c o u r t n e v e r r e a c h e d t h e i s s u e o f w h e t h e r h e h a d b e e n f u l l y c o m p e n s a t e d o r w h e t h e r t h e r e

w a s d o u b l e r e c o v e r y

. I d

. a t 6 0 2

.

M i c h i g a n l a w p r o v i d e s t h a t t h e l a n g u a g e w i t h i n t h e s e t t l e m e n t a g r e e m e n t i s c o n c l u s i v e o n w h e t h e r t h e f u n d s 8

w i t h i n t h e s e t t l e m e n t w e r e f o r e c o n o m i c o r n o n

- e c o n o m i c d a m a g e s , a n d “ [ w ] h e n a s e t t l e m e n t a g r e e m e n t f a i l s t o

c h a r a c t e r i z e t h e l o s s e s c o v e r e d
, a p r e s u m p t i o n a p p l i e s t h a t t h e c o m p e n s a t i o n f o r t h e i n j u r e d p a r t y w a s f

o r n o n e c o n o m i c d a m a g e s

. ” S e e M a t t h e w s v

. R e p u b l i c W

e s t e r n I n s

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. T h e p l a i n t i f f s ’ s e t t l e m e n t a g r e e m e n t w i t h M C H d o e s

n o t c a t e g o r i z e t h e p l a i n t i f f s ’ l o s s e s a s e c o n o m i c o r n o n

- e c o n o m i c

.
-6-I N C O N C L U S I O N

After a thorough re v i ew o f the applicable Michig an law, we have conclude d that Titan’s claim for reimburse ment is not barr ed or limit ed by the made whole doctrine, and that Titan is entitled to rec over, up to the extent of persona l protec tion insurance benef its paid by Titan to or for

eac h plaintiff, that po rt i o n of eac h plaintiff’s rec overy that was compensa tion for the plaintiff’s economic losses, as distinguished from non-ec onomic losses. We have also d et ermined that the

rec ord i s insufficient for this court t o d et er m i n e the amount Titan is entitled to rec over from eac h plaintiff. There fore
, we rema nd this issue to the trial court for such a deter mination and for the entry of a judg ment in favor of

Titan in the appropr iate amounts.

The judgme nt of the trial court is reve rsed and rema nded for further proce eding s consistent with this opinion. Costs of appea l are assessed one-ha lf ag ainst Titan I nsuranc e Company and onehalf a g ainst the plaintiffs, J ames Rios and Da niel Fr aire

.

___________________________________ FRANK G. CL EMENT, JR ., J UDGE

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