Opinion ID: 848642
Heading Depth: 2
Heading Rank: 1

Heading: Statutory Language and Legal Background

Text: M.C.L. § 500.3105(1) provides: Under personal protection insurance an insurer is liable to pay benefits for accidental bodily injury arising out of the ownership, operation, maintenance or use of a motor vehicle as a motor vehicle, subject to the provisions of this chapter. [Emphasis added.] According to the plain language of M.C.L. § 500.3105(1), a no-fault insurer is only required to pay benefits for accidental bodily injury arising out of an automobile accident. The no-fault act further restricts a no-fault insurer's liability by defining the limited types of benefits that are payable for accidental bodily injury .... M.C.L. § 500.3107(1)(a), the statutory provision at the center of this case, states: Except as provided in subsection (2), personal protection insurance benefits are payable for the following: (a) Allowable expenses consisting of all reasonable charges incurred for reasonably necessary products, services and accommodations for an injured person's care, recovery, or rehabilitation. [Emphasis added.] Thus, in addition to the requirement under M.C.L. § 500.3105(1) that benefits be for accidental bodily injury, M.C.L. § 500.3107(1)(a) circumscribes benefits to those expenses consisting only of items or services that are reasonably necessary for an injured person's care, recovery, or rehabilitation. Both this Court and the Court of Appeals have interpreted and applied the above statutes in cases involving claims for food or room and board expenses. In Manley v. Detroit Automobile Inter-Ins. Exchange, 127 Mich.App. 444, 448, 339 N.W.2d 205 (1983), rev'd 425 Mich. 140, 388 N.W.2d 216 (1986), the plaintiffs' minor son suffered severe head trauma in an automobile accident. He resided with the plaintiffs and received care from nurse's aides. Id. at 449, 339 N.W.2d 205. The plaintiffs sued the defendant no-fault carrier, seeking, among other things, reimbursement for his room and board costs. Id. at 448-449, 339 N.W.2d 205. The defendant insurance carrier argued that because the plaintiffs already had a legal duty to care for their child, room and board costs were not compensable. Id. at 451, 339 N.W.2d 205. The Court of Appeals rejected this argument, largely on the basis of a worker's compensation case that distinguished between ordinary household tasks such as cleaning and washing clothes and nonordinary tasks such as `[s]erving meals in bed and bathing, dressing, and escorting a disabled person ....' Id. at 452, 339 N.W.2d 205, quoting Kushay v. Sexton Dairy Co., 394 Mich. 69, 228 N.W.2d 205 (1975). The panel concluded that the distinction between ordinary and nonordinary tasks could be reconciled with the language of M.C.L. § 500.3107(a), which then provided that products, services, and accommodations not reasonably necessary for the injured person's care, recovery, or rehabilitation are not `allowable expenses.' 127 Mich.App. at 453, 339 N.W.2d 205. The Court reasoned: The necessity for the performance of ordinary household tasks has nothing to do with the injured person's care, recovery, or rehabilitation; such tasks must be performed whether or not anyone is injured. This reasoning supports a generalization concerning the circumstances in which a product, service, or accommodation can fall within the definition of allowable expense. Products, services, or accommodations which are as necessary for an uninjured person as for an injured person are not allowable expenses. [ Id. at 453-454, 339 N.W.2d 205 (emphasis added).] The panel then opined that food is as necessary for an uninjured person as for an injured person and thus would not ordinarily constitute an allowable expense under M.C.L. § 500.3107 for an injured person cared for at home. 127 Mich.App. at 454, 339 N.W.2d 205. When Manley was appealed to this Court, we effectively vacated the Court of Appeals room and board analysis. Manley v. Detroit Automobile Inter-Ins. Exchange, 425 Mich. 140, 388 N.W.2d 216 (1986). We stated that the question whether food, shelter, utilities, clothing, and other such maintenance expenses are an allowable expense when the injured person is cared for at home had neither been raised before the trial court nor argued in the Court of Appeals. Id. at 152, 388 N.W.2d 216. Accordingly, this Court declined to address the issue and stated that the Court of Appeals analysis of the issue shall not be regarded as of precedential force or effect. Id. at 153, 388 N.W.2d 216. Justice Boyle issued a concurring and dissenting opinion, asserting that the room and board issue was properly before this Court because the Court of Appeals had raised it sua sponte and discussed the issue in its opinion. Id. at 168, 388 N.W.2d 216 (Boyle, J., concurring in part and dissenting in part). She could find no principled basis for distinguishing between food provided in an institutional setting and food provided at home, and concluded that the Court of Appeals injured person vs. uninjured person test was not only unwieldy and unworkable but that it effectively punished those who choose to care for injured family members at home. Id. at 168-169, 388 N.W.2d 216. Justice Boyle opined that M.C.L. § 500.3107 imposes three requirements for allowable expenses: 1) the charge must be reasonable, 2) the expense must be reasonably necessary, and 3) the expense must be incurred. 425 Mich. at 169, 388 N.W.2d 216. Thereafter, in Reed, the Court of Appeals adopted Justice Boyle's Manley analysis. The insured in Reed had been severely injured in an auto accident. Reed, supra at 445, 499 N.W.2d 22. The plaintiff, the insured's mother, filed various claims against the defendant insurer and moved to amend her complaint to include a claim for room and board expenses. Id. at 445-446, 499 N.W.2d 22. The trial court denied the motion on the basis that such expenses were not recoverable under the no-fault act. Id. at 446, 499 N.W.2d 22. The Court of Appeals reversed, reasoning as follows: We see no compelling reason not to afford the same compensation under the act to family members who provide room and board. Subsection 1(a) does not distinguish between accommodations provided by family members and accommodations provided by institutions, and we decline to read such a distinction into the act. Moreover, holding that accommodations provided by family members is [sic] an allowable expense is in accord with the policy of this state. Denying compensation for family-provided accommodations while allowing compensation in an institutional setting would discourage home care that is generally, we believe, less costly than institutional care. Irrespective of cost considerations, it can be stated without hesitation that home care is more personal than that given in a clinical setting.... We hold that, where an injured person is unable to care for himself and would be institutionalized were a family member not willing to provide home care, a no-fault insurer is liable to pay the cost of maintenance in the home. [ Id. at 452-453, 499 N.W.2d 22 (citations omitted; emphasis added).] In addition to the above reasoning, the Court of Appeals relied on the notion that because the no-fault act is remedial in nature, it must be liberally construed in favor of persons intended to benefit thereby. Id. at 451, 499 N.W.2d 22.