CASE NUMBER:
16-009069-NF
COURT:
Wayne County Circuit Court
JUDGE:
Honorable John H. Gillis, Jr.
PUBLISHED OR UNPUBLISHED DECISION:
Unpublished
DATE:
March 5, 2018–March 8, 2018
ATTORNEYS:
Elaine Sawyer & Corey McPherson
TYPE OF ACTION:
No-Fault
DEMAND:
$202,000.00
ISSUE:
Plaintiff alleged that State Farm was liable for payment of all allowable expenses incurred for reasonably necessary products, services, and accommodations for his injuries allegedly suffered in a July 24, 2015 motor vehicle accident. State Farm put forward a defense based upon Plaintiff’s fraudulent representations made to State Farm in Plaintiff’s representations of his claim.
SUMMARY OF TRIAL:
Plaintiff alleged that he was entitled to replacement services and allowable expenses following a motor vehicle accident. The bulk of Plaintiff’s claim was related to a left shoulder surgery. Plaintiff’s surgeon testified that the SLAP II lesion tear in the shoulder was related to a traumatic event. Plaintiff’s household service provider also testified that Plaintiff had increased pain symptoms after the subject accident, which resulted in Plaintiff requiring daily assistance.
In defense of this matter, Defendants were able to utilize Plaintiff’s deposition testimony and Plaintiff’s household service provider’s deposition testimony to reveal inconsistencies within Plaintiff’s claim. Further, Defendant used surveillance to reveal that Plaintiff was able to drive, go to job sites, and perform his daily duties in a normal manner while simultaneously making claims for routine replacement services. Defendant also utilized three independent medical examiners that opined that the injuries identified on MRIs were actually degenerative conditions, not traumatically-induced injuries.
VERDICT:
The jury found that Plaintiff committed fraud in the presentation of his claims for no-fault benefits to State Farm.