Michigan crash victim sues insurance company for halting therapy payments

NORTHVILLE, Mich. (FOX 2) - Since Carmen Burgie was struck by a car that paralyzed her at Michigan State University in 2001, she has required a lot of care.

Carmen relies on her parents to be her caregivers, as well as an occupational therapist and a massage therapist to help with movement and her muscles. She has been receiving this type of therapy for more than a decade now.

However, about six months ago, Carmen's insurance company –Auto-Owners Insurance– stopped paying for her therapists.

"She helps with the spasticity, she helps with the tightness of the muscles," Carmen said. "It's about my quality of life. And without (therapy), then what are you saying? That my quality of life doesn't matter?" 

Carmen Burgie

Auto-Owners Insurance is the same company that stopped paying for Carmen's caregivers when changes were made to the state's no-fault insurance. 

The Michigan Supreme Court ruled that those catastrophically injured in car accidents were entitled to care even after the law changed. As a result, the Burgies had to be reimbursed. 

They thought their troubles were over, until six months ago.

"Unfortunately, it seems once we hopped over one hurdle, they placed another one in front of us," said Meagan O'Donnell, Carmen's attorney. "They hired an out of state doctor who does not specialize in anything related to Carmen's injuries. He specializes in kidneys."

That doctor decided Carmen should not receive therapy despite her own doctors prescribing it for her.

Cassandra Burgie, Carmen's mother and caregiver, knows firsthand how much therapy helps her daughter.

"If she doesn't get it, her body locks up," Cassandra said. "Walk in our shoes for one day, to kind of see how it is on a daily basis – you may just get a glimpse of it, but come in and see how it really is."

Carmen Burgie (left) and her mother Cassandra Burger (right).

That is why the Burgie family is once again filing a lawsuit to get the benefits Carmen needs and deserves.

"Now we're at the point like, 'okay, you're going to deny us; we're gonna fight for it,'" Carmen said. "Don't take no as an answer."

"Carmen's a fighter and we're here to fight for her as well," O'Donnell added.

Auto-Owners Insurance did not return FOX 2's calls for comment.