A boy who suffered a traumatic brain injury before he was even born, after a car fleeing Westland police slammed into his pregnant mother's vehicle in spring 2023, now faces the possible loss of the around-the-clock home healthcare that keeps him alive. Sire was delivered by emergency C-section following the crash, and his family's attorneys say an insurance-hired doctor's report could strip away the very care that has sustained him for years.
The crash happened near Inkster and Ford roads when a vehicle fleeing a Westland police traffic stop struck the car carrying Sire's mother, who was eight months pregnant at the time, according to ClickOnDetroit. The mother survived, and Sire was delivered by emergency C-section shortly after. Attorney Lawrence Kajy says the baby sustained a traumatic brain injury from reduced oxygen and blood flow to his central nervous system during the ordeal, and attorneys say Sire now scores as low as the second percentile compared with children his age.
The driver who caused the crash, 34-year-old Ryan Edward Smith, fled the Westland traffic stop near Inkster Road and Warren Road and reached roughly 100 mph before running a red light at Ford and Inkster, striking the victims' vehicle within about 30 seconds of the initial stop, according to FOX 2 Detroit. The Wayne County Prosecutor's Office charged Smith with second-degree fleeing and eluding, operating with a suspended license causing serious impairment, and fourth-offense habitual offender status, setting bond at $750,000, as reported by CBS News Detroit. Smith also had an outstanding felony warrant at the time of his arrest, the station noted.
A Grandfather's Plea and a Family's Daily Struggle
Sire's mother, Angelica, has brain function comparable to that of a 12-year-old, her attorney says, and her father, Michael Winton, says she has difficulty caring for Sire on her own. Winton, who is Angelica's father and Sire's grandfather, has urged USAA to take responsibility and care for his family, describing the unborn baby's involvement in the crash as a double concern for his household.
Sire currently receives around-the-clock care from Diversified Home Health Care, which provides shelter and continuous care for the boy, according to Kajy. The agency has kept providing that care despite not being paid, in good faith, per Chris Mene. Sire's attorneys say USAA is not fully paying for the care the family says both mother and child need.
Dueling Medical Opinions Over Sire's Needs
USAA hired a doctor who works at Henry Ford to write a report on Sire's care needs, attorneys say. That report concludes Sire does not need the services or benefits currently provided and could instead be cared for by a parent or family member, according to Chris Mene, and its findings indicate Sire could lose access to his current home healthcare. Sire's attorneys have obtained reports from his own treating doctors, and his three treating physicians oppose the insurance doctor's opinion, per Mene.
USAA, in a statement, said it takes member concerns seriously and is committed to resolving them. The insurer says it has paid more than $7 million in policy benefits on behalf of the accident victims and characterizes the dispute as a billing issue with one service provider, rather than a dispute over Sire's medical needs.
How Michigan Law Shapes the Fight Over Coverage
The clash sits inside a broader legal framework that governs how Michigan auto insurers can challenge ongoing medical care. Under the state's Auto No-Fault Insurance Act, insurers are legally required to conduct utilization reviews determining whether treatment, attendant care, or home health services remain medically necessary under accepted clinical standards, according to the Michigan Department of Insurance and Financial Services. Those reviews specifically scrutinize the duration and frequency of services like the kind Sire receives.
When an insurer denies or reduces benefits after such a review, healthcare providers can file an administrative appeal with the state within 90 days, per Michigan Auto Law, which notes that regulators issue binding determinations after reviewing provider documentation. But families and providers aren't required to exhaust that administrative route first — Michigan law allows injured crash victims and providers to go straight to state court to force payment of overdue benefits, according to Plunkett Cooney, which points to appellate rulings holding that regulatory appeals are permissive, not mandatory.
The legal terrain around attendant care has shifted substantially since Michigan's 2019 no-fault reforms. In July 2023, the Michigan Supreme Court ruled in Andary v. USAA Casualty Insurance Co. that statutory limits on family-provided attendant care and fee-schedule caps cannot be applied retroactively to crash victims injured under policies issued before June 2019, according to CMDA Law, which notes the ruling established that benefit rights vest at the time of the underlying policy and injury. More recently, the Michigan Court of Appeals clarified in October 2025 how statutory reimbursement caps apply to home health aide and skilled nursing services under the post-2019 rules, a dispute that continues to play out between insurers and home care agencies over whether Medicare pricing schedules apply to specialized care, per Plunkett Cooney's later reporting.
Amicus filings cited by the Michigan Supreme Court in 2023 from medical associations warned that post-2019 reimbursement reductions had already caused widespread understaffing and facility closures among specialized brain-injury home care providers statewide, according to the same CMDA Law account — a systemic pressure that mirrors the fight now playing out over Sire's care in western Wayne County.
