The Michigan Court of Appeals issued an unpublished opinion on Oct. 26 that should prove useful in the defense of agency attendant care claims for treatment of individuals injured prior to the enactment of No-Fault reform.
In Centria Home Rehab v. Allstate Ins Co (Docket No. 363699), Allstate filed a dispositive motion in the trial court arguing that the only charges “incurred” by the claimant was the $10 per hour that the claimant’s daughter, who was hired by Centria Home Rehab to provide services, testified she was paid for the hours that she worked. The trial court granted the motion, holding that there was no genuine issue of material fact and that under MCL 500.3107 the only fees “incurred” by the injured person was the $10 per hour her daughter was paid by the plaintiff’s agency.
In reviewing the case, the appellate court made several important determinations. It held that because the accident occurred before June 11, 2019 when the No-Fault reform revised MCL 500.3112 to grant medical providers a direct right to recover benefits, Centria Home Rehab’s standing was based solely on the assignment executed by the injured person. This is another example of the growing list of appellate case law confirming that the Andary decision applies across the entirety of Michigan’s No-Fault statutory scheme.
This continues to be an important defense for purposes of the “one year back” rule in MCL 500.3145, because it is clear the tolling provision can only apply to dates of loss after the No-Fault Reform. The appellate court’s decision should also be persuasive to convince trial court judges that medical providers whose services are being rendered to pre-reform accident victims must have assignments to maintain litigation against the respective insurance company.
Allstate successfully argued that the injured person only incurred the amount her daughter was paid for the services rendered, not that the claimant had incurred the inflated amount charged by Centria Home Rehab. This case provides a roadmap for the defense of similar cases.
It is imperative for insurers to demand assignments from providers for accidents that occurred prior to June 11, 2019 and, in cases where the home health aide has hired a family member, to determine the amount the family member is receiving for the services rendered, not the amount the agency is charging. These simple steps can continue to provide cost savings to insurers while ensuring that their insureds can still receive the care that is necessary for recovery.
A partner in the firm's Detroit office, Emily M. Coyle focuses her practice in the areas of transportation law and collections. Her practice also includes expertise with respect to investigating fraudulent or suspicious claims ...
Add a comment
- No Fault Liability
- Motor Vehicle Liability
- Appellate Law
- Auto Liability
- insurance policy
- Trucking Liability
- Civil Litigation
- Fraud Activity
- Personal Injury Protection (PIP)
- Premises Liability
- Cargo Liability
- Judicial Estoppel
- Retail Liability
- Driver Exclusion
- Risk Management
- Public Policy
- Governmental Immunity
- Environmental Legislation
- Environmental Regulation
- Medicare Issues
- How Well Do You Know Your Policyholders? Recent Appellate Case Encourages Full Discovery of Potential Rescission During Litigation
- Published Opinion Warns Insurers that Medical Claims can Survive MCL 500.3145 Indefinitely Without an Appropriate Denial
- Michigan Court of Appeals Outlines Several Important Defenses in Family Member Provided Attendant Care Cases
- Michigan Appellate Courts Help Define ‘Sudden Emergency’ in Motor Vehicle Liability Cases
- Post-Judgement Collection Techniques for Insurers
- Are Case Evaluation Sanctions Gone Baby, Gone?
- Michigan No-Fault Act Requires Diligent and Timely Action by all Parties
- Michigan Supreme Court Rules 2019 No-Fault Act Amendments not Retroactive
- No-Fault Litigation Utilization Reviews are Certainly no Vulcan Mind Trick
- Appellate Court Rules Medical Providers Cannot Revoke Assignments During No-Fault Litigation