Attendant Care Companies v. Farm Bureau General Insurance Company

CourtMichigan Court of Appeals
DecidedNovember 29, 2018
Docket340205
StatusUnpublished

This text of Attendant Care Companies v. Farm Bureau General Insurance Company (Attendant Care Companies v. Farm Bureau General Insurance Company) is published on Counsel Stack Legal Research, covering Michigan Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Attendant Care Companies v. Farm Bureau General Insurance Company, (Mich. Ct. App. 2018).

Opinion

STATE OF MICHIGAN

COURT OF APPEALS

ATTENDANT CARE COMPANIES, UNPUBLISHED ATTENDANT CARE SERVICES OF November 29, 2018 MICHIGAN, PROGRESSIONS, LLC, PROGRESSIONS OF SIL, and CARING HANDS HOME CARE SERVICES, LLC,

Plaintiffs-Appellees,

v No. 340205 Macomb Circuit Court FARM BUREAU GENERAL INSURANCE LC No. 2016-002115-NF COMPANY OF MICHIGAN,

Defendant-Appellant.

Before: JANSEN, P.J., and K. F. KELLY and BORRELLO, JJ.

PER CURIAM.

In this suit under the no-fault act, MCL 500.3101 et seq., seeking the recovery of personal protection insurance benefits for medical care provided to the injured insured, defendant appeals by leave granted1 the trial court’s order denying defendant’s motion for summary disposition without prejudice. For the reasons set forth in this opinion, we reverse and remand this matter for entry of an order granting summary disposition in favor of defendant.

I. BACKGROUND

On April 3, 2015, Milad Ishaq was involved in an automobile accident and suffered injuries that included a severe traumatic brain injury (TBI), resulting in a subsequent determination that he needed 24 hour, one-to-one care. Ishaq was a named insured on a policy of insurance issued by defendant.

1 Attendant Care Cos v Farm Bureau Gen Ins Co, unpublished order of the Court of Appeals, entered December 14, 2017 (Docket No. 340205).

-1- Ishaq was admitted to the Estates of Rochester, a group home facility operated by plaintiff,2 on approximately June 18 or 19, 2015. On approximately July 6 or 7, 2015, Ishaq was moved to plaintiff’s Semi-Independent Living Program, where he continued to receive “twenty- four hour direct, one-on-one supervision both at home in his apartment and out in the community.” Ishaq was discharged from the Semi-Independent Living Program on November 27, 2015, and he was placed in another facility that apparently is not owned by plaintiff.

Defendant denied requests for payment submitted by plaintiff. It is unclear from the documentary evidence submitted by the parties in the trial court exactly which bills were denied or which charges plaintiff was specifically claiming were wrongfully denied, but the one denial letter submitted by plaintiff referred to invoices “regarding Mr. Ishaq’s apartment.” It appears that defendant paid some of the charges billed by plaintiff, although the nature of the services paid for is also unclear from the record. Regardless of this lack of clarity about the nature and amount of the disputed charges, it appears from the record evidence that plaintiff provided services to Ishaq from approximately June 18, 2015 to November 27, 2015. The parties do not dispute that this was the period of time during which charges at issue were incurred.

On June 15, 2016, plaintiff initiated this action, filing a complaint against defendant that sought payment of no-fault benefits that plaintiff alleged were owed by defendant based on goods and services that plaintiff provided to Ishaq related to his medical care, attendant care, and medical transportation expenses.

On May 25, 2017, as the instant litigation was progressing, our Supreme Court issued its opinion in Covenant Med Ctr, Inc v State Farm Mut Auto Ins Co, 500 Mich 191; 895 NW2d 490 (2017). In Covenant, our Supreme Court held that “healthcare providers do not possess a statutory cause of action against no-fault insurers for recovery of personal protection insurance benefits under the no-fault act.” Id. at 196. Accordingly, healthcare providers do not have independent standing to sue no-fault insurers directly to recover these benefits. Id. at 195-196. However, the Court clarified that its conclusion was “not intended to alter an insured’s ability to assign his or her right to past or presently due benefits to a healthcare provider.” Id. at 217 n 40.

On May 30, 2017, plaintiff obtained an executed assignment of Ishaq’s rights “to payment for health care services, products or accommodations” provided by plaintiff to which Ishaq was entitled under the no-fault act from any insurer. The assignment further provided that the agreement was “not an assignment of a right to benefits payable in the future, but an assignment of a right to benefits payable as loss accrues and with respect to services already provided; in other words, this assignment affects only those services provided prior to its execution.” The assignment was signed by Ishaq’s guardian. Plaintiff also apparently obtained another assignment of Ishaq’s rights that was dated July 19, 2017.

2 The precise nature of the relationships between the plaintiff entities in this action is not clear from the record. However, it appears from our examination of the record that all of the plaintiff entities are essentially permutations of Attendant Care Services of Michigan in one form or another. Thus, for purposes of this opinion, we will refer to these entities collectively as “plaintiff.”

-2- Defendant moved for summary disposition under MCR 2.116(C)(5), (8), and (10), arguing as relevant to the issues now on appeal, that plaintiff lacked standing under Covenant to sue defendant directly and that plaintiff should not be allowed to amend its pleadings to rely on an assignment of rights from Ishaq because doing so would be futile. More specifically with respect to the futility of an amendment, defendant argued that the one-year-back rule in MCL 500.3145(1) would bar the recovery of benefits for care provided from June 18, 2015 to November 27, 2015, if the lawsuit were maintained on basis of the May 30, 2017 assignment of rights because an assignee cannot obtain greater rights than those held by the assignor on the date of the assignment.

Plaintiff argued in response that the instant lawsuit was not barred by the holding in Covenant because Covenant specifically preserved the ability of medical providers to pursue recovery from an insurer based on an insured’s assignment of rights to the medical provider, and plaintiff obtained a valid assignment of rights from Ishaq that allowed its lawsuit against defendant to proceed. Plaintiff further argued that this assignment of Ishaq’s claim for payment from defendant was not prohibited by the anti-assignment clause and that amendment of the complaint should be permitted to reflect plaintiff’s assignment-based theory of standing. Additionally, plaintiff argued that Covenant should only be applied prospectively.

The trial court denied defendant’s motion for summary disposition and granted plaintiff’s motion to amend its complaint.

This Court granted defendant’s application for leave to appeal, “limited to the following issues: (1) whether plaintiffs’ claims are barred by Covenant Med Ctr Inc v State Farm Mut Auto Ins Co, [500] Mich [191]; 895 NW2d 490 (2017); and (2) whether plaintiffs’ proposed amendment based on the assignment of the insured person’s claims is futile due to the operation of MCL 500.3145(1).” Attendant Care Cos v Farm Bureau Gen Ins Co, unpublished order of the Court of Appeals, entered December 14, 2017 (Docket No. 340205).

II. STANDARD OF REVIEW

This Court reviews a trial court’s summary disposition ruling de novo to determine, based on the entire record, whether the moving party is entitled to judgment as a matter of law. Maiden v Rozwood, 461 Mich 109, 118; 597 NW2d 817 (1999). This court also reviews de novo, as a question of law, whether a party has standing to bring an action. Franklin Historic Dist Study Comm v Village of Franklin, 241 Mich App 184, 187; 614 NW2d 703 (2000). Questions involving the interpretation of statutes and court rules are also reviewed de novo. Sanders v McLaren-Macomb, 323 Mich App 254, 265; 916 NW2d 305 (2018).

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Attendant Care Companies v. Farm Bureau General Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/attendant-care-companies-v-farm-bureau-general-insurance-company-michctapp-2018.