Jawad a Shah Md Pc v. State Farm Mutual Automobile Insurance Co

920 N.W.2d 148, 324 Mich. App. 182
Michigan Court of Appeals·Decided May 8, 2018·No. 340370·Published·Cited by 182 cases

Opinion

Borrello, P.J.

*152 *186 In this suit seeking recovery of medical expenses under the no-fault act, MCL 500.3101 et seq ., plaintiffs, Jawad A. Shah, M.D., PC, Integrated Hospital Specialists, PC, Insight Anesthesia, PLLC, and Sterling Anesthesia, PLLC, appeal as of right the trial court's order granting summary disposition in favor of defendant, State Farm Mutual Automobile Insurance Company, and denying as futile plaintiffs' motion for leave to amend their complaint. For the reasons set forth in this opinion, we reverse the trial court's order and remand this matter for further proceedings consistent with this opinion.

I. BACKGROUND

This case involves various healthcare providers attempting to recover from a no-fault insurer for services rendered to the insured, George Hensley. According to plaintiffs' initial complaint filed on February 24, 2017, Hensley was injured on November 30, 2014, in a motor vehicle accident and was insured by defendant. Plaintiffs submitted claims for services rendered to Hensley, but defendant refused to pay these claims. In their complaint, plaintiffs sought a judgment of approximately $82,000, plus interest and reasonable attorney fees. Defendant answered the complaint and filed its affirmative defenses on April 21, 2017, denying liability.

On May 25, 2017, our Supreme Court issued its opinion in Covenant Med. Ctr., Inc. v. State Farm Mut. Auto. Ins. Co. , 500 Mich. 191 , 895 N.W.2d 490 (2017). In *187 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," expressly overruling a body of caselaw from this Court that had concluded to the contrary. Id . at 196, 895 N.W.2d 490 . In explaining its holding, the Covenant Court rejected the notion that a medical provider had independent standing to bring a claim against an insurer to recover no-fault benefits. Id . at 195, 895 N.W.2d 490 . However, the Court clarified that its decision 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, 895 N.W.2d 490 .

On July 20, 2017, defendant moved for summary disposition pursuant to MCR 2.116(C)(8). Defendant argued that dismissal was required for failure to state a claim because plaintiffs' no-fault claim was "in direct contravention of the Michigan Supreme Court's decision in Covenant ."

Apparently anticipating defendant's motion, plaintiffs had obtained an assignment of rights from Hensley on July 11, 2017, 1 *153 to pursue payment of no-fault *188 benefits for healthcare services "already provided" by plaintiffs. 2 Plaintiffs relied on this assignment to then file a response to the summary disposition motion and a motion for leave to amend the complaint to reflect that the suit was being pursued through the assignment of rights obtained from Hensley. Plaintiffs argued that it was necessary to amend the complaint to allow the action to proceed pursuant to their respective assignments because the Covenant decision had extinguished their ability to pursue an independent, direct action against defendant under these circumstances. Again showing foresight in anticipating defendant's next tactical decision, plaintiffs also preemptively argued that if the trial court were to determine that a contractual provision within defendant's policy prevented assignments, then such a provision should not be enforced for one of two reasons. First, plaintiffs *189 argued that defendant would have to show that Hensley was a named insured under the policy (rather than, for example, a passenger entitled to benefits under someone else's policy) for the antiassignment clause to be enforced against him. Second, plaintiffs argued that the antiassignment clause was voidable as against public policy because the assignment was obtained after the loss occurred. Furthermore, in an effort to avoid problems with the one-year-back rule of MCL 500.3145(1), plaintiffs also argued that the amended complaint should relate back to the date of the original complaint because the amendment to accommodate the assignments was intended to support the previously filed no-fault claim that arose from the same transaction or occurrence, namely Hensley's injuries sustained in the November 30, 2014 accident. Plaintiffs did not contend that Covenant was inapplicable to their suit.

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Jawad a Shah Md Pc v. State Farm Mutual Automobile Insurance Co, 920 N.W.2d 148, 324 Mich. App. 182 (Mich. Ct. App. 2018).

920 N.W.2d 148 (Jawad a Shah Md Pc v. State Farm Mutual Automobile Insurance Co) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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