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

Procedural entryThis page is a short order in Jawad a Shah Md Pc v. State Farm Mutual Automobile Insurance Co. Read the opinion of the Court — 324 Mich. App. 182
Michigan Court of Appeals·Decided May 8, 2018·No. 340370·Published

Opinion

STATE OF MICHIGAN

COURT OF APPEALS

JAWAD A. SHAH, M.D., PC, INTEGRATED FOR PUBLICATION HOSPITAL SPECIALISTS, PC, INSIGHT May 8, 2018 ANESTHESIA, PLLC, and STERLING 9:00 a.m. ANESTHESIA, PLLC,

Plaintiffs-Appellants,

v No. 340370 Genesee Circuit Court STATE FARM MUTUAL AUTOMOBILE LC No. 17-108637-NF INSURANCE COMPANY,

Defendant-Appellee.

Before: BORRELLO, P.J., and SHAPIRO and TUKEL, JJ.

BORRELLO, P.J.

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 plaintiffs’ motion for leave to amend their complaint as futile. 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 encompasses various providers of medical and related healthcare services 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 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,” expressly overruling a body of caselaw from this Court that had concluded to the contrary. Id. at 196. 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. 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.

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 plaintiff’s 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, 20171 to pursue payment of no-fault benefits for healthcare services “already provided” by plaintiffs.2 Plaintiffs relied on this assignment to then file a

1 We note that there are four assignments attached to plaintiff’s brief in opposition to defendant’s motion for summary disposition and that two of those assignments explicitly designate plaintiffs Jawad A. Shah, M.D., PC, and Integrated Hospital Specialists, PC, as assignees. However, the names of the designated assignees in the other two assignments do not match the names of the remaining two plaintiffs. Nonetheless, in the trial court, defendant conceded in its reply brief in support of its summary disposition motion that Hensley had executed an assignment to each plaintiff. Thus, as will be further explained below, it appears that the parties assumed that all plaintiffs received assignments of rights from Hensley and that the parties essentially disputed only (1) whether these assignments were valid in light of the anti-assignment clause in Hensley’s insurance policy and (2) whether an amended complaint based on such an assignment would relate back to the date of the original complaint. For purposes of this opinion, we assume without deciding that the assignments effectively assigned the stated rights to plaintiffs in this case as long as such assignments were not barred by the anti-assignment clause. The only issue with respect to the validity of the assignments that was actually raised and decided in the trial court was the effect of the anti-assignment clause. Therefore, we limit our review accordingly to this issue. See Allen v Keating, 205 Mich App 560, 564; 517 NW2d 830 (1994). 2 The assignment of rights forms provided in pertinent part that Hensley was assigning all rights, privileges and remedies to payment for health care services, products or accommodations (“Services”) provided by Assignee to Assignor to which Assignor is or may be entitled under MCL 500.3101, et seq, the No Fault Act. This Assignment is for the right to payment of Assignee’s charges, only, and not for the right to payment of any other No Fault insurance benefits.

The Assignment as set forth above is for all services already provided to Assignor by Assignee prior to or at the time of Assignor’s execution of this agreement. Specifically, this Assignment does not include an Assignment of any future No Fault benefits.

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 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 anti-assignment clause to be enforced against him. Second, plaintiffs argued that the anti-assignment clause was voidable as against public policy where 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 20, 2014 accident. Plaintiffs did not contend that Covenant was inapplicable to their suit.

Free access — add to your briefcase to read the full text and ask questions with AI

Jawad a Shah Md Pc v. State Farm Mutual Automobile Insurance Co, (Mich. Ct. App. 2018).

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

Related

Joseph v. Auto Club Insurance Association
815 N.W.2d 412 (Michigan Supreme Court, 2012)
Walters v. Nadell
751 N.W.2d 431 (Michigan Supreme Court, 2008)
Miller v. Chapman Contracting
730 N.W.2d 462 (Michigan Supreme Court, 2007)
Rory v. Continental Insurance
703 N.W.2d 23 (Michigan Supreme Court, 2005)
Abela v. General Motors Corp.
677 N.W.2d 325 (Michigan Supreme Court, 2004)
Yudashkin v. Holden
637 N.W.2d 257 (Michigan Court of Appeals, 2001)
In Re Weber Estate
669 N.W.2d 288 (Michigan Court of Appeals, 2003)
Allen v. Keating
517 N.W.2d 830 (Michigan Court of Appeals, 1994)
Adell Broadcasting Corp. v. Apex Media Sales, Inc.
708 N.W.2d 778 (Michigan Court of Appeals, 2006)
Action Auto Stores, Inc. v. United Capitol Insurance
845 F. Supp. 417 (W.D. Michigan, 1993)
Houghton v. Keller
662 N.W.2d 854 (Michigan Court of Appeals, 2003)
Grist v. the Upjohn Company
134 N.W.2d 358 (Michigan Court of Appeals, 1965)
Maiden v. Rozwood
597 N.W.2d 817 (Michigan Supreme Court, 1999)
Napier v. Jacobs
414 N.W.2d 862 (Michigan Supreme Court, 1987)
Wilson v. Taylor
577 N.W.2d 100 (Michigan Supreme Court, 1998)
Burkhardt v. Bailey
680 N.W.2d 453 (Michigan Court of Appeals, 2004)
Kern v. Blethen-Coluni
612 N.W.2d 838 (Michigan Court of Appeals, 2000)
Jones v. Chambers
91 N.W.2d 889 (Michigan Supreme Court, 1958)
Smith v. Foerster-Bolser Construction, Inc
711 N.W.2d 421 (Michigan Court of Appeals, 2006)