Maple Manor Rehab Ctr of Novi Inc v. Travelers Casualty & Surety

CourtMichigan Court of Appeals
DecidedJuly 21, 2022
Docket355775
StatusUnpublished

This text of Maple Manor Rehab Ctr of Novi Inc v. Travelers Casualty & Surety (Maple Manor Rehab Ctr of Novi Inc v. Travelers Casualty & Surety) 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
Maple Manor Rehab Ctr of Novi Inc v. Travelers Casualty & Surety, (Mich. Ct. App. 2022).

Opinion

If this opinion indicates that it is “FOR PUBLICATION,” it is subject to revision until final publication in the Michigan Appeals Reports.

STATE OF MICHIGAN

COURT OF APPEALS

MAPLE MANOR REHAB CENTER OF NOVI, UNPUBLISHED INC. and MAPLE MANOR NEURO CENTER, July 21, 2022 INC.,

Plaintiffs-Appellees/Cross-Appellants,

v No. 355775 Washtenaw Circuit Court TRAVELERS CASUALTY & SURETY LC No. 17-001178-NF COMPANY,

Defendant-Appellant/Cross-Appellee.

Before: MARKEY, P.J., and BOONSTRA and RIORDAN, JJ.

PER CURIAM.

Defendant/cross-appellee Travelers Casualty & Security Company (Travelers) appeals by right the judgment entered by the trial court awarding plaintiffs/cross-appellants Maple Manor Rehab Center of Novi, Inc. (Maple Manor Rehab), and Maple Manor Neuro Center, Inc. (Maple Manor Neuro) (collectively, plaintiffs), $757,871.11 in damages, $276,069.28 in penalty interest, $136,290 in attorney fees, and $3,765.84 in taxable costs. Specifically at issue in this appeal is Travelers’ challenge to the trial court’s order denying its motion for summary disposition under MCR 2.116(C)(10) and granting summary disposition in favor of plaintiffs under MCR 2.116(I). We affirm in part, reverse in part, vacate in part, and remand the matter to the trial court for further proceedings.

I. PERTINENT FACTS AND PROCEDURAL HISTORY

James Bourdage (Bourdage) was injured in a motor vehicle accident in July 2014, while a passenger in his employer’s vehicle. The vehicle was insured under a commercial insurance policy issued by Travelers. Bourdage suffered catastrophic injuries, including a traumatic brain injury that left him “in a permanent vegetative state.” Bourdage’s wife was appointed as his guardian and conservator. After initially receiving care at another rehabilitation facility, Bourdage was transferred to Maple Manor Rehab in April 2015. Because Bourdage was Maple Manor Rehab’s first patient to receive medical services under Michigan’s no-fault insurance act, MCL 500.3101

-1- et seq., the facility hired billing consultant Susan Taylor to determine what to charge for Bourdage’s care and treatment and to negotiate with Travelers a price for Bourdage’s care. Taylor testified at her deposition that she and Amy Driscoll, Travelers’ claims adjustor for Bourdage, agreed to an all-inclusive rate of $3,800 per weekday and $1,520 per weekend day. Subsequently, Taylor and Driscoll negotiated a 10% discounted rate, reducing the rate to $3,420 per weekday and $1,368 per weekend day. Travelers made payments of approximately $667,735.24 to Maple Manor Rehab, which covered Bourdage’s care from April 1, 2015 until October 31, 2015. Although Bourdage remained at Maple Manor Rehab until August 31, 2016, Travelers did not pay for any of the care or treatment he received after October 31, 2015.

In March 2016, Bourdage’s attorney filed a complaint for coverage against Travelers in Washtenaw Circuit Court.1 In November 2017, the trial court entered a stipulated order for dismissal of the action without prejudice; the order provided that Bourdage should refile the complaint within one week of the dismissal, and that the reinitiated case would, for purposes of the one-year-back rule of MCL 500.3145, involve expenses incurred on or after March 4, 2015.2 Bourdage refiled the case on November 21, 2017, seeking to recover all no-fault personal protection insurance (PIP) benefits due and owing, statutory interest of 12% per annum on all overdue benefits, and reasonable attorney fees for Travelers’ allegedly unreasonable refusal to pay or delay in payment.

On September 14, 2018, plaintiffs, Bourdage, and Travelers entered into a litigation agreement according to which Bourdage would assign his right to collect no-fault benefits to plaintiffs, plaintiffs and Bourdage would execute a “Hold-Harmless Agreement,” and plaintiffs would then substitute for Bourdage in the pending litigation. The agreement provided that, should the trial court deny the motion to substitute, plaintiffs could file a new action in Washtenaw Circuit Court seeking the same relief, and Travelers would agree, among other things, to waive any assertion of “the 1-year back provisions of MCL 500.3145” as a defense in the newly-filed action. The trial court subsequently entered a stipulated order allowing plaintiffs to substitute for Bourdage in the underlying case and to file a first amended complaint. In Count I of their first amended complaint, plaintiffs sought payment for the no-fault benefits due and owing for Bourdage’s care, 12% statutory interest, and reasonable attorney fees. Plaintiffs also added claims for breach of contract (Count II), promissory estoppel (Count III), fraud and misrepresentation (Count IV), silent fraud (Count V), and quantum meruit (Count VI).

On April 24, 2019, Travelers moved for summary disposition with respect to Maple Manor Neuro under MCR 2.116(C)(10), contending that Maple Manor Neuro did not have a right of recovery because it had not contracted to provide medical services to Bourdage, had not provided medical services to Bourdage, and was not licensed to provide adult foster care, nursing home, or subacute care services. Travelers also sought summary disposition with respect to Maple Manor Rehab under MCR 2.116(C)(10), arguing that Bourdage had not “incurred” debt for purposes of

1 The procedural history of this and related actions is complex; we will address it only to the extent pertinent to the issues before us on appeal. 2 It appears that the parties entered into this stipulation in light of a then-upcoming trial date, to allow time to complete necessary discovery and to allow for a meaningful facilitation.

-2- MCL 500.3107(1)(a) and, even if he had, Travelers was not liable for charges more than one year back from the date of the assignment, September 14, 2018. Travelers also moved to preclude evidence about the calculation and negotiation of the per diem rate charged for Bourdage’s care.

In response, plaintiffs argued that Maple Manor Neuro was established to bill for the few patients at Maple Manor Rehab who required “catastrophic subacute rehabilitation services arising out of automobile accidents,” that there was no requirement for the billing entity to be licensed, and that Maple Manor Neuro had a right of recovery because it was one of Bourdage’s assignees. Plaintiffs also argued that Bourdage had indisputably incurred medical debt and had assigned to plaintiffs the right to recover PIP benefits in payment of that debt, and that Travelers had agreed to waive the one-year-back rule for the newly filed case. Plaintiffs also argued that Travelers had provided no basis for excluding evidence of Taylor’s rate calculation and Travelers’ agreement to the negotiated per diem rate charged for Bourdage’s care and treatment.

After a hearing and additional briefing on the application of the one-year-back rule, the trial court entered an order denying summary disposition to Travelers and granting summary disposition in favor of plaintiffs under MCR 2.116(I). In addition to adopting plaintiffs’ reasoning, the trial court made the following findings and conclusions:

(1) that Defendant agreed to waive application of the one-year back rule; (2) that Defendant is summarily liable to pay [Plaintiffs’] bills as charged; (3) that Defendant has presented no evidence demonstrating a valid defense to the subject charges, including that the subject charges are not reasonable and necessary; (4) that Defendant contracted with Plaintiff[s] to pay [Plaintiffs’] charges in accordance with an agreed rate plan; and (5) that said payments are overdue.

The trial court found Travelers’ remaining claims, defenses, and arguments without merit. The trial court denied reconsideration.

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Maple Manor Rehab Ctr of Novi Inc v. Travelers Casualty & Surety, Counsel Stack Legal Research, https://law.counselstack.com/opinion/maple-manor-rehab-ctr-of-novi-inc-v-travelers-casualty-surety-michctapp-2022.