Medical Alternatives v. Auto-Owners Insurance Company

CourtMichigan Court of Appeals
DecidedNovember 1, 2018
Docket340561
StatusUnpublished

This text of Medical Alternatives v. Auto-Owners Insurance Company (Medical Alternatives v. Auto-Owners 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
Medical Alternatives v. Auto-Owners Insurance Company, (Mich. Ct. App. 2018).

Opinion

STATE OF MICHIGAN

COURT OF APPEALS

MEDICAL ALTERNATIVES, UNPUBLISHED November 1, 2018 Plaintiff-Appellee,

v No. 340561 Washtenaw Circuit Court AUTO-OWNERS INSURANCE COMPANY, LC No. 15-000751-NF

Defendant-Appellant.

Before: BECKERING, P.J., and RIORDAN and CAMERON, JJ.

PER CURIAM.

In this action pursuant to the no-fault act, MCL 500.3101 et seq., defendant Auto-Owners Insurance Company appeals as of right the judgment entered in favor of plaintiff Medical Alternatives after a jury trial. The trial court also denied defendant’s motions for a directed verdict, judgment notwithstanding the verdict (JNOV), and summary disposition, and granted plaintiff’s motion to amend the complaint after trial and to have the judgment reflect plaintiff’s status as an assignee of the insured. We reverse in part, vacate in part, and remand for further proceedings consistent with this opinion.

I. FACTUAL BACKGROUND & PROCEDURAL HISTORY

This case arises out of defendant’s responsibility to pay long-term benefits for injuries to its insured, Mary Ann Malloy, under the no-fault act. Mary Ann suffered severe injuries during an automobile accident that occurred in 1979, during which she was thrown through the windshield of her car and ended up in a coma for several months. Mary Ann continues to struggle with severe cognitive issues, including an extremely short-term memory, necessitating 16 hours per day of direct attendant care and 24 hours per day of available supervision, as recommended by her doctor. Mary Ann’s mother, Kathern Malloy, generally attended to Mary Ann. However, as Kathern aged, she grew concerned about Mary Ann’s future. In an attempt to secure Mary Ann’s future, her family reached out to a firm, Siporin & Associates, which was appointed as Mary Ann’s co-guardian. Steven Siporin, the owner of the firm, reached an agreement with Rochelle Greenberg, plaintiff’s owner, for plaintiff to provide the direct attendant care, supervision, and various other services required for Mary Ann. Plaintiff retained Kathern to continue her direct care of Mary Ann in their home. Concurrently, plaintiff began preparing Mary Ann for a potential shift when Kathern grew too old to continue caring for her.

-1- Siporin and Greenberg agreed that plaintiff would be paid $360 per day for those services beginning in February of 2015.

When defendant received the invoices for the services provided by plaintiff, defendant refused to pay the full amount billed. Knowing that Mary Ann required some level of care, but believing that plaintiff’s charges were not reasonable, defendant began paying a reduced amount of $3,300 per month, or $110 per day. Plaintiff sued defendant for the unpaid charges on July 29, 2015. The case proceeded to trial largely regarding the factual issue of the reasonableness of plaintiff’s charges. After the close of plaintiff’s case-in-chief, defendant moved the trial court for a directed verdict, arguing that plaintiff had not provided evidence to support that it had incurred charges for the direct attendant care provided by Kathern. Specifically, Kathern had testified that she was being paid only $250 per month by plaintiff. Defendant argued that any additional money for direct attendant care had not been incurred. The trial court denied the motion, believing that Kathern’s wages were not relevant to the issue of whether Mary Ann had incurred charges from plaintiff, which was the proper test.

During deliberations, the jury sent a question to the trial court asking if it could award a specific sum of money to be paid to Kathern. The parties stipulated that the trial court should tell the jury that they could not do so, but that they could include a recommendation. On May 18, 2017, the jury issued a verdict in favor of plaintiff for $156,798.94 plus interest of $21,734.39, and recommended that $101,250 be paid to Kathern. One week after the jury’s verdict, the Michigan Supreme Court issued its opinion in Covenant Med Ctr, Inc v State Farm Mut Auto Ins Co, 500 Mich 191; 895 NW2d 490 (2017), overruling years of this Court’s caselaw that medical providers could bring a statutory claim directly against a no-fault insurer. Defendant then filed an array of motions, including one for summary disposition and one for JNOV, arguing that the trial court should vacate the jury’s verdict and dismiss plaintiff’s case pursuant to Covenant. Plaintiff, in response, argued that defendant had waited too long to raise the issue, and alternatively, that the trial court should permit plaintiff to amend the complaint, referencing an assignment of rights signed by Siporin on May 12, 2017, and enter a judgment that reflected plaintiff’s status as an assignee. After several more motions and briefs, and two hearings, the trial court ultimately denied all of defendant’s motions, finding that defendant was barred from raising Covenant because it failed to do so during trial, and granted plaintiff’s motions to amend the complaint and enter a judgment that reflected its status as an assignee. The trial court entered such a judgment, and this appeal followed.

II. RETROACTIVITY OF COVENANT

Defendant argues that the trial court erred in refusing to retroactively apply Covenant. We agree.

A. STANDARD OF REVIEW & GENERAL LAW

“[Q]uestions concerning the retroactivity of earlier judicial decisions are for this Court to decide de novo as matters of law.” Lincoln v Gen Motors Corp, 461 Mich 483, 490; 607 NW2d 73 (2000).

-2- Pursuant to MCL 500.3112, no-fault “insurance benefits are payable to or for the benefit of an injured person, or, in case of his death, to or for the benefit of his dependents.” In Covenant, 500 Mich at 196, 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.” “In so ruling, the Covenant Court declined to follow the long line of cases from the Court of Appeals recognizing that a healthcare provider may sue a no-fault insurer to recover PIP benefits under the no-fault act.” VHS Huron Valley Sinai Hosp v Sentinel Ins Co, 322 Mich App 707, 713; 916 NW2d 218 (2018) (quotation marks omitted). When applying Covenant, this Court has held that, “[q]uite simply, as a healthcare provider, plaintiff has no independent statutory claim against defendants.” Bronson Healthcare Group, Inc v Mich Assigned Claims Plan, 323 Mich App 302, 305; ___ NW2d ___ (2018).

This Court also has considered arguments regarding the retroactive effect to be given the Court’s holding in Covenant. To wit, in W A Foote, 321 Mich App at 191 (quotation marks omitted), this Court held that the rule announced in Covenant must be retroactively applied “to all cases still open on direct review and as to all events, regardless of whether such events predate or postdate [the] announcement of the rule.” In Bronson Healthcare, 323 Mich App at 305-306, this Court clarified that Covenant was to be applied to cases even where the issue of standing or legal capacity to sue was never raised before the trial court. The Bronson Healthcare panel reasoned that “we have previously rejected preservation arguments relating to Covenant and exercised our discretion to review Covenant arguments that were not raised before, addressed and decided by, the trial court.” Id., citing W A Foote, 321 Mich App at 173-174; VHS Huron Valley, 322 Mich App at 714-715.

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Medical Alternatives v. Auto-Owners Insurance Company, Counsel Stack Legal Research, https://law.counselstack.com/opinion/medical-alternatives-v-auto-owners-insurance-company-michctapp-2018.