Michigan Head & Spine Institute Pc v. Mi Assigned Claims Plan

CourtMichigan Court of Appeals
DecidedNovember 13, 2018
Docket339766
StatusUnpublished

This text of Michigan Head & Spine Institute Pc v. Mi Assigned Claims Plan (Michigan Head & Spine Institute Pc v. Mi Assigned Claims Plan) 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
Michigan Head & Spine Institute Pc v. Mi Assigned Claims Plan, (Mich. Ct. App. 2018).

Opinion

STATE OF MICHIGAN

COURT OF APPEALS

MICHIGAN HEAD & SPINE INSTITUTE, P.C., UNPUBLISHED November 13, 2018 Plaintiff-Appellant/Cross-Appellee,

v No. 339766 Oakland Circuit Court MICHIGAN ASSIGNED CLAIMS PLAN, LC No. 2016-153530-NF

Defendant-Appellee/Cross- Plaintiff/Cross-Appellee, and

HOME-OWNERS INSURANCE COMPANY,

Defendant-Appellee/Cross- Defendant/Cross-Appellant, and

UNNAMED ASSIGNEE OF THE MICHIGAN ASSIGNED CLAIMS PLAN,

Defendant.

Before: MURRAY, C.J., and METER and GLEICHER, JJ.

PER CURIAM.

Following a recent pronouncement of our Supreme Court, healthcare providers no longer have a direct cause of action against no-fault insurers to collect for services provided to injured parties. The injured party in this case, however, assigned her right to collect benefits to the healthcare provider. The circuit court improperly denied the healthcare provider’s motion to amend its complaint based on the assignment and therefore erroneously dismissed its action for lack of standing. We reverse that part of the circuit court’s opinion and order denying the motion to amend, vacate that portion summarily dismissing the action for lack of standing, and remand for further proceedings.

-1- I

Maureen Calcatera was seriously injured in a motor vehicle accident on February 9, 2016, while driving a Toyota Camry owned by and registered to her father, Michael Cuddihy, Jr. Calcatera did not live with Cuddihy, but had some level of permission to drive the vehicle, which was kept in the driveway at Cuddihy’s house. On the day in question, Calcatera entered Cuddihy’s home while he was sleeping, picked up the keys, and took the Camry to run errands.

Unfortunately, the Camry was not insured. On June 3, 2015, Cuddihy’s grandson, Sean Horvath, allegedly called the Lenahan-Versical Insurance Agency, at Cuddihy’s request, and cancelled a no-fault insurance policy covering the Camry because Cuddihy intended to transfer title to Calcatera.1 According to the insurance agent, Calcatera contacted the agency approximately two weeks later to confirm that the Camry’s policy had been cancelled. Calcatera denied making such a call and claimed that she “assumed” the vehicle was insured. Cuddihy never followed through with his gift, but also never restarted coverage. And Calcatera personally did not own a motor vehicle and therefore did not possess her own no-fault insurance coverage.

Michigan Head & Spine Institute (MHSI) provided medical and rehabilitative services to Calcatera from February 10 through June 6, 2016, leaving her with a $95,123 bill. MHSI had difficulty identifying the no-fault policy covering Calcatera in her accident. It therefore pursued reimbursement for Calcatera’s treatment from the Michigan Assigned Claims Plan (MACP).2 The MACP “serves as the insurer of last priority.” Titan Ins Co v American Country Ins Co, 312 Mich App 291, 298; 876 NW2d 853 (2015). Pursuant to MCL 500.3172, the MACP is required to investigate whether any policy of higher priority exists (as enumerated in MCL 500.3114) and if none are found, to assign an insurer to bear the duty of coverage. The MACP delayed in assigning the claim to a no-fault insurer, leading MHSI to file the instant lawsuit on June 16, 2016. Two months after MHSI filed suit, Calcatera assigned to MHSI her “right to collect no- fault insurance benefits, if any, for unpaid services rendered by [MHSI] to date.” The assignment was consistent with MCL 500.3143, which precludes the assignment of a right to collect future benefits.

The MACP investigated coverage options and eventually discovered that Cuddihy possessed no-fault insurance through Home-Owners Insurance Company, although the parties later discovered that this policy actually covered only Cuddihy’s other vehicle—a Jeep. The circuit court granted MHSI’s motion to add Home-Owners as a party defendant in its first

1 Cuddihy remembered that he intended to transfer title to Calcatera and that he changed his mind. However, Cuddihy did not remember that he had ever insured the vehicle. During his deposition, Cuddihy indicated that at age 81, his memory was not what it used to be. 2 Calcatera was also treated at McLaren Macomb Hospital and the hospital joined MHSI in seeking reimbursement from the MACP outside of court. The hospital is not a party to this lawsuit and there is no record indication whether McLaren pursued separate legal action.

-2- amended complaint and the MACP filed a cross-complaint against Home-Owners as well, claiming that Home-Owners had first priority to provide coverage to Calcatera.

Home-Owners sought summary disposition of both MHSI’s and the MACP’s claims, asserting that Calcatera knowingly operated an uninsured vehicle and therefore was not entitled to personal protection insurance (PIP) benefits under the no-fault act. Home-Owners explained that Cuddihy had maintained insurance on the vehicle through June 3, 2015, when he and his grandson contacted the agency to remove the Camry. Home-Owners further argued that Calcatera did not fall within the three categories of individuals entitled to benefits under MCL 500.3114(1); she was not the named insured or the named insured’s spouse, and she was not a resident relative of the insured.

The MACP challenged Home-Owners’ motion with evidence that Calcatera believed the Camry was insured. It also contended that Home-Owners was on the hook because Cuddihy “remained a Home-Owners insured” by virtue of his other vehicle. MHSI added that Home- Owners relied upon the inadmissible hearsay statements of its agent, making the motion “[a]t best . . . premature as the facts regarding insurance coverage have not been fl[e]shed out due to the fact that no discovery has been served upon Home-Owners.”

Before the circuit court had considered Home-Owners’ motion,3 the Michigan Supreme Court issued Covenant Med Ctr, Inc v State Farm Mut Auto Ins Co, 500 Mich 191; 895 NW2d 490 (2017), on May 25, 2017. In Covenant, 500 Mich at 196, the Court held “that healthcare providers do not possess a statutory cause of action against no-fault insurers for recovery of [PIP] benefits under the no-fault act.” Healthcare providers still “may seek payment from the injured person for the provider’s reasonable charges,” id. at 217, and the injured person may in turn fight the insurance battle. Covenant’s ruling also 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. Accordingly, an injured party could still assign his or her right to recover benefits.

The very next day, Home-Owners filed a renewed motion for summary disposition. Home-Owners clarified its initial argument, asserting that Calcatera was a “constructive owner” of the Camry as she regularly used it under a blanket grant of permission, and knowingly drove it without mandatory no-fault insurance coverage. Accordingly, neither she nor her medical service providers were entitled to recovery or reimbursement pursuant to MCL 500.3113(b).4 Home-Owners added that MHSI lacked standing to bring suit under Covenant.

3 In its final opinion and order, the circuit court indicated that it had previously dismissed Home- Owners’ first summary disposition motion as moot. No such order appears in the lower court record. 4 MCL 500.3113(b) excludes a person from claiming PIP benefits when he or she “was the owner or registrant of a motor vehicle . . . involved in the accident with respect to which the security required by [MCL 500.3101 or MCL 3103] was not in effect.”

-3- The MACP responded by playing both sides of the field. It contended that evidence showed that Calcatera was not a constructive owner of the Camry and denied that Covenant applied to eliminate MHSI’s standing.

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Michigan Head & Spine Institute Pc v. Mi Assigned Claims Plan, Counsel Stack Legal Research, https://law.counselstack.com/opinion/michigan-head-spine-institute-pc-v-mi-assigned-claims-plan-michctapp-2018.