Spine Specialists of Michigan Pc v. Memberselect Insurance Company

CourtMichigan Supreme Court
DecidedApril 1, 2025
Docket165445
StatusPublished

This text of Spine Specialists of Michigan Pc v. Memberselect Insurance Company (Spine Specialists of Michigan Pc v. Memberselect Insurance Company) is published on Counsel Stack Legal Research, covering Michigan Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Spine Specialists of Michigan Pc v. Memberselect Insurance Company, (Mich. 2025).

Opinion

Michigan Supreme Court Lansing, Michigan

Syllabus Chief Justice: Justices: Elizabeth T. Clement Brian K. Zahra Richard H. Bernstein Megan K. Cavanagh Elizabeth M. Welch Kyra H. Bolden Kimberly A. Thomas

This syllabus constitutes no part of the opinion of the Court but has been prepared by the Reporter of Decisions for the convenience of the reader.

SPINE SPECIALISTS OF MICHIGAN PC v MEMBERSELECT INSURANCE COMPANY

Docket No. 165445. Argued on application for leave to appeal October 9, 2024. Decided April 1, 2025.

Spine Specialists of Michigan PC brought an action in the Macomb Circuit Court against MemberSelect Insurance Company, seeking payment for medical care it provided to Jeremy Woods, defendant’s insured, pursuant to Woods’s assignment of personal protection insurance (PIP) benefits under the no-fault act, MCL 500.3101 et seq. Woods was injured in an automobile collision in 2017 and received medical care from plaintiff. Woods assigned plaintiff his right to payment from defendant, but defendant refused to pay plaintiff. After plaintiff filed its action, defendant moved for summary disposition, asserting that the amounts sought by plaintiff were barred by the one-year-back rule, MCL 500.3145, which requires a claimant to file an action to recover benefits within one year of when the medical services in question were rendered. This provision was amended in 2019 to add MCL 500.3145(3), a tolling provision that extends the one- year period under certain circumstances. The trial court, Edward A. Servitto, J., granted defendant’s motion regarding plaintiff’s claims for services rendered before the amendment became effective on June 11, 2019, but denied defendant’s motion regarding plaintiff’s claims for services rendered between June 11, 2019 and August 12, 2020. Plaintiff appealed. The Court of Appeals, RIORDAN, P.J., and BOONSTRA and GADOLA, JJ., affirmed, reasoning that the tolling provision should not apply to the claims because PIP benefits accrue as each expense is “incurred,” which occurs when treatment is received, not when payment is denied. 345 Mich App 405 (2023). Plaintiff sought leave to appeal in the Supreme Court, which ordered oral argument on the application. 513 Mich 904 (2023).

In an opinion by Chief Justice CLEMENT, joined by Justices ZAHRA, BERNSTEIN, CAVANAGH, and BOLDEN, the Supreme Court held:

MCL 500.3145(3) does not apply retroactively to causes of action that began to accrue before that provision became effective on June 11, 2019. Accordingly, because a claim for PIP benefits accrues when medical services are rendered, plaintiff’s claims for services rendered between June 11, 2019 and August 12, 2020 were barred by the one-year-back rule. The Court of Appeals judgment was affirmed. 1. The one-year-back rule, which was the key aspect of the version of MCL 500.3145 effective before June 11, 2019, strictly limited any claims for benefits to expenses incurred within the year preceding the filing of the action. Under the amended statute, which added MCL 500.3145(3), the allowable period may be extended by the time between a “specific claim for payment” and when the insurer “formally denies” that claim. Accordingly, a claimant may now seek benefits beyond the strict one-year limit, depending on (1) the timing of the insurer’s response to the claim and its issuing of a formal denial, and (2) whether the person claiming benefits pursues the claim with reasonable diligence. Plaintiff filed its complaint after the amendment of MCL 500.3145 became effective, seeking payment for services rendered in April and May 2019. If the preamendment version of the statute applies, as the Court of Appeals held, the claims were time- barred because they pertained to losses incurred more than one year before the date on which the action was commenced under MCL 500.3145(2). By contrast, if the postamendment version applies, the claim might remain viable more than one year after accrual in the absence of a formal denial.

2. Substantive rights and liabilities are presumptively governed by the law in effect at the time a cause of action accrues. Because the one-year-back rule, which the tolling provision is a part of, may substantively reduce the monetary amount of benefits available, it is a substantive provision that affects substantive rights. A claim for PIP benefits accrues at the moment medical services are rendered—that is, when the expense is incurred by the provider. To “incur” means to become liable or subject to, especially because of one’s own actions. Woods received the medical care at issue from Spine Specialists in April and May 2019. On those dates, Woods incurred the expenses for the treatment he received, thereby creating liability for payment—a right he assigned to Spine Specialists. When Woods incurred these expenses, under MCL 500.3110(4), the claims accrued. Applying the amended statute to causes of action that accrued in April and May 2019— before the amendment’s effective date—would necessarily require retroactive application of the statute.

3. To determine whether a modified statute applies retroactively, courts consider the four principles set forth in LaFontaine Saline, Inc v Chrysler Group, LLC, 496 Mich 26 (2014): whether there is specific language providing for retroactive application, whether the statute is operating retroactively merely because it relates to an antecedent event, whether vested rights acquired under existing laws will be impaired and whether new obligations or duties will be created with respect to transactions or considerations already past, and whether the injury or claim is antecedent to the enactment of a remedial or procedural statute that does not affect vested rights. Though often labeled as the “LaFontaine factors,” they are better understood as discrete principles or considerations, each of which independently informs the retroactivity inquiry. Only the applicable principles need to be assessed, and any one may be dispositive, obviating the need to address the others. Under a LaFontaine analysis, the first and often most important principle to consider is whether there is specific language providing for retroactive application. While the amendments of MCL 500.3145 were specifically designated to be given “immediate effect,” they are still presumed to apply prospectively only, and the amendments of MCL 500.3145 contain no clear legislative intent that they apply retroactively. The “immediate effect” designation signifies a prompt enactment without implying retroactive applicability. By failing to modify the existing accrual rule under MCL 500.3110(4), the Legislature preserved the framework governing when claims accrue, reinforcing that the tolling provision should apply only to claims that began to accrue postamendment. Furthermore, applying the relevant LaFontaine principles showed that retroactive enforcement would impose new duties on insurers regarding previously completed transactions. This holding did not suggest that a tolling provision could never apply retroactively; rather, it emphasized that when such a provision introduces a new duty, retroactivity must be clearly indicated. In this case, the Legislature’s silence on retroactivity, combined with the imposition of new obligations and duties for transactions already past, confirmed that the tolling provision added to MCL 500.3145 should operate solely on a prospective basis.

Affirmed.

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