Therapy First LLC v. State Farm Mutual Automobile Insurance Co

CourtMichigan Court of Appeals
DecidedDecember 10, 2015
Docket321853
StatusUnpublished

This text of Therapy First LLC v. State Farm Mutual Automobile Insurance Co (Therapy First LLC v. State Farm Mutual Automobile Insurance Co) 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
Therapy First LLC v. State Farm Mutual Automobile Insurance Co, (Mich. Ct. App. 2015).

Opinion

STATE OF MICHIGAN

COURT OF APPEALS

THERAPY FIRST, LLC, d/b/a THERAPY 1ST, UNPUBLISHED December 10, 2015 Plaintiff-Appellant,

v No. 321853 Wayne Circuit Court STATE FARM MUTUAL AUTOMOBILE LC No. 11-009809-NF INSURANCE COMPANY,

Defendant-Appellee.

Before: MURRAY, P.J., and METER and RIORDAN, JJ.

PER CURIAM.

Plaintiff, Therapy First, LLC, d/b/a Therapy 1st, appeals as of right the trial court’s order awarding defendant, State Farm Mutual Automobile Insurance Company, attorney fees of $56,152 pursuant to MCL 500.3148(2). We affirm in part, vacate in part, and remand for further proceedings consistent with this opinion.

I. FACTUAL BACKGROUND

This appeal arises from an August 28, 2009 motor vehicle accident in Detroit involving Roger Bonds, to whom defendant had issued a no-fault insurance policy. In August 2011, plaintiff sued to recover under the no-fault act, MCL 500.3101 et seq., approximately $60,000 in physical therapy treatments that it provided to Bonds for injuries allegedly stemming from the August 2009 accident. In October 2013, a jury found that Bonds had suffered an injury arising from the August 2009 accident, but found that plaintiff had not incurred allowable expenses arising from the accident in treating Bonds between August 2010 and March 2012. The trial court entered a judgment for defendant and later awarded defendant $56,152 in attorney fees.

II. AWARD OF ATTORNEY FEES UNDER MCL 500.3148(2)

Plaintiff first argues that the trial court erroneously awarded defendant attorney fees under MCL 500.3148(2). According to plaintiff, even though defendant disputed the reasonableness and necessity of the services that plaintiff provided to Bonds, the trial court failed to find that any of the services qualified as excessive or without a reasonable foundation. Additionally, plaintiff contends that an award of attorney fees was improper under MCL 500.3148(2) because it introduced evidence that Bonds’ doctors had prescribed the physical therapy services that plaintiff provided, and defendant never suggested that plaintiff or Bonds

-1- engaged in any fraudulent conduct. Plaintiff further argues that the trial court erred to the extent that it relied on the jury’s verdict because the jury never made a finding that the therapy services were unreasonable. We reject plaintiff’s arguments.

A. STANDARD OF REVIEW

We review for an abuse of discretion a trial court’s “decision to award or deny attorney fees under MCL 500.3148(2).” Gentris v State Farm Mut Auto Ins Co, 297 Mich App 354, 361; 824 NW2d 609 (2012).

An abuse of discretion occurs when the trial court’s decision is outside the range of reasonable and principled outcomes. However, for purposes of MCL 500.3148(2), a trial court’s findings regarding the fraudulent, excessive, or unreasonable nature of a claim should not be reversed on appeal unless they are clearly erroneous. A decision is clearly erroneous when a reviewing court is left with a firm and definite conviction that a mistake was made by the lower court. Any issues regarding what legally constitutes fraud “in some respect,” excessiveness, and an unreasonable foundation are questions of law subject to de novo review. [Id. (quotation marks and citations omitted).]

We review de novo the legal questions inherent in statutory interpretation. Fieger v Cox, 274 Mich App 449, 464; 734 NW2d 602 (2007). In Pohutski v City of Allen Park, 465 Mich 675, 683; 641 NW2d 219 (2002), the Michigan Supreme Court summarized:

When faced with questions of statutory interpretation, our obligation is to discern and give effect to the Legislature’s intent as expressed in the words of the statute. We give the words of a statute their plain and ordinary meaning, looking outside the statute to ascertain the Legislature’s intent only if the statutory language is ambiguous. Where the language is unambiguous, we presume that the Legislature intended the meaning clearly expressed—no further judicial construction is required or permitted, and the statute must be enforced as written. [Quotation marks and citations omitted.]

B. ANALYSIS

Plaintiff incorrectly asserts that the trial court misconstrued the circumstances in which it may properly award attorney fees under MCL 500.3148(2). In relevant part, the statute provides that “[a]n insurer may be allowed by a court an award of a reasonable sum against a claimant as an attorney’s fee for the insurer’s attorney in defense against a claim that was in some respect fraudulent or so excessive as to have no reasonable foundation.” MCL 500.3148(2) (emphasis added). As explained in Gentris, 297 Mich App at 361-362:

The language of MCL 500.3148(2) indicates that a court may exercise its discretion by awarding attorney fees to an insurer, but only if a claim was in some respect fraudulent or so excessive as to have no reasonable foundation. The statute does not mandate that the court award attorney fees on a finding of fraud or excessiveness, nor does the statute require the court’s findings to be based on the jury’s verdict. However, the findings must be able to survive review under the -2- clearly-erroneous standard. Further, an award of attorney fees under the statute can be entered by a court on the basis of either fraud standing alone or excessiveness with no reasonable foundation or, of course, on the basis of both factors. [Footnote omitted.]

An appellate court should determine the trial court’s reasoning in ruling on the motion for attorney fees. Id. at 362.

In arguing that the services rendered were reasonable, plaintiff relies on deposition testimony introduced at trial from four doctors who provided the prescriptions for Bonds’ physical therapy between November 2009 and March 2012: Dr. Sunitha Santhakumar, a neurologist; Dr. Saul Weingarden, a specialist in physical medicine and rehabilitation; Dr. John Ryan, an orthopedic surgeon; and Dr. Jeffrey Pierce, a specialist in physical medicine and rehabilitation. These doctors agreed that all of the physical therapy they prescribed for Bonds was reasonable and necessary for his recovery from the August 2009 vehicle accident.

However, plaintiff largely ignores the testimony of two witnesses that defendant presented at trial.1 Dr. Annette DeSantis, a physician who specialized in physical medicine and rehabilitation, testified that she examined Bonds on April 1, 2010. At the time of the examination, Bonds complained about pain in his neck, left hand, left hip, and left leg down to his ankle, which he reported experiencing after an August 2009 motor vehicle accident. Dr. DeSantis undertook a physical examination of Bonds that yielded entirely normal results, including normal ranges of flexion and motion in Bonds’ neck, full ranges of motion in both shoulders, no abnormalities in the muscles around Bonds’ shoulders, and normal examinations of Bonds’ middle back and lower back areas. Dr. DeSantis concluded that Bonds might have suffered “some level of soft tissue strain” in the “neck and low back” and a sprained left elbow due to the August 2009 accident, but “four to six weeks of a therapy program” usually resolved those types of injuries. Likewise, Dr. DeSantis confirmed that four to six weeks of physical therapy would have been reasonable under the circumstances. Dr. DeSantis further noted that she saw in Bonds no objective signs of any “injury or disability related to the motor vehicle accident,” and Bonds required no additional physical therapy treatment when she examined him in April 2010.

Defendant also called Polly Swingle, an expert in physical therapy, to testify at trial. Plaintiff did not contest defendant’s summary of Swingle’s testimony at the hearing on defendant’s motion that “the prescriptions were lacking.

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Therapy First LLC v. State Farm Mutual Automobile Insurance Co, Counsel Stack Legal Research, https://law.counselstack.com/opinion/therapy-first-llc-v-state-farm-mutual-automobile-insurance-co-michctapp-2015.