W a Foote Memorial Hospital v. Michigan Assigned Claims Plan

CourtMichigan Court of Appeals
DecidedAugust 31, 2017
Docket333360
StatusPublished

This text of W a Foote Memorial Hospital v. Michigan Assigned Claims Plan (W a Foote Memorial Hospital v. Michigan 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
W a Foote Memorial Hospital v. Michigan Assigned Claims Plan, (Mich. Ct. App. 2017).

Opinion

STATE OF MICHIGAN

COURT OF APPEALS

W A FOOTE MEMORIAL HOSPITAL, doing FOR PUBLICATION business as ALLEGIANCE HEALTH, August 31, 2017 9:00 a.m. Plaintiff-Appellant,

v No. 333360 Kent Circuit Court MICHIGAN ASSIGNED CLAIMS PLAN and LC No. 15-008218-NF MICHIGAN AUTOMOBILE INSURANCE PLACEMENT FACILITY,

Defendants-Appellees, and

JOHN DOE INSURANCE COMPANY,

Defendant.

Before: BOONSTRA, P.J., and RONAYNE KRAUSE and SWARTZLE, JJ.

BOONSTRA, P.J.

Plaintiff appeals by right the trial court’s order denying its motion for summary disposition and granting the cross-motion for summary disposition filed by defendants Michigan Assigned Claims Plan and Michigan Automobile Insurance Placement Facility (collectively, “defendants”). We affirm, and remand for further proceedings consistent with this opinion.

I. PERTINENT FACTS AND PROCEDURAL HISTORY

This case arises out of an automobile accident that occurred on September 4, 2014. Zoie Bonner was a passenger in a 2003 Ford Taurus driven by her boyfriend, Philip Kerr, when it rear-ended another vehicle. The Taurus was owned by Bonner’s aunt or uncle, and was insured under an automobile insurance policy issued by Citizens Insurance Company of the Midwest (“Citizens”). The police report generated by the Jackson City Police Department concerning the accident identified the applicable insurance for the Taurus as “Citizens Insurance.” It also contained Kerr’s name, a description of the vehicle, the vehicle registration number, and the vehicle identification number. It did not, however, identify Bonner as a passenger in the Taurus or as an injured party. Bonner did not seek immediate medical attention, but was treated for rib pain by plaintiff’s emergency department the following day. Bonner’s emergency department

-1- chart indicates that she told medical providers that she was involved in a motor vehicle accident the previous day in which she was a passenger in a vehicle that had rear-ended another vehicle. It does not appear that any employees of plaintiff asked Bonner about applicable automobile insurance. Plaintiff provided Bonner with medical services valued at $9,113.

During the year following the accident, plaintiff repeatedly attempted to contact Bonner to obtain information concerning applicable insurance coverage. Plaintiff sent letters, telephoned Bonner, and hired a private investigator eight months after the accident. The private investigator eventually made contact1 with Bonner in June 2015. Bonner stated that neither she nor her boyfriend had automobile insurance but that her aunt owned the vehicle that Kerr had been driving. Neither plaintiff nor its investigator obtained any contact information for Bonner’s aunt or boyfriend, apparently failing even to obtain Bonner’s aunt’s or Kerr’s name. They also did not obtain the police report from the accident.

On September 3, 2015 (one day before the one-year anniversary of the accident), plaintiff filed a claim with defendants, seeking no-fault personal protection insurance benefits (also called personal injury protection benefits or PIP benefits) on Bonner’s behalf under Michigan’s no-fault insurance act, MCL 500.3101 et seq. Under the no-fault act, an injured person may seek PIP benefits from defendants within one year of the injury when no personal protection insurance applicable to the injury can be identified. MCL 500.3172(1); MCL 500.3145.2 The following day, and before any response from defendants, plaintiff filed suit requesting that the trial court enter a judgment declaring that defendants had a duty to promptly assign its claim to an insurer and that, upon assignment, the insurer would be responsible to process and pay the claim.

On September 17, 2015, defendants responded to plaintiff’s claim with a letter indicating that it was unable to process the claim without additional information. The letter requested that additional information be forwarded to defendants and stated that the claim would be reviewed once complete information was received. In October 2015, defendants answered plaintiff’s complaint, asserting, among other defenses, that plaintiff had failed to state a claim for which relief could be granted, that plaintiff had not submitted a completed claim for PIP benefits, that defendants did not owe benefits because they were not “incurred” by Bonner, and that plaintiff was precluded from obtaining relief because plaintiff had “failed to obtain primary coverage within the obligation of the primary carrier(s)” to the detriment of defendants.

Bonner was deposed in December 2015. She testified that her aunt owned the vehicle and maintained insurance on it,3 although she did not know the name of the insurer. Citizens was subsequently identified as the insurer of the vehicle. Plaintiff attempted to submit a claim

1 The investigator’s report states that an unnamed employee of plaintiff called the investigator with “Zoie on the other line” and relayed information to the investigator from Bonner. 2 The applicable limitations period may be extended if written notice of injury has been provided to the insurer within 1 year after the accident. MCL 500.3145(1). 3 Apparently, it was actually Bonner’s uncle who owned and purchased insurance on the vehicle.

-2- for PIP benefits to Citizens, but Citizens denied the claim as being beyond the one-year deadline contained in MCL 500.3145.

Defendants moved for summary disposition under MCR 2.116(C)(10), arguing that plaintiff’s claim was ineligible for assignment because applicable insurance had been identified, and because plaintiff could have recovered PIP benefits from Citizens if it had acted in a timely fashion. Plaintiff responded and also moved for summary disposition, arguing that defendants were required to promptly assign plaintiff’s claim at the time of the claim application unless the claim was obviously ineligible, and that they had failed to do so. Plaintiff argued that the subsequent discovery of information concerning the Citizens policy did not alter this obligation.

After a hearing on the parties’ motions, the trial court denied plaintiff’s motion for summary disposition and granted defendants’ motion for summary disposition, reasoning that plaintiff had failed to demonstrate that it could not have identified applicable insurance at the time it submitted its application for PIP benefits to defendants. Further, plaintiff could have learned of the Citizens policy if it had filed suit directly against Bonner for the unpaid medical bills, if it had obtained proper information from Bonner at the time of treatment, if it had obtained the police report concerning the automobile accident, or if it had followed up on information that Bonner’s aunt owned the vehicle in question.

This appeal followed. During the pendency of this appeal, our Supreme Court issued its opinion in Covenant Med Ctr, Inc v State Farm Mut Ins Co, ___ Mich ___; 895 NW2d 490 (2017) (Docket No. 152758). Covenant reversed decisions of this Court that had recognized that healthcare providers could maintain direct causes of action against insurers to recover PIP benefits, and held that no such statutory cause of action exists. Id., slip op at 2. On August 1, 2017, defendants filed motions with this Court for immediate consideration and for leave to file a nonconforming supplemental authority brief addressing Covenant and its effect on this case. This Court granted the motions, and accepted the supplemental briefs that had been submitted by both plaintiff and defendants.4

II. STANDARD OF REVIEW

This Court reviews de novo the grant or denial of motions for summary disposition under MCR 2.116(C)(10). See Johnson v Recca, 492 Mich 169, 173; 821 NW2d 520 (2012).

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W a Foote Memorial Hospital v. Michigan Assigned Claims Plan, Counsel Stack Legal Research, https://law.counselstack.com/opinion/w-a-foote-memorial-hospital-v-michigan-assigned-claims-plan-michctapp-2017.