e-Journal Summary

e-Journal Number : 81388
Opinion Date : 04/04/2024
e-Journal Date : 04/16/2024
Court : Michigan Court of Appeals
Case Name : Aja v. Progressive MI Ins. Co.
Practice Area(s) : Healthcare Law Insurance
Judge(s) : Per Curiam – Garrett, Riordan, and Letica
Full PDF Opinion
Issues:

No-Fault Act PIP benefits; Assignments; Motion to reinstate certain medical bills; Wallace v Suburban Mobility Auth for Reg’l Transp; Sale or assignment of right to recover payment to a third party; Revocation of assignments of rights to the medical providers; One-year-back rule

Summary

In this no-fault case, the court held that the trial court did not abuse its discretion by denying plaintiff-insured’s motion to reinstate certain medical bills. Plaintiff was in an auto accident. He was insured by defendant. He executed assignments to various medical providers including nonparties-Columbia Clinic and Capital Surgery (the providers). In each assignment, he “transferred his right to collect insurance benefits related to the treatment he received from each provider.” The court concluded that “the medical providers as assignees held the right to seek to recover the unpaid medical bills, and plaintiff no longer had a cause of action to pursue, having transferred it away to” the providers. The court also held that the providers’ claims “were barred by the one-year-back rule.” It found that the case was “similar to the circumstances in Wallace, which featured a claimant, like plaintiff, seeking the recovery of medical bills that were assigned before the initiation of litigation. However, at the time of the subsequent revocation of assignment, the medical providers no longer maintained a viable, transferrable right to recover PIP benefits because they failed to comply with the one-year-back rule.” Thus, the court held there that “the medical providers’ rights under the assignment were statutorily barred.” The court determined that here, “much like in Wallace,” when plaintiff obtained revocations of his assignments, “‘each provider’s right to collect on these claims for benefits had already been extinguished by the one year-back rule. Thus, there remained no actionable causes of action to give back to plaintiff.’” Finally, the providers filed suit on 7/22/21, “approximately one year and four months after they provided services to plaintiff, and any liability for their claims was extinguished by the time plaintiff received the revocations of the assignments in” 1/22. The court concluded that “even if the parties complied with” a mandated 3/3/22 deadline for “the dismissal of the provider suit, the matter of plaintiff bringing suit when he was not the real party in interest remains an insurmountable obstacle to obtaining relief due to the previous assignments.” Affirmed.

Full PDF Opinion