e-Journal Summary

e-Journal Number : 69906
Opinion Date : 02/26/2019
e-Journal Date : 03/13/2019
Court : Michigan Court of Appeals
Case Name : North Shore Injury Ctr., Inc. v. Home-Owners Ins. Co.
Practice Area(s) : Healthcare Law Insurance
Judge(s) : Per Curiam - Cavanagh, Borrello, and Redford
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Issues:

Action by healthcare providers to recover personal protection insurance (PIP) benefits under the No-Fault Act (MCL 500.3101 et seq.) for medical services provided to defendant’s insured; Covenant Med. Ctr., Inc. v. State Farm Mut. Auto. Ins. Co.; Jawad A Shah, MD, PC v. State Farm Mut. Auto. Ins. Co.; Henry Ford Health Sys. v. Everest Nat’l Ins. Co.; Principle that an accrued cause of action may be freely assigned after the loss & that an anti-assignment clause is not enforceable to restrict such an assignment because such a clause violates public policy in that situation; Roger Williams Ins. Co. v. Carrington; Principle that an agreement for assignment of a right to benefits payable in the future is void; MCL 500.3143; Professional Rehab. Assoc. v. State Farm Mut. Auto. Ins. Co.

Summary

The court held that the trial court did not err by denying defendant-insurer’s motion for summary disposition in plaintiffs-healthcare providers’ action seeking to recover PIP benefits for medical services they provided to defendant’s insured. The court rejected defendant’s argument that it was entitled to summary disposition because medical providers do not have a cause of action against insurers under the No-Fault Act and the insured was prohibited from splitting his cause of action into separate damage claims and assigning them to others. “Under Covenant, plaintiffs and intervening plaintiff do not have a statutory cause of action against defendant to pursue payment of no-fault benefits, but clearly Covenant does not prevent their claims by way of assignment.” The assignments of rights in this case “specified that they allowed plaintiffs ‘to enforce payment of benefits due or past due for the Services.’” Thus, the question was whether they “afforded plaintiffs and intervening plaintiff a legally sufficient cause of action such that they could state a claim upon which relief can be granted in their amended complaints.” The court also rejected defendant’s claim that its insured was “prohibited from using assignments to split his single cause of action for PIP benefits into multiple claims” filed by several providers. “Because each payment presents a new claim, the [N]o-[F]ault [A]ct necessarily permits multiple suits to enforce the payments.” It next rejected defendant’s contention that the anti-assignment clause in the policy prevented the assignments that occurred. “Although the trial court found the clause to be an ‘anti-transfer clause,’” it was “actually an anti-assignment clause.” Under Roger Williams, the “policy’s prohibition against [the insured] assigning his claims [wa]s unenforceable because it [wa]s against public policy.” As such, “the anti-assignment clause [wa]s unenforceable to prohibit the assignments that were executed.” Finally, the court rejected defendant’s argument that MCL 500.3143 prohibited the assignments because the PIP benefits were disputed and had not yet been paid. “Because the Shah and Henry Ford assignments were enforced despite the providers’ refusal to pay benefits, [the insured’s] assignments [we]re enforceable too, even though defendant disputes the payment of benefits.” Affirmed.

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