e-Journal Summary

e-Journal Number : 75900
Opinion Date : 07/22/2021
e-Journal Date : 08/03/2021
Court : Michigan Court of Appeals
Case Name : Spectrum Health Hosps. v. Farm Bureau Gen. Ins Co. of MI
Practice Area(s) : Healthcare Law Insurance
Judge(s) : Per Curiam – Borrello, Servitto, and Stephens
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Issues:

Whether plaintiff-healthcare provider had standing; Validity of an assignment; Applicability of Jawad A Shah, MD, PC v State Farm Mut Auto Ins Co; Use of “all”; Assignment of the right to no-fault penalty interest & attorney fees; Lakeland Neurocare Ctrs v State Farm Mut Auto Ins Co; Attorney fees under MCL 500.3148(1); Moore v Secura Ins

Summary

Concluding that Shah did not apply, the court rejected defendant-insurer’s assertion that plaintiffs-healthcare providers lacked standing to sue it for unpaid charges for its insured’s (S) medical treatment. Under S’s assignments, plaintiffs took all rights S had at the time of the assignments. The court also rejected defendant’s argument that S could not assign them his right to no-fault penalty interest and attorney fees. But the trial court did not err in denying plaintiffs attorney fees under MCL 500.3148(1). While defendant relied on Shah in making its standing argument, no assignments here “were obtained long after the services were provided in order to avoid summary disposition, and plaintiffs did not file any supplemental pleadings. More importantly, the last assignment” S signed, on 11/23/18 (which defendant specifically challenged) contained the same language as those S signed on 11/17/17, 1/8/18, 3/6/18, and 10/18/18. Further, the plain language of the assignments made it “clear that plaintiffs, as assignees, take all rights that [S] had at the time . . . .” Thus, defendant was properly denied summary disposition as to “the scope of the assignments and their impact on plaintiffs’ standing.” The trial court also did not err in denying its summary disposition motion as to S’s alleged “inability to assign his right to no-fault penalty interest and attorney fees to plaintiffs.” Covenant made it clear that insureds “are free to assign all of their rights to a healthcare provider." But as to attorney fees, when defendant decided not to pay the charges, its question as to whether they “were reasonable, and what criteria may be used to determine whether those charges were reasonable, was an ongoing source of litigation in” the court and the Supreme Court. Thus, it was not unreasonable for it “to deny payments while it awaited the conclusion of those issues because they presented legitimate legal questions.” Affirmed.

Full PDF Opinion