Attorney fees under MCL 500.3148(1); Principle that PIP benefits are overdue if not paid within 30 days after an insurer receives reasonable proof of the fact & amount of loss sustained; MCL 500.3142(2); Reasonableness; Moore v Secura Ins; Case evaluation sanctions; Whether a verdict may be adjusted for amounts paid before trial; MCR 2.403(O)(1) & (3)

The court held that plaintiff was entitled to fees and costs because of defendant-insurer’s failure to timely pay PIP benefits, but it rejected his argument that the verdict should be adjusted for case evaluation sanction purposes based on money defendant paid to satisfy a Medicaid lien before trial. Thus, it affirmed in part, reversed in part, and remanded with instructions that “the trial court, after determining the amount of attorney fees to which plaintiff is entitled, shall then address whether the verdict should be adjusted for purposes of case evaluation sanctions by adding the amount of the attorney fee award.” Plaintiff was injured in an auto accident and defendant “was responsible for the payment of certain medical and replacement services benefits.” The matter was submitted to case evaluation, resulting in an award of $50,000, which both sides rejected. Following a bench trial, plaintiff was awarded $27,806.24. Because this amount was less than the case evaluation award, the trial court awarded sanctions to defendant. On appeal, the court agreed with plaintiff that he was entitled to fees and costs because of defendant’s failure to timely pay the benefits. It seemed that he was “entitled to an attorney fee award for any attendant care and replacement services benefits that the trial court awarded at trial and for which defendant could have determined, at the time of the case evaluation, were, in fact, due and owing and not paid within 30 days.” The court found that the “trial court’s conclusions that plaintiff was entitled to interest from the date of case evaluation on the amounts awarded at trial because defendant was at that time aware of the outstanding claim is at odds with its later conclusion that the payment was not overdue and the delay in payment was not unreasonable.” However, it rejected his claim that the award should have also included over $65,000 defendant paid the day before trial to the State of Michigan in satisfaction of a Medicaid lien for medical bills initially paid by Medicaid after the accident. First, it was “clear that the Medicaid lien was never included in the case evaluation award and, therefore, there would be no basis for including it in the verdict in determining case evaluation sanctions.” Second, MCR 2.403(O)(1) does not “provide for an adjustment for the pretrial payment of a portion of the claim.”