e-Journal Summary

e-Journal Number : 79079
Opinion Date : 03/09/2023
e-Journal Date : 03/22/2023
Court : Michigan Court of Appeals
Case Name : Health Partners, Inc. v. Progressive MI Ins. Co.
Practice Area(s) : Healthcare Law Insurance
Judge(s) : Per Curiam – Patel, Borrello, and Shapiro
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Issues:

Retroactive application of the 2019 amendment to MCL 500.3145 adding a tolling provision to the one-year-back rule; Spine Specialists of MI, PC v MemberSelect Ins Co; Encompass Healthcare, PLLC v Citizens Ins Co; Devillers v Auto Club Ins Ass’n

Summary

The court held that the claims at issue in this interlocutory appeal concerning “medical care that was provided more than one year before this action was commenced and before the effective date of the” 2019 amendment, were time barred. Thus, it reversed the denial of defendant-insurer’s summary disposition motion and remanded. The court recently held in Spine Specialists “that the amendments to § 3145 do not apply retroactively to claims that accrued before [6/10/19], the effective date of the amendments.” That decision was directly applicable to the facts here and binding. “The pre-amendment version of § 3145 applies to the claims at issue here, which were incurred from” 12/17 through 3/10/19. Plaintiff-Health Partners could not “rely on the tolling provision in the amended statute and the at-issue claims are time barred.”  Health Partners argued that the court should not apply Spine Specialists, and, instead, relied on Encompass Healthcare “for the proposition that the amended statute applies to losses incurred before [6/10/19]. Because Encompass Healthcare was released prior to Spine Specialists,” Health Partners argued that it should control the outcome of the case here. The court disagreed. Encompass Healthcare, like Spine Specialists, and the case here, “dealt with medical care provided before [6/10/19] (the effective date of the amended statute), the one-year-back rule, and the amended version of § 3145. The distinction, however, is that the parties in Encompass Healthcare did not dispute that the amended statute—with the tolling provision—applied.” Instead, the parties disputed, and the court “decided, whether the defendant had ‘formally denied’ the plaintiff’s claims. This Court held that the claims were never formally denied because the defendant ‘did not provide the explicit and unequivocal expression of finality required to constitute formal denials[.]’” The court held there that, “because there was never a formal denial, the one-year-back rule was tolled.” The issue of whether the amendment applied retroactively was raised and decided in Spine Specialists, and the court was bound by that decision. But the court noted that “Spine Specialists did not address the impact of the holding in Encompass Healthcare that the amendment to MCL 500.3145 is remedial in nature, or whether the remedial nature of the amendment makes it retroactive. We recognize that there is arguably some tension between the holding in Spine Specialists and Encompass Healthcare. This is, however, an issue for the Supreme Court to clarify.”

 

Full PDF Opinion