Action seeking PIP benefits under MCL 500.3107(1)(a); Allowable expenses; Douglas v Allstate Ins Co; Whether an expense is “incurred”; Proudfoot v State Farm Mut Ins Co; Comparing Shanafelt v Allstate Ins Co & Bombalski v Auto Club Ins Ass’n; Detroit Medical Center Sinai-Grace Hospital (DMC)

The court held that the trial court did not err by granting defendant-insurer’s motion for partial summary disposition of plaintiff’s action seeking no-fault benefits after a car crash. The parties were able to resolve all of their differences except for whether defendant was obligated to pay PIP benefits for the billed cost of plaintiff’s treatment at DMC from 12/5/19 to 12/8/19. On that issue, the trial court ruled in favor of defendant. On appeal, the court noted that “the evidence submitted by the parties leads to one conclusion: that DMC accepted Medicaid’s payment as satisfaction of” plaintiff’s medical bill. Defendant “submitted evidence showing that, after DMC accepted Medicaid’s payment, [it] reduced the amount [plaintiff] was required to pay on her bill to $0.” In response she “failed to submit evidence creating a question of fact whether Medicaid’s payment to DMC satisfied [her] liability to DMC. Without evidence that [she] remains liable to DMC for any amount in excess of what Medicaid paid,” defendant was correct that the only charges she “incurred” for services provided at DMC between 12/5/19 and 12/8/19 was the amount paid by Medicaid. As such, defendant is “only responsible for paying that amount under MCL 500.3107(1)(a).” Ultimately, there was “no question of fact that [plaintiff] did not ‘incur’ allowable expenses beyond what Medicaid paid, and [defendant] is only responsible for paying that amount at this time.” The court expressly declined “to reach the issue of whether it would hypothetically be legal for DMC to collect additional payment from [plaintiff] beyond what Medicaid paid because there is no evidence that DMC has done that or is planning to do so in this case.” Thus, it affirmed the trial court, but on different grounds.