No-fault insurance; Personal protection insurance (PIP) benefits; Allowable expenses; MCL 500.3107(1)(a); Reasonably necessary products, services, & accommodations; Nasser v Auto Club Ins Ass’n; Objective standard; Krohn v Home-Owners Ins Co; Care, recovery, or rehabilitation; Admire v Auto-Owners Ins Co; Experimental treatment for a traumatic brain injury (TBI); Hyperbaric oxygen therapy (HBOT); Genuine issue of material fact

The court held that a genuine issue of material fact existed as to whether HBOT was an allowable expense under MCL 500.3107(1)(a). Plaintiff-hospital sought nearly $900,000 from defendant no-fault insurer for HBOT provided to a minor (DK) who suffered a TBI in a motor-vehicle accident. The trial court granted summary disposition to defendant, reasoning that the treatment was experimental for a TBI and not FDA-approved. On appeal, the court held that “[n]either factor is dispositive in and of itself.” Relying on Krohn, it explained that MCL 500.3107(1)(a) does not require treatment to have “gained general acceptance within the medical community,” but requires “objective and verifiable evidence that an experimental procedure is efficacious.” Viewing the evidence in plaintiff’s favor, the court concluded there were fact questions because Drs. P and H testified about studies and data supporting HBOT for TBIs, progress notes connected DK’s anxiety, sleep, attention, and behavioral issues to his TBI, and MRI reports arguably showed improvement after HBOT. But the court also noted summary disposition for plaintiff was not warranted because one treating doctor declined to order HBOT, Dr. P questioned whether the 2021 and 2022 treatment was necessary, and the treatment remained “‘off-label’ and perhaps ‘experimental.’” Reversed and remanded.