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Lakeland Neurocare Centers, et al. v Everest National Ins. Co., et al. (COA – UNP 10/8/2019; RB #3979)

Michigan Court of Appeals; Docket # 340346, 340349; Unpublished
Judges Jansen, Cameron, and Tukel; Per curiam
Official Michigan Reporter Citation: Not Applicable; Link to Opinion


STATUTORY INDEXING:
One-Year-Back Rule Limitation (§3145(1))

TOPICAL INDEXING:
Assignments of Benefits—Validity and Enforceability


SUMMARY:

In this unanimous unpublished per curiam decision dealing with consolidated appeals, the Court of Appeals reversed the trial court’s summary disposition order dismissing the plaintiff medical providers’ first-party action to recover no-fault PIP benefits and affirmed the trial court’s order granting intervening plaintiff Jaculyn Gordon’s motion to intervene in that action.  As to its reversal of the trial court’s summary disposition order in favor of the defendant, Everest National Insurance Company (“Everest”), the Court of Appeals reaffirmed its prior holding in Jawad A. Shah v. State Farm Mut. Auto. Ins. Co., 324 Mich. App. 182 (2018) that antiassignment clauses such as the one found in the subject automobile insurance policy violate public policy and are therefore unenforceable.  As to its affirmance of the trial court’s order granting intervening plaintiff Jaculyn Gordon’s motion to intervene, the Court of Appeals determined that the trial court did not err by allowing Gordon to intervene in the first-party action, even though she was not adding new claims or defenses, because she had an interest in the plaintiffs’ action for reimbursement.  However, although Gordon sought to assert the same claims as her providers’, she could only claim benefits dating one year back from when she filed her intervening complaint per MCL 500.3145.

On June 27, 2016, Jaculyn Gordon struck a pot-hole at a high rate of speed and sustained a broken arm, dislocated hip, and multiple pelvic fractures requiring surgery.  Gordon received treatment from Lakeland Neurocare Centers (“Lakeland”) and VHS of Michigan (“VHS”), but when Lakeland and VHS tried to claim reimbursement from Everest under Gordon’s automobile insurance policy, Everest claimed that Gordon made a material misrepresentation by not disclosing a licensed driver of her household on her original application, and attempted to void her policy altogether.

At some point, after Lakeland and VHS obtained the first assignment of benefits from Gordon, on March 18, 2017, they filed suit against Everest.  While their suit was pending, the Supreme Court issued its opinion in Covenant Med. Ctr., Inc., v. State Farm Mut. Auto. Ins. Co., 500 Mich. 191 (2017), prompting Everest to move for summary disposition.  Gordon, meanwhile, was still receiving treatment from the plaintiffs and executed a second assignment on June 17, 2017.  Then, on July 28, 2017, Gordon filed an emergency motion to intervene as a party plaintiff.

The trial court ultimately granted Everest’s motion for summary disposition, relying on the policy’s antiassignment clause, but also granted Gordon’s motion to intervene, and determined that her claims did relate back to the filing date of her providers’ original complaint.

The Court of Appeals reversed the trial court’s summary disposition order in favor of Everest, nd reaffirmed its previous holding in Shah that antiassignment clauses such as the one in Gordon’s policy are unenforceable.  The Court of Appeals also ruled that Lakeland and VHS could proceed with their claims upon remand without filing an amended complaint—even though they did not attach the executed assignments to their original complaint—because “their status as assignees was made clear in their original complaint.”

The Court of Appeals then affirmed the trial court’s order granting Gordon’s motion to intervene, because Gordon had an interest in her providers’ action for reimbursement.  However, Gordon’s motion to intervene did not relate back to the filing date of her providers’ original complaint, so she could only claim benefits for the period dating back one year from the date she filed her intervening complaint.

Under MCR 2.209(A)(3), Gordon had an interest in the transaction because she had a right to claim benefits under the no-fault act, MCL 500.3112. Under her insurance policy with Everest, Everest was obligated to provide PIP benefits to Gordon. Plaintiffs provided healthcare services to Gordon after she was injured in the car accident, so Gordon had an interest in plaintiffs’ action for reimbursement. Should Everest be found not responsible to reimburse plaintiffs, Gordon would still be liable for the payment of her medical bills, totaling $288,073.52. MCR 2.209 is to be “liberally construed to allow intervention where the applicant’s interests may be inadequately represented.” State Treasurer v Bences, 318 Mich App 146, 150; 896 NW2d 93 (2016) (quotation marks and citations omitted). Thus, the trial court did not abuse its discretion by granting Gordon leave to intervene by right.

* * *

Gordon is clearly a different party than plaintiffs. She is not seeking to add new claims or defenses, MCR 2.118(D), but rather, assert the same claims as plaintiffs, but as a different party. Therefore, her claims would not relate back to the date of plaintiffs’ complaint. Because Gordon’s claims would not relate back to the date of the filing of the original complaint, she could only claim benefits dating one year back from the date that she filed her intervening complaint under MCL 500.3145, which was September 21, 2017. Because we affirm Gordon’s ability to intervene, her claims on remand are limited to this period of time.


Michigan auto accident attorney Stephen Sinas is the lead editor of the appellate case summaries published on this site regarding the Michigan auto insurance law. To learn more about how Stephen Sinas and how the Sinas Dramis Law Firm can help you if you have been injured in a Michigan auto accident, visit SinasDramis.com.

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