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Michigan Head & Spine Institute PC v. Pioneer State Mut. Ins. Co. (COA – UNP 3/26/2019; RB #3871)

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Michigan Court of Appeals; Docket # 342979; Unpublished
Judges Shapiro, Beckering, and Kelly; per curiam
Official Michigan Reporter Citation: Not Applicable; Link to Opinion


STATUTORY INDEXING:
Not Applicable

TOPICAL INDEXING:
Assignments of Benefits—Validity and Enforceability
Medical Provider Standing (Post-Covenant)


SUMMARY:
In this unanimous unpublished per curiam decision, the Court of Appeals reversed the trial court’s grant of summary disposition for defendant Pioneer State Mutual Insurance Company, because plaintiff Michigan Head & Spine Institute PC obtained a valid assignment of rights from its patient.

Plaintiff provided medical treatment to an injured motorist, Larry Tullio, who was insured under a no-fault policy with Pioneer at the time of the accident. Pioneer refused to pay PIP benefits for treatment plaintiff provided to Tullio, prompting plaintiff to file the present action. While the case was pending before the trial court, the Supreme Court decided Covenant, and Pioneer moved for summary disposition, arguing that plaintiff had no statutory cause of action against it, and that an anti-assignment clause in Tullio’s no-fault policy barred plaintiff’s claim “to the extent that it was based on the assignments from Tullio.” The trial court granted Pioneer’s motion, concluding that it had to enforce the anti-assignment clause in the policy.

The Court of Appeals reversed, analogizing the present case to Shah, in which the Court ruled that an anti-assignment clause was unenforceable, as it was against public policy. Since Tullio had an accrued claim against Pioneer for treatments already provided by plaintiff, the assignment of rights obtained by plaintiff was in fact valid. The Court reasoned as follows:

The facts in this case are remarkably similar to those in Shah. And we conclude that, like the antiassignment clause in Shah, the antiassignment clause in the no-fault policy at issue in this case was unenforceable because of public policy. Tullio had an accrued claim against Pioneer for the payment of health care services that had already been provided by Michigan Head & Spine. The claim existed before the assignments were executed. Therefore, Tullio was free to assign this claim to Michigan Head & Spine, despite the antiassignment clause in his no-fault policy. See also Henry Ford Health Sys, ___ Mich App at ___; slip op at 4 (following Shah and holding that an antiassignment clause prohibiting the assignment of already accrued benefits is unenforceable because it violates public policy).

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