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Facts & Ruling By Court:

A man was hauling waste to a landfill using his attached trailer.  The tailgate would not open freely.  The man pushed on the tailgate and it sprung open, causing him to lose his balance.  He fell down into the landfill and suffered bodily injury requiring medical care.  The no-fault act provides coverage for instances when your car is parked and your injury was a direct result of physical contact with equipment permanently mounted on the vehicle.  MCL 500.3106(1)(b).  The man’s auto no-fault insurer refused to pay his medical expenses because it believed that the stated rule did not apply arguing that the tailgate did not constitute “equipment” mounted on a vehicle as contemplated by the statute.  (Note that the no-fault act includes in its definition of a “motor vehicle”, “a trailer” [MCL 500.3101(2)(e)]).  The Court of Appeals disagreed with the defendant no-fault insurer and ruled in favor of the injured person, holding that that the tailgate did constitute “equipment” under the law.  Left unanswered, the Court said that a jury must now decide whether the man’s injury suffered had a causal relationship to his opening of the tailgate “that is more than just incidental.”

What this means for injured persons and medical service providers:

First, in bodily injury scenarios factually similar to this case involving the opening of equipment mounted on a vehicle, submit your claim for payment for medical expenses to your no-fault insurer.

Second, the court’s decision illustrates that factual questions about the cause of an injury are not decided arbitrarily by a person’s no-fault insurance company or the court.  Instead, such questions must be decided by fair-minded and unbiased jurors of your peers.  Therefore, do not be deterred by a blanket denial by an auto insurer; instead, rightfully challenge its denial.

You can read this Opinion here.

Authored by L. Page Graves

Facts & Ruling by Court:

A man was catastrophically injured in a car accident and was taken to the Detroit Medical Center for care.  The patient’s medical expenses were covered by the No-Fault law.  Before the patient was discharged and before the DMC issued an itemization of charges to the patient’s no-fault insurer, the patient’s lawyer claimed an attorney’s charging  lien (MCL 500.3148) against the charges incurred arguing that he facilitated in procuring coverage and payment.   The DMC refused to honor the lien arguing, in part, that there was no attorney-client relationship between it and the patient’s attorney.  The Michigan Supreme Court ruled that the DMC was not liable to pay the patient’s attorney fee.  That said, the Court was silent about whether the attorney fee lien was validly asserted against the DMC’s charges recovered; ducking to answer this pressing question, the Court instead held that the DMC could pursue the balance of its charges directly against the patient.

What this case means for injured persons and medical service providers:

  1. It reaffirms medical provider’s longstanding position that the relationship between the patient and provider is one of creditor (provider) and debtor (patient).  Thus, regrettably, it seemingly pits providers against patients instead of the liable auto no-fault insurance company.
  2. The Court held that no common fund was created which seemingly overrules Aetna Cas & Surety Co , 116 Mich App 630 (1982), which has the effect of undercutting the entire basis that attorneys have relied upon in enforcing a lien against the funds recovered.
  3. Regarding an attorney-client relationship between an attorney and a provider, the Court does say that there must be some kind of explicit waiver or “unequivocal acquiescence.”  This will like spur more litigation.  At worst, however, medical providers can argue that it reaffirms the meaning of ethics opinion C-226.  On that note, it is incumbent that medical providers be proactive when there is attorney contact: send the form letter making clear that there is no attorney-client relationship and they are not authorized to pursue the provider’s charges.
  4. The ultimate quandary this Order creates is how does the medical provider now collect its bill that the attorney has retained?  The Order does not contain any remand language on procedure.  These important procedural questions remain unanswered.

Your can read the Supreme Court Opinion here.  Your can read the Court of Appeals Opinion, that led to this decision by the Supreme Court, here.

Authored by L. Page Graves

Facts & Ruling by Court:

Three cars were traveling south on M-37 approaching a curve in the roadway.  Heading northbound was a motorcyclist.  The first of the three cars was looking for wood.  It is here where testimony of several witnesses differed on what actually occurred next: the driver of the first car says he slowed and pulled completely off the road; others said he stopped abruptly and straddled the fog line before getting off the travel lane.  The second vehicle says she slowed and that there was no way she could pass the first car and therefore, she either came to a complete stop or was almost stopped; the testimony was disputed whether she was straddling the fog line.  The third motorist came around the curve to see the two cars ahead as described.  He could not go left or around the second car because he thought she was in the travel lane; he therefore swerved over the center line at the same time the motorcyclist was rounding the corner in the opposite direction.  The car struck the motorcyclist who was killed.

The estate for the deceased motorcyclist sued the three motor vehicles for liability damages suffered by the family’s loss of their loved one.  The third motorist who actually crossed the center line and struck the motorcyclist settled out of court.  The remaining two motorists (one and two in scenario) contested their role as being a factor in this occurrence.  The Court of Appeals agreed with the estate that a jury must decide whether the actions of one or both of the two motorists also played a role in causing the accident.  The Motor Vehicle Code requires that motorists not travel too close behind another so as to be able to stop safely within the assured clear distance ahead.  This is commonly referred to as the basic speed lawMCL 257.627(1).  A motorist also may not stop or park his or her motor vehicle in a travel lane when it is possible to pull completely off the travel lane.  MCL 257.672(1).  Finally, the common law requires every person to exercise ordinary care when engaged in any undertaking so as to not endanger others.

What this means for injured persons.

As to liability for personal injury damages claims, this case illustrates that multiple liability policies may be applicable.  Do not accept an insurance carrier’s denial of liability because it is not the final arbiter of your claim; instead, a jury of your peers makes that decision for you.

Even though this case did not discuss the application of no-fault benefits, it nevertheless does illustrate that more than one auto no-fault insurer may be liable to pay the motorcyclist’s no-fault claim under MCL 500.3114(5).  These benefits include medical bills, wage loss, replacement services and if necessary, funeral expenses and survivor’s loss benefits.  The no-fault statute only requires that a motor vehicle be “involved” in the incident with a motorcycle; not that it actually comes into physical contact with the motorcyclist.    MCL 500.3114(5).  Therefore, when factual scenarios illustrate that more than one motor vehicle may be involved, the motorcyclist or his/her estate must apply for no-fault benefits with all of the involved motor vehicle insurers.  One will accept responsibility and pursue recoupment from the others.  Failure to notify all potentially liable insurers in the same order of priority could prove detrimental and lead to only a partial recovery of no-fault benefits.  MCL 500.3145.

What this means for medical service providers.

This case illustrates that when collecting an injured motorcyclist’s charges incurred for care, medical providers must submit their claims to all involved motor vehicle insurers involved in the motorcycle accident.  Failure to do so may be partially fatal to recovering fully, the charges owed.  MCL 500.3145.

You can read this Opinion here.

Authored by L. Page Graves

An 18 year old moved out of his family home and into a friend’s home to attend school in another town.  The son, however, kept his family home address on his driver’s license and provided his school and a part-time employer with it as opposed to the friend’s.  His checking account also kept his home address.  He maintained possessions in a bedroom at his family’s home.  Often, he would return home during breaks, catch up with his family, sleep in his bedroom, eat with his family and clean his laundry before going back to school.  He was allowed to drive the family cars and he was listed as a driver on the family auto policy.  His parents provided clothing, food, a cell phone and other maintenance items including cash.  He was maintained on his mother’s health insurance through her employer because she represented he still lived with the family. Finally, the son intended to return to the family home after school concluded.

While away at school, the son borrowed his friend’s car and was involved in a motor vehicle accident and suffered bodily injuries requiring medical care.  The family auto insurance and the friend’s auto insurance each denied liability to pay the injured son’s medical bills pointing the liability finger at each other instead.  Under the no-fault law, one is covered by family auto insurance provide s/he is considered “domiciled” in the family household.  MCL 500.3114(1).  The Court of Appeals held that the son was domiciled in the family home, thus holding the family auto insurer liable to pay his medical bills.  The court reasoned that while young adults who transition from parental homes to independent living arrangements pose special problems in determining domicile, children studying abroad who clearly have not severed ties to the family household such as this case, remain legally domiciled in the family home.

What this means for injured persons:

Frankly, the outcome really does not matter for the injured person because either way, s/he is going to be covered by no-fault insurance.  If the facts were tilted in the opposite where a return to home or fewer ties existed, then the injured son would have been covered by the friend’s auto insurance.  MCL 500.3114(4).  What this case importantly illustrates, however, is the correct decision by the injured person to timely file a lawsuit against both insurance companies to protect his rights under the no-fault law.  Failure to file suit within one year [MLC 500.3145] and/or to name both insurers could have been fatal to his claim.   Has he not done either, the medical bills could have become his legal responsibility.

Thus, always submit your claims to all potential auto no-fault insurers in the chain of priority under MCL 500.3114 and/or MCL 500.3115.  The general rule is that one of the insurers will accept responsibility and then settle its dispute with the other; regrettably, more often than not, no-fault insurers do not follow the law hoping instead that the injured person will not learn that if s/he does nothing about it within one year, the claim is lost.  MCL 500.3145.

Another recommendation to follow is that when two or more auto insurers are disputing liability, the injured person should file a claim with the Michigan Assigned Claims Facility [MCL 500.3172].  The MACF, by law, will literally randomly assign the claim to a third auto insurer which must pay the benefits and seek recoupment from the other insurers who are later determined to be legally liable.  Failure to timely submit a claim to the MACF within the one-year rule [MCL 500.3145] is likewise fatal to that claim, too.

What this means for medical service providers:

This case illustrates is that medical providers must continue to be diligent on intake and discover the identity of all potential auto insurers within the chain of priority [MCL500.3114 and MCL 500.3115] and then submit the claim to them all.  And where the potential insurers refuse responsibility, the provider must file its own claim with the MACF, too.  Finally, the one-year time limitation [MCL 500.3145] applies to medical providers too and therefore, they must be equally cognoscente of this fact and keep watch.  Medical providers cannot rely on patients to take action on his/her own; often they do not and ignore repeated efforts at collection.  Therefore, providers must be pro-active and pursue their claim directly against the auto insurers.

Injured people and medical providers can obtain an application to file a claim with the MACF here.

And, you can read the Opinion that provided the back-drop for this discussion here.

Authored by L. Page Graves

Facts & Ruling by Court:

An adult was placing personal items into her motor vehicle which was parked.  She had reached into the passenger side of the vehicle with its door open.  In one fluid motion, she stood back up to regain her upright balance and stepped away from the car while also shutting the door with her hand.  It was at this point that she slipped and fell on a patch of ice beneath her feet and suffered bodily injury requiring medical care.  The no-fault law provides coverage when a person is “entering” or “alighting” from a parked motor vehicle [MCL 500.3106(1)(c)].  The Michigan Supreme Court ruled that the injured person was not “alighting” from her motor vehicle because, it reasoned, she was in no way reliant upon the vehicle itself to maintain her balance.  The Court said she had already alighted and that closing a car door is not part of the alighting process.

 

What this means for injured persons:

 

This is new law created by the Court.  Closing the door used to be considered a part of the alighting process since the no-fault act was enacted in 1973.  Now it is not.  Therefore, in fact patterns identical to this case, injured persons are no longer covered by their auto no-fault insurance which they must purchase as mandated by law.  Instead, coverage for their medical care falls to any other accident or health coverage applicable (e.g., BC/BSM, Medicare, Medicaid, etc.) or private pay.

 

What this means for Medical Service Providers:

 

In fact patterns identical to this case, medical providers can no longer pursue auto no-fault coverage in cases just like this.  Instead, they must submit their claims to the patient’s applicable health coverage.

 

You can read this Opinion here.

 Authored by L. Page Graves


Facts & Ruling by Court:

 

A minor riding a school bus suffered bodily injuries when the school bus swiped a temporarily stopped city garbage truck that pulled back into the travel lane while the school bus was passing.  The Michigan Court of Appeals held that even if the garbage truck was temporarily stopped, that fact did not shield the city from liability for the minor’s injuries under governmental immunity.  The truck was still in “operation” as contemplated by the law [MCL 691.1405] because temporarily stopping is carrying out the garbage truck’s designed and intended function and purpose.

 

What this means for accident victims:

 

This is good because the court followed existing law which holds governmental bodies liable for personal injury caused by the negligent operation of governmentally owned vehicles.

 

What this means for Medical Service Providers:

 

This case does not change or affect a medical provider’s independent claim for no-fault insurance to cover the injured person’s incurred charges for medical care.  The child was in the bus which was operating.  The bus could have hit any standing object and no-fault coverage would apply.  The no-fault rules of priority apply [MCL 500.3114]: submit claim to the child’s household family auto coverage; if there is no family auto coverage in the household, then submit claim to the city’s auto coverage.

 

You can read the Opinion here.

Authored by L. Page Graves