There has been a radical change to Michigan’s No-fault Law. The radical change was announced in the recent decision published by the Michigan Court of Appeals, on September 10, 2015. The radical case is Perkovic v Zurich American Insurance Company, __ Mich App __ (2015). Since the no-fault act was enacted back in 1973, it has been common and routine industry practice and custom for medical providers, like hospitals, to submit claim information on behalf of the insured patient to open a claim and get medical bills paid. This rudimentary custom was founded upon the plain and ordinary language of the written notice provision set forth at MCL 500.3145(1) which provides:
“An action for recovery of personal protection insurance benefits payable under this chapter for accidental bodily injury may not be commenced later than 1 year after the date of the accident causing the injury unless written notice of injury as provided herein has been given to the insurer within 1 year after the accident or unless the insurer has previously made a payment of personal protection insurance benefits for the injury. If the notice has been given or a payment has been made, the action may be commenced at any time within 1 year after the most recent allowable expense, work loss or survivor’s loss has been incurred. However, the claimant may not recover benefits for any portion of the loss incurred more than 1 year before the date on which the action was commenced. The notice of injury required by this subsection may be given to the insurer or any of its authorized agents by a person claiming to be entitled to benefits therefor, or by someone in his behalf. The notice shall give the name and address of the claimant and indicate in ordinary language the name of the person injured and the time, place and nature of his injury.” (Emphasis supplied).
In the Perkovic case, Mr. Perckovic was injured in a motor vehicle crash on February 28, 2009. Within 61 days later, the hospital that provided him care sent to Zurich a copy of its medical bills which identified Mr. Perkovic’s name and address. The hospital also (as is customary) submitted corresponding medical records which contained the following information (which included the date of the MVA service record when Mr Perckovic was received in ER and treated):
“46 yo male semi truck driver. R upper back pain after MVC. States that he was driving down interstate when car in front of him began to spin, he swerved to avoid the car since in semi and ran into a wall hitting front driver side.”
“back sprain, cervical sprain or fracture, chest wall contusion, contusion, head injury, liver injury, myocardial contusion, pneumothorax, splenic injury, sprained or fracture extremity.”
On May 19, 2009, Zurich denied the claim arguing that “‘No injury report on file for this person.'” Mr. Perckovic filed a lawsuit and Zurich defended, claiming “that no written notice of injury was provided to it within one year” as contemplated by MCL 500.3145(1). In an extremely radical departure from over 4 decades of industry custom and procedure between medical providers and Michigan auto no-fault insurers, as well as established Michigan No-fault law jurisprudence under MCL 500.3145(1), the Court of Appeals held that the hospital’s claim submission for Mr. Perckovic “did not provide sufficient notice pursuant to MCL 500.3145(1)”. In reaching its decision, the Court of Appeals reasoned, as follows:
“In this case, however, no letter or written form was sent that would alert the defendant to the possible pendency of a no-fault claim. Rather, the medical bill and medical records were sent to defendant without any indication or a possible claim. In fact, according to [the hospital representative], the bill and records were sent for the purpose of obtaining payment. This notice of injury, which was unrelated to a possible claim for no-fault benefits, did not trigger defendant’s investigative procedures or advise defendant of the need to appropriate funds for settlement.” (Emphasis supplied).
Going back to the plain language of the statute above, obviously there is nothing in it stating that a “letter” is required. And respectfully, what is this “letter” that the Court refers to? Similarly, nothing in the statute indicates that a “written form” is to be used or completed. And again, respectfully, what is this “written form” that the Court refers to? As has been common, customary practice, the hospital sent in its claim documentation which the sophisticated Michigan no-fault insurance company has routinely understood and accepted as notice of a claim because, as the plain language of the statute says, notice can be submitted “by someone in his behalf”. And by the content of the information submitted by the hospital to Zurich, who can objectively state that it was not advised of its insured, Mr., Perckovic “name and address” and the “time, place and nature of his injury.”
The tragic consequence of the decision reached by the Court — and why its decision is so radical — is that Mr. Perckovic ended up being 100% stuck with the hospital bill. Mr. Perckovic’s insurer, which was timely and fully paid auto-insurance premiums, walked away from the courthouse having to pay absolutely nothing, simply by the radical stroke of the pen by the Court of Appeals. Parenthetically, notice that this radical change in the law did not comport with the Michigan Constitutional division of government: the law change was not authored by the Legislature and was not signed into law by the Governor.
This extremely radical change in the Michigan No-Fault law now applies to all concerned: the injured, insured person and all treating medical providers. The Court of Appeals gave no indication or explanation as to what a “letter” or “written form” must look like or conform to.
Injured people and their medical treaters are welcomed to call our law firm to discuss conceptual methods and procedures that may satisfy the notice requirement of MCL 500.3145(1), as contemplated by the Court of Appeals in Perckovic.
Authored by L. Page Graves