Posts

IMPORTANT NO-FAULT UPDATE FOR MEDICAL SERVICE PROVIDERS AND MVA VICTIMS WHO ARE MINORS AND/OR SUSTAIN TRAUMATIC BRAIN INJURY

Yesterday, the Michigan Supreme Court did away with the long-held rule of protecting minors and the infirm in no-fault claims.   This legal issue has literally been a political ping-pong match with the balance of the court changing so much since 1999.   Since 1973 — when the no-fault act was enacted — it had always been the rule to protect this class of persons.

In 2006, however, AAA of Michigan got its request granted when the new court created a new rule that no longer protected minors and the infirm.  This directly impacted medical providers because their unpaid claims approaching one year were now at risk.  If not paid or a lawsuit filed, those unpaid claims became barred under no-fault.  Resorting to Medicare or Medicaid or writing off as bad debt were the only remaining options.

The old no-fault law protecting this class of persons was restored in 2010 when the U of M Hospital challenged the new rule.  But now the political ping pong has been hit back in Joseph v ACIA .  Once again, children, the infirm and their medical service providers must adhere to the one-year-back-rule for no-fault claims.

Authored by L. Page Graves

/by

The battle to save Northern Michigan jobs and to preserve Michigan’s Auto No-fault Insurance resumes in 2012

In the 1992 and 1994 Michigan statewide elections, many remember the no-fault insurance industry’s ballot initiatives (Proposals C and D) which sought to dramatically convert Michigan’s auto no-fault insurance system into managed care funded by tax payers.  These efforst were resoundingly defeated by the people of Michigan.  See the Official election results here.

After 17 years of dormancy, the no-fault insurance industry viewed Michigan’s current political landscape and climate ripe again to institute its wish list to keep more premium dollars while shifting the burden of paying for accident victims’ medical care to the taxpayers, i.e., the state and federal treasury (Medicaid and Medicare).  Instead of asking and involving the people of Michigan directly at the ballot booth, the no-fault industry has used its political influence to package its desired goals into Michigan House Bill 4936.

For a thorough summary and analysis of the bill’s current devastating impact on patient and provider rights and our local economy, see Part 1, Part 2, Part 3, by Tim Smith, of Smith & Johnson, Attorneys, P.C.

To understand the real life impact that our current no-fault system provides for and how it would drastically change, meet and listen to Katie’s and Katlin’s stories about how our no-fault system has changed their lives for the better.

Fortunately for now, HB 4936 has stalled thanks primarily to the efforts of the Michigan Health & Hospital Association and the Brain Injury Association of Michigan who have educated Michigan legislators about this important issue.  Locally, Munson Medical Center has similarly contributed to educating the public and northern Michigan legislators (Senator Howard Walker and Representative Wayne Schmidt) too, on how changes in the bill will impact both injured persons and the local economy.

The battle is not over, however.  The effort to pass HB 4936 will begin again with the opening of the 2012 Michigan legislative session.  That is why your voice needs to be heard.   To assist you, Munson Medical Center has further created a sample letter for you to adopt and send to your local legislator here.  Make a difference and be heard: save people and save Northern Michigan jobs.

Authored by L. Page Graves

 

 

/by

Driving too close behind another and stopping abruptly are factors that may lead to driver liability for personal injury suffered by another. And, when multiple motor vehicles are involved in a scenario which is a factor resulting in a motorcyclist’s injury, liability for no-fault coverage afforded to the motorcyclist may rest with more than one of the involved motor vehicles.

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 law.  MCL 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

/by