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Spine Specialists of Mich, PC v MemberSelect Ins Co (COA – UNP 11/17/2022; RB #4508)   

Michigan Court of Appeals; Docket #358296; Unpublished  
Judges Riordan, Boonstra, and Gadola; Per Curiam 
Official Michigan Reporter Citation: Not Applicable; Link to Opinion


STATUTORY INDEXING: 
One-Year-Back Rule Limitation – Tolling Under 2019 Amendments [§3145(3)]

TOPICAL INDEXING: 
2019 PA 21 – Retroactivity


SUMMARY: 
In this unanimous, unpublished, per curiam decision, the Court of Appeals affirmed the trial court’s partial summary disposition order dismissing certain of Plaintiff Spine Specialists of Michigan, PC’s (“Spine Specialists”) claims for no-fault PIP benefits against Defendant MemberSelect Insurance Company (“MemberSelect”).  The Court of Appeals held that the 2019 amendments to the No-Fault Act—specifically, that which added “formal denial” tolling to MCL 500.3145—do not apply retroactively, and that Spine Specialists’ claims, which accrued prior to the effective date of the 2019 amendments and more than one-year prior to the filing date of its complaint, were barred by the applicable, pre-amendment version of MCL 500.3145.

From April of 2019 to May of 2019, Spine Specialists rendered treatment to Jeremy Woods for injuries he sustained in a motor vehicle collision in January of 2017.  Woods subsequently assigned his right to pursue no-fault benefits related to his treatment to Spine Specialists, and Spine Specialists, in turn, filed a claim with MemberSelect, Woods’ no-fault insurer.  MemberSelect denied the claims in August of 2020, after which, in September of 2020, Spine Specialists filed the underlying suit.  MemberSelect moved for summary disposition, arguing that Spine Specialists’ claims accrued prior to the effective date of the 2019 amendments to the No-Fault Act, and that said claims were therefore barred by the version of MCL 500.3145 which existed in April and May of 2019.  The trial court ultimately agreed and granted MemberSelect’s motion.

The Court of Appeals affirmed the trial court’s summary disposition order, holding that the 2019 amendments to MCL 500.3145 do not apply retroactively, to claims which accrued prior to the amendments’ effective date.  Michigan appellate caselaw has established that ‘the substantive rights and liabilities of the parties are determinable according to the law as it stood when the causes alleged by the plaintiff accrued.’  Accordingly, Spine Specialist’s claims from April and May of 2019 were governed by the version of the one-year-back rule in effect on those dates.

"Plaintiff argues, however, that the “wrong” on which its claims are based is defendant’s failure to pay the claims, and that the claims therefore accrued when defendant denied the claims, which plaintiff contends was August 13, 2020, after the June 11, 2019 effective date of the statutory amendment. Plaintiff relies upon the general accrual statute, MCL 600.5827, which provides that generally, a claim accrues “at the time the wrong upon which the claim is based was done.” In this case, however, plaintiff has filed “an action for recovery of personal protection insurance benefits . . . for an accidental bodily injury. . . .” MCL 500.3145(1). Plaintiff, as the assignee of Woods, is seeking to assert against defendant Woods’ right to payment of PIP benefits under the insurance policy issued to Woods by defendant . . . 

. . . PIP benefits accrue when they are incurred, MCL 500.3110(4), and are incurred when the insured receives medical treatment and becomes obligated to pay. See Bronson Health Care Group, Inc, 335 Mich App at 35-36. 

In this case, the loss was incurred when Woods received medical treatment from plaintiff in April-May 2019, and the claims for those services accrued at that time. The law in effect at the time the claims accrued was the pre-amendment version of MCL 500.3145; the amended version of the statute did not take effect until June 11, 2019, and does not apply retroactively. See Andary, ___ Mich App at ___; slip op at ___. The trial court therefore did not err by applying the pre-amendment version of MCL 500.3145 to plaintiff’s April-May 2019 claims and granting defendant summary disposition of those claims." 


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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