Martinico v Allstate Insurance Company; (COA-UNP, 11/6/1991; RB #1514)

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Michigan Court of Appeals; Docket No. 139085; Unpublished  
Judges Michael Kelly, Gillis, and Gribbs; Unanimous; Per Curiam  
Official Michigan Reporter Citation:  Not Applicable; Link to Opinion alt   


 STATUTORY INDEXING:  
Allowable Expenses for Medical Treatment [§3107(1)(a)]  
Allowable Expenses: Reasonable Necessity Requirement [§3107(1)(a)]

TOPICAL INDEXING:  
Not Applicable  


CASE SUMMARY:  
In this unanimous per curiam Opinion, the Court of Appeals affirmed summary disposition on plaintiff’s no-fault PIP claim for the reason that plaintiff had not satisfied her burden under Nasser v Automobile Club Ins Association (Item No. 1358) of proving that medical expenses she incurred at the Mayo Clinic were "reasonably necessary" and therefore payable under §3107(a) of the statute. 

Plaintiff in this case sustained spinal fractures in an automobile accident in October, 1988. Between March and July of 1989, three physicians, including a neurosurgeon, expressed the opinion that plaintiffs prognosis was good, that she had no evidence of neurological deficit, that her fractures had fully healed and that she should stop all treatment. In July of 1989, defendant informed plaintiff it would no longer pay any medical expenses as a result of the opinions of the three physicians. In October of 1989, on recommendation of her chiropractor, plaintiff visited the Mayo Clinic, the result of which was no treatment was rendered and no recommendations for treatment were made. Defendant refused to pay for plaintiff’s medical expenses at the Mayo Clinic. The Court of Appeals agreed with the trial court that "plaintiff has not borne the burden of proving that the medical expenses incurred at Mayo Clinic were reasonably necessary. The circuit court did not err in concluding that no record could be developed which would leave open an issue upon which reasonable minds could differ."