Michigan Court of Appeals; Docket # 344583; Unpublished
Judges Tukel, Jansen, and Riordan; per curiam
Official Michigan Reporter Citation: Not Applicable; Link to Opinion
STATUTORY INDEXING:
Not Applicable
TOPICAL INDEXING:
Assignments of Benefits—Validity and Enforceability
SUMMARY:
In this unanimous unpublished per curiam decision involving assignments of benefits, the Court of Appeals vacated the trial court’s order granting the defendant’s motion for summary disposition, and remanded for determination of whether a recent amendment to MCL 500.3145, tolling the period of limitations applicable to any first-party action until the date the insurer formally denies the claim for benefits, should be applied retroactively in this case. The Court of Appeals rejected the other arguments raised by the plaintiff on appeal, specifically that the relevant date for purposes of applying the one-year-back rule in a case involving an assignment of rights is the filing date of the original complaint, as opposed to the date an assignment is executed. The Court reaffirmed its prior holding in Shah that an amended complaint to reflect an assignment is actually a supplemental pleading, and does not relate back to the original filing.
On June 7, 2016, Fred Mouzon, who was insured by the defendant, Farm Bureau General Insurance Company of Michigan, was struck by a motor vehicle and injured. Mouzon was treated by the plaintiff, VHS of Michigan, Inc., and on May 16, 2017, VHS filed an action directly against Farm Bureau to recover PIP benefits for the treatments it provided to Mouzon. On May 25, 2017, the Michigan Supreme Court issued its decision in Covenant, holding that medical providers do not possess any direct cause of action against no-fault insurers, and on June 13, 2017, VHS obtained an assignment of rights from Mouzon. One week prior to VHS obtaining an assignment of rights from Mouzon, on June 6, 2013, Mouzon filed his own, independent lawsuit against Farm Bureau to recover PIP benefits. Then, on June 21, 2017, VHS filed its first amended complaint to reflect the assignment it obtained eight days prior.
Farm Bureau moved for partial summary disposition, arguing that VHS could not recover benefits for any treatments it provided before June 13, 2016, the date it received the assignment from Mouzon. In response, VHS argued that the relevant date for purposes of applying the one-year-back rule in this case was the date on which VHS commenced its action, not the date Mouzon executed the assignment. The trial court granted Farm Bureau’s motion, and held that VHS could only recover benefits for treatments it provided in the one year preceding the date the assignment was executed.
The Court of Appeals ultimately vacated the trial court’s partial summary disposition order in favor of Farm Bureau, but first rejected the plaintiff’s argument on appeal that “the pertinent point of reference for the application of ML 500.3145’s one-year-back rule is the date on which [the] plaintiff filed its complaint or, in the alternative, the date on which Mouzon filed his independent lawsuit.” The Court reaffirmed its prior holding in Shah that an amended complaint such as the one filed by VHS is actually a supplemental pleading, which does not relate back to the original complaint. Therefore, the relevant date for purposes of applying the one-year-back rule is the date the complaint is executed, not the date VHS’ original complaint was filed, or the date Mouzon filed his separate complaint.
The Court of Appeals vacated the trial court’s partial summary disposition order because it was unsure about how to apply a recent change to the no-fault act, specifically MCL 500.3145, providing:
A period of limitations applicable under subsection (2) to the commencement of an action and the recovery of benefits is tolled from the date of a specific claim for payment of the benefits until the date the insurer formally denies the clam. This subsection does not apply if the person claiming the benefits fails to pursue the claim with reasonable diligence.
VHS argues that since Farm Bureau never formally denied the claim, the period of limitations had been tolled ever since the claim was first submitted. The Court of Appeals determined, however, that it did not have the pertinent facts necessary to determine how or the statutory provision should be applied.
On the present record, we are unable to tell if applying the amended statute could make a difference here. Plaintiff claims that because defendant has never formally denied the claim, the period of limitations has been tolled ever since the claim was submitted, per the amended statute. Assuming without deciding that this statutory provision should be applied retroactively to the time defendant’s motion for summary disposition was decided at the trial court, the record is devoid of the pertinent facts that would be needed to apply this statutory provision. In other words, the parties have not identified anything in the lower court record that would identify “the date of a specific claim for payment of the benefits” or “the date the insurer formally denies the claim.” This is not surprising, nor a critique of the parties, as these dates were not relevant at the time the motion for summary disposition was being litigated. Although plaintiff argues that defendant never has “formally denied” the claim, therefore making such a date unascertainable on this record, defendant effectively denied this assertion in its answer to plaintiff’s complaint. Factually, therefore, we are unable to discern whether the amended statute could make a difference, before we even address the legal issues involved.
As such, we vacate the trial court’s grant of defendant’s motion for summary disposition and remand to allow plaintiff to file a supplemental response brief opposing defendant’s motion for summary disposition, limited solely to the applicability of new subsections (2) and (3) of§ 3145, including the threshold question of retroactivity. The trial court shall then permit defendant to file a supplemental reply brief in response to plaintiff’s supplemental brief, limited to the same subjects. After receiving these supplemental filings, the court will render its decision regarding defendant’s motion for summary disposition.
