Michigan Court of Appeals; Docket #221119; Unpublished
Judges Jansen, Collins and Cooper; unanimous; per curiam
Official Michigan Reporter Citation: Not applicable, Link to Opinion 
STATUTORY INDEXING:
Allowable Expenses: Reasonable Charge Requirement [3107(1)(a)]
Work Loss Benefits: Calculation of Benefits [3107(1)(b)]
Providers Entitled to Charge Reasonable Amount for Services
Prohibition Against Charging No-Fault Insurers More Than Uninsured Patients
TOPICAL INDEXING:
Not applicable
CASE SUMMARY:
In this unanimous unpublished per curiam opinion interpreting the “reasonable charge” provisions of section 3157, the Court of Appeals upheld the jury verdict finding that Farm Bureau was obligated to pay the medical expenses of plaintiff’s treatment at a chiropractic clinic.
Farm Bureau contended in this case that there was evidence that the chiropractic clinic that treated the plaintiff, charged insured patients more than uninsured patients, in violation of section 3157 of the No-Fault Act, which provides that medical expense charges “shall not exceed the amount the person or institution customarily charges for like products, services and accommodations in cases not involving insurance.”
In this case, the evidence established that the chiropractic clinic charged every patient the same amount for the same procedures, but that special consideration was given to patients who had special situations, such as being short of money. Where a patient signed an affidavit of indigence stating an inability to pay, there were some situations where the clinic would reduce the bill.
In upholding the jury verdict and the trial court’s denial of Farm Bureau’s motion for directed verdict, the Court of Appeals held that although there was evidence that the clinic may have charged patients without insurance less than it charged patients with insurance, there was no evidence that the clinic customarily charged uninsured patients less because they were uninsured. Instead, there was evidence that the clinic charged uninsured patients less only when they signed an affidavit of indigence stating that they could not afford the standard charge. The court distinguished this case from Hofmann v Auto Club Insurance Association, 211 Mich App 55 (1995) [Item No. 1787], where it was shown that patients were billed less based on whether they had reimbursable insurance, not whether they could afford to pay for the services.
The court also addressed an issue of whether or not plaintiffs were entitled to work loss benefits under 3107(1)(b) of the No-Fault Act. Plaintiff testified that he resumed doing tree service about a month or two after the accident, but could no longer do heavy work because of his injuries. He testified that after the accident, he turned down approximately 40 or 50 tree service jobs because of his injuries from the accident. Although plaintiff did not present evidence that he had made a profit from the tree service before the accident, he was working full-time as a millwright before the accident and did not have the opportunity to work full-time on his tree service until he retired from being a millwright after the accident. The court held that whether he would have actually earned the profits he claimed he lost was a question of fact for the jury.
