Michigan Court of Appeals; Docket No. 182797; Unpublished
Judges Taylor, Hood, and Reilly; 2-1 (with Judge Taylor, dissenting); Per Curiam
Official Michigan Reporter Citation: Not Applicable; Link to Opinion
STATUTORY INDEXING:
Service Providers as Payees [§3112]
TOPICAL INDEXING:
Intervention by Service Providers and Third Party Payors in PIP Claims
CASE SUMMARY:
In this 2-1 per curiam Opinion, the Court of Appeals held that medical providers in Michigan do not have a lien on insurance payments received by a patient which include reimbursement for medical services rendered by the medical provider. That being the case, a no-fault insurance company is not authorized to pay the provider directly without the patient's consent.
In this case, the plaintiff and his no-fault insurance company agreed to settle plaintiffs no-fault first-party lawsuit for the sum of $10,912.36; $7,000 of this represented wage loss benefits and the remaining $3,912.36 represented a medical expense claim. When it came time to issue the settlement check, the insurance company paid plaintiff $7,000 for the wage loss claim, and sent $3,912.36 to the medical provider. The plaintiff objected to the direct payment to the provider, and the Court of Appeals agreed with plaintiff.
In so holding, the court noted that
"Under the no-fault act, personal protection insurance benefits are payable to and for the benefit of an injured person, or in case of his or her death, to or for the benefit of the injured person's surviving spouse or dependents. If there is doubt about the proper person to receive the benefits, the insurer may apply to the circuit court for an appropriate order. (§3112)"
The court went on to observe:
"In response to plaintiffs arguments, defendant also claims that it has no alternative but to honor liens of medical providers, because failure to do so could result in being required to pay certain medical bills twice. However, defendant has provided no law to support its claim that a valid lien exists, or that it must pay plaintiffs medical provider directly rather than pay plaintiff her medical expenses incurred. The trial court resolved the controversy by determining as a matter of law that the clinic was entitled to a lien the same as a mechanic, whether or not the clinic was situated in Michigan We conclude that the trial court erred in its determination that the consent judgment was satisfied by direct payment of plaintiff s medical bills, because we find no basis for the imposition of a lien on insurance payments for medical services. Liens can only be created by agreement, or by some fixed rule of law. It is not one of the functions of courts to create them Unlike a number of other states, Michigan has no "hospital lien" statute authorizing a lien on tort recovery for medical services rendered to an injured person.... Because there is no basis in Michigan law for the imposition of a lien on insurance payments for medical expenses, defendant was under no obligation to pay the clinic directly rather than pay the medical benefits to its insured."
Judge Taylor dissented on the basis that the plaintiff had not tendered back to the defendant the $7,000 wage loss payment and, therefore, had not satisfied a condition precedent to setting aside a settlement.