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Hofmann v Auto Club Insurance Association; (COA-PUB, 8/18/1987; RB #1075)

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Michigan Court of Appeals; Docket No. 94401; Published  
Judges Maher, McDonald, and Deming; Unanimous; Per Curiam  
Official Michigan Reporter Citation: 162 Mich App 424; Link to Opinion alt   


STATUTORY INDEXING:  
Providers Entitled to Charge Reasonable Amount for Services [§3157]  
Prohibition Against Charging No-Fault Insurers More Than Uninsured Patients [§3157]

TOPICAL INDEXING:
No-Fault Insurer Claims for Reimbursement   


CASE SUMMARY:  
In this unanimous per curiam Opinion, the Court of Appeals addressed the issue of whether two chiropractors were obligated to make reimbursement or restitution for payments previously made to them by defendant on claims for payments which exceeded the injured party's health insurance coverage. Under the decision in Dean v Auto Club, 139 Mich App 266 (1984), leave denied, 422 Mich 918 (1985), the Court of Appeals had held that the medical service provider was not legally entitled to recover the unpaid excess cost of services from the patient's no-fault insurance company, where the provider had signed an agreement with the health insurance company that the provider would accept payment from it as payment "in full" for services rendered.

The chiropractors in this case contended that the decision in Dean (Item No. 791) should be applied prospectively only, and that previous payments made to them were made under a mistake of law rendering them "voluntary" and that it would be unfair to require reimbursement. The Court of Appeals reversed the trial court granting of the chiropractors' motion for summary disposition, and held that Dean, supra, should be given "retroactive" effect thereby allowing Auto Club to obtain reimbursement for claims erroneously paid prior to Dean.


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