Attorney General Opinion, Frank J. Kelley, Attorney General
Opinion #6129; February 1983
MTLA FileNo, 3100
STATUTORY INDEXING:
Allowable Expenses for Rehabilitation [§3107(1)(a)]
Providers Entitled to Charge Reasonable Amount for Services [§3157]
TOPICAL INDEXING:
Not Applicable
CASE SUMMARY:
This Attorney General's Opinion made several significant observations regarding the obligation of a no-fault insurer to provide rehabilitation benefits pursuant to §3107(a) of the No-Fault Act. First,
Attorney General Kelley ruled that a person becomes entitled to rehabilitation benefits as party as his personal protection benefits upon sustaining bodily injury arising out of the ownership, operation, maintenance, or use of a motor vehicle.
Second, pursuant to the governmental set of provisions of §310(1), if the State Board of Education administers vocational rehabilitation on behalf of an accident victim, it is entitled to collect the full cost of providing these rehabilitation services from the insurance company responsible to provide those benefits under the Michigan No-Fault Act.
Third, the scope of an insurer's obligation to provide "rehabilitation" benefits is very broad. Specifically, Attorney General Kelley ruled, "Thus, the statutory term 'rehabilitation' under §3107(a), in accordance with its plain and ordinary meaning, must be interpreted in a broad sense to embrace comprehensive care and services reasonably necessary to restore the injured person not only to a condition of physical health, in keeping within the limitation of his or her physical disability, but also, to restore that person to useful and constructive activity through occupational retraining if necessary. Had the legislature intended to narrowly restrict the interpretation to be given 'rehabilitation,' they could have done so by expressly providing for only 'medical' rehabilitation or 'physical' rehabilitation, for example." Attorney General Kelley also pointed to §3157 which refers to rehabilitative occupational training as a service for which a health care provider may assess a reasonable charge against a no-fault insurer.
Attorney General Kelley pointed out that one of the objectives of the no-fault statute is to "return the accident victim, as far as possible, to his or her pre-injury status. For many accident victims, such as those who sustain permanent physical disability, that effort must go beyond mere medical treatment to include other forms of counseling, reeducation, and retraining so as to restore the person to useful and constructive activity within the limits of his or her physical disability, the precise scope of such a rehabilitative effort may be assessed only on a case by case basis. The scope shall not exceed 'reasonable charges' for a 'reasonably necessary' products, services, and accommodations for the injured person's rehabilitation. It must be recognized that the No-Fault Insurance Act is remedial in nature and must be liberally construed in favor of persons intended to be benefited thereby." Finally, Attorney General Kelley stated that he was in agreement with Insurance Bureau Bulletin 81-15 (item number 451) ruling that a no-fault insurer is responsible to pay all reasonable charges for reasonably necessary services in connection with rehabilitation.
