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Aetna Casualty v Starkey; (COA-PUB, 5/6/1982; RB #539)

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Michigan Court of Appeals; Docket No. 51175; Published  
Judges Gillis, Beasley, and Deegan; Unanimous; Per Curiam  
Official Michigan Reporter Citation: 116 Mich App 640; Link to Opinion alt   


STATUTORY INDEXING:  
Prohibition Against Assigning Future Right to Benefits [§3143]

TOPICAL INDEXING:
Attorney Fee Liens   


CASE SUMMARY:  
In this unanimous per curiam Opinion, the Court of Appeals made the following holdings regarding the right of an attorney to claim a lien and collect a fee out of PIP benefits which are recovered to reimburse the charges of various health care providers. First, the Court held that the claimant's attorney had a valid attorney lien against the PIP fund recovered and that the trial court had erred in ordering payment of the entire amount of PIP benefits to the medical care providers. The Court held, "On the basis of the general principles of law concerning attorneys charging liens, defendant's attorney had the right to receive his fee from any fund, including the PIP fund, recovered as a result of his services in connection with the auto accident injury suffered by defendant's son." Furthermore, the fact that this fee was based on a contingent fee contract did not render it void as an assignment of benefits which is prohibited pursuant to §3143 of the Act

Second, the court held that where the injured person gives an assignment of his rights to collect no-fault benefits directly to the health care providers, such an assignment is void under the nonassignability provisions of §3143. Once the no-fault carrier received notification of other claims or the attorney fee lien, it could not pay benefits directly to the medical care providers.

Third, the medical care providers cannot avoid liability to reimburse the insured's attorney on the basis that they never requested his services. The Court held, "It can be said that medical providers would have an obligation to the attorney, his lien notwithstanding, on the theory of unjust enrichment. The providers knew that the attorney was expending time and energy in substantiating the insurance claims which led to their payment by Aetna."

Finally, the Court held that the delay in paying the benefits in this case was not an unreasonable one because it arose from a legitimate doubt on the part of the no-fault carrier as to whether or not the injured person's heart condition was in fact caused by the automobile accident in question. Thus, there was no unreasonability on the part of the carrier in paying the benefits beyond the 30 day statutory deadline.


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