Insurance Commissioner Consent Order; No. 79-1390-CK;
Written Order; Unpublished
Official Michigan Reporter Citation: Not Applicable; Link to Opinion
STATUTORY INDEXING:
Allowable Expenses for Medical Treatment [§3107(1)(a)]
Allowable Expenses: Reasonable Charge Requirement [§3107(1)(a)]
TOPICAL INDEXING:
Not Applicable
CASE SUMMARY:
In this written consent order, League General Insurance Company was required to pay, as an allowable expense under §3107(a) a nonresident surcharge in the amount of 10 percent of a hospital bill that was assessed by Pontiac General Hospital on a patient who was a nonresident of the City of Pontiac. Such a surcharge is regularly made by the hospital for those patients that do not reside within the city. It is in the amount of 10 percent of the hospital bill. League General contended that the nonresident surcharge did not fit the definition of an "allowable expense" under §3107(a). The Insurance Commissioner held that "a nonresidency charge and/or surcharge for hospital care such as is assessed by the Pontiac General Hospital in this matter is a reasonable charge incurred for reasonably necessary products, services, and accommodations for an injured person's care, recovery, or rehabilitation as provided under §3107 of the Insurance Code."