Michigan Court of Appeals; Docket #321531; Published
Judges Talbot, Wilder, and Fort Hood; Unanimous Opinion by Judge Wilder
Official Michigan Reporter Citation: 312 Mich App 244 (2015) Link to Opinion: 
On 5/25/2016, the Michigan Supreme Court directed the clerk to schedule mini-oral arguement on whether to grant the application for leave to appeal; Link to Order
STATUTORY INDEXING:
Required Content of Notice/Sufficiency of Notice [§3145(1)]
Who May Give Notice [§3145(1)]
TOPICAL INDEXING:
Not Applicable
CASE SUMMARY:
In this unanimous published Opinion written by Judge Wilder, the Court of Appeals held that an insurer properly denied PIP benefits to an injured claimant, because the medical records and bills that the treating hospital sent the insurer did not satisfy the notice requirements of MCL 500.3145.
After plaintiff was injured in an auto accident, the hospital that treated plaintiff sent defendant Zurich American Insurance, plaintiff's no-fault insurer, a bill for its services and a copy of plaintiff's treatment records. Zurich refused payment, claiming these documents did not sufficiently put it on notice that plaintiff would be making a claim for benefits. Plaintiff filed this action seeking coverage, arguing he complied with the notice requirements in §3145 because the bill and the treatment records were in written form, and included his address and the nature of his injury. The trial court held the bill and medical records did not satisfy the requirements and dismissed plaintiff's claim. On appeal, plaintiff contended there was no requirement that the documents be sent with the intent to file a claim and, therefore, he provided sufficient notice under §3145(1).
The Court of Appeals rejected plaintiff's argument, finding the treatment records and medical bill were insufficient to put Zurich on notice that a claim for PIP benefits would be filed. In this regard, the Court noted the information sent to Zurich did not convey an intent to make a claim for PIP benefits, as required by §3145(1).
The Court of Appeals explained that, while strict compliance with the requirements of §3145(1) is not always required, prior appellate decisions on this issue do not indicate the insurers in those cases were unaware of a possible no-fault claim. The present case was different, the Court said, because no letter or written notice form was sent to Zurich that would alert it to a possible no-fault claim and, instead, the medical bill and records were sent without any explanation of a possible claim.
Accordingly, the Court of Appeals concluded:
"This notice of injury, which was unrelated to a possible claim for no-fault benefits, did not trigger defendant's investigative procedures or advise defendant of the need to appropriate funds for settlement. ... [T]he medical bill and medical records, although sufficient in content, did not fulfill the purposes of the statute. Accordingly, plaintiff did not provide sufficient notice pursuant to MCL 500.3145(1) and the trial court properly granted summary disposition in favor of defendant."
