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Allstate Insurance Company, et al v Lewerenz, et al; (COA-UNP, 10/19/2006, RB #2804)

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Michigan Court of Appeals; Docket #261296 and #262199; Unpublished
Judges Borrello, Jansen, and Cooper; unanimous; per curiam
Official Michigan Reporter Citation: Not applicable, Link to Opinion courthouse graphic


STATUTORY INDEXING:
Allowable Expenses for Products and Medical Equipment [3107(1)(a)]
Allowable Expenses for Medical Treatment [3107(1)(a)]
General / Miscellaneous [3107]
Lawfully Rendered Treatment [3157]

TOPICAL INDEXING:
Not applicable


CASE SUMMARY:
In this unanimous unpublished per curiam opinion, the Court of Appeals affirmed summary disposition for defendant medical service providers, finding defendants properly rendered services under MCL 500.3157. Plaintiff no-fault insurers brought this action against defendants for repayment, alleging that defendants improperly billed for overhead fees; did not lawfully render treatment under MCL 500.3157 because they were not properly incorporated and were operating under an assumed name without filing an assumed name certificate; and were not lawfully rendering treatment because they were rendering care beyond the scope of their licensure and allowed employees to provide care without proper supervision.

In affirming, the Court of Appeals first found that the overhead fee of $25 was an allowable expense under MCL 500.3107(1)(a) because it was an “accommodation” in that it covered the expenses associated with medical supplies, medical services, and costs associated with accommodating patients injured in automobile accidents with medical appointments. In this regard, the court stated:

Plaintiffs . . . argue that the $25 overhead fee is not an ‘allowable expense’ under MCL 500.3107(1)(a) because it was not directly related to the ‘care’ of an injured person. The term ‘care’ ‘may encompass expenses for products, services, and accommodations that are necessary because of [an] accident but that may not restore a person to his preinjury state.’. . . We reject plaintiffs’ contention that the $25 overhead fee is not related to the ‘care’ of plaintiffs’ insureds because it covers the expenses associated with medical supplies, medical services, and costs associated with accommodating patients injured in automobile accidents with medical appointments.”

The court next rejected plaintiffs’ argument that in order to be “lawfully rendering treatment” under MCL 500.3157, medical providers must be lawfully incorporated and may not operate under an assumed name without first filing an “assumed name” certificate. In rejecting this argument, the court reasoned that if the Legislature had intended for health care providers to have a particular corporate status or complete certain filing requirements, it could have so specifically provided. In this regard, the court explained:

Determination of this issue requires this Court to construe the phrase ‘lawfully rendering treatment’ in MCL 500.3157. We agree with the trial court’s interpretation of this phrase. If the Legislature had intended for MCL 500.3157 to require a health care provider to have a particular corporate status or to engage in specific corporate filing requirements, it could have made specific provisions mandating such requirements in MCL 500.3157. However, it did not do so. This Court may not read a provision into an unambiguous statute that is not within the manifest intent of the Legislature as derived from the words of the statute itself. . . . This court will not read mandates into MCL 500.3157 which the Legislature did not include. Furthermore, it would be nonsensical and violate the rule that the no-fault act must be liberally construed in favor of its intended beneficiaries to interpret the no-fault act as not providing coverage for medical treatment rendered to victims of automobile accidents by licensed and competent medical professionals on the basis of the corporate status or lack thereof of the medical care providers. Therefore, we find that the trial court properly granted summary disposition on this issue.”

Similarly, the court found that the trial court properly denied plaintiff summary disposition under a claim that defendants did not render care beyond the scope of their licensure, nor did they allow others to provide care without proper supervision. First, the record did not support plaintiffs’ claim that one of the doctors performed functions outside the scope of a chiropractic practice. Second, physicians are authorized by statute to delegate selected tasks to properly trained individuals if certain conditions are met. Plaintiffs failed to articulate the specific facts establishing that defendants did not meet the conditions required to delegate tasks. Therefore, the trial court properly denied plaintiffs’ motion for summary disposition on this issue.

Finally, the court rejected plaintiffs’ argument that the defendants’ award for attorney fees and costs violated the interest of justice exception found in MCR 2.403(O)(11). In support of their argument, plaintiffs cite the unusual facts of this case. However, plaintiffs did not raise this argument below. Therefore, the trial court did not abuse its discretion when it refused to exercise the interest of justice exception and awarded defendants attorney fees and costs.


Michigan auto accident attorney Stephen Sinas is the lead editor of the appellate case summaries published on this site regarding the Michigan auto insurance law. To learn more about how Stephen Sinas and how the Sinas Dramis Law Firm can help you if you have been injured in a Michigan auto accident, visit SinasDramis.com.

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