Michigan Court of Appeals; Docket #264693; Unpublished
Judges Sawyer, Neff, and White; unanimous; per curiam
Official Michigan Reporter Citation: Not applicable, Link to Opinion 
STATUTORY INDEXING:
Allowable Expenses for Medical Treatment [3107(1)(a)]
Requirement That Benefits Were Overdue [3148(1)]
TOPICAL INDEXING:
Not applicable
CASE SUMMARY:
In this unanimous unpublished per curiam opinion, the Court of Appeals affirmed the trial court’s decision to grant the insured’s health care providers summary disposition, finding that the no-fault insurer did not dispute that the health care providers’ charges were reasonably necessary. In addition, the Court of Appeals affirmed the trial court’s award of attorney fees to the health care providers, finding that although they “block billed,” the attorneys’ tasks were specifically detailed to enable the trial court to assess the reasonableness of the fees. Finally, the Court of Appeals determined that even though the insured did not file this action, he was properly awarded attorney fees under MCL 500.3148(1), because the insured’s entitlement to no-fault benefits were at issue in this action.
This case arises out of a motor vehicle accident in which Jason Smith sustained catastrophic injuries for which he received treatment from Spectrum Health and intervening plaintiffs, Trinity Health-Michigan and Mary Free Bed. Smith’s father had a no-fault insurance policy with plaintiff Bristol West under which Smith was eligible to receive personal injury protection benefits. Smith’s father also participated in a group health insurance plan through his employer, the Parker Hannifin Corporation.
Bristol West filed this action against Spectrum Health and the Parker Health Insurance Plan Administrator, alleging its no-fault policy was coordinated with the Parker plan and that the Parker Health Insurance Plan was primarily liable for Smith’s medical expenses. The intervening plaintiffs alleged they provided necessary medical care to Smith for treatment of his auto-related injuries and that Bristol West unreasonably refused to pay the amounts owed. The trial court granted the intervening plaintiffs summary disposition based upon its ruling in an action involving Bristol West, Spectrum, and the Parker Plan, in which it determined that Bristol West was primarily liable for Smith’s medical expenses. It then awarded the intervening plaintiffs no-fault attorney fees and penalty interest.
On appeal, Bristol West argued that even if it was primarily liable, the intervening plaintiffs were not entitled to summary disposition, because they failed to submit proof that their charges for Smith’s care were reasonably necessary. In affirming, the Court of Appeals determined that in response to the intervening plaintiffs’ motion for summary disposition, Bristol West did not dispute that their expenses were reasonably necessary. Instead, its counsel conceded that it was liable for the expenses, but that the intervening plaintiffs were not entitled to attorney fees and penalty interest because they had failed to show their charges were reasonably necessary. Moreover, the Court of Appeals noted that Bristol West stated that in determining whether charges were reasonably necessary, it relied on its outside medical billing auditor, ManageAbility, which concluded that the charges were reasonably necessary. In this regard, the court stated:
“We find no basis for relief on the grounds argued by plaintiff. As noted above, and as pointed out by intervening plaintiffs on appeal, plaintiff did not dispute, in response to the motion for summary disposition, that the expenses claimed by intervening plaintiffs were ‘reasonably necessary.’. . . Moreover, . . . Plaintiff maintained throughout this litigation that it was not an expert in determining what was reasonably necessary and, therefore, it relied on its outside auditor to make this determination. Plaintiff’s auditor determined that the charges were reasonably necessary. Under the circumstances, we find no error in the grant of summary disposition in favor of intervening plaintiffs.”
Bristol West also argued on appeal that the trial court improperly determined the amount of attorney fees requested by the intervening plaintiffs was reasonable because they did not list each task separately. In affirming, the Court of Appeals noted that although the intervening plaintiffs’ attorneys “block billed,” the tasks were specifically detailed to enable the trial court to assess the reasonableness of the fees. In this regard, the court stated:
“Plaintiff . . . asserts that the documentary evidence submitted by the intervening plaintiffs was insufficient to enable the trial court to determine the reasonableness of their requested fees because they did not list each task separately. Instead, intervening plaintiffs’ counsel ‘block-billed.’ After reviewing the schedule of charges, we conclude that the tasks were specifically detailed to enable the trial court to assess the reasonableness of the fees.”
Finally, Bristol West argued that Smith was improperly awarded attorney fees under the no-fault statute, because he did not file an action and, therefore, is not a claimant under MCL 500.3148(1) of the No-Fault Act. The Court of Appeals disagreed, noting that Smith was a claimant because he had made a demand for payment of PIP benefits. Moreover, the statute does not state that only the entity filing the action under the No-Fault Act is entitled to attorney fees, instead the statute states that in order to be entitled to attorney fees “an” action must be filed. Furthermore, plaintiff clearly put Smith’s PIP benefits at risk when it filed this action seeking a declaration that it was not liable for payment of Smith’s medical expenses. Therefore, the trial court properly determined that Smith’s attorney was entitled to a reasonable fee. In this regard, the court stated:
“Plaintiff argues that Smith was not entitled to attorney fees because he does not meet the definition of a ‘claimant.’ We disagree. In construing MCL 500.3148(1), this Court has observed that a claimant is defined as ‘a person who makes a claim.’. . . Smith was making a demand for something as due, i.e., PIP benefits, was asserting a right, and made a demand for payment in accordance with an insurance policy. Plaintiff further argues that Smith cannot recover under the statute because he did not file ‘an action.’ However, plaintiff’s emphasis is misplaced. The statute only states that ‘an’ action needs to be filed; it does not restrict recovery to only claimants who file an action. . . . Smith’s entitlement to PIP benefits was directly at issue in this action, and thus the trial court did not err in determining that Smith’s counsel was ‘entitled to a reasonable fee for advising and representing a claimant in an action for personal or property protection insurance benefits which are overdue. MCL 500.3148(1).”
