Wyo. Chiropractic Health Clinic, PC v. Auto-Owners Ins. Co.

• Decision Date: 09 December 2014
• Docket Number: Docket No. 317876.
• Citation: 308 Mich.App. 389,864 N.W.2d 598
• Parties: WYOMING CHIROPRACTIC HEALTH CLINIC, PC v. AUTO–OWNERS INSURANCE COMPANY.
• Court: Court of Appeal of Michigan — District of US

308 Mich.App. 389

864 N.W.2d 598

WYOMING CHIROPRACTIC HEALTH CLINIC, PC

v.AUTO–OWNERS INSURANCE COMPANY.

Docket No. 317876.

Court of Appeals of Michigan.

Submitted Dec. 3, 2014, at Detroit.

Decided Dec. 9, 2014, at 9:00 a.m.

Haas & Goldstein, PC, Farmington Hills (by Laurie Goldstein ), for plaintiff.

Secrest Wardle, Troy, (by Mark F. Masters and Drew Broaddus) for defendant.

Before: JANSEN, P.J., and TALBOT and SERVITTO, JJ.

Opinion

TALBOT, J.

Auto–Owners Insurance Company (Auto–Owners) appeals as of right an order entering judgment in favor of Wyoming Chiropractic Health Clinic, PC (Wyoming Chiropractic). We affirm.

Auto–Owners argues that the trial court erred by denying its motion for summary disposition because Wyoming Chiropractic, a healthcare provider, did not have standing to bring an action against Auto–Owners, an insurer, for the purpose of obtaining personal injury protection (PIP) benefits under the personal protection benefits provision of the no-fault act.¹ We disagree.

Auto–Owners brought the motion for summary disposition under MCR 2.116(C)(8) and (10). This Court reviews de novo a trial court's ruling on a defendant's motion for summary disposition.² This Court also reviews de novo issues of statutory interpretation.³

A motion for summary disposition is properly considered under MCR 2.116(C)(8) or (10) when the movant argues that the nonmovant is not the real party in interest in a suit.⁴ In this case, Auto–Owners argued that Wyoming Chiropractic was not the real party in interest because Wyoming Chiropractic improperly asserted the rights of the insured individuals, Mary Catoni and her grandson, Kalem Rowe–Catoni, under the no-fault act.⁵ Therefore, the motion was properly considered under MCR 2.116(C)(8) or (10).

A motion for summary disposition under MCR 2.116(C)(8) is granted if the party opposing the motion “ ‘has failed to state a claim on which relief can be granted.’ ”⁶ A trial court's decision under MCR 2.116(C)(8) is based solely on the pleadings.⁷ Accordingly, “[a] party may not support a motion under subrule (C)(8) with documentary evidence such as affidavits, depositions, or admissions.”⁸ “[T]his Court accepts all well-pleaded factual allegations as true and construes them in the light most favorable to the nonmoving party.”⁹ Summary disposition under MCR 2.116(C)(8) is only proper when “the claim ‘is so clearly unenforceable as a matter of law that no factual development could possibly justify a right of recovery.’ ”¹⁰ The parties did not support their arguments with documentary evidence, and the trial court based its decision solely on the pleadings. Therefore, this Court's review of Auto–Owners's motion for summary disposition is proper under MCR 2.116(C)(8).

Auto–Owners also argued in its motion for summary disposition that there was an issue of statutory standing, which implicated the trial court's jurisdiction under MCR 2.116(C)(4). Specifically, Auto–Owners asserted that the no-fault act did not give Wyoming Chiropractic standing to bring a cause of action.¹¹ This Court reviews de novo a claim that a trial court lacks jurisdiction to hear a case.¹² Summary disposition under MCR 2.116(C)(4) is proper “when the trial court ‘lacks jurisdiction of the subject matter’ ” in a case.¹³ This Court examines whether the pleadings, affidavits, depositions, admissions, and documents in the case show that the trial court lacked subject matter jurisdiction.¹⁴

“Under personal protection insurance an insurer is liable to pay benefits for accidental bodily injury arising out of the ownership, operation, maintenance or use of a motor vehicle as a motor vehicle, subject to the provisions of [MCL 500.3101 through MCL 500.3179 ].”¹⁵

Personal protection insurance benefits are payable to or for the benefit of an injured person or, in case of his death, to or for the benefit of his dependents. Payment by an insurer in good faith of personal protection insurance benefits, to or for the benefit of a person who it believes is entitled to the benefits, discharges the insurer's liability to the extent of the payments unless the insurer has been notified in writing of the claim of some other person.^{[ 16 ]}

This Court has discussed the issue whether a healthcare provider may sue an insurer for PIP benefits under the no-fault act. In Munson Med. Ctr. v. Auto Club Ins. Ass'n.,¹⁷ the plaintiff was a hospital, which sued an insurer for payment of unpaid bills under the no-fault act. This Court noted that the plaintiff had a “right to be paid for the injureds' no-fault medical expenses” under the no-fault statute.¹⁸

Additionally, in Lakeland Neurocare Ctrs. v. State Farm Mut. Auto Ins. Co.,¹⁹ the issue before this Court was whether the trial court erred by holding that the plaintiff, a healthcare services provider, was entitled to enforce the penalty interest and attorney fee provisions of the no-fault act against the defendant, a no-fault insurer. The plaintiff provided rehabilitation services to an insured individual injured in a motor vehicle accident.²⁰ The plaintiff filed a claim for payment for healthcare services provided to the injured individual.²¹ In the trial court, the defendant was ordered to pay the plaintiff for the rehabilitation services.²² On appeal to this Court, the defendant did not challenge the plaintiff's ability to recover for the medical services that the plaintiff provided to the injured individual.²³ This Court analyzed the plain language of MCL 500.3112 and determined that the plaintiff was entitled to prompt payment because the plaintiff brought a claim for PIP benefits “for the benefit of” the injured individual when the plaintiff submitted a claim for PIP benefits to the defendant.²⁴ Therefore, the plaintiff could sue the defendant for enforcement of the penalty interest provision of the no-fault act, which requires an insurer to pay interest if a payment is overdue by more than 30 days.²⁵ This Court further clarified that the fact that the plaintiff was not the injured individual was “not dispositive” because the no-fault act permits an insurer to pay another person or entity “ ‘for the benefit of’ ” the injured individual.²⁶ This Court stated that it was common practice for insurers to reimburse healthcare providers directly, but this was because MCL 500.3112 allows a healthcare provider to receive payment from an insurer.²⁷ Therefore, industry practice was not the basis for this Court's decision.

Then, in Univ. of Mich. Regents v. State Farm Mut. Ins. Co.,²⁸ one issue that this Court discussed was whether the plaintiffs' claim for medical expenses under the no-fault act was barred by the applicable statute of limitations even though the plaintiffs were a political subdivision of the state of Michigan. The plaintiffs were the Regents of the University of Michigan and ran the hospital that provided medical care to the individual involved in an automobile accident.²⁹ The defendant argued that the plaintiffs' claim was subject to the statute of limitations because the plaintiffs' claim derived from the insured individual's claim.³⁰ This Court disagreed and clarified that, “[a]lthough plaintiffs may have derivative claims, they also have direct claims for personal protection insurance benefits.”³¹ This was because the plaintiffs governed a hospital that provided medical care, rather than because the plaintiffs were a political subdivision of the state.³² This Court cited Munson for the proposition that “a hospital that provides medical care is to be reimbursed by the injured person's no-fault insurance company.”³³ Thus, this Court explained that the plaintiffs had a direct claim against the defendant for the medical expenses associated with treatment of the injured individual.³⁴

Next, in Borgess Med. Ctr. v. Resto (Resto I ),³⁵ this Court cited Lakeland Neurocare for the premise “that a party providing benefits to an injured person entitled to no-fault benefits may make a direct claim against a no-fault insurer.” This Court clarified that a healthcare provider does not “stand[ ] in the shoes” of the injured person, but instead has a direct claim against the insurer under the no-fault act.³⁶ This Court reiterated the fact that MCL 500.3112 “contemplates the payment of PIP benefits to someone other than the injured person and that a provider of health care to a person injured in an automobile accident is a no-fault ‘claimant’ entitled to seek [penalty interest and attorney fees].”³⁷ Therefore, under Resto I, a healthcare provider that provides benefits to an injured individual has a cause of action against a no-fault insurer.³⁸ In Borgess Med. Ctr. v. Resto (Resto II ),³⁹ however, the Michigan Supreme Court vacated the majority opinion in Resto I, because of the Court's determination of an unrelated issue. The Michigan Supreme Court affirmed this Court's judgment based on the reasoning of the concurring opinion.⁴⁰ The concurring opinion did not discuss whether the plaintiff had standing to sue.⁴¹ Therefore, this Court cannot rely on the majority opinion in Resto I.

Recently, this Court reiterated the fact that the no-fault act creates an independent cause of action for healthcare providers when it stated, “We note that the language ‘or on behalf of’ in the release is similar to the phrase ‘or for the benefit of’ in MCL 500.3112, which this Court has recognized creates an independent cause of action for healthcare providers.”⁴²

Based on the above, we conclude that Wyoming Chiropractic had standing to bring a cause of action against Auto–Owners for PIP benefits under the no-fault act. This Court established in Munson that a healthcare provider has the “right to be paid for the injureds' no-fault medical expenses....”⁴³ This Court further explained in Lakeland Neurocare that when a healthcare provider submits a claim for payment under the no-fault act, the healthcare provider submits the claim “for the benefit of” the injured individual.⁴⁴ The fact that a healthcare provider submits a claim on...