966 N.W.2d 393
Mich. Ct. App.2020Background:
- Plaintiff Bronson sought $5,411.22 from USAA for emergency-department care provided to insured Brian Moore from two visits (May 8 and May 23, 2018).
- On both visits Moore signed a hospital "consent-to-treat" form that included an open-ended assignment of his rights to pursue insurance payment; each form was signed before the medical services were rendered that day.
- Bronson sued USAA under Moore's no-fault (PIP) coverage, relying on those assignments to collect directly from USAA.
- USAA moved for summary disposition, arguing the pre-treatment assignments were void under MCL 500.3143 (assignment of future benefits prohibited).
- The district court denied USAA’s motion (finding contemporaneous execution/treatment); the circuit court denied leave to appeal; the Court of Appeals granted leave and reversed, holding the assignments void and directing judgment for USAA.
Issues:
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether assignment forms signed before services are void under MCL 500.3143 | Bronson: PIP benefits pay as loss accrues; loss accrues when expense is incurred; an expense is incurred when a patient becomes contractually liable (signs the form), so the assignments conveyed presently payable benefits | USAA: At the time of signing Moore had no right to benefits because services had not yet been provided; the forms assigned rights to benefits payable in the future and are void under MCL 500.3143 | Court: Assignments signed before services were rendered concerned future-payable benefits and are void under MCL 500.3143; reverse and remand for judgment for USAA |
Key Cases Cited:
- Covenant Med Ctr, Inc v State Farm Mut Auto Ins Co, 500 Mich 191 (Mich. 2017) (Supreme Court: providers lack independent statutory cause to sue insurer; endorses assignment of past or presently due benefits but not future benefits)
- Rory v Continental Ins Co, 473 Mich 457 (Mich. 2005) (rules for contract interpretation; give words their plain meaning)
- Proudfoot v State Farm Mut Ins Co, 469 Mich 476 (Mich. 2003) (definition of "incur" and discussion when liability arises; signing a contract can incur liability depending on context)
- Clark v Al-Amin, 309 Mich App 387 (Mich. Ct. App. 2015) (an insured becomes liable for an expense when he accepts medical treatment)
- New Amsterdam Cas Co v Sokolowski, 374 Mich 340 (Mich. 1965) (ambiguities in contract may be explained by testimony)
- McIntosh v Groomes, 227 Mich 215 (Mich. 1924) (cardinal rule: ascertain parties' intent; give contract words plain meaning)
- Johnson v Vanderkooi, 502 Mich 751 (Mich. 2018) (standard of review for summary disposition)
