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966 N.W.2d 393
Mich. Ct. App.
2020
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Background:

  • 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)
Read the full case

Case Details

Case Name: Bronson Health Care Group Inc v. Usaa Casualty Insurance Company
Court Name: Michigan Court of Appeals
Date Published: Dec 10, 2020
Citations: 966 N.W.2d 393; 335 Mich. App. 25; 351050
Docket Number: 351050
Court Abbreviation: Mich. Ct. App.
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    Bronson Health Care Group Inc v. Usaa Casualty Insurance Company, 966 N.W.2d 393