27 N.W.3d 904
Mich. Ct. App.2023Background
- In 2018 Linda Frisch was severely injured in a motor-vehicle accident and required attendant care.
- Centria Home Rehabilitation hired Frisch’s daughter, Diana Irons, to provide care and paid Irons $10/hour.
- Frisch executed an assignment of her PIP benefits to Centria; Centria billed Allstate at a higher hourly rate than it paid Irons.
- Allstate partially paid Centria and refused the remainder, contending Frisch did not incur liability for the higher billed rate.
- Centria sued to recover the unpaid portion; Allstate moved for summary disposition under MCR 2.116(C)(10). The trial court granted Allstate’s motion and denied reconsideration.
- On appeal the Court of Appeals affirmed, holding (1) the pre-2019 no-fault law applied (no independent provider cause of action) and (2) Centria failed to produce documentary evidence that Frisch incurred the higher rate.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Centria has an independent statutory right to sue an insurer under MCL 500.3112 | Centria argued it could rely on the amended §3112 to assert a direct cause of action | Allstate argued the accident occurred before the 2019 amendments, so the earlier statute (no independent provider right) governs | Held: Pre-2019 version applies; no independent provider cause of action—Centria proceeds only by assignment |
| Whether the higher hourly rate billed by Centria was an "incurred" PIP expense recoverable from Allstate | Centria argued the assignment authorized recovery of charges billed to the insurer | Allstate showed Frisch actually paid Irons $10/hr and produced payroll/pay logs; argued increased rate was not incurred by Frisch | Held: Allstate met its initial burden; Centria produced no documentary evidence that Frisch incurred the higher rate, so summary disposition for Allstate was proper |
Key Cases Cited
- Douglas v. Allstate Ins. Co., 492 Mich 241 (2012) (defines “incurred” for PIP expenses and instructs analysis of insurer liability)
- Maiden v. Rozwood, 461 Mich 109 (1999) (summary-disposition standard under MCR 2.116(C)(10))
- Quinto v. Cross & Peters Co., 451 Mich 358 (1996) (burden-shifting framework for C(10) motions)
- Covenant Med. Ctr., Inc. v. State Farm Mut. Auto. Ins. Co., 500 Mich 191 (2017) (healthcare providers recover PIP benefits by assignment)
- Burkhardt v. Bailey, 260 Mich App 636 (2004) (assignment agreements are contracts; courts enforce unambiguous terms)