Rodney Harrison v. Allstate Property & Casualty Insurance Company
334083
| Mich. Ct. App. | Nov 28, 2017Background
- Intervening plaintiff Michigan Head & Spine Institute, PC (MHSI) sued Allstate for no-fault Personal Protection Insurance (PIP) benefits allegedly owed for treatment of insured Rodney Harrison.
- Trial court granted summary disposition in favor of Allstate based on alleged fraud by the insured.
- On appeal, while the case was pending, the Michigan Supreme Court decided Covenant Med Ctr, Inc v State Farm Mut Auto Ins Co, holding that healthcare providers lack a statutory cause of action against no-fault insurers (but noted insureds may assign benefits to providers).
- The Michigan Court of Appeals (Riordan, J., dissenting) observed Covenant applies retroactively and that the trial record contained no assignment from Harrison to MHSI.
- Because no assignment appeared in the record, Riordan concluded MHSI had no statutory basis to recover under Covenant and summary disposition for Allstate was required; he recommended remand to allow MHSI to seek leave to amend and assert an assignment claim.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether a healthcare provider may recover PIP benefits directly from a no-fault insurer without an assignment | MHSI proceeded as a healthcare provider entitled to recover PIP benefits | Allstate argued MHSI lacked standing absent an assignment and challenged the claim (also raised insured fraud) | Under Covenant, providers lack a statutory cause of action; because no assignment was in the record, MHSI had no statutory ground to recover |
| Whether the trial court properly granted summary disposition based on the insured’s alleged fraud | MHSI did not adequately have assignment evidence in the trial record to counter summary disposition | Allstate prevailed at trial on the fraud theory; sought affirmance | Riordan would affirm summary disposition for Allstate but on Covenant grounds, decline to resolve the fraud issue, and remand to allow MHSI to move to amend to plead assignment if it can |
Key Cases Cited
- Covenant Med Ctr, Inc v State Farm Mut Auto Ins Co, 500 Mich 191 (2017) (healthcare providers do not have a statutory cause of action against no-fault insurers; assignments remain permitted)
- Sherman v Sea Ray Boats, Inc, 251 Mich App 41 (2002) (appellate courts generally will not expand the trial-court record on appeal)